Psych-Out

from THE CIVIL WAR by Anne Sexton

I am torn in two
but I will conquer myself.
I will dig up the pride.
I will take scissors
and cut out the beggar.
I will take a crowbar
and pry out the broken
pieces of God in me.
Just like a jigsaw puzzle,
I will put him together again
with the patience of a chess player.

On October 3, 1974 Anne Sexton was unable to pry out the broken pieces. She closed up the garage, turned the ignition key, and waited for the waft of carbon monoxide exhaust to carry her off toward that “pint-sized journey” into death.

Anne Sexton

Was Anne Sexton’s suicide an inevitable result of parental hostility, or a child’s life gone astray? Was it alcoholism, bipolar disorder, her genes, or caused by some chemical imbalance that might have been corrected if Prozac, or Wellbutrin, or the right combination of Lamictal and Abilify were available then?

Don’t they know
that I promised to die!
I’m keeping in practice.
I’m merely staying in shape…

We like certainty. We like tidy explanations. We prefer our answers to “why” wrapped in simple, easy-to-organize, packages. “It’s in your brain” makes as much sense as finding causation in child-rearing, toilet training, or that kid who bullied you in 5th grade. A chemical imbalance? It’s enough to make us feel comfortable taking the pill because at least, now, we have a digestible explanation for “why.” We’ll call it a useful little lie.

When it comes to “whys” of human emotional sufferings, the truth is as elusive as it is messy. In the world of psychiatry, causation is a chimera. (1)

psychotic chimera

If there’s anything that modern neuroscience says for certain about the human brain, it’s to keep our humility. One human brain has over 100 billion neurons, 109 trillion synapses, and hundreds of thousands of interconnecting circuits. There are no biochemical, anatomical, or functional signs to distinguish Anne Sexton’s brain, from that of the Dalai Lama, or your neighbor next door who washes his car every weekend and obsesses over his front lawn. Yes, we’ve learned much in the last 10 or so years. But even then, we’ve not scratched the surface of understanding the workings of this magnificent, and at times troubling, organ.

“In a dot of brain no larger than a single grain of sand, 100,000 neurons go about their work at a billion synapses.” Diane Ackerman, An Alchemy of Mind

Drug companies have marketed the idea that depression represents a chemical imbalance — a decreased availability in the brain of the neurotransmitter serotonin. Before you jump on the wagon and proclaim your own chemical imbalance, however, consider that there are no tests to date that assess the chemical status of a living person’s brain. There are at least fifteen different serotonin receptors. We have little idea what these receptors actually do, or how they may relate to any psychological state. In fact, it is now estimated that there may be over 100 neurotransmitters, and most psychotherapeutic drugs affect many more neurotransmitters than were initially suspected.

As for genes? Every day we read some article about scientists uncovering a gene that causes shyness, or depression, or fearfulness, or talkativeness, or sexual promiscuity. One gene, one behavior. But, genes do not produce either behaviors or mental states. Genes carry instructions for producing amino acids and proteins, and then assembling these proteins into enzymes and anatomical structures.

Yes, somewhere down the line these structures, whether they be neurons, brain circuits, or the number, kinds, and functioning of synapses, are faintly related to what we do and how we feel. It’s never just one gene acting alone, however, but in concert with other genes. Even our genes have to be switched on or off by a chemical reaction caused by a specific environmental influences — like being spanked, or falling in love, or getting divorced, or reading the Brothers Karamazov, or taking LSD. How this all works to cause anxiety, depression or schizophrenia, we have only the faintest of clues.

Elliot Valenstein, in his book Blaming the Brain, reminds that there is no way that a mere one hundred thousand genes can determine the precise configuration of 10 trillion synapses in the human brain. Genes may build the structure of the house, but it’s our collection of experiences that furnish it, decorate the walls, landscape the yard, create the mood, whether chaotic, calm, or melancholic – in essence, make a life our home. (2)

Does it mean we should shun the help offered, whether it be talk therapy, pharmaceuticals, or some combination thereof? Of course not. Ask the tens of thousands who have been be mercifully spared the fate of the worlds’ Anne Sextons. Poet Jane Kenyon wrote:

We try a new drug, a new combination
of drugs, and suddenly
I fall into my life again

like a vole picked up by a storm
then dropped three valleys
and two mountains away from home.

I can find my way back. I know
I will recognize the store
were I used to buy milk and gas.

I remember the house and barn,
the rake, the blue cups and plates,
the Russian novels I loved so much,

and the black silk nightgown
that he once thrust
into the toe of my Christmas stocking (3)

Neither does it mean, however, we accept tidy, spoon fed explanations. The paradox is that psychiatry has been slightly better at solutions than causes – though the solutions are often hard fought, partial, and not without sometimes troubling trade-offs.

Concrete Blonde, “Dance Along the Edge“

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All Anne Sexton poems are from: Sexton, L. G. (Ed.). The Complete Poems of Anne Sexton. 1999: Mariner Books.

(1) Michael McGuire and Alfonso Troisi, in their book Darwinian Psychiatry, remind: “….some persons with depression grow up and live in adverse social environments while others do not; some come from families in which depression is common while others do not; and significant individual differences in depression-causing physiological systems have been reported. What is more, some respond to one type of anti-depressant medication but not to another; some do not respond to any type of medication but do respond to electroconvulsive treatment; and some do not respond to any known intervention.” (Quoted by Andrew Solomon in Noonday Demon, p. 401

(2) Valenstein, E. S. (2000). Blaming the Brain. New York: The Free Press.

(3) In Solomon, A. (2001). The Noonday Demon: An Atlas of Depressioin. New York: Simon & Schuster. (p.79)

WORDS
by anne sexton

Be careful of words,
even the miraculous ones.
For the miraculous we do our best,
sometimes they swarm like insects
and leave not a sting but a kiss.
They can be as good as fingers.
They can be as trusty as the rock
you stick your bottom on.
But they can be both daisies and bruises.

Yet I am in love with words.
They are doves falling out of the ceiling.
They are six holy oranges sitting in my lap.
They are the trees, the legs of summer,
and the sun, its passionate face.

Yet often they fail me.
I have so much I want to say,
so many stories, images, proverbs, etc.
But the words aren’t good enough,
the wrong ones kiss me.
Sometimes I fly like an eagle
but with the wings of a wren.

But I try to take care
and be gentle to them.
Words and eggs must be handled with care.
Once broken they are impossible
things to repair.

Peter Gabriel & Anne Sexton:  Mercy Street - All My Pretty Ones

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It’s in our animal heritage to size each other up – the guy down the street with the new BMW;  the co-worker who just received the promotion.   Then, there’s your friend who’s wife suddenly up and left.  What’s up with that?

We watch.  We listen.  We exchange stories.  Then, we spin it inside our heads.  Morning, noon, and night our thoughts are abuzz with people. What will he do if I don’t get my report in on time?   How could they pass me over for that ditz, Sara?  What did Michael mean by that remark about me?  The storyline behind it all – how do I measure up?  And why?

We are endowed with a craving for status.  It shows itself in our need to be seen as attractive, successful, well-connected, and smart.  And if we fall short — what’s gone wrong and how do we get there.

Cognitive neuroscientist Michael Gazzaniga observed, “When you get up in the morning, you do not think about triangles and squares…You think about status.  You think about where you are in relation to your peers.  You’re thinking about your spouse, about your kids, about your boss.  Ninety-nine percent of your time is spent thinking about other people’s thoughts about you, their intentions…” (1)

In his play No Exit, Sartre wrote, “hell is other people.”  No.  Hell is our continual need to compare ourselves with other people.  Compare down, we feel better.  (Poor Joe.  Three kids.  Lost his job.)  Compare up, we feel worse.  (Lakefront property, a new girlfriend half his age, AND a new boat?!)  And unfortunately, most of the time, we compare up.

Animals raise their status by exaggerating their size.  They balloon, bristle, bellow, ruff, and rear. We have symbols of status.  Cars.  Jewelry.  Clothing.  Name-dropping.  Suntans.  Tell the right story, you improve your reputation, or tear down that of a rival.   “Try to look like the people above you;  if your at the top, try to look different from the people below you.”  (Quenton Bell, On Human finery.)  Our versions of ruffs, balloons, and bellows. (2)

“Look at me!  Not only is mine bigger, but I’m just plain better!”

There’s a cost, however.  Think of the peacock’s tail.  It may impresses the peahen, yes.  But, that great fan consumes nutrients, hinders movements, and attracts predators.  Some theorists propose that the display evolved precisely because of its cost.  Only the healthiest animals can afford them.  Like the peacock, our drive for status and reputation consumes energy – emotional energy, financial energy, and psychological energy.

For we humans, just because something’s part of some biological heritage doesn’t mean we have to play the game. Just because Jack down the hall is expending precious energy bellowing, doesn’t mean I have to.  We can ask ourselves is that big truck really worth it?  Does that story the guy is telling about himself have any real meaning to my life? Look around.  Most of our worry about status happens between our ears inside our own heads.   We can often choose not to play certain games that are part of our evolutionary heritage.   As psychologists Richard Gregory and Vilayanur Ramachandran have pointed out, “our conscious mind may not have free will, but it does certainly have free won’t.”

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(1) Seed. “The Seed Salon: Tom Wolfe & Michael Gazzaniga,” Seed 17 (2008): pgs 41-46.

(2)Pinker, Steven. How the Mind Works. New York: W.W. Norton & C., Inc, 1997.

“…the simplest thing cannot be made clear to the most intelligent man if he is firmly persuaded that he knows already, without a shadow of doubt, what is laid before him.”    Leo Tolstoy.

Life besets us with gambles.  Do I invest in stocks or stash my money under the mattress? Do I leave my job for more money now, or wait it out for that promotion? Is it Obama, or McCain? Yet, choose we must. And, it always feels better coming to the table knowing that our choice is absolutely the right one.

Our feeling of certainty is seldom the result of logical analysis.  In reality, it’s an involuntary mental sensation firing off deeply in our brain’s circuitry.  First, we think a thought.  Then, we make an involuntary assessment of the accuracy of that thought.  When that assessment lights up our reward circuitry, we glow beneath that hot, intoxicating feeling “I am right!”

Archimedes shouting, "Eureka!"

Our perceptual circuitry has evolved to reinforce our conclusions, whether or not the information we receive is convincing. During elections, how many of us actually go seek out information against our pet candidate, party, or issue.   In fact, if you’re honest with yourself, you might have to agree that any thought of doing just that is met inside your head with a resounding “No!”

Research has shown that we determine whether something is good or bad within a quarter of a second.  The rest is mental fine tuning.  Once that evaluation is made, we are primed to seek out evidence upholding that initial evaluation and avoid, or spin, information that contradicts it.  First impressions are highly weighted in our perceptual system, and thus powerful cues to the formation and sustaining of our beliefs.

Ask a subject to evaluate a person’s happiness, or sociability, or likeability on the basis of a list of adjectives describing him.  Envious.  Stubborn.  Critical.  Industrious.  Talkative.  Intelligent. If the list is given in the above order, the subjects will rate the person negatively.  Reverse the order — same words, same person — the subjects will rate the person positively (Myers, 2007).

Our brains have evolved in favor of rapid evaluation about the world around us.  First impressions bring us to certainty most quickly.  In low complexity, high danger situation, it’s highly adaptive to go with “gut instinct.”  We give up accuracy, yet gain in our capacity to leap quickly into action. In more complex situations, especially ones where we have more time to think, this mental tendency leaves us vulnerable to prejudice, premature judgment, and possibly costly error.

If you want to be truly fair in your evaluation of a circumstance and you’re not running from a saber-tooth tiger:  question your initial perceptions;  spend time looking for evidence that you are wrong;  in forming an impression of a person (or object) try to break your judgment down into his (or its) separate qualities without letting any strikingly good or bad first impression influence your opinion about the remainder; and,  practice suspending judgment, especially in light of that great feeling of “I know I’m right!”

Finally, beware of people who claim absolute certainty on matters where certainty is impossible.  As neurologist and “certainty” researcher Robert Burton suggests, “Intuitions, gut feelings and hunches are neither right nor wrong but tentative ideas that must then be submitted to testing. If such testing isn’t possible (such as in deciding whether or not to pull out of Iraq), then we must accept that any absolute stance is merely a personal vision, not a statement of fact.”

Rummy’s “Theory of Knowing.”

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Lehrer, J. (2008). The Certainty Bias: A Potentially Dangerous mental Flaw. Scientific American.

Mlodinow, L. (2008). The Drunkard’s Walk: How Randomness Rules our Lives. New York: Pantheon Books.

Myers, D. G. (2007). The Powers and Perils of Intuition. Scientific American Mind, Vol. 18, No. 3, 24-31.