Just the other day, I was debating the merits and downsides to counseling, psychology, psychiatry, and psychoanalysis with my husband; we explored the differences between the four as well as their work with patients dealing with depression, bipolar disorder, anxiety, and ADD/ADHD. It was probably the most interesting non-Christ focused discussion we had ever had, and it really got me thinking.
Back story: I have an insatiable thirst for knowledge about the human nervous system, especially the somatic (voluntary) and central (brain and spinal cord) nervous systems (I could care less about the autonomic/enteric nervous systems). My interest has taken me as far as to be the main instructor of Neurobiology at the Massage Therapy Institute I currently work at. This interest has introduced me to David Eagleman, whom I am extremely excited to read both his research based and fictional works. I will post later about my experience with this brilliant mind’s writings!
Ok, back to the crux of the issue. My husband and I came to one very pointed topic: the difference between those who have a chemical imbalance and those who have behavioural imbalances (yes, I spell behavioural with the European “ou” because I’m a Canadian!). I would like to flesh out – in the simplest way possible – how the brain works to give us cognitive function before describing the theories I propose.
The nervous system is made up of clusters of neurons (neuron = a nerve cell) that has a cell body (houses the ‘decision maker’ of a neuron), dendrites (little projections that sense changes around it and relay that information to the cell body), and an axon (a single projection that sends out an electrical signal from the cell body to communicate with another nerve, a gland, or a muscle). Neurons communicate with other nerves, glands, or muscles by sending little chemicals across a synapse (a small gap between structures) that fit like keys into a lock on the nerve, gland, or muscle it wishes to “speak” to. These chemicals can either open doors or make sure doors stay shut; depending on the door they open, certain ions (positively or negatively charged elements such as sodium) either enter or exit the cell. If positive ions are allowed into the cell in mass amounts, that nerve, gland, or muscle becomes excited and creates an action; for example, if a muscle cell is excited by positive ions flowing into it, the resulting action is a muscle contraction. If positive ions exit the cell through the opened door, then action is slowed or stopped, causing inhibition and means that if that cell needs to be excited, it takes longer.
Because my debate centered in the brain, we’ll focus on neurons communicating with other neurons. Inside the brain, there are millions of neurons and billions of synapses (communications), and millions of circuits (patterns of synapses). Think of it like a social network:
It’s a really neat concept to just think about. The example above is a miniscule portrayal of short term memory. Now, imagine that there were thousands of neurons in continuous communication, causing excitation and inhibition: now you’ve got the basic model of long-term memory and emotional memory.
Ok, so hopefully you’ve got somewhat of a basic understanding of how the brain works. Now, I would love to express the latest theories about emotions, memory, and logic, but that would take way too long! So, let’s get back to chatting about chemical versus behavioural imbalances in the brain.
During our debate, my husband was fairly irate about psychiatrists and doctors just prescribing medication to people who come in sad without doing any testing, or doing tests to find nothing wrong with the chemical makeup of their nervous system. We are both supportive of naturopathic medicine/healing, and only take medication when absolutely necessary. So, we delved into critical thinking about how to define the differences between those who have chemical imbalances that can be monitored and then supplemented with medication and those who show no chemical imbalances and need a behavioural shift in their brain. Hence the terms chemical and behavioural imbalance.
Someone with Bipolar disorder generally speaking will only be diagnosed if both a physiological/chemical imbalance is proven and a psychological examination comes back with a high probability of bipolar (bipolar, by the way, is a condition where someone goes through times of severe depression followed by high-energy, highly excitable episodes, and is an extremely serious condition that should be monitored and balanced with Medical supervision). I believe that anyone with this condition can have their chemicals balanced through the proper medication (unfortunately, it can sometimes take years to find the right balance of medication, and can change over the years). Psychologically, it is best for bipolar patients to have someone whom they trust, like a counselor, to be a listener and someone who can give tools to help balance the emotional struggles they have to endure (which, by the way, are far more difficult to handle with bipolar than without because many times the emotional reaction is exaggerated because of the chemical imbalance). One of the hardest things to deal with is the neuronal circuits that have been created from years of living with a chemical imbalance. Where someone without bipolar has created circuits that can overlook when someone forgets to bring back their favourite pen because they can reason that they can buy a new one or ask the person later, someone with bipolar may have an exaggerated response because the chemical imbalance causes more or less excitement in the neurons in the brain (you may see this person yelling/chasing after that person, getting unreasonably angry, or falling into a depressive state quickly). Along with the medication, they also have a feat of restructuring the neuronal circuits through extensive counseling, sometimes going so far as hypnosis. So, they not only have to deal with a chemical imbalance, they also have to retrain their physical brain and behaviours. Believe me, as someone who does not struggle with bipolar, it is a privilege to support those who do and an honour to be part of their life!
Now, behavioural imbalances by themselves can be extremely difficult to explain, and even more difficult to accept and work on as an individual. The best example I can use is abusive relationship victims. First, I do have to go into emotional and physiological memory for a minute. Because our nervous system is constantly developing until we reach around the age of 21, every experience from birth to 21 either creates or demolishes neuronal circuits fairly easily, and repetition matters. After 21, it becomes more and more difficult to retrain the communications in our brain, and in old age, it become easier to destroy circuits and memory because the nerves are slowly degenerating and dying off. So, learning something new is simple: new information in the form of words, pictures, emotional experiences, and influences of people, media, and nature is presented to someone. Long-term memory is the consistent presentation of this information creating neuronal circuits that are solidified in an area of the brain called the Limbic System. Repetition is the best proponent in creating long-term memory. It’s like starting up and running a business: there are certain processes and protocols that have to stay consistent for the business to run efficiently. Processes that work keep running; ones that do not work or cause disaster are stopped; ones that only serve a purpose once or twice are used then discarded. For example, a large corporation with many departments that receives mail needs a mail carrier to visit each department to drop of the mail along a route or ‘circuit’ that is consistent and timely. That way, each department receives direction to better their work. This information is then passed from the manager to the other workers, which creates a – hopefully – positive result that is then relayed back to the manager and then to the head of the company, usually through the mail system.
Now, imagine that the accounting department manager was trained by someone to disregard the instructions in the mail and to do whatever they pleased because the head of the company did not care. That department would not be run in conjunction with the values of the company and may actually cause damage to the company’s finances, causing some workers to lose their jobs or law suits or company audits. It`s not until the manager is retrained or replaced that the accounting department can function properly and in conjunction with the company’s mission. Well, it’s very similar in our brains. Sometimes we will have circuits that operate outside of the best interests of our being because it was trained badly (usually through the examples and influences of the people around us, media, and nature).
In the case of the interdepartmental company, an outside company would probably be confused, judgmental, and the like; consumers would be distrusting and at risk; affiliates would probably give advise, good or bad. What the company would need is mediation and professional counseling to best deal with the situation. This process would provide open communication with an outside source that would listen to the issues and provide tools for the company to retrain the manager or hire a new manager and do a complete overhaul of the entire department. In the brain, this process is called plasticity (the ability of the brain to alter neurons, eliminate circuits and synapses, and create new circuits and synapses), which can happen all throughout life. Although we cannot grow new neurons, we can alter the flow of information of our neurons and alter the structure of our neurons to better suit our personal preferences and direction in life.
Now, let’s transpose the situation of this company into one human being. Meet Marsha, a 32 year old woman successful in her work, married, maybe has kids, maybe not. One problem though, her husband Frank is an abusive alcoholic. Marsha has a few friends who see what is going on and have made suggestions or cast judgement upon her, but to no avail. She continues to live battered and sincerely believes it is her fault that Frank beats her and still loves him regardless. She’s even seen in media that people say it’s bad and that women in abusive relationships will have a better life if they can get out. Maybe she is threatened by Frank if she says she’s leaving, or maybe when he’s sober he apologizes and life is really good for a term. Who knows the full situation but her. The question that is always burning in everyone’s mind is WHY? Why would anyone choose to live with someone who beats them? Why would someone forgive the physical and emotional damage their spouse causes?
In this instance we will assume that there is nothing wrong with the chemical makeup of Marsha’s brain. Everything is running smoothly, connections are strong, circuits are functional, and she is able to work and live a “normal” life in spite of the abuse. What is it then that causes Marsha to believe what Frank is doing to her is ok and is, in fact, her fault and she deserves it? Remember how I mentioned earlier that any experiences that happen up to age 21 can easily create synapses and circuits, and that repetition would solidify those circuits? Well, what most people do not know about Marsha is her father was also an abusive alcoholic who beat her mother. From a young age, Marsha was taught by example that a husband beating a wife was normal. Now, in a young child’s eyes, everything their parents do is law and is right and becomes ingrained into their character, personalities, and belief systems. So, every time her dad beat her mom and her mom submitted and accepted the beatings, it was a confirmation that this behaviour was normal. Even when teachers or friends or media would try their best to convince Marsha otherwise, the influence of the two most trusted people in the world was ingrained in far deeper circuits. The manager of that specific circuit of the brain was very persistent at keeping those workers doing what they wanted, not what was best for the whole company, so to speak. There could also be other factors such as being bullied at school that would enhance the idea that her lot in life was to take abuse and that it was in fact her fault and she deserved it.
From the outside, we know this is not true. We know that everyone has the right to live in an environment free of abuse and judgement, but it seems that what we know is often trumped by what we believe, and sometimes what we believe is based in a lie that has been supported through various circumstances in our lives. In Marsha’s case, it would not be until she recognized her own worth and sought help to retrain the circuits of accepting abuse. Depending on the circumstance, to recognize self-worth takes reaching rock bottom and being forced out of a damaging situation; sometimes it comes from the intervention of friends and family, but it always comes from a revelation inside of oneself. The head of the company is made aware that the accounting department manager is not following the best practices for the well being of the business. Maybe awareness came from a law suit filed by another business, or affiliates who stepped in before it was too late, or by a huge crash in their numbers in the stock market. Whatever the circumstance, the head of the company has to seek help to gain control and retrain the department. The same follows for Marsha. Once the recognition that she is worth more than the abuse and that it is not her fault, she has to seek help, guidance, and a fresh location to learn and grow. That circuit or those circuits that made her submit to abuse must be found and retrained. Many times, an outside influence must be there to support and walk through the training with her. It is not a matter of taking some pills to make her happier; it’s a matter of changing the communications of her neurons so she believes in her own worth and refuses to submit to abuse.
This is where I love counselors. They do not prescribe medication that will do nothing but bandage a bullet hole. They provide ears to hear, sympathy, and exercises that remove the bullet, help stitch the area, and remove shrapnel over time. The body’s immune system will provide the major healing, but it is hard for us to pull the bullet out ourselves or to stick needles into our bodies for stitching. It takes time, and the chronic pain that comes with healing can sometimes make us unsure if we are doing the right thing, but the end result is always better; the resulting scar can also become a tool in helping others who struggle with the same or similar issues. The memories never go away, but the quality of life after cognitive recalibration renews our life and restores our self-worth.
Now, each of us have areas in our lives that we struggle with. Looks, being abused, abusing others, addictions, overeating, overspending, hording, etc. It is my belief that all areas of struggle are rooted in circumstances that have damaged our self-worth and have left us living in fear, anger, depression, or self-hatred. Somewhere, in the midst of the billions of synapses and circuits in our brains, there is a belief that holds fast that must be broken and retrained in order to function for the betterment of our lives and the lives of those around us. The question is, are we willing to honestly examine our beliefs and recalibrate ourselves with the help that we need? Are we willing to do what needs to be done to determine if there is a chemical or behavioural imbalance in our minds.
I want to make sure I am not misunderstood here. I am not against alopathic medicine or the use of pharmaceuticals in the rehabilitation of our lives. What I am against is using medication as a bandage for something much more serious, or taking medication to solve a problem that needs hands-on work. If you try to stitch an area of skin that has no cut, you cause bleeding and pain where there is no need. If you put a bandage on a bullet hole, you get infected and can get gangrene and need to cut off a limb or die. But, if that medication is prescribed to combat the issue at hand, I am all for it! In the brain’s case, medication should be taken when needed, but the retraining of circuits should never be overlooked, as it is the largest proponent in altering one’s future and the quality of one’s life.