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Response-Based Neurology in Psychiatric Practice Robin Routledge, MD

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5. Response-Based Neurology in Psychiatric Practice Robin Routledge, MD. Summary. The brain is a response to the world. The brain is in a systemic balance with the world it perceives. It has many adaptations to context. These ideas show responses to extreme adversity are not illness. 2.

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Presentation Transcript
slide1
5
  • Response-Based Neurology in Psychiatric Practice
  • Robin Routledge, MD
summary
Summary
  • The brain is a response to the world.
  • The brain is in a systemic balance with the world it perceives. It has many adaptations to context.
  • These ideas show responses to extreme adversity are not illness.

2

neuron shapes
Neuron shapes

TOO COMPLICATED

schematic of a neuronal system
schematic of a neuronal system

One neuron

Another neuron

slide9
Mind is social

Mind emerges from interaction between brain and environment

Bateson: Mind and Nature

human sensation
Human sensation
  • Hearing
  • * Volume
  • * pitch
  • * location
  • Vision
  • * Light
  • * Colour
  • * 3D
human sensation1
Human sensation
  • Touch
  • * Size
  • * Shape
  • * texture
  • Temperature
  • * Pain
  • * Fast
  • * slow

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human sensation2
Human sensation
  • Taste
  • Smell
  • Stretch
  • Joint position
  • vibration

12

human sensation3
Human sensation
  • hormone levels
  • Satiety (grehlin, leptin, PYY, GLP)
  • Carbon dioxide
  • Arterial Pressure

13

maintaining the machine
Maintaining the machine

Autonomic control

Hormones

immune response

inflammation

making meaning
Making meaning

local sensation suppresses sensation around it

making meaning1
Making meaning
  • Competing maps of three dimensional space are assembled from combined sensations and given a sense of time.

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making meaning2
Making meaning

More than one organization or meaning is generated.

These are like competing virtual realities.

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making meaning3
Making meaning

One “representation” (Plato)suppresses

other versions around it.

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slide22
Networks of neurons located in different parts of the brain hum together like guitar strings. They assemble chords.

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making meaning6
Making meaning
  • The brain is split in two halves with very little communication between them.
  • Each half organizes perception very differently and the difference allows a subtlety of perception.

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Memory
  • The brain does not recall exactly.
  • Memories are stored better if they are emotional.
  • Memories are recalled differently depending on the circumstances at the time of recall.
brain action
Brain Action

Parts of our brain cooperate to number and to name things. These actions (calculations and language) are like actions we take on our external world.

slide27
“Mirrorcells” fire when we see another person do something we understand. Mirror cells act as though we are doing what we perceive the other to be doing.
  • This sense of the other may be the foundation of compassion.

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slide28
The social smoothnessof physical movements is coordinated by the most foreword part of the frontal cortical lobes.
  • This part of the brain can modify amygdala’s warning of danger.

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neuroplasticity
neuroplasticity

Neurons constantly replace or prune connections. They do this in response to how they are used. So if you do something different, they will slowly make new connections.

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neuroplasticity1
neuroplasticity

The brain is like a hedge

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neuroplasticity2
neuroplasticity

An opening in a hedge

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summary1
Summary
  • The brain is a response to the world.
  • The brain assembles representations of the world.
  • The brain adapts to the circumstances it selects.

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psychiatry is itself a response
Psychiatryis itself a response
  • a response to current culture
  • it started with the beginning of industrialism
  • Psychiatric classification began in the asylums

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the psychiatric history of trauma
the Psychiatric History of “Trauma”

1. da Costa American Civil War

2. Shell Shock World War One

3. Combat Fatigue World War Two

4. Brain WashingKorean War

5. Post Traumatic Stress DisorderVietnam War

6. Trauma Informed Carecurrent theory

7. Response Based Care future theory

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some brain responses to adversity
Some Brain responses to adversity
  • Physical Readiness
  • Option One:
  • increased muscle tone
  • increased heart rate
  • increase breathing
  • lubricated armpits
  • increased pupil size (more light in)
  • Harder to poop or pee

.

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slide36
Some Brain responses to adversity
  • Physical Readiness
  • Option Two:
  • loss of skeletal muscle tone
  • decreased heart rate
  • decrease breathing
  • decreased pupil size (less light in)
  • poop and pee

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slide37
Some Brain responses to adversity
  • Cognitive Readiness
  • numbed/calm emotional response
  • heightened alertness & vigilance
  • altered perception of time
  • rapid review of meaning of context
  • evaluation of social “representations”
  • weighing alternative strategies/tactics

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social responses to adversity
Social*responses to adversity

Expressed Emotion (EE) studies show social response to terrible things has a powerful influence on outcome.

* ”social” as the brain sees it

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conclusion
Conclusion
  • The brain is responsive.
  • It grows in the direction it is used.
  • The brain is in a systemic balance with the world it perceives. It has many adaptations to context.

36

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slide41
References

APA formatting by BibMe.org.

Bateson, G. (1972). Steps to an ecology of mind. New York: Ballantine Books.

Bateson, G. (1979). Mind and nature: a necessary unity. New York: Dutton.

Berkowitz, R., Coplan., Reddy., & Gorman. (2007). The human dimension: how the prefrontal cortex modulates the subcortical fear response.. Rev Neurosci., 18(3-4), 191-207.

Blackmore, S. J. (2005). Consciousness: a very short introduction. Oxford, UK: Oxford University Press.

Blackmore, S. J. (2005). Conversations on consciousness. Oxford: Oxford University Press.

Damasio, A. R. (1999). The feeling of what happens: body and emotion in the making of consciousness. New York: Harcourt Brace.

Darby, D., & Walsh, K. W. (2005). Walsh's neuropsychology: a clinical a pproach (5th ed.). Edinburgh: Elsevier Churchill Livingstone.

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References

Das, P., Kemp., Liddell., Brown., Olivieri., Peduto., et al. (2005). Pathways for fear perception: modulation of amygdala activity by thalamo-cortical systems.. NeuroImage, May(15;26(1)), 141-148. Neuroscience Institute of Schizophrenia and Allied Disorders (NISAD), Darlinghurst, NSW, Australia

EDGE: MIRROR NEURONS. (n.d.). Edge.org. Retrieved May 25, 2013, from http://www.edge.org/3rd_culture/ramachandran/ramachandran_p1.html

Gerhardt, S. (2004). Why love matters: how affection shapes a baby's brain. Hove, East Sussex: Brunner-Routledge.

Goleman, D. (2006). Social intelligence: the new science of human relationships. New York: Bantam Books.

Greenfield, S. (1997). The human brain: a guided tour. New York: Basic Books.

Greenfield, S. (2000). The private life of the brain: emotions, consciousness, and the secret of the self. New York: John Wiley & Sons.

Heekeren, H., Marrett., & Ungerleider. (2008). The neural systems that mediate human perceptual decision making. Nature Reviews Neuroscience, 9(June), 467-479.

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slide43
References

Levitin, D. J. (2008). The world in six songs: how the musical brain created human nature. New York: Dutton.

Lewontin, R. C. (1992). Biology as ideology: the doctrine of DNA. New York, NY: HarperPerennial.

McGilchrist, I. (2009). The master and his emissary: the divided brain and the making of the Western world. New Haven: Yale University Press.

McGraw, J. (n.d.). Ramachandran on Consciousness: Neuroscience as Philosophy. Ramachandran on Consciousness: Neuroscience as Philosophy. Retrieved May 25, 2013, from www.aistpain.it/en/files/CONSCIOUSNESS/Neuroscience_Ramachandran.pdf.ai st-pain.it/en/files/CONSCIOUSNESS/Neuroscience_Ramachandran.pdf.

Neisser, U. (1976). Cognition and reality: principles and implications of cognitive psychology. San Francisco: W.H. Freeman.

Ramachandran on Consciousness: Neuroscience as Philosophy. (n.d.). Ramachandran on Consciousness: Neuroscience as Philosophy. Retrieved May 25, 2013, from www.aist-pain.it/en/files/CONSCIOUSNESS/Neuroscience_Ramachandran.pdf

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References

Ramachandran, V. S. (2004). A brief tour of human consciousness: from imposter poodles to purple numbers. New York: Pi Press.

Russell, S. A. (2006). Hunger: an unnatural history (Pbk. ed.). New York: Basic Books.

Shea, M. (2005). The brain: a very short introduction. Oxford: Oxford University Press.

Shubin, N. (2008). Your inner fish: a journey into the 3.5-billion-year history of the human body. New York: Pantheon Books.

Siegel, D. J. (2007). The mindful brain: reflection and attunement in the cultivation of well-being. New York: W.W. Norton.

Taylor, J. B. (2009). My stroke of insight. London: Hodder Paperbacks.

Thomas, B. (2012, November 6). What’s So Special about Mirror Neurons? Guest Blog, Scientific American Blog Network. Scientific American Blog Network. Retrieved May 25, 2013, from http://blogs.scientificamerican.com/guest- blog/2012/11/06/whats-so-special-about-mirror-neurons/

Vaughn, Christine, and Julian Leff. "Expressed Emotion In Families. By J. Leff And C. Vaughn. (Pp. 241; Illustrated; £19.95.) The Guilford Press: London. 1985.." Psychological Medicine 17.03 (1987): 794.

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