Mental Health and the Brain:
Our fifth session and resulting on-line forum discussion  focused on two "loops" by which the brain learns/adapts/changes. One, largely unconscious, involves a number of parallel comparisons between expectations and the results of action and yields a wide array of unconscious understandings of both of both the world and one's relation to it The other involves a comparison of conscious experiences and understandings ("stories") with unconscious ones. The latter provides an interesting framework for thinking about "mental states," including those characterized as "mental illness," and suggests a possible locus for psychotherapy. The perspective also calls attention to the need to account for interactions between brains, in connection not only with psychotherapy but also social and cultural influences. That's the topic for this coming week.
Readings for this week
Relevant new things elsewhere
Thomas L. Friedman, OpEd, New York Times, 12 October 2008  ...
"Mother Nature is just chemistry, biology, and physics .... you cannot spin Mother Nature. You cannot bribe Mother Nature. You cannot sweet talk her, and you cannot ignore her ... And Mother Nature always bats last, and she always bats a thousand."
Friedman suggests "There is a parallel with markets." And, perhaps there is some parallel with the brain and culture as well? Because most of our experience is in dealing with other human beings, perhaps we overestimate the potency of bribery, sweet talk, logic, and well-meaningness? How potent are virtue, reasonableness, and the like in dealing with the brain? with culture? Why do they work to the extent they do, and can we make sense of their limits?
Reaching an autistic teenager, NY Times Magazine, 19 October 2008 "Perhaps, this kind of learning teaches the child that their own story is valid rather than requiring the child to learn a new story that may be incompatible with their story-teller's reconciliation of information ... If tacit knowledge, instead, receives a message that behavior is "valid" and not "weird" or needing correction, does the story-teller "relax" and engage in the world with less reticence?" ... Sophie F 
Where we've been ...
Sacks seems to describe a phenomena of the cognitive unconscious, or tacit knowledge, breaking though, almost taking over or hijacking the conscious, or the storyteller. Does this happen in other mental illness--the conscious or storyteller losing its "supremacy" over the [un]conscious? ... mstokes 
Perhaps mental illness is not only a disconnect between storyteller and tacit knowledge (not that anyone suggested it was) but can also arise from a malfunctioning storyteller or a malfunctioning tacit knowledge ... ryan g 
I've been thinking more about "the storyteller"/conscious and it's characteristics... and whether or not a need for logical coherence (or rationality?) is really one of them. I bring this up because I've been thinking about the concept of confabulation ... it was said during class that in essence "we are all confabulators" which I think is a good (useful?) way of thinking about how the brain and specifically the "storyteller"/conscious works ... LauraC 
it seems to me like the conscious can almost be explained away. (I'm not sure I agree, in fact, with an assertion Dr. Grobstein made after class that there *can* be something new under the sun.) .... it seems to me the storytelling function is only of benefit in that it allows us to coherently share our narrative world with others .... ysilverman 
I do think that it is important to think about the role that the story teller has in our lives and how we can learn to control our story teller instead of being controlled by our story teller ... adiflesher 
is tacit knowledge soaking up and storing its own form of “knowledge” of which we are not aware? And, if so, is it not possible that therapy can reshape tacit knowledge through dealing with the “story teller” which mingles with tacit knowledge, and thus, give new meaning to the implicit nature of tacit knowledge and the explicit nature of consciousness? ... Sophie F 
I am offering another horse and rider metaphor, where the horse is the unconscious and the rider is the storyteller. The horse has a set of specialized skills, like flying lead changes. It is also able to perform multiple tasks simultaneously. Interprets primary sensory information and observations, such as shying at a new sight. In contrast, the rider analyzes the information she receives from the horse and attempts to imagine a better way of moving about in the ring, woods, or world. The rider acts as a “semi-independent agent.” This might mean asking the horse to reconsider their previous reaction to a stimulus, not spooking at it. The story that is created by the rider affects the behavior of both the horse and rider ... the trainer’s role is to help the horse and rider pair perform better or get their story less wrong. The most important ambition is to increase meaningful communication between the horse and rider ... The trainer’s role can be adopted by the therapist. The therapist can try to increase contact between the unconscious and the storyteller ... jrlewis 
The advantages and problems of two loops
Empirical knowlege  and getting it less wrong in distributed systems
Finding new directions: the story teller as creator 
My first act of free will  shall be to believe in free will ... William James, 1870
The capacity to to tell new stories, to create meaning is robust/resilient ....
Problems: unresolved internal conflict 
Adding a third loop: additional advantages and problems ....
Brain re mental health summary to this point ...
- Observations to date are consistent with the mind being in the brain, and hence with the mind being material
- Observations to date are consistent with the brain having unconscious and story telling functions (all internal experiences), with the latter deriving from and acting through the former
- Observations to date are consistent with unconscious understandings being rooted in an ongoing exchange with the outside world, and story telling understandings being rooted in an exchange between the the story teller and the multiple elements of the unconscious
- Observations to date are consistent with recognizing conflicts in understandings as an important feature of human life, one that can create both problems and opportunities
- Manipulations of matter can affect both the unconscious and internal experiences and so behavior
- Stories reflect organizations of matter and so can also affect both the unconscious and internal experiences as well as behavior
- "Mental health" issues emphasize the important role of stories and conflicts (both within and between people) in human life
- "Mental illness" can be understood as breakdowns in ability to make use of conflict to create new stories and new meanings?
- The task of mental health workers is to enhance peoples' ability to make productive use of conflicts within themselves, as well as between themselves and other people and other aspects of the outside world? To create new stories/meanings that in turn open new possibilities?
Trying it out .... (see links for background and discussion of each case)
- Following a car accident, a man experiences uncontrollable bouts of depression ... Exploring Disability  ... discussion 
- Following a care accident, a man accuses his sister, who has been taking care of him, of being an imposter. ... The Echo Maker ... discussion 
- A man who hears voices in his head and has successfully hidden that from everyone close to him becomes enraged when he discovers that his father had also heard voices all his life and had never told him about it ... Muses, Madmen, and Prophets ... discussion 
- A resident in a rehabilition hospital urinates in bed every night, and insists there is an unknown nightly visitor who is responsible ... LauraC  ... discussion 
- A woman on a train has what seem to be involuntary jerking fits and makes strange guttural noises. She seems to be very angry, and having trouble controlling herself ... ryan g 
- A young girl is terrified of a mysterious person who finds her in bed at night and lies on her, preventing her from moving ... ... Sleep paralysis  ... discussion 
- A woman becomes preoccupied by someone repeatedly writing "I love Sarvis" on the stall divider of the girls' bathroom in the school where she works . Sarvis is her nine year old son. .... The tiny hand that rocks the cradle  ... discussion 
Moving on to more specifics ...