The Body: A Guide for Occupants

Bill Bryson

Bill Bryson is a talented communicator who has written about travel, language and science and manages to insinuate humor to increase the reader’s pleasure and to inject emphasis which makes facts more meaningful and memorable. The Body is his latest book which would make a wonderful Christmas gift for any curious readers on your list. Instead of attempting a review, I will include two excerpts as examples.

“The great paradox of the brain is that everything you know about the world is provided to you by an organ that has itself never seen that world. The brain exists in silence and darkness, like a dungeoned prisoner. It has no pain receptors, literally no feelings. It has never felt warm sunshine or a soft breeze. To your brain, the world is just a stream of electrical pulses, like taps of Morse code. And out of this bare and neutral information it creates for you – quite literally creates – a vibrant, three-dimensional, sensually engaging universe. Your brain is you. Everything else is just plumbing and scaffolding.”

“Just sitting quietly, doing nothing at all, your brain churns through more information in thirty seconds than the Hubble Space Telescope has processed in thirty years. A morsel of cortex one cubic millimeter in size – about the size of a grain of sand – could hold two thousand terabytes of information, enough to store all the movies ever made, trailers included, or about 1.2 billion copies of this book. Altogether, the human brain is estimated to hold something on the order of two hundred exabytes of information, roughly equal to “the entire digital content of today’s world,” according to Nature Neuroscience. If that is not the most extraordinary think in the universe, then we certainly have some wonders to find yet….”

“There is a huge amount we have left to learn and many things we may never learn. But equally some of the things we do know are at least as amazing as the things we don’t. Consider how we see – or, to put it slightly more accurately, how the brain tells us what we see.”

“Just look around you now. The eyes send a hundred billion signals to the brain every second. But that’s only part of the story. When you “see” something, only about 10 percent of the information comes from the optic nerve. Other parts of the brain have to deconstruct the signals – recognize faces, interpret movement, identify danger. In other words, the biggest part of seeing isn’t receiving images; it’s making sense of them.”

“For each visual input, it takes a tiny but perceptible amount of time – about two hundred milliseconds, one-fifth of a second – for the information to be processed and interpreted. One-fifth of a second is not a trivial span of time when a rapid response is required – to step back from an oncoming car, say, or to avoid a blow to the head. To help us deal better with this fractional lag, the brain does a truly extraordinary thing: it continuously forecasts what the world will be like a fifth of a second from now, and that is what it gives us as the present. That means that we never see the world as it is at this very instant, but rather as it will be a fraction of a moment in the future. We spend our whole lives, in other words, living in a world that doesn’t quite exist yet….”

All the richness of life is created inside your head. What you see is not what it is but what your brain tells you it is, and that’s not the same thing at all.What Bill Bryson does not say is that much of this function is learned though experimentation and experience disguised as play and we all learn a little differently.

For More:

Action in Perception

The River of Consciousness

Vision Therapy Changes in the Brain

            Everything that we learn changes our brains, but brain imaging is now able to show which areas of the brain change and how they change. The research described in the link below evaluated successful patients, pre- and post- vision therapy, matched with patients who did placebo therapy. The imaging (functional magnetic resonance imaging) confirmed which areas of the brain became more active and which areas became less active. These changes in brain efficiency enable improved ocular motor skills, improved attention, and reduced symptoms.

            Most visual problems which affect reading and learning are functional. The eyes and eye muscles are healthy, but they do not function efficiently. Focusing, tracking, and keeping two eyes precisely aligned are our fastest and most precise motor skills and are controlled by the brain. These ocular motor skills coordinate with cognitive processing. By enhancing brain efficiency, vision therapy develops more accurate and automatic vision. Vision therapy improves foundational visual skills and the processing of visual information.

            The visual condition used in this research was convergence insufficiency, the most common functional eye teaming problem. Convergence (aiming both eyes inward to have binocular vision at near) is not an isolated function. Most people with convergence insufficiency also have difficulty focusing and tracking. It is just one way in which the visual system does not develop adequately or becomes dysfunctional due to prolonged visual stress. Other functional visual conditions are treated similarly with comparable outcomes. Further research based on this study may reveal more about how vision and attention are linked in the brain and contribute to the continuing evolution of increasingly effective therapies.

            Vision therapy has been developing visual skills for many years; since 1941 in our office for example. Brain research and the associated technologies were primitive then by today’s standards. As vision therapy has evolved, it is a reminder that clinical observations and methodologies are typically in advance of research.

https://covdblog.files.wordpress.com/2018/12/2018_widmer_mri-after-vt-for-ci.pdf

For More:

Tracking

Visual Intelligence

Crowding

Visual Factors in Reading

Plasticity in Sensory Systems

2011 International Conference on Plastic Vision

Edited by Jennifer K. E. Steeves and Laurence R. Harris

The term “plasticity” in neuroscience means that the brain can change and discoveries over the last couple of decades have proven that we retain a degree of neuroplasticity into old age. This volume is a collection of papers from the presentations at the meeting. None of the scientists are optometrists but all of their research relates to vision development and vision therapy. Visual skills and the processing of visual information develop through experience and can be modified through directed, intensive rehearsal. This happens as people improve at a craft, hobby, music, art, job, or sport. Visual skills and visual processing can also be developed through vision therapy. The following excerpts are taken directly from the scientific papers.

This revolutionary finding indicated that critical periods are not, in fact, critical and that the brain is not, completely hard wired in adulthood.

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Up to now I have neglected the most frequently occurring learning of visual patterns that has no evolutionary significance: reading. The presentation of visual letter strings is associated with activity in a region referred to as the visual word form area (VWFA). Given the lack of evolutionary significance, the mere presence of a region found only in literates is already suggestive of an important role for learning. The responses of the VWFA are indeed modulated strongly by manipulations of expertise. Strikingly, the VWFA can still develop in adulthood. This was demonstrated by comparing illiterates with literates that learned to read as adults (Dehaene, et. al., 2010). Reading in the Brain: The Science and Evolution of a Human Invention

In this study, we seem to have many factors coming together – as is predicted given that informativeness is related to the many maps that together make up the organization of the visual object representations: bottom-up shape characteristics matter, the cognitive processes involved during training matter, and top-down task factors matter. We divide vision into ocular motor skills and perception to aid understanding, testing, and communication. But ocular motor skills (tracking, aligning, and focusing) and visual perception cannot really be divided. When children have visual perceptual problems, we expect them to also have ocular motor problems since the development of perception is dependent on the intake of consistent, accurate information which, in turn is dependent on accurate eye movements and clear, single vision. And enhancing their ocular motor skills is dependent on visual attention and the processing of feedback. One of the most basic examples is what is known as visual crowding. Is having difficulty counting these lines / / / / / / / or these lines /////// a tracking problem or a perceptual problem? To count them, you need very good control of your eye movements. You also need to see more than one line at a time to keep your place which requires the integration of information across your visual field which is a fundamental perceptual skill.

Directing the eyes to a target prior to initiation of hand movement allows the central nervous system to obtain a high-resolution image of the target before the reach is initiated, which can facilitate programming of the reaching movement. In addition, when the eyes fixate on the target early during the trajectory, visual feedback can be used to update the initial motor plan…. In contrast, patients with mild or severe amblyopia initiated reaching prior to directing the eyes to the target in significantly more trials when viewing with the amblyopic eye. This behavior is not limited to children with amblyopia and is commonly seen in children with learning-related vision problems and in those who are viewed as clumsy. These poorly learned skills can be enhanced with commensurate outcomes in performance.

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The accuracy and precision of our movements depend on our ability to predict the consequences of our own actions and use sensory feedback. In directing movement, vision is actually predicting the future. The ways that you use vision to do this are endless. As examples, consider how vision functions to enable you to catch a ball or to drive a car.

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Robert Hess presented a very unusual scientific paper. Hess was mentored by Fergus Campbell and in the 1970s they developed a device based on sound theory to treat amblyopia. (We purchased one right away and used it for a number of years in vision therapy.) Hess discusses the device with a perspective and humility which is refreshing. This was the beginning of the CAM treatment of amblyopia which was to have an interesting, if not checkered, history over the next 40 years. The device consisted of a rotating wheel with stripes which were designed to stimulate edge detectors in the visual system. Edge detectors were discovered by Hubel and Weisel which changed the course of neuroscience and won them a Nobel Prize. To maintain the child’s attention on the wheel, the children did tasks such as “naughts and crosses” on a piece of plastic in front of the rotator. Subsequent research demonstrated that it was the minutes of engaged eye-hand coordination which improved the visual function in amblyopia, not the rotating stripes. The device worked, but for a serendipitous reason. In recent decades, numerous studies have shown that a range of visual functions in normal adult subjects can be improved as a result of intensive training (termed perceptual learning).

Hess goes on to write: It has long been assumed that the primary problem in amblyopia is monocular loss of vision and that loss of binocularity is a secondary consequence. The traditional treatment is patching, which is directed to restore the vision in the amblyopic eye with the assumption, using the preceding logic, that binocular function will eventually follow suit. Patching does have a level of success, although, at a cost in terms of a child’s social and emotional development. However, the binocular expectation is often not realized, and one is tempted to think that keeping a child monocular for a significant part of early visual development may not be the ideal way of going about restoring binocularity.

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Sue Barry is a neuroscientist who successfully became binocular with stereopsis for the first time at age 48 through vision therapy. This was assumed to be impossible by the scientific community and most of the medical community. She states: We must ask whether poor success in establishing binocular vision in adult strabismics and amblyopes has resulted, not because of irreversible changes in neural circuitry, but because standard clinical treatments do not address the underlying causes of these disorders…. The underlying problem in amblyopia is not poor acuity in one eye but rather a poor ability to use the two eyes together…. Surgery for the human patient is an entirely passive experience. Although an operation may reorient the eyes in the sockets in a way that makes fusion more likely, it does not teach the patient how to fuse…. Active learning must be involved. 

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RightEye: Computerized Assessment of Eye Movements

Visualization

Function alters Structure = Plaslasticity

The Power of Play

On Pluto: Inside the Mind of Alzheimer’s

Greg O’Brien

It is important to know the numbers and the facts that are known about Alzheimer’s, but Alzheimer’s is not best understood by facts. It is best told as a story.

For those of you who have read Still Alice by Lisa Genova, it is a novel which enables the reader to experience Alzheimer’s from the patient’s perspective. On Pluto goes further. It is Greg O’Brien’s personal story; bravely told, humble, and skillfully written. Since Greg’s mother was in the middle and end stages of the disease while he was in the early stages. It also presents what it is like to be a family member and caregiver.

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O’Brien’s mother and maternal grandfather died of Alzheimer’s. O’Brien is a reporter and a talented writer. As a reporter, he started to take notes early in his disease. It is difficult to believe that someone could write this story about themselves and even more difficult to imagine that it could be written with humor, but he does. He opens up what it is like to be him in an attempt to bring the disease out of the shadows; to try to get people to discuss it as they discuss cancer which people would not discuss decades ago and tended to use the euphemism “the big C”; To get people to take it for what it is and to push for research to find a cure for this monster.

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“Boomers will drift, facing an unimaginable epidemic of Alzheimer’s and related dementias, in projected numbers seven times greater than cancer or heart disease, whose critical research funding starkly outpaces Alzheimer’s tenfold. p. 13

“But I crave the simple touch – an earnest smile, a hug, a touch of the hand – far more than a medical prescription or a clinical trial. A simple touch increases body awareness and alertness for those with Alzheimer’s, and reduces feelings of confusion and anxiety.” p. 26

Helping hand

“It is vital for those with Alzheimer’s to connect with the past, the long-term memories and relationships. The short term is a flash.” p. 137

“I’ve come now to understand that Alzheimer’s is not about the past – the successes, the accolades, the accomplishments. They offer only context and are worthless on places like Pluto. Alzheimer’s is about the present and the struggle, the scrappy brawl, the fight to live with a disease. It’s being in the present, the relationships, the experiences, which is the core of life, the courage to live in the soul.” p. 195

dementia-umbrella

The Brain That Changes Itself

Memory Book

Howard Engel, 2005.

Memory Book by Howard Engel is the most recent of his Benny Cooperman detective novels. In addition to being a good mystery, the protagonist solves the mystery after suffering a head injury which creates alexia sine agraphia, i.e., he can write but he cannot read. The stimulus for Engel writing this book is his own stroke which produced the symptoms of his protagonist and the rehabilitation experience.

In addition to having problems with reading, Benny has other problems with memory, working memory, visual perception, and is easily overstimulated. He explains how it feels to try to think when his brain does not work as it did. He has difficulty focusing on one thought no less juggling multiple thoughts. We don’t realize how often we keep more than one thought in working memory to be able to function adequately and problem solve when it is happening automatically. Cars that are far away look smaller. Pieces of paper blowing randomly in the wind create confusion. Going outside when it is warm has a much greater influence on his function than it did prior to his head injury. He must sleep a great deal.

Oliver Sacks contributed an Afterward to the book in which he states: “Normally the perception of letter clusters, syllables, or words, as well as inferences and hypotheses based on such perceptions, are instantaneous and automatic, so that we read fluently and swiftly, able to attend to the meaning (and perhaps the beauty) of written language, unconscious of the innumerable cues and inferences that make this possible.” and: “Engel’s weeks in the rehabilitation hospital thus proved to be a neurological revelation as to how the mind works and how seemingly automatic processes can fall apart and have to be reconstructed in other ways.”

The book is 250 short pages and doesn’t take more than a few hours to read. Besides being a good read, it provides insight into some of the processing problems we all have and what it is like when those problems are greater.

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Howard Engel

A Causal Link between Visual Spatial Attention and Reading Acquisition

Book Review: Active Vision:The Psychology of Looking and Seeing

A Skeptic’s Guide to the Mind

What Neuroscience Can and Cannot Tell Us About Ourselves

Robert A. Burton, MD

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Science cannot explain everything about the mind and the author doesn’t believe that it ever will. The long-standing nature-nurture controversy is now called epigenetics; the study of how genes are expressed due to the interactions of genetic predispositions with the environment and experience, but the temptation for some to believe that it is all in the genes is difficult to put to rest.

 

Since the Decade of the Brain (1990s), information from small studies is extrapolated beyond reason. These extrapolations are usually by the press to make a more interesting story and, after numerous repetitions, it is only the extrapolations that are remembered and perpetuated. Believing that we know more than we do can cause harm. The examples in healthcare over the last century abound. Research on the brain is fascinating but this research doesn’t explain how to improve function; how to become a better reader, teacher, therapist, or how to become a better person. Many philosophical questions about life will not be answered by science and will always be important to how we live and how we value life. Consider the following from Dr. Burton…

Our brains possess involuntary mechanisms that make unbiased thought impossible yet create the illusion that we are rational creatures capable of fully understanding the mind created by these same mechanisms.

We live in an ever-more-speedy environment where information passes as wisdom and the need for public recognition often trumps caution and confirmation.

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Successful motor behavior is dependent upon continuously updated subconscious calculations…. Neuroscience has suggested that planning and predicting motor movements is the primary reason for having a mental life…. All motor behavior is the execution of some motor plan…. Brains are limited to organisms that move.

Most of the time you are not aware of what you are doing. What you are aware of is what you intend to do. As long as your intentions are fulfilled, you are not aware what movements you are actually making.

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Consider a recent study on the genetics of attention deficit hyperactivity disorder (ADHD). Scientists from Cardiff University found a genetic difference between two groups of children – a normal control group and a group diagnosed with ADHD. According to the lead author, a professor of child and adolescent psychiatry, “Too often people dismiss ADHD as being due to bad parenting or poor diet. As a clinician it was clear to me this was unlikely to be the case. Now we can say with confidence that ADHD is a genetic disease and that the brains of children with this condition develop differently to the brains of other children.” The authors argue that the study proves that gene differences cause ADHD. The actual data: fewer than one-fifth of the 360 children with ADHD had a particular genetic variant, while more than four-fifths didn’t. After reviewing the same data, others with equal background and expertise have come to an opposite conclusion – most ADHD must be caused by non-genetic factors.

Is It All In Your Head?

ADHD Nation Children, Doctors, Big Pharma, and the Making of an American Epidemic

The Mislabeled Child

Movement helps children with “ADHD” maintain alertness

Attention is intention.

We are not aware of the actual mechanics and steps involved; the nuts and bolts of cognition occur in utter silence in out-of-sight synapses and neuronal connections.

Ignorance more frequently begets confidence than does knowledge. Charles Darwin

As history has repeatedly warned us, reductionist statements about the genetics of human behavior carry an enormous potential for misuse and abuse.

There are no mind measurements; there are only stories derived from scientific data and filtered through personal perceptions.

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Is It All In Your Head?

Suzanne O’Sullivan, MD

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Suzanne O’Sullivan reveals the power of mind-body connections through the enigma of psychosomatic illness. She is a neurologist, and while the treatment of this condition falls under the purview of psychology and psychiatry, the neurologist must first prove that there is not an organic explanation for the illness, have the patient accept the diagnosis, and convince them to engage in cognitive behavioral therapy.  Pharmaceuticals are not effective. The patient has real symptoms which convince them that it is an organic disease. “It can be very difficult for a patient to accept that they suffer from a conversion disorder (a medically unexplained neurological symptom) when that assumption is based entirely on what is missing.” Psychosomatic illness threatens an individual’s image of themselves and they fear that they will be perceived as being weak.

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Suzanne O’Sullivan introduces the book with a discussion of blushing. “Blushing is an instantaneous physical change seen on the surface but reflecting a feeling of embarrassment or happiness that is held inside. When it happens, I cannot control it.” This leveler helps us to be more open about psychosomatic illnesses and understand that; they are real; they are no more a weakness than is succumbing to an organic illness; the patient cannot control them; their conscious mind wants to get better; it can happen to any of us. Somatization (a bodily response to a psychological effect) is usually benign, of short duration, and does not become an illness. Examples are trembling hands, perspiration, butterflies, shortness of breath, and laughing. “A psychosomatic illness is the body’s physiological response to stress. They serve a purpose even if that purpose is not always obvious.” The stress is not recognized because the subconscious moves the stress to the body. The person feels that they have handled the stress or may not even have recognized the degree of stress.

“Illness is not the same as disease. Illness is the human response to disease. It refers to the person’s subjective experience of how they feel but does not assume an underlying pathology. Illness can be either organic or psychological.” “Approximately 70% of the people referred to me with poorly controlled seizures were not responding to epilepsy treatment because they did not have epilepsy. Their seizures were occurring for purely psychosomatic reasons.” “The effect the psyche can have on the physical self has long been observed, but for all that time, scientists and doctors have also been trying and failing to understand how it occurs.”

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We cannot live without stress. Positive stress motivates us (see The Upside of Stress). It is stress that continues and that we are impotent to relieve that causes changes in our brains. To balance the stress in our lives, we must maintain our resilience. One concern that I have is that I see an increasing number of children who are anxious. We went from the extreme of everyone receiving a reward because they participated, to accelerated curricula and the majority of “play” being on organized teams. Children have little free time, supervised from afar, whose importance in development is overlooked. Children need time for unstructured play; to daydream, relax, and decompress; to solve problems of their own or with peers; to imagine; to figure out how to occupy themselves other than an addiction to electronics; to create; and to learn from errors of their own choosing. (see What If Everyone Understood Child Development and How to Raise an Adult)

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Worried Sick

Behavioral and Emotional Problems Associated With Convergence Insufficiency in Children: An Open Trial 

Welcome to Your Child’s Brain