WCW Blog

The Women Change Worlds blog of the Wellesley Centers for Women (WCW) encourages WCW scholars and colleagues to respond to current news and events; disseminate research findings, expertise, and commentary; and both pose and answer questions about issues that put women's perspectives and concerns at the center of the discussion.

"E" Is for Energy

EnergyBlog“E” Is for Energy

The Dopamine Reward System—Friend or Foe?

Dopamine is trending as the most popular neurotransmitter. And why not? There are days I think it rules the world or at least the day–to-day activities of my friends and family. The craving you have when you smell the coffee brewing in the morning—thank dopamine. That elation you feel throughout your body when you fall hopelessly and deeply in love? Again, dopamine. The thrill of a shopping spree at the mall, the desire for the second and third glass of wine at dinner. You guessed it, dopamine. Dopamine seems to be everywhere giving people a little rush of pleasure and energy when we need it most. So what’s the harm? It’s a natural, biologically based chemical that provides energy and motivation.

The harm is best understood by remembering the infamous rats in Skinner boxes back in the 1950s. Scientists put electrodes into the limbic system (feeling centers) of the rats’ brain and sent a little shock to the area when the rat entered a particular corner. The theory was that if the shock was unpleasant enough it would cause the rat to stay away from the corner. Enough shocks and the rat’s brain would wire the corner with the aversive stimuli. However, a strange and unexpected thing happened when the electrode was placed in the nucleus accumbens (a dopamine pathway that is part of the limbic system)—the rats did just the opposite. Instead of avoiding the corner, they went back to get the shock over and over and over again. Up to 700 times an hour! In fact, this was so compelling to the rats that they opted for the stimulation over food. The rats could not describe “craving “ to us, but certainly, the repetitive nature of their dopamine seeking made it clear that this was something they “needed” to do. The increase in motivation and energy that dopamine provides can be a good thing, but when your brain gets wired to compulsive behaviors that stimulate the dopamine reward pathway (addictions) then your life can be as out of control as the poor rat in Skinner’s Box.

blogpullquoteDopamineEnergySo dopamine itself is not the problem, nor is the dopamine reward system. Dopamine is simply the carrot on a stick designed to give a reward to life-sustaining activities like eating healthy food, having sex, drinking water, and being held in nurturing relationships so that you would keep doing these healthy things over and over again. The problem is how we stimulate the dopamine pathway. In an ideal world—one that understands the centrality of healthy relationship to health and wellness—the dopamine reward system stays connected to human connection as the primary source of stimulation. Unfortunately, we do not live in this ideal world. We live in a culture that actively undermines this precious dopamine-relationship connection. We raise children to stand on their own two feet while the separate self is an American icon of maturity. It is making us sick.

This disconnection is a set-up for addiction as we search for other sources of dopamine. The “other sources” look shockingly similar to the list of common cultural complaints—overeating and obesity, drug and alcohol abuse, consumerism, chronic hooking up. Not only do these addictive, destructive behaviors get paired to the dopamine reward system but they create a feedback loop of isolation that pushes people towards more addictions.

Without healthy relationships we each become like the rats in Skinners box—seeking dopamine from all the wrong places. Let’s rewire our brains for the healthy relationships and connections that reward us with positive energy and motivation.

Amy Banks, M.D., has devoted her career to understanding the neurobiology of relationships. She was an instructor of psychiatry at Harvard Medical School and is the Director of Advanced Training at the Jean Baker Miller Training Institute (JBMTI) at the Wellesley Centers for Women at Wellesley College. She is the author with Leigh Ann Hirschman of the forthcoming book, Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships (Penguin Random House).

 

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"R" is for Resonance

resonanceblog"R" is for Resonance

The Four R’s – Reading, ’Riting, ’Rithmetic, and Resonance

Do you have someone in your life that “gets” you? I do. My friend Angel and I see each other every six weeks or so but each time we get together I am struck by the resonance we share, the ability to jump back into a conversation as if no time has passed. How does that happen? When I heard about the discovery of mirror neurons I thought I had found the answer.

First discovered by accident in 1998 by scientists studying arm movements in monkeys, mirror neurons were originally described as individual, specialized brain cells with the sole purpose to help us “get” or read other people. They were thought to be unique among brain cells because of their ability to multitask—registering actions, feelings and sensations all in a single specialized cell. I loved this! My heart already believed that relationships were central to health and wellness and these mirror neurons could be the proof my brain needed to believe that humans are “hardwired to connect.” But, even as I was sharing the news with others, I felt a little worried. How could Angel and I click so easily when I struggled with many other relationships in my life?

Also, when I looked at my friends and family, I noticed I was not alone. Everyone I know has some variability in his or her capacity to read others and to be read. So, if we’re hardwired to connect, what explains the variability? Is people-reading something we learn how to do or are we blessed with the hardware to automatically understand what others close to us are doing or feeling? Turns out, it’s both.

As babies, we are born with reflexes to connect with others. Watch an infant for a few minutes and you can see the vast amount of energy devoted to connection. The wiggling and writhing invested in finding the nipple of a full breast, the waving of a tiny, unsteady hand in search of a finger to wrap around or the neck to grab hold of. These reflexes are a pretty good start for connection, but, are not nuanced enough to allow an infant to “read the room.” A baby may become fussy when held by a distracted, tense mother but could not “know” the mother arrived home from work exhausted and irritable after being up all night working on an important presentation.

Researchers are now describing a mirror neuron system rather than unique mirror neurons. This is a more complex, efficient, and coordinated wiring of existing of neural pathways that communicate the actions feelings, and sensations of those around us. It is the way these pathways become interconnected through experience that really counts in clicking with others and making sense of relationships. Imitation plays a key role. Each of us literally “knows” other people by mimicking them internally. This mimicking is concrete. If I watch you walk toward the door with your hand out, I “spontaneously and automatically “know you are going to open the door and leave. I do not need to ask. blogpullquoteResonanceDeep in my brain, the area in the prefrontal cortex that plans and executes the physical movement of walking out the door is being stimulated. Though I am not moving, the same nerve cells are firing. When you touch the door and pull your hand away quickly and shake it a little I “know” that the door was quite hot from the pounding sunshine on the glass. My somatosensory cortex that creates sensations fires and my hand feels a low-grade sense of heat and smoothness from the window window. That is added to the immediate mix of how I am reading your experience. And finally, you walk through the door and a large smile crosses your face as you fall into the arms of a loved one. In my brain and body the nerve signal has now traveled through the insula into my “feeling centers” in my body and I feel a similar joy and lightness. I “know” you are with someone you love. All of this has happened in the blink of an eye and without you sharing any of your experience with me. My brain and body uses itself as a template to have a shared experience with you and the closer our life experiences internally have been, the more resonant we feel.

But imitating is not the whole story. Grown-ups must name feelings and experiences accurately when you are little so that when you name them in others later they match. You fall down and skin your knee and your parent says, “Ouch, that hurts.” The pain in your knee and the tears running down your face are paired with being hurt. A friend knocks over your block tower and the energy surging through your body and the tension in your eyebrows and face gets paired with a teacher saying, “You feel angry because Tom knocked over your blocks.” It seems like an easy process except that many people don’t know what feelings feel like in their body. Even as adults, well-meaning parents can mislabel a child’s experience and potentially confuse the development of the mirror neuron system.

Here’s an example. Ten years ago my pre-school aged twins and I were in a terrifying accident. I had driven the one-mile route to school mindlessly for a couple of years. On this day, as we approached a four-way intersection, another van turned left and hit us almost head on. Both vans were totaled and immediately chaos ensued. The front airbags in our car deployed filling up most of the front seat and giving off a pungent, rubber smell; the engine hissed and sent water and steam spraying into the air. Within minutes the local rescue teams arrived en masse—fire, police, and ambulance sped to the accident with blaring sirens and lights. In the midst of the overstimulation, I crawled into the back seat and looked directly into the trusting, scared faces of my children and said, “Everything is fine”—a delusional thought if ever I had one. My son looked right back at me and said, “Everything is not fine, this is a bad accident. “ A reality check for sure, I immediately backtracked and agreed that it was a bad accident and that it was scary.

We develop these pathways for accurate reading in the context of being accurately read by others! When I tell my children everything is fine at the same time their bodies are registering that things are dangerous, their developing people-reading pathways are getting a mixed message. Done often enough, as is often the case with childhood trauma or domestic violence, and the person’s mirror neuron system wires in an inaccurate and confusing way. They drift into isolation as their capacity for resonance is diminished.

A cultural belief that human development should be towards increased levels of separation and individuation can create a mirror neuron system that is not accurate. If I am busy “hiding my feelings” from you for fear of being seen as weak or needy, or if I believe that being impacted by another person’s feelings or experiences diminishes my strength, then chances are my mirror neuron system is not getting the stimulation needed to develop the essential human capacity of resonating and reading others and being read. And the impact of this is far reaching. Human beings are built to be healthiest in mind and body when in strong connections with others. Connection and cooperation are part of the everyday lives of most people and a strong mirror neuron system is essential in each and every one of life’s negotiations. It is high time that we add the fourth “R” to the basic skills taught in education—reading, ‘riting, ’rithmetic, and resonance!

Amy Banks, M.D., has devoted her career to understanding the neurobiology of relationships. She was an instructor of psychiatry at Harvard Medical School and is the Director of Advanced Training at the Jean Baker Miller Training Institute (JBMTI) at the Wellesley Centers for Women at Wellesley College. She is the author with Leigh Ann Hirschman of the forthcoming book, Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships (Penguin Random House).

 

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"A" Is for Accepted

AisforAccept“A” is for Accepted

I was many things at ten years old, but one thing I wasn't was accepted. My family moved to a new town that summer—it was 1972—and on the first day of school when the school bell rang I stood in the middle of the girls’ line anxiously waiting to meet my new classmates. As I was studying my shoes I heard the laughter and the whispering, “What is that new boy doing in the girls line!” They were talking about me, well-dressed in boys clothing. I was humiliated, filled with shame, desperate to go back to my old school where people knew and accepted me. It was a long year of pain, accentuated by my teacher who routinely tried to force me to join the Girl Scouts.

This memory popped back into my mind when I first discovered social pain overlap theory (SPOT) by Eisenberger and Lieberman at UCLA. These researchers study the brain in social situations. They devised a clever experiment during which people were asked to join a virtual cyberball game on a computer screen. As the game progresses, the research subject is attached to a functional brain imaging machine. Now, being left out of a cyberball toss experiment where you do not even know or see the other players is nothing compared to my year of ridicule and ostracism in fifth grade, nor does it compare to the many forms of being socially rejected from bullying, to racism and homophobia, but still, this rather mild social exclusion told these researchers something very important: Being left out hurts most people. They feel uncomfortable, unsettled, irritated… distressed. The next step was to see what area of the brain was activated with this distress.

blogpullquoteAcceptedThis is where the story gets really interesting. The area that lit up when a subject was excluded is a strip of brain called the dorsal anterior cingulate gyrus (dACC). The dACC already had been mapped as the area of the brain that is activated when a person is distressed by physical pain. To humans, being socially excluded is so important that it uses the same neurological pathways used to register when you are in danger from a physical injury or illness. Remember the old saying, “sticks and stones will break your bones and names will never hurt you”? Not true. It should have been “sticks and stones will break you bones and names will hurt you too!”

The human nervous system has evolved to be held within the safety of safe relationships. When we drift away from our group or are pushed out, when we are ridiculed, bullied, or shunned it creates real pain. This happens to individuals within groups and to groups of people within the larger society. SPOT theory confirms that people who live in glass houses shouldn’t throw stones—but it also tells us that we all live in glass houses, we are all vulnerable to the pain of being left out. It is simply how we are wired.

Amy Banks, M.D., has devoted her career to understanding the neurobiology of relationships. She was an instructor of psychiatry at Harvard Medical School and is the Director of Advanced Training at the Jean Baker Miller Training Institute (JBMTI) at the Wellesley Centers for Women at Wellesley College. She is the author with Leigh Ann Hirschman of the forthcoming book, Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships (Penguin Random House).

 

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"C" Is for Calm--Four Ways to Click

blog1.5“C” is for Calm—Four Ways to Click

Twenty-five years ago, when I was studying the human nervous system in medical school, I learned that the body has an automatic system running in the back ground 24/7—the autonomic nervous system—like the system that runs in the back ground of your computer updating time and date without needing to be asked. I was taught that the autonomic nervous system had two branches with opposite functions. The sympathetic nervous system (SNS) keeps you awake, alert, and engaged in life when it is running at a steady level, while the parasympathetic nervous system (PNS) helps you relax and rejuvenate yourself after a period of activity.

In popular science the SNS and the PNS are associated with their most dramatic functions—the fight, flight, or freeze responses that are activated when a person is threatened. If a bear charges you on a hike or your boss yells at you at work, bam, your SNS fires causing energy and blood flow to be diverted to your large muscles, heart, and lungs. You automatically assess the situation and either gear up for a fight or run like hell away from the threat. On the other hand, if you come across a mother bear with her cubs and she is standing over you ready to pounce and there is nowhere to run or your spouse comes home drunk and mean again and has a history of attacking you, your parasympathetic nervous system might activate causing you to freeze and even fall on the spot as your heart and respiratory rate decrease dramatically and your body’s pain blogpullquoteFourWaystoClickkillers flood your system buffering the pain. Neither of these reactions are under your conscious control. You are automatically protected.

What happens, though, when what you are facing is a kind, welcoming face or your favorite pet? Do you need to then rely on conscious functioning, do you need to think about it before you act and engage? According to Stephen Porges, the answer is “non.” He has discovered a third branch of the autonomic nervous system—one he calls the smart vagus nerve—that innervates the muscles in the face, throat, vocal chords, even the tiny muscles in your inner ear. The smart vagus balances the SNS and PNS and gives us automatic responses to safety. Imagine meeting your best friend—chances are your mouth breaks into a smile, your eyebrows raise, and you tune in and listen a little more attentively. You share stories and maybe even eat a meal together. All of these activities stimulate the smart vagus nerve which travels to the heart and lungs and tells the SNS and PNS they are not needed. You feel calmer.

The capacity to feel calm in a healthy relationship is as natural and automatic as the ability to feel terrified in Friday the 13th. It is how we are wired. A culture that teaches “self-regulation” and finding comfort by standing on your own two feet over stimulates your SNS making it harder to recognize a healthy connection. In Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships you can evaluate your neural pathways for connection and strategize ways to rebalance your autonomic nervous system to help you feel responsive and less reactive in your healthiest relationships.

Amy Banks, M.D., has devoted her career to understanding the neurobiology of relationships. She was an instructor of psychiatry at Harvard Medical School and is the Director of Advanced Training at the Jean Baker Miller Training Institute (JBMTI) at the Wellesley Centers for Women at Wellesley College. She is the author with Leigh Ann Hirschman of the forthcoming book, Four Ways to Click: Rewire your Brain for Stronger, More Rewarding Relationships (Penguin Random House).

 

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Supportive Human Relationships: Often Overlooked in Our Search for Quick Fixes

OctABblogSupportive Human Relationships: Often Overlooked in Our Search for Quick Fixes

October 10th is Mental Health Awareness Day.

We live in a time of easy access and quick fixes. People expect to be able to stream a video in less than 60 seconds, to have the entire written history of the world at their fingertips, even to have a complete dinner delivered in under 30 minutes. Given the mind-numbing pace of life, perhaps I shouldn’t be surprised by my clients’ impatience and disappointment when I offer an antidepressant to treat disabling anxiety or severe depression that takes three to six weeks to kick in. Just 100 years ago they would be resigned to a life of tormenting melancholia. Sure, there are new treatments on the horizon that promise quicker response times. Maybe ketamine will be the Netflix of mental health treatment. Most people overlook the one thing that unequivocally helps our emotional and physical health--supportive human relationships.

The fact that healthy human relationships are central to all human growth and development is not self-evident in a culture that values and promotes separating from and competing with others as the pinnacle of maturity. But research now shows the blogpullquoteSupportiveRelationshipshuman nervous system is literally wired to function best when in healthy relationships. If you do not believe it, try a very simple experiment to see and feel the impact of healthy relationships on your mind and body. Close your eyes and think about a positive interaction you have had with a friend or partner. As you play it out in your mind, watch how your body changes. Most people describe an openness in their chest, a smile forming on their face, a lift in their mood. This simple visualization, something I call a positive relational moment, allows you to tap into the healing physiology of connection and changes your neural chemistry just as clearly as Ativan or Prozac--but with fewer side effects! In honor of National Mental Health Day, reach out to others, engage in healthy interactions, and build new positive relational moments. It is perhaps the ultimate win-win in this culture of competition.

Amy Banks, M.D., is the Director of Advanced Training at the Jean Baker Miller Training Institute at the Wellesley Centers for Women, Wellesley College. She is the author with Leigh Ann Hirschman of Four Ways to Click: Rewiring your Brain for Stronger, More Rewarding Relationships, forthcoming from Penguin Random House (Feb. 2015).

 

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Interdependency and Mental Health

Comforting Interdependency and Mental Health

May is National Mental Health Awareness month, a fitting time to be mindful of the suffering caused by mental illness. Even though I am a psychiatrist, working daily with people diagnosed with mental illness, I am stunned by the statistics on the incidence of mental illness. According to the National Institute of Mental Health in any 12 month period, 26.2 percent of adults are diagnosed with a mental illness. That is one in four adults who are experiencing disturbing and often debilitating symptoms--the constant distress of an anxiety disorder, the aching despair of a major depression, the terror of psychosis. The lifetime incidence of mental illness is over 50 percent. These statistics tell us that if you have not been diagnosed with some form of mental illness, someone you know and love has. When you go to work today or even out with friends in the evening, see if you can identify the one in four people who has a mental illness. Don’t be surprised to walk away thinking there are none in your group. Also don’t be surprised to find out that you are wrong.

blogpullquoteInterdependencySo, where are all the people with mental illness? From what I hear in my office, many are hiding and suffering in silence for fear of being stigmatized, pitied, or seen as weak. American, Westernized culture plays a large role in this fear. The pervasive image of an American is a person who is strong, independent, and can “make it” on his or her own. There is no direct media campaign telling people who have a mental illness to stay in the closet, but the chronic cultural myth of the “self made man” acts as a reference point from which we all measure our worth. The more dependent you are on others, the less value you hold. This cultural bias is insidious and contributes to an environment that makes each of us hide our vulnerabilities behind a wall of shame at not being strong enough to manage our day to day lives on our own.

The idea that we are stronger on our own is destructive, dangerous, and undermines our natural physiology that works best in healthy interdependency. Professor Emeritus at the University of British Columbia, Jilek Wolfgang, M.D., M.Sc. reports that people who develop a psychotic illness actually heal faster in a non-Westernized world. A stunning finding given that Western societies are known to have the most educated doctors and best hospitals in the world. So what accounts for the improvement? A lack of stigma. In the West, psychosis or the loss of reality testing is seen as the ultimate failure of individual strength. It is frightening and dangerous. On the other hand, in many parts of Africa, extended family and community reach out and embrace the individual with psychosis rather than fearing or shunning him.

Relational neuroscience offers some explanation for this finding. Researchers at UCLA, Eisenberger and Leiberman, have discovered that the pain of social exclusion is registered in the exact area of the brain, the dorsal anterior cingulate gyrus, as the pain from a physical illness or injury. Because humans are meant to function best in healthy human connection, this area of the brain fires an alarm for things that are life threatening. The chronic pain of an acute physical injury or illness can be lethal, but Social Pain Overlap Theory (SPOT Theory) tells us that being socially rejected is every bit as dangerous. When we stigmatize and ostracize people with mental illness we increase their stress levels, decrease their ability to fight illness, and prolong their healing process.  

The range of functioning in the people I treat everyday is tremendous--from CEOs capable of running a company while having a mental illness to individuals on disability unable to work because of severe symptoms. Almost every person I see is hiding their diagnosis from at least one important person in their lives out of fear of the anticipated rejection. In this month of May let’s all open our eyes and our hearts to see and embrace someone with a mental illness and to support those who are suffering knowing full well that statistics show having a mental illness is not an individual failure nor a weakness. Mental illness is, well, an illness and the best hope for a speedy recovery is the support of extended families and friends. This cultural shift from pathological independence to healthy interdependence holds the power to heal many wounds and to improve the lives of all of us who will experience the pain of mental illness.

Amy Banks, M.D. is the director of Advanced Training at the Jean Baker Miller Training Institute at the Wellesley Centers for Women, Wellesley College. Over the last ten years at the JBMTI, she has been integrating emerging neuroscience information with relational-cultural theory.

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Alison Akant
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