On Tuesday, December 2, 2008, Henry M., the most famous patient in modern neuroscience research and literature, passed away. He was 82. In 1953, H.M. had an experimental brain operation to try to stop his frequent seizures; his medial temporal lobes were resected bilaterally, with significant portions of his amygdalas and hippocampi in both cerebral hemispheres removed (parts of the brain are still resected in intractable epilepsy cases, however neurosurgeons do not perform that exact surgery any more because of the negative effects). His seizures stopped but immediately after the operation he had a severe anterograde amnesia. This means that from when he received the operation at age 27, he was unable to establish new memories for world events and for general information.
His amnesia became the focus of much scientific study from after his operation until the present. No one patient has been studied more in the 20th and 21st centuries than H.M. His memory impairment was also interesting because his overall intellectual abilities were still intact as was his personality. Neuropsychologists and neuroscientists will forever be grateful for the things they learned from H.M.
Yesterday I posted a video clip about Clive Wearing. Here is the first part of a different documentary about Clive. This video goes more in-depth about his condition. Clive is sometimes referred to as the man with the shortest memory. Not only were his two hippocampi destroyed, but also surrounding areas of the his temporal lobes as well as portions of his left frontal lobe. He also remembers very little from before his illness, which is quite rare; this condition is called retrograde amnesia. Clive lives in an ever-present now, without connection to past or future. Other parts to this video can be found on YouTube.
Clive Wearing is a 70 year old British man who contracted herpes simplex encephalitis in 1985. The virus destroyed his hippocampi bilaterally (as well as surrounding areas). He has complete anterograde amnesia and can only remember up to about 20 seconds. He retained the ability to play the piano and conduct a choir (which he did previously to his illness); this is because this procedural memory involves different areas of the brain, including the basal ganglia and the cerebellum. I’ll revisit this case over the coming days. Meanwhile, here is a clip from a BBC production that presents part of Clive’s story.
To follow up my previous post on the hippocampus, here’s a video posted by drbobrd on YouTube. He uses a model of a brain to explain some brain anatomy, including the hippocampus and fornix.
Within the temporal lobe of the brain is an elongated structure called the hippocampus. Some people have compared its shape to that of a seahorse (the word hippocampus comes from the Greek {hippos + campos}, which roughly means “seahorse”). This structure is special for a number of reasons. One is its role in memory encoding and consolidation.
From cytoarchitectonic standpoint, the hippocampus is special because unlike the surrounding cortex, it consists of only three layers instead of six. The hippocampus is phylogenetically an old part of the cortex, which means that it is an older branch on the evolutionary tree, whereas the rest of the cortex (more accurately called the neocortex), especially cortex of the frontal lobes, is a much newer development.
The hippocampus resides within the medial portion of the temporal lobe. It is continuous with the parahippocampal cortex, entorhinal cortex (the hippocampus receives its main input from this cortex), and perirhinal cortex.
The hippocampus sends white matter tracts off its dorsal and posterior portions (the hippocampus also communicates through other tracts and pathways – this circuit is not the only output of the hippocampus). These white matter tracts are the fimbria of the hippocampus (technically, the fimbria are the “offshoots” of the alveus of the hippocampus). The fimbria proceeds upwards from the posterior portion of the hippocampus, at which point it ceases to be the fimbria and is called the fornix.
The fornices (plural of fornix) are prominent white matter tracts passing above the thalamus and medially in the brain. The fibers travel forward, then turn downward just posterior to the anterior commissure (a white matter tract that connects both hemispheres) to terminate in the mammillary bodies, two bumps on the ventral side of the brain. They are part of the hypothalamus of the brain. From there, the pathway courses upward through the mammilothalamic tract (MTT) to the anterior nucleus of the thalamus. From there axons course to the cingulate gyrus, then to the underlying cingulum (large white matter tract), and back to the hippocampus (via the parahippocampal and entorhinal cortices). This circuit is part of the limbic system and is called the Papez circuit. This circuit is important for emotion and memory.
I recently interacted with a person who is depressed (I’ve had a lot of exposure to people with depression over the years but I want to write about one in particular). This person was a pleasant person but a bit dysthymic in general; this person came across as somewhat down and depressed. Recently he started taking bupropion (Wellbutrin) for depression. It’s made a world of difference. Now he appears euthymic and quite animated – it’s a good change. I know that anti-depressant medications are not effective for everyone (and I am fairly critical of psychotropic medications in general and don’t think any should be taken lightly) but in this case, the improvement was marked. It was like night and day. Wellbutrin, incidentally, is also an effective medication for helping people stop smoking (trademark name of Zyban). I have no affiliation with GlaxoSmithKline, who makes the drug (it’s also available as a generic), I just recently witnessed its effectiveness.
I’m going to preface my review by stating that the book I’m going to review is not directly about psychology; it has nothing to do with neuroscience. However, it has everything to do with interpersonal relationships and social interactions, which are two areas frequently addressed in psychology. I do not have any affiliation with The Arbinger Institute; I just enjoyed the book.
The book Leadership and Self Deception: Getting Out of the Box was written by The Arbinger Institute. The work was derived from the ideas of C. Terry Warner, a U.S. philosopher. The Arbinger Institute is a management training and consulting firm that works with businesses and individuals to help them improve their businesses and lives. The 168 page book is easy to read; it is written in a simple prose like a novel.
The main character in the book is Tom, a recently-hired mid to upper level manager at the fictional company Zagrum. Throughout the book Tom mainly interacts with two other characters – Bud, his boss who is the executive vice president of the company, and Kate, Zagrum’s president. Both Bud and Kate take time out of their busy schedules to train Tom about “the box”, which is self-deception.
The gist of the book is that much conflict between people is based on self-betrayal and self-deception. It comes from viewing other people as objects, as “things” that either help or hinder our own progress. The self-deception is that we are more important than other people and that they only exist to help us (or at least not stop us) self-actualize (I’m using different terms than used in the book; the author(s) of the book are not particularly fond of the humanistic concept of self-actualization, by the way). However, we deceive ourselves when we think that if we want to have improved relationships with others – especially if they are strained – then it is others who need to change and not ourselves.
Self-betrayal occurs, according to the author(s), when we are not true to that part of ourselves that is other-centered; this results in self-centeredness. In the book the author(s) give an example of how self-betrayal occurs. I’ll summarize that example.
At night a husband and wife are sleeping. The husband wakes up when the baby in the other room starts to cry. The husband’s first thought is to get up and get the child before his wife wakes up; after all, she works so hard all day and needs all the sleep she can get. The husband’s next thought though is that he too works hard all day and needs to get up early for a meeting. “Why should I get up? My responsibility in this family is to go to work and earn money so we can live. I need all the sleep I can get so I can function at my job – I have a big project to complete tomorrow. [Baby continues to cry]. Why doesn’t my wife get up and get that baby? Doesn’t she realize I need to get sleep? Okay, I know she’s awake now. Why doesn’t she get up? Now she’s just being lazy. [And so on].
These types of thoughts often become self-fulfilling prophecies, such that all our our own actions and thoughts inflate our self-worth (i.e., we do see ourselves as good, hard-working people) while simultaneously deflating the self-worth of another (i.e., we attribute certain attributes to them – “lazy” or “inconsiderate” – and then much of what we see them do after that only supports that hypothesis). While this specific example has not occurred with everyone, we have all experienced similar situations. Maybe the situation is at work where you had a thought that you should do something but then didn’t do it. When it created a problem you were able to rationalize your behavior and blame someone else (“I would have done X had Susan done her job” or “I was just too busy with other things to get X done.”). Basically, self-betrayal results from not being true to what you [hopefully] know is the right thing to do. When we don’t do what we know is right, the normal human response is to rationalize and justify our action or inaction in order to protect our egos, per se. This leads to us shifting the blame from ourselves onto others. We start to view others as hindering our progress; when this occurs they stop being people and start being objects (in other words, people are viewed as either starting blocks or stumbling blocks – they help or hinder us).
It is relatively straightforward to see how this can lead to interpersonal problems – at home or at work. The problem is that we do not know that we are betraying and deceiving ourselves, so we continue to ascribe most of our problems to others. The author(s) further points out that even if we recognize our self-betrayal and self-deception, we never will completely be free of these behaviors; however, we will be able to reduce these negative behaviors and improve our relationships with others.
Overall, this book provides an important and novel way to approach interpersonal behavior. The overarching message is that we should not worry about changing others (or even ourselves! – but I’ll let you read the book to understand that); we should instead recognize that the problem lies within ourselves and go from there. One very creative application of this philosophy is how this is being applied in businesses to increase productivity, human relations, public relations, and even the profitability of the company. I’ll let my readers read this book to understand how this philosophical approach to other-interaction can help a business make more money.
One of my criticisms of this approach to interpersonal behaviors is that it is fairly esoteric and difficult to grasp conceptually. That’s not necessarily a negative; however, it means that most people will really have to study and ponder on the concepts in order to understand them. The book also only serves as a brief – but important – introduction to the topic, leaving one a bit unsure exactly how to implement this new attitude and these new behaviors in one’s own life (although, there is enough information in the book that an astute reader can understand enough to follow this method of interpersonal interaction). This is where the Arbinger Institute’s training workshops and seminars come in. Additionally, C. Terry Warner wrote a book called Bonds That Make Us Free: Healing Our Relationships, Coming to Ourselves, which is a more complete description of the concepts found in Leadership and Self-deception.
I’m quite fascinated by human anatomy, especially neuroanatomy. The human body is amazing; it’s something of a miracle that it develops and works as well and as often as it does. The brain is very complex with up to 100 million neurons (that’s also an estimate of the number of stars in our galaxy) and 100 trillion synapses (connections between neurons)! 100 trillion is an estimate of how many individual cells the entire human body has. We have as many synapses as cells in the entire body. The brain is complex and beautiful. It has symmetry but individuality.
I discovered a website that allows you to watch some surgeries live (or to view archives of past surgeries). OR-Live.com is informational and free. For those interested in neurosurgeries – everything from scoliosis surgery to tumor resection to deep brain stimulation – here is the direct link. Most of the videos are available in Flash format for web-viewing. Many are also available to download as a video podcast. Warning – please don’t watch the videos if you get queasy easily; if you feel queasy while watching one, take a break and do something else for a while.
I hope my readers enjoy this site as much as I have in the past and will continue to in the future.
Mo at Neurophilosophy posted a great video of Deep Brain Stimulation (DBS) surgery being performed on a man with essential tremor, while he plays the banjo. As with most brain surgeries, the patient was awake, alert, and talking. The doctors had him play the banjo so they could fine tune (pun intended) the electrode placement in order to have the best response.
was written by The Arbinger Institute. The work was derived from the ideas of