Richard G. Petty, MD

Dogs, Infants and Imitation

Human beings have a remarkable ability to be able to understand the goals and intentions of others. This ability develops gradually during infancy and early childhood and is known as the theory of mind. This ability seems often to go wrong in people with autism spectrum disorders and schizophrenia. Psychologists have tended to think that this is a purely human ability, yet every one who spends a lot of time with animals is sure that they have a similar ability.

New research from the University of Vienna and the University of Budapest, have found striking similarities between humans and dogs in the way they imitate the actions of others.

The researchers were examining a phenomenon known as "selective imitation." Dogs were given the task of opening a food container by pulling a rod.  Normally dogs prefer to use their mouths for this kind of task, but a female dog was trained to open the box with her paw. When the other dogs watched how she did it, they imitated her to get the food. But the dogs only imitated selectively.

When the “training dog” used her paw while holding a ball in her mouth, they used their mouths instead of their paws for manipulating the rod. But when the demonstrating dog's mouth was free, the dogs once again imitated her and used their paws.  This implies that they assumed that she was only using her paw because her mouth was otherwise occupied.

It also indicates that dogs are like human infants in that they do not simply copy an action that they observe, but they adjust the extent to which they imitate depending on the situation. Neither dogs nor humans blindly copy what another creature is doing: they copy what is appropriate for the task at hand. The research has just appeared online in the journal Current Biology.

After their millennia of association with humans, dogs may be a special case. But I doubt it: this is yet more evidence that the gap between animals and humans is shrinking much more rapidly than many of us realize.

Industrial Chemicals and Autism

There is an exceedingly important article in this week's issue of the Lancet, that has not yet received the attention that it deserves.

I have time and again discussed the extraordinary burden of artificial chemicals now born by the human body. None of which was present 100 years ago. It is not rocket science to ask whether this toxic burden may have soething to do with the the rise of many neurological and psychiatric illnesses, given the sensitivity of the growing brain to any kind of environmental insult.

The article, entitled "Developmental Neurotoxicity of Industrial Chemicals," is written by two senior academics from Denmark who also hold positions at the Department of Environmental Health at Harvard School of Public Health, the Departments of Community Medicine and Pediatrics at Mount Sinai School of Medicine in New York.

What they say is this. The report begins by saying that neurodevelopmental disorders such as autism, attention deficit disorder, mental retardation, and cerebral palsy are common and can cause lifelong disability. Indeed, 1-in-6 children has a developmental disability, which mostly affect the nervous system. The causes of these problems are largely unknown.   

Secondly, the prevention of neurodevelopmental disabilities is hampered by the great gaps in testing chemicals for developmental neurotoxicity and the high level of proof needed for regulation.

Next, the list of potentially damaging chemicals is extremely long. A few industrial chemicals  are recognised causes of neurodevelopmental disorders and subclinical brain dysfunction, for instance methylmercury, arsenic and lead. we simply do not know how manyother chemicals may affect the brain. Exposure to these chemicals during early fetal development can cause brain injury at doses that are much lower than those affecting adult brain function. Recognition of these risks has led to evidence-based programmes of prevention, such as the gradual elimination of lead additives in petrol. Although these prevention campaigns have been highly successful, most were initiated only after substantial delays. Another 200 chemicals are known to cause clinical neurotoxic effects in adults. That being the case, since the young brain is so much more sensitiv, we can only assume that many of these chemicals must also be dangerous to the fetus, baby and growing child.

This article is published at the same time as an investigative report in the National Geographic. The magazine paid $15,000 for a reporter to have a full toxicological analysis, and if you have any doubts about toxins, I would urge you to read the article.

As a side bar, many clinical practitioners offer different kinds of toxicological analysis based on hair, skin, blood or electrical testing. Some years ago we looked into many of these methods using confirmatory analyses using a full scale research laboratory at Northwick Park Hospital in London. We found very poor correlations between the results obtained by the laboratory and three labs doing hair and blood analysis. I'm sure that some labs do a good job using hair and other types of analysis for a good deal less than $15,000. But It's good to be a little cautious before relying too much on some of these unorthox evaluations. Just ask the lab to give you the methods that they use, the standard errors of their testing, their false positive and false negative rates, and how often they get their results checked by an independent laboratory. Then you can be confident that you or your practitioner is using a good one.

The conclusion from all the published literature, some of which is summarized in the Lancet?

Environmental toxins are there, growing and they may be responsible for the catstrophic rise in some neurodevelopmental disorders, in particular autism.

We probably have enough empirical evidence toadvocate some serious cleaning up of the environment, which will likely only happen once people begin to vote with their feet. Governments are taking notice of global warming now that it is being suggested that it may damage national economies.

We need urgently to see whether, if the are present, we have - or can develop - viable methods for clearing these toxins from the human brain
and restoring normal structure and function.

Music Therapy

Music therapy has been in use for millennia: in the Bible David played his harp to try to ease the suffering of King Saul and there are whole systems of musical healing in the traditional healing systems of China and India. I have commented before on the extraordinary power of music.

Apart from our experience, there is an astonishingly large and diverse body of scientific literature on music therapy, not just to help individuals, but also on possibly improving the performance of health care providers. Many surgeons attest that they do a better technical job if they are listening to music.

This month’s issue of the British Journal of Psychiatry carries an interesting article about the value of music therapy in people with schizophrenic illnesses. Though small, it indicates that music therapy can be helpful, and speaks to the integrity of many components of the nervous systems of people with this large and diverse group of problems.

There is good evidence that music therapy may help with:

• Treatment-related distress in people having treatment for several cancers
• Autistic spectrum disorders 
• Calming people who are having cardiac catheterization procedures
• Pain relief 
• Distress after total knee replacement
• Pain after leg fractures
• Apathy in people with dementia
• Sleep and heart rate patterns in pre-term babies

This is by no means an exhaustive list: I have found several hundred studies, many of which are quite well designed. There are also several professional organizations such as the American Music Therapy Association.

It is clearly important to choose the right kind of music: I would guess that Metallica is less likely to soothe the fevered brow than Steve Halpern.

Background music can be wonderful for improving the ambience of your home or workplace. But you can also be more focused in your use of music to help or support other types of health and wellness programs.

Select the music that you like: there are now many wonderful programs geared toward using music for healing: I can give you a list of some that I have tested. The good ones will entrain your heart rate, some of your brain rhythms and the subtle systems of your body.

If you can find 20 minutes, the right music listened to while sitting or lying with your eyes closed can be as effective as a short meditation. For this to work well, it is best to use good quality headphones and to allow the music to wash over and soak you like a warm bath, while gradually slowing and deepening your breath.

I’ve also made extensive use of specifically chosen music during massage, acupuncture, yoga, and while practicing t’ai chi ch’uan and qigong. Some purists don’t like using music while doing these activities, but I’ve usually found that music can enhance each type of practice.

Try it and see what you think.

Body Posture and Memory

“Memory moderates prosperity, decreases adversity, controls youth and delights old age.” --Lactantius Firmianus (Roman Rhetorician often known as the "Christian Cicero,” A.D. 260-340)

The Ancients had many methods for remembering factual details: the best known were methods for associating memories with physical places, the columns in a theater, part of the body or body positions.

There a very interesting new study form Florida State University in Tallahassee that examined the impact on autobiographical memory of assuming the same (congruent) or different (incongruent) postures that the person held during the original event.

Response times were shorter when the subjects' body positions during memory retrieval of  were similar to the body positions in the original events than when the body position was incongruent. Free recall of the autobiographical events two weeks later was also better for congruent-posture than for incongruent-posture memories. This has theoretical implications for the idea of embodied cognition: that the environment plays a role in the formation of cognition, and perhaps also for the two other ideas:

1. That the body can hold memories and

2. Antonio Damasio's concept of the "somatic marker mechanism" that may provide the neurological mechanism for a crucial psychological concept: theory of mind.

Theory of mind refers to our ability to understand that other people have minds that have desires, beliefs and intentions that are separate form our own. Some experts believe that an inability to fully form a theory of mind underlies some of the problems in autism and schizophrenia.

The fact that specific body postures can be used to improve autobiographic memory may also be one of the mechanisms by which mudras, or symbolic gestures may activate memories and their associated feelings and states of consciousness.

This research follows a study that indicated something that you might already have noticed: positive thoughts are more easily recalled in the upright posture. Slouching tends to make you feel negative and to generate and recall negative thoughts. You may also have noticed how you, or the people around you become more still when they are concentrating on something. Research has shown that when people are successfully engaged in complex cognitive tasks, the normal swaying of their bodies is reduced. So what are we to make of all this? If you are trying to recall something that happened to you, adopting the same sort of posture may help your recall. Conversely, some body work to stop you getting into that same position may perhaps lessen recall. And physical stillness may help you focus if you have to engage in a complex cognitive task.

“To a mind that is still, the whole universe surrenders.”
--Chuang Tzu (Chinese Philosopher, c.369-286 B.C.E.)

Temperament, Depression, Class and Resilience

Within the first few weeks of life, infants show marked individual differences in their level of activity, their responsiveness to change in the environment and their irritability. Some clearly enjoy being touched and mold their bodies to the person holding them, while other stiffen and squirm and do less to adjust their bodies to another person. These mood-related personality characteristics are called temperaments. There is some evidence that temperament is one of the basic building blocks of the personality. Temperament appears to consist of inborn traits, but they can be modified by parental contact: there is actually a reciprocal relationship between child and parent. The child modifies the behavior and attitude of the parent.

It is commonly said that a child’s temperament is as fixed as handedness or eye color, but this is inaccurate: we have overwhelming evidence that temperament can be changed by environmental influences. This makes sense. In Healing, Meaning and Purpose, we discuss the implications of the new findings about genes in the brain: they do not so much determine behavior as predispose you to the way that you will handle the environment. An important questions is just how plastic is human temperament? To what extent can you overcome your genetic programming and early rearing? Some recent research has indicated that the environment of the first three years of life is not as critical to later development as we used to believe. But I think that it’s dangerous to read too much into this research. Early emotional deprivation may leave the deepest scars and also be associated with physical deprivation. If a developing brain is deprived of key nutrients, it is difficult to catch up later.

More and more research is finding key genes that contribute to temperament. There is important evidence from animal research that the temperament of infant female rats can predict life span in those who develop spontaneous tumors. It is difficult to extrapolate from that to humans, but it is a further demonstration of the incredibly subtle interactions between genes, the environment, behavior and physical illness.

Some important recent research has examined the impact of temperament on the clinical features of bipolar disorder and of ADHD and autistic spectrum disorders. As expected, people with ADHD reported high levels of novelty seeking and high levels of harm avoidance. Patients with autism spectrum disorders were low on measures of novelty seeking, they had little dependence on rewards and high harm avoidance. Cluster B personality disorders, the dramatic, emotional, or erratic disorders ones (antisocial, borderline, narcissistic and histrionic), were more common in people with ADHD and the other clusters A and C were more common in autistic spectrum disorders. This tells us that these tow clinical conditions can have some specific effects on the structure of temperament, and on the risk of developing specific personality disorders.

In a new study in next month’s issue of the Journal of Personality, Kati Heinonen and colleagues from the Department of Psychology at University of Helsinki, have found a correlation between adult pessimism and childhood temperament in low socioeconomic status (SES) families. It is no surprise to learn that children raised in higher socioeconomic groups have a more optimistic outlook on life. But this is what is interesting, and the thing that will launch a great many more studies. It was discovered that the effect of childhood socioeconomic status on pessimism tended to remain the same despite opportunities for socioeconomic fluidity. A person from a low SES childhood who moved upwards in status was less likely to be optimistic as an adult than someone from a high SES childhood who remained in a high SES environment. The inverse also held true, as people from a high SES childhood who moved downwards in socioeconomic status were more optimistic than those who remained in low SES. This indicates that children who had the chance to develop coping strategies during childhood and subsequently developed a sense of mastery and control that protected them in adulthood from the adverse effects of lower SES. By contrast children from lower SES backgrounds who are subsequently upwardly mobile may not have had the opportunities to develop those psychological resources. They are thus unable to benefit as much as possible from later experiences of success.

We already know that pessimism is related to physical and mental health, so this new study provides a critical link between socioeconomic status and long-term outcome. This is essential information for policy makers and for parents interested in helping children develop more effective coping strategies.

This research really proves that some of the excessive optimism of the self-help movement can sometimes be misplaced: just wanting something to be different does not make it so. If you had a lousy up-bringing in impoverished surroundings, it will make it more difficult to bounce back and learn essential coping skills.

More difficult, but not impossible.

Research on resilience has provided us with a great deal of information about developing mastery and coping skills in the face of being in a low SES, and we shall return to some of that work in the near future.

Technorati tags: Temperament Socioeconomic status Resilience Depression Attention deficit hyperactivity disorder Autistic spectrum disorders Personality disorders

Autism and Mirror Neurons

On November 28th, I made some comments about the discovery of "mirror neurons" in the frontal cortex that enable us to imitate other people. I have just seen a most interesting report implicating these cells in autism. The paper was published in the journal Nature, but click here for a good summary.

Autism, an illness that affects a person’s ability to communicate with others and to mount appropriate responses to environmental cues, is part of a spectrum of developmental differences, which run all the way from people who are severely disabled to people who function at extremely high levels. In recent years there has been renewed interest in the apparently linked disorder, called Asperger’s Syndrome. There has been a lot of speculation that some well-known high achievers have a form of it. We are always loath to describe something as an "illness, " unless there are strong grounds for doing so: some people’s brains are just wired differently. So perhaps the best criterion for calling something an "illness," is whether it is causing suffering. I was once cussed out by someone whom I had treated for a manic illness. He was as happy as a clam and was not suffering in the slightest. But he was causing great suffering to his wife and young children. And to fellow motorists, as he drove his car at extremely high speed down the wrong side of the highway.

Researchers from the University of California in Los Angeles found that some children with autism had less brain activation in a region in the frontal lobes that is involved in understanding another person’s state of mind. The degree of activation of the 'mirror neurons' in this region correlated with measures of social impairment. The children with the lowest activation had the most severe social impairment.

I do not doubt the value of this neurological approach to autism, but it is important to recognize that it is only a part of the picture. We also need to respect the importance of other ways of looking at an individual. As an example, using the Four Quadrant model developed by the philosopher Ken Wilber, we also need to consider not just the objective neurological aspect, but also the subjective, social an cultural aspects of a person. And each of these perspectives is irreducible: we cannot explain culture by neurons or how your liver works by an appeal to cultural dynamics.

So although studies like this are valuable in that they show that there is a neurological association with autism, and it is not the result of, say, bad parenting, they do not tell us the whole story. And we must not allow these findings to blind us to the other domains when we are working on coping strategies or treatments.

"I loathe the expression "What makes him tick." It is the American mind, looking for simple and singular solution that uses the foolish expression. A person not only ticks, he also chimes and strikes the hour, falls and breaks and has to be put together again, and sometimes stops like an electric clock in a thunderstorm."

--James Thurber (American Writer, 1894-1961)

Technorati Tags:  autism  Ken Wilber   More blogs about Mirror Neurons.