Book Reviews, Mind Management

Myelin and Mind

To play a musical instrument, it’s not enough to put your fingers in the right place. They have to arrive there at the right time. Getting to the right place is controlled by the wiring of the neurons. Right timing is controlled by myelin.

Myelin is a fatty sheathe around the axon – the part of the neuron that carries signals out from the cell body. Just as neurons form new connections as we learn, so the brain adds myelin to axons. Special cells called oligodendrocytes wrap myelin around the axons that carry the heaviest traffic. Each wrap causes the signal to move faster.

This improved speed helps us to think faster. This applies to all forms of thinking – logical deduction as well as muscle movement. That isn’t always a good thing – we’ve all heard the term “motor mouth,” somebody who talks faster than we can follow. To correct for such problems, myelin gradually decays, slowing the speed along the affected pathways. To maintain optimum performance, then, myelin must be constantly restored.

Building optimum performance is the subject of The Talent Code by Daniel Coyle. The book sings the praises of myelin and the processes that refine its placement. The most heartening insight is that talent – broadly understood to be the capacity to respond rapidly and precisely – can be cultivated through proper training.

Both internal attitudes and external feedback (coaching) figure in the development, refinement, and maintenance of myelin networks. Attitudes include commitment, caring, challenge and consequences. Commitment is recognized as the belief that a life will be built around execution of our skill. Caring manifests as an emotional response to competence: irritation at failure and joy in achievement. Challenge is the restless seeking beyond current skill – to always be in pursuit of greater aptitudes. Lastly a demonstrable connection between skill and social recognition is the honey of consequence that draws others into challenge with us, giving us the stimulus to continue to improve.

Coyle sees these factors at play in many settings: sports, music and academics are highlighted. While explicitly considered only in the afterward, every example highlights the value of tension between creativity and discipline. Creativity is the goal, but can be cultivated only when the student believes that what she does makes a difference. In the proper setting, then, negative feedback becomes a positive when self-awareness (shame or guilt) is followed immediately with repetition that is rewarded with approval when competence is achieved.

From this, it is clear that mentors are critical to the development of mastery. It’s not a one-size-fits all proposition. In the early stages of talent development (what Coyle calls “ignition”), the mentor must build an emotional connection between the student and their skill. As mastery is approached, the mentor creates conditions of constant challenge. Performance is driven by practice with others of high skill, and the mentor intervenes mostly to help the competitors leap-frog past each other.

In this pursuit, myelination alone is insufficient. In a competitive setting, mastery is not repeatable, because competitors will adapt to its demonstration. This requires endless variation that can be achieved only by composing smaller elements as sequences. Part of coaching is to break skills down into chunks that can be creatively sequenced. Coyle illustrates this with a detailed breakdown of how a master coach teaches a quarterback the drop-back. The most telling proof of the principle, however, is in the failure of chess masters to recall random board configurations, where they can instantly recall actual game configurations. The chess master sees actual game configurations in “chunks” of related pieces.

While hypnotherapists are not life coaches, the insights of The Talent Code are critical to our discipline. Emotional attachment is the foundation of excellence. Hypnotic rehearsal builds myelin networks in the brain, but must be tied immediately to myelination in the rest of the body. Habits are best maintained under variations that instill challenge, and best undermined by substituting alternatives to feed higher behaviors. Recovery from loss may be facilitated by seeking actively to tie high-level networks to new contexts for expression (“chunking-down” instead of “chunking-up”).

Perhaps most importantly, however, is in managing client expectations. Learning is not life-long – it must be actively maintained, and constantly evolves as others adapt to our capabilities. In fact, that tension is critical to skill. The subconscious may resist change, but great accomplishments derive from the struggle to overcome that resistance. In some sense, the properties of the myelin system are how the brain comes to understand what is really important to us.

Book Reviews

Behavior and Adaptation

Life is change. For most of history, change was transmitted only through birth. Looking at the natural world, then, Darwin and his followers upheld the survival of our genes as the compulsion that drives our every behavior. In the mental health world, Freud also flirted with that view (everything is about sex).

But humanity has subdued the natural world with our ideas. Corn, cows and cars wouldn’t exist if ideas weren’t transmissible from person to person after birth. That exchange of ideas is also an adaptive process, but it’s not Darwinian. It’s closer to the evolution proposed by Lamarck, which is thousands of times faster than Darwin’s evolution through gene transmission.

As human beings, then, we are a combination of Darwinian (sexual) impulses and Lamarckian (intellectual) impulses. Sadly, just as our relationship with the natural world is out-of-balance, the tension between genes and ideas also drives us out of balance in our relationship with the self. Our mind changes far faster than our body. Worse, improving the mind occurs through experiences that often limit the body (and visce-versa). To keep this competition under control, the mind divides into two: the conscious mind that learns and adapts to a changing world, and the subconscious mind that manages our well-being and “automatic” behaviors.

Hypnotherapy is helpful in maintaining or restoring balance between the conscious and subconscious parts of our mind. Often that means negotiating alternatives to genetically inherited behaviors – most commonly the “fight or flight” response, but also lowered mood (sadness or depression) or pain. It’s important to understand those foundations of the personality as the basis for our work.

It was this need that stimulated my interest in Randolph Nesse’s new work “Good Reasons for Bad Feelings.” Nesse is an advocate of Evolutionary Psychiatry – a discipline that holds that we can understand the cause of mental disease as imbalances or extreme cases of behaviors that ensure that our genes are passed on. Explicit in the Nesse’s framing of the issue is that those genes cause defects in our brains that predispose us to the disease.

The book considers, chapter by chapter, our major mental health problems. In each case, Nesse proposes explanations for why more primitive species would have benefited from the behavior. The fear response triggers fight or flight, which in the right balance ensures that we mate as frequently as possible. Depression pushes us to abandon unattainable goals. Altruistic behaviors imply loyalty to sexual partners that depend upon that loyalty to ensure the survival of children over the decade preceding self-sufficiency. These are all plausible explanations for why genes that code for those traits would continue to be passed on, despite making us susceptible (respectively) to irrational phobias, suicide, and sexual manipulation.

As documented in detail by Nesse (I have to admire his integrity), the defect in this proposition is that no study has been able to identify consistent genetic differences between those that suffer from mental illness and those that don’t. The doubt generated by this observation is reinforced by clinical studies that demonstrate the importance of individual life experience in determining who suffers from mental illness. Unfortunately, the administration of determinative assessments takes hours – far more than is possible in a busy clinical setting.

Of course, life experience is not predictable. As with medicine, the preventative utility of genomic markers is seductive, perhaps leading Nesse to flog a proposition that appears to have a limited future.

In specific sections of the book, the blurry boundary between genomics and culture is evident. Child rearing doesn’t require a commitment from the male – in fact some feminist authors assert that agriculture was invented by women in part because they stayed in camp to share those duties while the men went out to hunt. So Nesse’s explanation for cooperation is arguably cultural. A more direct descent from genomics might be grooming to remove pests, which is manifested even among fish.

Nesse sets his observations against the backdrop of his clinical and professional development. All are set as heroic outcomes – illustrations of clinical innovations, or transformative insights that puncture professional myopia. As a hypnotherapist, however, some of the clinical innovations seem barbaric – exposure therapy for those suffering severe phobias is one illustration. And the primacy of evolutionary psychiatry seems overblown when outcomes depend upon life experience.

Both matters are dealt with more elegantly in practices (such as hypnotherapy) that recognize the division of the mind between conscious and subconscious realms. I was surprised when I encountered psychologists that disputed that division, and Nesse is defensive in the sections in which he recognizes its importance. His hesitancy indicates that the dispute is more widely entrenched than I knew.

This is an omission that I find indefensible. The tension between biological and social imperatives explains so much regarding our behavior – and mental vulnerabilities.  Even more, those insights inform powerful therapeutic strategies that are known to be gentler and more efficacious than the alternatives described by Nesse.

To conclude, “Good Reasons for Bad Feelings” is an excellent survey of mental health issues, and in relating those pathologies to behavioral benefits, Nesse reduces the stigma that burdens sufferers. I am concerned, however, that his focus on genetics will delay recognition that the genome specifies an architecture for the brain that is vulnerable to cultural pathologies. In both the formation of synapses and the allocation of blood flow, the brain is wonderfully plastic. That faculty facilitates the spread of ideas, but also the insinuation of contradictions that manifest as pathological behavior. Evolutionary psychiatry only sets the table – it doesn’t determine the contents of life’s meal.

Book Reviews

Ericksonian Elicitation: A Book Review

Milton Erickson was a titan of psychological research. He’s also a personal hero. His most important paper on trance makes the firm statement that the therapist’s highest priority is to protect the integrity of the subject’s personality. For me, this commitment has been central to the development of clinical rapport. We can analyze technique and method, but I read Erickson’s papers and understand that his intuition was guided by people that wanted to reveal themselves to him. His phrasing of suggestions reflects the tenderness with which he confirmed their invitation.

Erickson’s impact upon his students was profound. One of them – Jeffrey Zeig – peppers “The Induction of Hypnosis: An Ericksonian Elicitation Approach” with personal vignettes. The instruction that follows makes evident his devotion to Erickson’s memory. A whole chapter celebrates his impact on the history of psychology following World War II.

For the professional, the development is a little slow. In part this follows from ambiguity in the definition of hypnosis. For the first six chapters, Zeig offers metaphors and stories in building a procedural definition rooted in the experience of the subject. The subject experiences, in order:

  1. Modified awareness – even something as simple as becoming aware of their breathing.
  2. Altered intensity – noticing the correlations between focused attention and experience.
  3. Avolitional experience – being guided into awareness without conscious ratification.
  4. Avolitional response – responding to experience without conscious ratification.
  5. Ratification of hypnosis – the operator bringing these elements into awareness and labelling them as “hypnosis” or “trance.”

The goal is for the subject to become receptive to suggestions from the operator. This requires agency on both sides: the subject trusts, and the operator builds rapport. On the operator’s side, Ericksonian phrasing makes the transition extremely comfortable. The pattern is pace, lead, and motivate. In pacing, the operator offers truisms – observations that are natural to the situation. Having attained that agreement, the subject is then led into the next step of the elicitation. Finally, they are offered a statement that aligns the step with their motivations. When the step is taken, it seems not only natural but as though it always was that way.

Zeig guides the reader through the grammar of Ericksonian elicitation. This is a finicky subject, and while clearly described, actual use of the grammar requires extended practice. This is emphasized: Zeig cautions that the operator should not be thinking “This would be a good place for a presupposition. Oh, and then I can offer an embedded command!” Instead, the operator is tracking the subject’s descent into hypnosis, and intuitively offers statements that serve the elicitation. To facilitate the development of that intuition, Zeig analyzes transcripts for study – all involving students that offer intelligent analysis of their experience. That is no substitute for immediate practice.

As a professional, I found myself wanting more at the end of the book. Zeig does a detailed deconstruction of a “traditional” model of hypnosis that I would characterize as a “straw man.” Zeig focuses on scripts. While the structure of a session does follow the pattern Zeig lays out, non-Ericksonian therapy does not require scripts – and even when I reference a script I rarely follow it slavishly.

Having demolished his straw man, Zeig promotes a core virtue of Ericksonian therapy: a session begins with elicitation. Unfortunately, the shift to therapy takes us out of the pattern of elicitation, into (progressively) 1) confusion and destabilization, 2) perceptual alteration, and 3) disassociation. The goal is to identify the mechanisms held in the subject’s mind that allow behaviors to be adapted. Sensory metaphors figure prominently, each wrapping a suggestion to create, modify, or delete an experience or behavior. Once disassociation is attained, those mechanisms can then be used to alter behaviors independently of the rest of the mind.

Zeig allows that to survey the subject’s inventory of adaptive mechanisms involves several sessions before therapy can proceed. Unfortunately, that procedure is not developed in depth, leaving the professional to wonder what to do after hypnosis is elicited.

The focus on disassociation is also troubling. Disassociation allows the subconscious to control movement and sensation without conscious awareness. In his writings, Erickson was proud of automatic writing and waking hallucinations. But ultimately the subject must integrate their experience and learnings. That may be accomplished by reinforcement as the subject is brought back into the normal state. Erickson never addressed this point, and neither does Zeig. What Erickson reported was, in fact, that by use of these disassociation he could create long-term syndromes in colleagues .

At the conclusion, Zeig’s writing left me a little flat. In attacking the methods that I use every day, Zeig showed a lack of respect for the work that has been done in the “traditional” model to assimilate Erickson’s central tenet: protecting the integrity of the subject’s personality. That includes:

  • offering the subject’s conscious mind a simple explanation of the therapeutic process,
  • the origination of free-style imagery in which the subject has autonomous engagement with their subconscious as the unified mind seeks for healing, and
  • allowing that the subject may evolve new behavioral development strategies.

More daunting, however, is Zeig’s observation that Erickson seemed to make it up as he went along – and that his most impressive elicitations involved unspoken elements. Erickson may not have been a therapist in the normal sense – he may have been a guru.  Zeig steers safely clear of those waters.

Book Reviews

We Are All Energy Workers (A Book Review)

In The Women’s Book of Healing, Diane Stein presents both theory and practice for developing our natural skills to project healing energy.

In the theory, physical dis-ease (Stein used hyphens to emphasize the tendency of the being toward wellness) is the manifestation of energetic imbalances in the psychic layers that surround it. Those layers focus the emotional, mental and spiritual aspects of our lives. As Stein explains, the layers also host one or more chakra energy centers, each chakra having a corresponding color in the rainbow. Red is the color of the body, progressing outward to purple at the highest spiritual layer. Beyond that is the transpersonal layer, which as the source of all colors is white.

Obviously much of this is metaphorical – concepts built over milennia that humanity uses to access energies that reach all the down to subatomic realities. For that reason, there are some inconsistencies. As Stein testifies in discussion of practice, healers that honor the intentions of the “Goddess” can dispense with the metaphors.

Stein explains not only how to use the metaphors for healing, but how to heighten sensitivity through meditative practices. That begins with the ability to see the psychic layers as auras. Next comes color visualization as the healer scans upwards through the chakra centers in the physical body. In remote healing, dis-ease is imagined as blotches on the psychic layers. “Tinker Woman” work describes the development of personal healing metaphors (stapling cuts closed, putting in faucets and drains for blockages).

Laying on of hands is more abstract, dealing directly with energy flows. The book ends with chapters on crystal work, building and enhancing the color metaphors at the beginning of the book.

The resources of the earth is emphasized throughout as essential to grounding energies, thereby avoiding transference and to ensuring that both parties (healer and healed) are not left open to harmful invasion.

In talking about these methods, the book is generally light-hearted and generous. According to Stein, the ethic of the woman healer is to work without compensation. Respect for the autonomy of the dis-eased is emphasized again and again.

Where most fault is to be found is in Stein’s militant feminism. Matriarchy is good, patriarchy is evil. Conflation of patriarchy and allopathic medicine is rampant. Both serve to suppress women’s self esteem, seeing their bodies and intentions as foul and inferior. Male practitioners are recognized, but their contributes are cast as “finding the Goddess within.” Conversely, Stephen Harrod Buhner (The Lost Language of Plants) reports that many country doctors were intuitive herbalists.

I have reached out to Stein with the observation that the ethic she mandates is modern. Allopathic medicine (surgery and medicine) was pursued in part to guarantee that both patients and doctors were protected from psychic entanglements. Negative intentions can be projected in both directions. I know that a tender of money justifies abusive rage in clients that don’t receive the benefits they expect. But how else is a practitioner to stay alive? And how can we believe that those dependent upon their craft might not be moved to extort money from their clients?

The slipperiness of this slope is evident in one particular practice offered by Stein. This is the use of an imaginary “healing bag” to store negative energies collected during visualizations. These can be splotches on the aura or pools of negative energy. The practice, at the end of the session, is to imagine the bag burning up along with its contents.

But how did those splotches originate? Stein tends to the perspective that they all originate from patriarchal abuse, but I have met dragon ladies that fail to honor Stein’s ethic. Just as a healer can remove blotches, the dragon lady can tear pieces out of the souls of her victims. Those pieces never integrate properly, and so manifest as blotches that generate dis-ease in the dragon lady. Is it right to remove them and burn them up? Or should they be returned to their point of origin?

This contextuality is not acknowledged by Stein. It is non-trivial. Priests talk about predators the “lie with their whole being.” This is a practice used by abusers to hide their intentions behind the façade of victimization. (Their victims, after all, will naturally fight back against them.) Peering past that façade is safe only for practitioners that have progressed past the use of metaphors to work directly with the underlying spiritual forms.

When I was in graduate school, I met a massage therapist at a bar in Boulder. He troubled me with his difficulties clearing the negative energies he accumulated while working with Wall Street bankers. I finally told him “Look, don’t be an enabler.” Reading Stein’s work, I am concerned that she is unwittingly creating a culture of enablers. That concern is reinforced by the way my skin crawls every time she inveighs against “the patriarchy.” Damn it, Diane, their wives profit from that system as well.

So put away the hatred, and write a book that offers useful metaphors for transforming negative associations in the psychic layers. I’ll offer my own system in the near future.

And for those that wish to use the beautiful metaphors and practices collected by Stein: make sure that you know your clients well. To do otherwise is prideful, and leads down harsh and painful roads.