Vision publisher David Hulme recently interviewed Jeffrey Schwartz, professor of psychiatry at the University of California at Los Angeles and author of a number of books on brain research.
DH What are we to understand by the term neuroplasticity?
JS It means that environmental factors change how the brain works. If you take simple animals such as rodents and put them in an enriched environment, you can see that physical changes occur in the brain. This becomes really interesting in “self-directed neuroplasticity.” Humans have the unique capacity to take advantage of these rewiring mechanisms. People can learn to change how their brain responds to circumstances by focusing their attention differently. Focus of attention influences how the brain responds to phenomena, and those changes leave physical traces that you can see with brain imaging.
DH Has the concept of self-directed neuroplasticity been known for long?
JS No. In fact, I coined the term in my  book, The Mind and the Brain, which was co-authored with Sharon Begley of the Wall Street Journal. The explanation for how the mind can change the brain was first elaborated in collaboration with my physics colleague, Henry Stapp. It turns out that quantum physics has a very coherent way of explaining how attention can change how the brain works—how attention can hold functioning brain circuits in place.
What I did was to make a theoretical model to describe what was happening. It shows that in a condition where there are actually symptoms caused by known brain problems such as obsessive-compulsive disorder [OCD] or stroke, you can train people to respond in ways that have therapeutic results. You actually change the underlying wiring of the brain so that the problem is ameliorated.
Now, in a psychiatric condition where the primary problem has to do with thinking and emotional feelings, that really becomes important. In OCD, people get intrusive, unwanted thoughts. In the ’80s we took brain pictures that showed that the bottom of the front of the brain, called the orbital frontal cortex, was overactive, and that there was a gearshift mechanism that was broken in a structure called the caudate nucleus. We used this brain information to get people to understand better that the intrusive, unwanted thoughts were caused by a medical condition: it was a brain wiring problem that was causing them to get these ideas. That helped them to recognize even more clearly that these ideas had nothing to do with them. When they started to respond differently with that knowledge (which took training and effort), not only did their clinical condition improve, but they also changed the underlying brain wiring pattern in the orbital frontal cortex and the caudate nucleus. So the way you think about your situation, and the way you respond, and the effort you make to focus your attention differently based on knowledge, literally rewires how your brain works.
DH How does this compare with the use of negative reinforcement to treat compulsive disorders?
JS Well, that never really worked. But there were other behaviorist approaches that were very effective, using a method called “exposure and response prevention.” My difficulty with that was that it didn’t take advantage of people’s capacity to recognize that the symptoms are false messages from their brain; that the symptoms are really just caused by a medical condition. The mechanical behavioral interventions that behaviorism used, while effective, required the person to go through a lot of anxiety, so they were extremely difficult for people to do on their own. I explained to people with OCD that they could respond differently to those intrusive thoughts and urges. That would not only change their brain, it also would empower them to not be a slave to their brain.
The word I use for the introspection part of the therapy is mindfulness —looking inside yourself with the rational, calm perspective of an outside, impartial, fair-minded observer. That allows you to get outside of the fear.
DH Mindfulness is a Buddhist concept. Are you a Buddhist?
JS No, I’m Jewish, but I am very serious about practicing Buddhist meditation. I’ve been doing it for going on 30 years.
DH How does your Jewish side connect with Buddhism? How do these two worlds come together for you?
JS On an ethnic level, I certainly view myself as Jewish, and that’s why I like to refer to the Buddhist side as more of a philosophy rather than a religious belief that might conflict with my Jewish identity. I view Buddhism as a scientific, philosophical practice and Judaism more as my core identity. The Buddhist philosophy is framed in a way that is very analytical and technically elaborated. I found explanations involving words like karma (which means “will”), mindfulness, wise, unwise and attention, and the fact that these kinds of wise and unwise attentions will very much influence the moral qualities that people act with. That isn’t unique to Buddhist philosophy. It is entirely consistent with things you’ll read in the Torah and the Talmud. The new thing was that Buddhism allowed an alignment with modern scientific psychology, and especially with brain mechanisms, because of the stress on introspective, mindful awareness and how much that kind of mental action could be applied in a systematic way.
What I found was that my very strongly believed Judeo-Christian moral belief system was not only consistently confirmed in the Buddhist moral system, but also that I now had a bridge to science. This has always been the culturally difficult part. Science has always been presented as amoral or empirical to the point of not making value judgments. The other thing that’s very interesting about Buddhist philosophy is that it has a strong mind-matter interaction component. It says that mind moves and affects matter, while also allowing, in a way that’s consistent with modern science, that matter can influence mind as well.
DH This takes you a long way from the traditional Cartesian approach within scientific thought.
"There's one huge problem with the Cartesian perspective: It views mind and matter as two separate things."
JS There’s one huge problem with the Cartesian perspective: It views mind and matter as two separate things, and that turns out to be a very bad mistake. Descartes set up two substances, mind and matter, and he tried to finesse a way to get them connected, but he never really did it very successfully. Matter is extended. You can hold it in your hand. Mind is immaterial; it’s experiential. Viewing them as separate substances, with science investigating the material, and religion and the spiritual being relevant to the mental side, really created an artificial split in Western civilization that has had negative implications. At the very least, it’s outlived its usefulness.
The advantage of this newer way of thinking, with self-directed neuroplasticity based in mindfulness—this quantum physics model of mind-brain relation—is that it does not take the perspective that mind and matter are two intrinsically different things. It views them as an integrable unified reality. The big advantage of quantum physics is that it answers the problem that Descartes (and the entire philosophical tradition for nearly half a millennium after Descartes) had never been able to address: integrating the terms we use when we describe our experiences—pain, pleasure, happiness, sadness, the sense of knowing, the sense of understanding, the sense that life has meaning. These are very real things. In fact, they’re the things that make life worthwhile. None of those kinds of terms are translatable into material terms. What the quantum physics allowed us to do was to show how, by taking a mental perspective and having it influence your focus of attention, you could literally hold the brain circuitry (the physical manifestation of the mental experience) in place. In the end, the common denominator of all our experiential reality is how we focus our attention. We choose what parts of our experience we focus on. We choose what parts grab us and take control of us, like greed or ill will; or on the other hand, we let them go by and focus on wholesome, community-oriented acts.
And that’s where neuroplasticity kicks in. We know that any repeated action causes the brain to rewire. It’s the same as Hebb’s rule: basically, brain cells that fire together, wire together. That’s all very well established science. Now, what we’ve done is simply show how focus of attention can get the brain circuits to fire together and then wire together; that’s the basic building mechanism whereby you restructure your brain. So this whole mind-brain dichotomy disappears, and what we have is an integrated view of mind-brain as one organically interacting spiritual-material unity.
“Basically, brain cells that fire together, wire together. That's all very well established science."
DH So no “ghost in the machine.”
JS That term was coined by [British philosopher] Gilbert Ryle in what he felt was a great fit of cleverness. It attempted to make it look like anyone who wasn’t understanding reality just from five-sense data was locked in phantasmagorias—some primitive, archaic way of thinking where you believe in ghosts. It’s the kind of thing that modern, scientifically oriented people aren’t supposed to believe in. Well, this is utter nonsense, because the thing that went out the window with “the ghost” was any concept of willfully directed attention.
The explanation I’m putting forward has nothing whatsoever to do with a ghost in the machine. It has to do with the fact that we all have conscious awareness and the capacity to focus that awareness. It’s the opposite of ghostlike; it’s as clear as the clearest sunshiny day. You can pick out things in your field of vision and focus on them; and you can certainly pick out behavioral choices and focus on those.
DH You say that your approach helps various maladies like stroke, Tourette’s Syndrome, tinnitus and dyslexia. Can we add depression and other maladies to the list?
JS Oh, absolutely! Especially now with mindfulness-based cognitive therapy. We should also add things like panic disorder and phobias. Another colleague, Mario Beauregard, has done some extremely interesting research in normal people, showing that we have the full capacity to turn off and on the sexual arousal systems in response to erotic stimuli just by emotionally distancing ourselves. In other words, we make choices about that too. I think we can use that to teach younger people about sexual abstinence training.
DH You used the word spiritual a few minutes ago. That’s unusual for a scientist.
JS It is, but I don’t think it needs to be. That’s a cultural phenomenon that needs to change. It’s important to stress that it wasn’t always so by any stretch of the imagination. If you go back about 125 years, before science really got caught up in this cult of materialism, scientists were perfectly comfortable to talk about the spiritual parts of their nature, even though they might say, once they walked into the laboratory, that they weren’t exactly sure about how to address those questions in a scientific context. But we’ve made advances, because when I talk about spirit, I’m not talking about ectoplasm. I’m simply talking about practical, willful action. When I talk about spiritual practice, I’m talking about the fact that belief guides what we do. In that way, faith can be rational, faith can be experiential, faith can be verified to a greater or lesser extent. It’s certainly not a matter of blind faith.
When we strive to do good, that’s precisely what I mean by spiritual action. When I talk about spiritual truths, I simply mean that the human mind has the capacity to intuitively recognize that charitable, helpful, nongreedy, nonharming actions are wholesome actions. Actions that are based in greed and ill will and rigid ignorance are unwholesome actions. People know these things, and they also know that these kinds of truths have spiritual content, because they influence the way we direct our willful actions. So in that way it all becomes part of a broader scientific worldview.
DH In your book Dear Patrick, you speak to “recovering our souls.” What do you mean by this?
JS Just the sense that we are getting back to what we know is true about the distinction between right and wrong, between wholesome and unwholesome actions. We live in a culture that is relativistic and advocates that there is no such thing as moral truth. People have become disconnected from their inner sense that there is a moral reality. The elite secular culture of Western civilization, through the excessive pursuit of self-gratification, has lost contact with the basic truth that to live a happy life you have to have a core connectedness with moral truth. Does it take effort? You bet it takes effort. But we have this capacity for mindful awareness, for honest introspection, for asking ourselves, “Is what I’m doing here wholesome or unwholesome?” Without spending the effort to ask yourself that question, you can degenerate into living an animal life. One of my biggest problems with the way the materialist culture has gone is that it encourages people to view themselves as no different in principle than animals. It encourages people to follow physical pleasure as if that is some ultimate determinant of the difference between what makes life worthwhile and what makes it a burden. These messages have taken their toll, and young people are looking at their elders and saying, “You’ve given us a false set of values.” These false values are based on materialism. There’s been a lot of rebellion against that and a real return to spirituality among young people in the United States.
“People have become disconnected from their inner sense that there is a moral reality.”
DH Steven Pinker writes that the new discoveries in neuroscience explain what makes us what we are and also invite us to ponder who we want to be.
JS I only wish he would take that seriously, because he has a whole chapter in his book saying that determinism must be true. If determinism is true, what he’s describing is not going to have any efficacy. He’s trying to have it both ways. We, on the other hand, will take that quote at face value and say that we now know from quantum physics that you actually can do what he’s saying there and have it make a difference in how your brain works.
DH The Judeo-Christian tradition talks about repentance, the ancient Hebrew concept of introspecting and changing one’s way of doing something so that it’s a lasting change—which is really what repentance in its totality means. How does that play into what you’re talking about?
JS It’s a restatement of what I’m talking about! That is repentance properly understood! In this modern, secular society, there is a media elite culture that tends to view the word repentance as if it’s some leftover, guilt-laden practice from a benighted past. In the cynical modern age, they say “Never explain; never apologize.” That is a prescription for profound dissatisfaction. You cannot form trustful relations with others without acknowledging error, without sincerity. And repentance is just, when you get right down to it, a form of sincerity. It’s saying, “I realize I made errors. I’m not perfect. There are things I could try to do better.” The fact that a term like that has come to be viewed as part of some unsophisticated, retrograde morality that comes from without and disempowers a person is the tragedy of our age. It’s why we need to emerge from that materialist age, because that materialist age has nothing but ego to fall back on, and ego is just not enough to live a happy, fulfilled life.