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Asprey labrador

 

Above is a great audio clip on how the old parts of the brain can govern behaviour. The clip is from a talk by Dave Asprey. I am never entirely sure about many bio hacking claims, but this is a novel way of explaining the triune brain.

Note Asprey is talking about an untraumatised brain. Even without trauma, the old parts of our brain are easily distractable, prone to trigger random eating, focused on sex and biased to hardwired reflexes in response to danger. In a sensitised nervous system the reptile and mammalian elements react even quicker and limit the prefrontal cortex even more.

I like the idea of the energy economy of the body being stacked to deal with reptile brain, then mammal brain, and only then conscious processing. So, for example, if there is inflammation or toxicty in your liver (Asprey is very keen on not stressing the liver with molds) then the resources of your system will be diverted to the liver by the reptile brain. You will not be able to think clearly or maintain energy, focus and willpower.

Watching the video made be think of an old friend – Mike The Headless Chicken. Another example of how many of functions can be done without thinking. For Asprey that is scary – we need to learn how to exert control on these unconscious systems or they will control us. He likes meditation, gratitude, sleep and clean diet, all aided by bio feedback, as good starting points to influence what is happening in the old parts of your brain.

 

Mike the headless chicken

Pain Throw Amputated Leg

This is a great story of how extreme the body can be in prioritising threat.

Pain has a geography in the body. Suffering is a bigger category and existential?

This is tricky territory, hence the question mark.1

My view is that in pain there is an explicit representation that involves the body. Considering suffering as initially experienced through thoughts and emotions is a broader category that acknowledges that thoughts feel primarily psychological. Of course mental events have correlates in body physiology, they have to; there is no such thing as a pure thought or pure mind outside of body.2 However it is an achievement to be embodied. Tracking psychology, thought, or emotion in our bodies is a skill that requires practice and discipline.

It is not efficient to always track every sensation associated with a thought, in exactly the same way that it is not efficient to track every muscle we contract to pick up a glass of water. The goal of the brain is predictions and outputs that work quickly in nature. When we are suffering and in pain then retraining our brain to operate differently necessitates bringing awareness to the steps that make up our thoughts and movements. Only then can we can chose to assemble the simple building blocks of how we think and move in more optimum, non painful ways.

‘I think this is a quote from Antonio Damasio that is worth repeating: “The mind is embodied, not embrained.”
Let’s consider some of the evidence that shows how important the body is to the mind. For example, the role of emotion. We’ve talked in the past about the importance of the parts of the brain that monitor the body’s internal state. Antonio Damasio is the one that has shown that when parts of the frontal lobe that are involved with getting emotional input are damaged, a person can’t even make decisions. So we need the body’s input. That’s why separating the brain out by itself is a dangerous example of reductionism. It’s the whole person that has experiences, not the brain.’ Ginger Campbell (2009)3

Pain is a conscious experience

‘Pain is an unpleasant conscious experience that emerges from the brain when the sum of all the available information suggests that you need to protect a particular part of your body.’ Lorimer Moseley4

You cannot be in pain and not know about it. Your body can be working poorly, be inhibited, have silent tumors growing, and have metabolic disorders humming away all outside of your awareness. That is disease. Pain is something that grabs attention as the brain decides the information it is receiving is dangerous. The goal of acute pain is to change behaviour to protect.

The body has other ways of changing behaviour. Tiredness is an output that limits behaviour, it is also a conscious perception like pain. Interestingly inflammation is increasingly being understood as a protective output, in parallel to pain but led by the immune system.5 However inflammation has the difference of running outside of our awareness and is non-conscious.

A consequence of embodied awareness is that as you pay attention and learn to feel you may suffer more. What you learn to feel is your suffering. Often as people come out of dissociation what they encounter is pain. The strategy of cutting off from sensation occurred because something was too much. This is why pacing and resources and are essential when meeting the body if there has been trauma. Levine (2010)6 offers that health is the ability to hold increasingly intense sensations and not get activated.

‘Let me tell you something really, really shocking. As late as the 1970’s young infants in hospitals, having major operations, including amputations, are having them without any form of anaesthetic, let alone analgesic.’ Jonna Bourke7

In the 18th century the baby was seen as exquisitely sensitive, there was a shift in 1870’s to infants being considered not at all sensitive and this continued for another century. Small children were not perceived to experience pain in the same ways as adults, it was thought you needed to have the capacity to suffer to feel pain. Presumably babies were thought to have no self consciousness and no memory. Oh dear, a sad example of why clear understanding of pain matters.

References

1 Bourke (2014 p60-62) gives a good discussion of pain versus suffering and relates it to an historical split between mind and body:

‘Finally, astute readers will already have noticed that I am using the terms pain and suffering interchangeably. It used to be radical to question the distinction between the mind and the body. Not any more. The assumption that there is a clear distinction between the mind (characterized as disembodied, rational, computational, and male) and the body (caricatured as presocial, emotional, impetuous, and female) has been attacked from all sides. Feminists have led the assault on the representation of the mind as some kind of superior, active, unique entity, which ‘feeds’ information to a passive, universal, and inferior physiology. In more recent decades, though, anthropologists, social scientists, and cognitive scientists have enthusiastically joined in the skirmish. Historians have been relatively slow to commit themselves.

Of course, people-in-pain typically highlight one aspect of the pain-event over another (I am in physical pain because I burnt myself while making coffee; I am psychologically suffering because I have fought with my lover). The Cartesian distinction between body and spirit or soul is deeply embedded in our culture. Nevertheless, mental pain always involves physical events – neurochemical, muscular nervous, and so on – and physical pain does not exist without a mental component. My burn depresses me; my sadness weighs down my body. As physician and writer David Biro astutely argues in ‘Is There Such a Thing as Psychological Pain? And Why it Matters’ (2010), ‘psychic distress can itself be painful in a meaningful sense, that it can be phenomenologically akin to physical pain, and, therefore, should be categorized under the same rubric’. Furthermore, the Cartesian distinction made between ‘bodily pain’ and ‘psychological distress’ (often denigrated as the difference between ‘real pain’ and its ‘psychosomatic’ variety) has done a vast amount of ideological work for physicians, psychiatrists, psychologists, the pharmaceutical industry, and chronic pain patients. For researchers in the arts and humanities as well as in the sciences, however, mind/body dichotomies have been an impediment to scholarship. There are many grounds to be suspicious of them, including the vast scientific and medical scholarship that demonstrates the interconnectedness between physiological and mental processes. Bodies are actively engaged in the processes that constitute painful sensations. Mindfulness is engaged in a dialogue with physiological bodies. And culture collaborates in the creation of physiological bodies and linguistic systems. The body is mind-ful and the mind is embodied.’

2 Another very tricky bit: no pure, independent mind is the materialist view. Dualists and religions argue that mind/soul is distinct and independent from the body.

3 Campbell, G. (2009) Did My Neurons Make Me Do It? Brain Science Podcast Episode #53: Aired January 17, 2009

4 Mikkelsen S. (2014) Notes on Lorimer Moseley lecture 7 June 2014. Facebook post. https://www.facebook.com/ManuellterapeutSigurdMikkelsen?fref=ts. Accessed 17 July 2014 Manuellterapeut Sigurd Mikkelsen

5 ibid

6 Levine P. (2010) In An Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books.

7 Bourke J. (2014) The Story of Pain: From Prayer to Painkillers. Oxford University Press. http://www.bbc.co.uk/programmes/b046j8z5  Interview July 2014 @10.00mins.

 

I’ve Seen A Lot Dance Moves, But Nothing Like This. I Can’t Stop Watching This!

 

Dancers always inspire around how I can move my body.

Graded Exposure Helps Pain

‘If you perform some movement without pain that normally hurts, your brain is likely to get very interested. It is ‘good news’ that reduces threat. A major goal of any program for movement health should be to send as much ‘good news’ to the nervous system as possible about the state of the body and its ability to withstand the stress of movement’

Todd Hargrove (2014) Better Movement. p143 (A stunning book and blog)

Let’s say you have 10 muscles holding your shoulder in a given position. Let’s also say, being really simple, each muscle can be on, off or halfway. That’s three options per a muscle. That is already 1000 (10x10x10) options on how to hold your shoulder still. Even this number is orders of magnitudes below the actual degrees of freedom you have available to move your shoulder.

Maybe an injury has limited the range of movement or strength in one position – there is a tear in some tissues or some wear or tear (arthritis) in the joints. It turns out these are normal signs on medical imaging, they are commonly seen in pain free individuals. Consider how many other possibilities exist to perform any given motor act. At least 1000 if my maths is any good.

Feed your brain novel and non threatening ways to move. Try lots of small, gentle, movements and build up to more complex and long sessions. Visualise the movements to enhance the maps of your body in your brain (neurotags). Be persistent, it is about learning new, non pain habits; it may take the amount of work you would have to do to write with your opposite hand.

Your body and brain will accommodate to the limitation and you will be able to live and move without pain. And, yes, you are a little bit older and little more experienced than you were before. You may not have a tennis serve that is going to win Wimbledon, that can be sad and a loss, but it does not mean pain. You will still be able to do amazing things with your body.

Famous welcome sign, Las Vegas, Nevada.

Research into the fabulous vagus nerve is a gift that keeps on giving. Activating the vagus supports people to be less depressed, enhances the immune system, including regulation of inflammation, and reduces pain. The first section is a summary from Dacher Keltner of some vagal highlights. The second section has some tips on working with the vagus from a biodynamic craniosacral therapy perspective.

How can you become a vagal superstar? How can you help your clients become vagal superstars?

Vagal superstars

The following are all features of the vagus according to Dacher Keltner (1), researcher and author of ‘Born to be Good’.

  • The vagus nerve is almost like an alternative spinal cord.
  • When you stimulate the vagus you improve people’s capacity to make decisions, this is true of the vagus nerve but not so much the spinal cord.
  • The vagus stimulates the release of oxytocin.
  • It optimises your heart rate. It evolved to support communication, social engagement and prosocial emotions such as compassion.
  • Nice touch to the back, you see a smiling face, (compassion towards) images of harm; these all cause the vagus nerve to fire. It gives specific stimulation to emotional processing centres. (Italics added)
  • ‘Vagal superstars’ demonstrate elevated base activity in vagal tone. Vagal superstars are more generous, more trusted, and kids with high vagal tone break up play ground fights.

Tips on applying the vagal brake: increasing vagal tone inhibits the sympathetics

Enhance vagal tone

  • Stimulating the new vagus (2) is the best way of switching of the sympathetics and supporting homeostasis (3), (4).
  • Be soft, slow and present.

Engage the extensors

  • Think of a monkey grabbing onto a tree trunk; all the muscles being used are flexors and are associated with sympathetics, stress and making ourselves small. The sympathetics are switched on when we contract into the fetal position.
  • We are in parasympathetic mode when we come into an upright posture with the extensors engaged. We feel safe enough to show our belly, heart and throat. We can engage with our environment, make ourselves big and move towards new things.
  • On the treatment table you can engage the extensors by getting your client to orient to the back of the body: ‘Can you feel the weight of your body on the table? Push your elbows and/or feet into the table.’

Engage the feet

  • Loss of the vagal brake results in a surge upwards as we orient; the head gets hot and tight, there is increased activity in the neck, cranium, heart, and lungs. We lose relationship to the bottom of the body and tend to disappear from our belly and our feet.
  • Grounding, being present and firing in parasympathetics nearly always involves engaging the lower half of the body and feeling the feet.
  • On the treatment table keep asking people if they can feel the size, shape and weight of their feet and their belly. Be persistent.

Facts_of_back_pain_a_man_sitting_straight_in_chair

Go slow and embody vagal states

  • Words associated with the vagal activity are trust, love, compassion, acceptance, joy. Work to find these qualities in your own body as you treat. The clients body will mirror your state.
  • Think of a perfect lazy afternoon, full of a delicious dinner, in front of a warm fire, cosy in a chair, chatting with old friends……

Know the anatomy of the vagus and its ganglia

  • The vagus can be influenced by supporting change around the jugular foramen, the superior and inferior sensory ganglia below the jugular foramen, the carotid sheath, the larynx (4), the tragus of the ear, freedom in the breath and diaphragm, and resolving inertia in and around organs (especially the heart, lungs and sub diaphragm organs) to free up vagal motor ganglia and the enteric nervous system.
The Vagus. Left: The territory innervated by the paired vagus nerves above and below the diaphragm.     Right: Vagus nerves in black, and sympathetics in white, supply the heart and organs above the diaphragm.

The Vagus. Left: The territory innervated by the paired vagus nerves above and below the diaphragm.
Right: Vagus nerves in black, and sympathetics in white, supply the heart and organs above the diaphragm.

(1)  Keltner D. (2009) Born to Be Good: The Science of a Meaningful Life. 1st Ed, W. W. Norton & Company. See also Dacher Keltner in Conversation. http://fora.tv/2009/02/05/Dacher_Keltner_in_Conversation.

(2) The ‘new vagus’ refers to the mylinated vagus controlled by the ventral vagus complex (nucleus ambiguus) that co-ordinates oxygen control inline with muscles of facial expression. Porges, S. (2011) The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. New York: Norton

(3) ‘The relative sympathetic activation seen in anxiety disorders may represent dis-inhibition due to faulty inhibitory mechanisms.’ The vagus inhibits the sympathetics.   – Thayer J. and Lane R. (2000) ‘A model of neurovisceral integration in emotion regulation and dysregulation.’ Journal of Affective Disorders 61, 201–216.

(4) ‘We propose that these findings have important implications for the understanding of the two-way communication between the heart and the brain, and provide a connection among negative emotions and negative health consequences via the common mechanism of autonomic imbalance and low parasympathetic activity.’  – Thayer J. and Ruiz-Padial E. (2006) Neurovisceral integration, emotions and health: An update. International Congress Series 1287 (2006) 122–127

(4) ‘The vagus nerve innervates the larynx’ it carries ‘general sensation, including pain, touch and temperature’ from the larynx. –  Laryngeal nerve anatomy: emedicine.medscape.com accessed Feb 2014.

Chronic pain is nearly always a habit in the nervous system. Acute pain is an interpretation of nociceptive signals indicating tissue damage and inflammation. The tissues optimise the local repairs after a few months, so if the experience of pain persists then it is far more likely your central nervous system still frames the region initially damaged as unsafe in some way.

Here is a really nice graph (adapted from a NOI group training manual) giving some sense of the shift from tissue damage making up 3/4 of the pain experience in acute pain, to central processing making up 3/4 of the pain experience in chronic pain.

pain gifford graph_edited-2

New Research – you can see the changes in the brain in chronic pain

Here is a video describing how brain changes can be seen in chronic pain patients on MRI scans. Wild stuff, pain is very strange, and not what I was taught at chiropractic college.

The full original article on brain changes can be seen here

http://americannewsreport.com/nationalpainreport/scientists-say-brain-hot-wired-chronic-pain-8821714.html

The video below is another wonderful development of how pain works. There is a revolution in how researchers are framing pain over the last few years. As teachers in the cranial community we are trying hard to catch up. We have changed our essential reading list to include Painful Yarns by Lorimer Moseley and tweaked the Body Intelligence Training manuals and teaching to reflect these new understandings.

The good news is that much of the territory we have been exploring for many years. The video below gives some great science backing up the model of using WOSI (Weight Outline Skin and Inside) as a framework of exploring how people actually perceive their body and our general goal of being embodied.

The research on two point discrimination described about half way through is fabulous. Also the left right discrimination. In fact the whole thing is just great.

Osteoarthritis pain is at least as much about the perception in your brain as it is tissue damage to the joint:

Screen Shot 2013-09-16 at 18.17.40

You can access many of the papers here   http://www.bodyinmind.org/resources/journal-articles/  A really good start is scroll down to 2008 to: Moseley,GL (2008) I can’t find it!  Distorted body image and tactile dysfunction in patients with back pain. Pain 140,1 239-43.

Daniel Dennett. A philosopher interested in consciousness.

Daniel Dennett. A philosopher interested in consciousness.

First 6 minutes and then to 16 minutes of this video are wonderful – the transcription is good if you only have time to scan.

http://www.edge.org/conversation/the-normal-well-tempered-mind
Click this link for the video and transcription

Some quotes are below. I love the idea of a risky brain that is not hierarchical but is a mix of anarchy and democracy. There is competition between individual neurons – descended from free cells that survived for a billion years on their own – and alliances of neurons. Social interaction and culture provide the drive and rewards for the risk taking brain.

‘because each neuron, far from being a simple logical switch, is a little agent with an agenda, and they are much more autonomous and much more interesting than any switch.’

‘We’re beginning to come to grips with the idea that your brain is not this well-organized hierarchical control system where everything is in order, a very dramatic vision of bureaucracy. In fact, it’s much more like anarchy with some elements of democracy. Sometimes you can achieve stability and mutual aid and a sort of calm united front, and then everything is hunky-dory, but then it’s always possible for things to get out of whack and for one alliance or another to gain control, and then you get obsessions and delusions and so forth.’

‘Realize that every neuron in your brain, every human cell in your body (leaving aside all the symbionts), is a direct descendent of eukaryotic cells that lived and fended for themselves for about a billion years as free-swimming, free-living little agents. They fended for themselves, and they survived.’

‘Maybe a lot of the neurons in our brains are not just capable but, if you like, motivated to be more adventurous, more exploratory or risky in the way they comport themselves, in the way they live their lives. They’re struggling amongst themselves with each other for influence, just for staying alive, and there’s competition going on between individual neurons. As soon as that happens, you have room for cooperation to create alliances, and I suspect that a more free-wheeling, anarchic organization is the secret of our greater capacities of creativity, imagination, thinking outside the box and all that, and the price we pay for it is our susceptibility to obsessions, mental illnesses, delusions and smaller problems.’

‘We got risky brains that are much riskier than the brains of other mammals even, even more risky than the brains of chimpanzees, and that this could be partly a matter of a few simple mutations in control genes that release some of the innate competitive talent that is still there in the genomes of the individual neurons. But I don’t think that genetics is the level to explain this. You need culture to explain it.’

 

See also https://cranialintelligence.com/2012/03/21/great-pain-video-understanding-pain-in-less-than-5-minutes/

I have just discovered the site http://saveyourself.ca It looks like it has loads of good stuff on and is the source for this video.

FIGURE 1 | Illustration depicting the predominant veins and sinuses involved in the craniocervical venous outflow. Venous narrowing is depicted at locations of interest in chronic cerebrospinal venous insufficiency. http://www.frontiersin.org/Endovascular_and_Interventional_Neurology/10.3389/fneur.2011.00044/full

Illustration depicting the predominant veins and sinuses involved in the craniocervical venous outflow. Venous narrowing is depicted at locations of interest in chronic cerebrospinal venous insufficiency. Lazzaro M.A. et al (2011)

‘Recent reports have emerged suggesting that multiple sclerosis (MS) may be due to abnormal venous outflow from the central nervous system, termed chronic cerebrospinal venous insufficiency (CCSVI).’

Lazzaro M.A. et al (2011)

http://www.frontiersin.org/Endovascular_and_Interventional_Neurology/10.3389/fneur.2011.00044/full

This is a very exciting article on the how venous outflow could be implicated in MS. The diagram above shows the sites the researchers have identified as being restricted.

There is a long tradition in cranial work of supporting drainage from the head by working at the thoracic outlet (or inlet, depending on what term you prefer, both are used for the same area). The first craniosacral therapist I ever saw would always start at the thoracic outlet, maybe he was on to something.

In the thoracic outlet hold the hands are above and below the base of the neck – upper hand spread over  the suprasternal notch, first rib and clavicles, the lower hand underneath the the cervical thoracic junction. I like to try and feel the shape of the hole made by the first rib and orient to the health of all the tubes moving through the region (dural tube, oesophagus, trachea, carotid sheaths). Pulsing arteries softening, spreading of the fascia sheets, easing of the movement of C7 and a shift in the first rib and clavicles all speak of change in this region.

The image above includes drainage routes via ‘spinal column drainage route’, ‘pterygoid plexus’ and ‘vertebral vein’ that are fairly new to me – nice bits of anatomy to appreciate.

Another route for cerebrospinal fluid (CSF) to leave the skull you can consider is shown below. A significant amount of CSF drains as lymphatic outflow from the cranial cavity via the ethmoid (and to a lesser degree perineural spaces of cranial and spinal nerves) and is collected by the lymphatic vessels of the head and neck (Pollay 2010).

This research helped me appreciate the dynamics of the ethmoid and cervical lymphatics as important in fluid draining from the skull. Pollay also indicates that poor outflow of CSF is not good for the health of the nervous system.

A great image from Pollay 2010 showing the dual outflow system for drainage of CSF. Outflow is via both the arachnoid villi into the venous sinuses and the lymphatic outflow (mostly through the ethmoid via CN I)

A great image from Pollay 2010 showing the dual outflow system for drainage of CSF. Outflow is via both the arachnoid villi into the venous sinuses and the lymphatic outflow (mostly through the ethmoid via CNI olfactory nerve sheaths)

‘The lymphatic system has been shown to develop earlier than that of the arachnoid villi and therefore appear to be a dominant CSF outflow route in the late fetal and early neonatal period. There is convincing evidence that the arachnoid villi system loses it efficiency with age, which can influence the total turnover rate of the CSF with possible neurodegenerative consequences.’

Pollay 2010

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904716

See also this post for more on the venous outflow in cranial work

https://cranialintelligence.com/2012/01/19/working-with-the-venous-sinuses/

References

Lazzaro M.A. et al (2011) Endovascular therapy for chronic cerebrospinal venous insufficiency in multiple sclerosis. Front. Neur., 14 July 2011 | doi: 10.3389/fneur.2011.00044

Pollay, M. (2010) The function and structure of the cerebrospinal fluid outflow system. Cerebrospinal Fluid Res. 2010; 7: 9. Published online 2010 June 21. Accessed 2/10/12 via http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2904716

Massive ventricular enlargement, in a patient with normal social functioning(A) CT; (B, C) T1-weighted MRI, with gadolinium contrast; (D) T2-weighted MRI. LV=lateral ventricle. III=third ventricle. IV=fourth ventricle. Arrow=Magendie's foramen. The posterior fossa cyst is outlined in (D).

Massive ventricular enlargement, in a patient with normal social functioning
(A) CT; (B, C) T1-weighted MRI, with gadolinium contrast; (D) T2-weighted MRI. LV=lateral ventricle. III=third ventricle. IV=fourth ventricle. Arrow=Magendie’s foramen. The posterior fossa cyst is outlined in (D).

From article in The Lancet 2007 titled ‘Brain of a white-collar worker’

A 44 year old man presented to the doctor with a weakness in his leg. ‘His neurological development and medical history were otherwise normal. He was a married father of two children, and worked as a civil servant.’ On CT scan they found an incredible brain that is mostly ventricles.

Wild, how does that work?

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)61127-1/fulltext

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