In The Mind and the Brain, neuropsychiatrist Dr. Jeffrey Schwartz and science writer
Sharon Begley assert that the human brain throughout the lifespan has dynamic properties
of neuroplasticity: that is, the ability of neurons to form new brain connections, stimulate
new pathways through the cortex, assume new roles and functions (e.g. rewire brain circuitry).
The authors review neuroscience's early and more recent history in relation to various
insufficient philosophies -- dualism (brain and mind separate) and epiphenomenalism
(emergent mind, but illusionary consciousness and no willful causation), Newtonian physics, materialism, reductionism, and the radical behavioral treatment of obsessive-compulsive
disorder (OCD). Dr. Schwartz's clinical research and treatment approach with obsessive-compulsive, "brain-locked" patients overwhelmed by insistent, repetitive urges to wash
their hands of feared germs or ward off uncomfortable feelings of danger by persistently
checking stoves, lights, and door locks are presented. We learn how Dr. Schwartz's "Relabel, Reattribute, Refocus, Revalue" (4Rs) approach differs dramatically from a rigid, distasteful,
and sometimes unsafe behavioral (Exposure-Response Prevention) approach -- an approach
which, at times, has forced patient compliance and ordered patients to rub feces from public toilets on their hands, face, and hair to learn not to fear and respond to perceived germ contamination.
Schwartz and his colleagues used positron emission tomography (PET) scanning technology
to document images in treated patients' orbital frontal cortex, anterior cingulate gyrus and
caudate nucelous areas of the brain that demonstrated hypermetabolic changes in brain
circuitry. Patients actively directed attention to and practiced the 4Rs to become mindful
of faulty brain messages and to generate the willpower needed to unlock and replace ego-
dystonic OCD symptoms with healthier, alternative mental states and behavioral activities.
In Chapter Three, "Birth of a Brain," the authors describe how the brain develops from
conception to adulthood. They sketch out basic brain structures and specific functions
central to neuroplasticity, regeneration, and reorganization, rather than presume a fixed,
ended (at birth, childhood, or by injury), and immutable brain. In Chapter Four, "The Silver Springs Monkeys," the authors describe the filthy conditions in Edward Taub's laboratory
at the Institute of Behavioral Research in Silver Spring, Maryland, in the 1980s, and the
cruel treatment of seventeen deafferented monkeys used in vivisectional experiments. Afferent,
or sensory, input into the body enters the spinal cord over the back to the spine's nerves
which, in turn, innervates different parts of the body (e.g. sensations in the finger, hand,
arm, leg). A cut afferent nerve means the loss of all sensation in one area of body, but not
brain, functioning. Experimentalists cut sensory nerves in monkeys' fingers, hands, arms,
and legs in order to investigate the kinds of "stimulation" (e.g. immediate operant conditioning, prolonged physical restraint of an intact arm or leg, persistent electric shock, threatened starvation) would force those with intact motor nerves to seek a return to some level of
Despite the physical consequences for the monkeys, the legal, criminal, social, ethical, and
political controversies generated by these experiments resulted in the founding of PETA
(People for the Ethical Treatment of Animals), the Animal Welfare Act of 1985; and the
authors claim these studies supported two subsequent lines of research: first, constraint-
induced movement therapy helped some stroke patients relearn the use of limbs, and second,
the monkeys' adaptive experiences with the experiments resulted in the reorganization and remapping of their sensory cortexes.
Illustrative animal experiments and laboratory procedures used to physically remap new representative areas in the brain are detailed in Chapter Five. A variety of applicable studies
suggesting changes in sensory and motor functions in humans with disorders like Tourette's syndrome, blindness, deafness, dyslexia, stroke, focal hand dystonia, language/speech recovery, tinnitus and depression are discussed later.
If one has difficulty attending to a discourse on the fixed "hidden" laws of a Newtonian
world versus the mathematical probabilities and uncertainties of quantum physics, subatomic wave and particle experiments or the ongoing debate about "reality", the wait can be well
worth the reader's efforts to understand clinical issues and underlying philosophy of science questions. For examples: What is the importance of the kind of question we ask nature?
What is the inherent influence of the observer's involvement in the dynamic phenomena to
be observed and interpreted?
In The Mind and the Brain, the seminal work of William James (e.g., Principles of
Psychology, 1890) is integrated with the teachings of Buddha, Henry Stapp's interpretation
of quantum physics, neuroscientific history, and the authors' theoretical views and clinical experience with OCD. In concluding chapters this exciting, integrated perspective details, restates, and centers the causal significance of human consciousness; self-directed, purposeful attention; mental effort and experience; to one's evolving brain, mental health and behavior. This promising model of brain functioning and the need to literally pay attention for change
has prospective applications to and many implications for medicine, rehabilitation, mental
health treatment, social service, addiction intervention, and the moral education practices in today's changing world.