The goal of my psychotherapeutic work, what I do besides prescribing, is to utilize the brain’s natural ability to craft and create itself, its “neuro-plasticity,” once thought to be salient only in youth, now known to continue unabated throughout life.
What I wish for from my patients is that they be, as I recall from a famous radio campaign in my youth, “educated consumers” (as in Sy Simms: “an educated consumer is our best customer”). When I ask them to allow me to teach them personalized mental exercises, and when I ask them to perform these exercises in a disciplined manner when they are not with me, I want them to understand why I am doing what I am doing. I want them to begin to learn about their brains, as I have spent my entire life learning about mine.
At this point many of the people that find their way into my offices have already read my book (Getting Unstuck, available here) or read some material on my website. Invariably, if they are reader types and they are willing, I send them off with two or three other titles I’d like them to read.
For some time now I’ve been meaning to organize these recommendations and present them online.
In general, I find that the ability of the mind to program structural changes in the brain through chosen experience breaks down into a few major areas of endeavor:
a) esoteric/meditative practices that create connections between aspects of brain functioning, improve attention and integration generally.
b) interpersonal and emotional experiences that create connections (attachment) between empathy and language and “others”.
c) cognitive thought exercises that challenge repetitive ideas in a consistent manner.
d) exercises that address/heal specific deficits and create specific skills, as in dyslexia (often completely overcome), complex athletic, musical or other motor skills, and physical and mental rehabilitation.
There are 18 titles here, books that reflect my need to instruct myself beyond what was available to me as a psychiatric resident 30 odd years ago, books that inform and supplement any work that one might do to develop one’s brain. I’ve divided these books as I group them in my mind. If you’ve read more than a even just a few of them, you’ll know a lot of what I know, and therapy with me (or anyone else) will be far easier and more productive than you can imagine.
1. The Main Event
The Mindfulness Prescription for Adult ADHD by Lydia Zylowska (2012)
This book is mandatory reading for anyone with adult ADHD. It focuses not only on creating meditative practices suitable for those with attention issues, but also on the idea of a mindful life in general, outside of the practice itself. Lydia’s work is a formal attempt to adapt, for adults with ADD, the widely tested and accepted Mindfulness Based Stress Reduction program created by Jonathan Kabat-Zinn. Lydia did her work at the MARC (Mindful Awareness Research Center) at UCLA where she worked alongside Daniel Siegel and Jeffrey Schwartz, whose works are discussed below.
2. Game Changers
Buddha’s Brain by Rick Hanson (2009)
Your Brain at Work by David Rock (2009)
As an experienced professional who has studied neuroscience and consciousness and had long been interested in esoteric/meditative/hypnotic practices, it can be a great gift to befriend an avid reader with similar interests. Both of these books were recommended to me by a Mr. Chris Skelly, a brilliant software developer and advanced student of all things consciousness, as works that might be useful for me to look at, and for that I thank him here publicly. Though they come from different perspectives, and neither of them specifically claims to target ADDers, these two are by far the most accessible yet enlightening brain “user guides” I’ve encountered, and I push them on most everyone.
“Buddha’s Brain” looks elegantly at how Buddhist ideas and practices have been validated and contextualized by recent brain science. Its especially good on explaining how understanding the roots of chronic hyper-arousal in evolutionary terms allows us to CHOOSE to override toxic reflexes; why we create useless stress, how to recognize it, how to change it. A charming clever read, inspiring and reassuring.
“Your Brain At Work” comes from a different place entirely, a business case study model that integrates neuroscience to inform sustainable win-win business strategies and practices. It focuses on attention, but in the context of “normal” executives understanding, manipulating and optimizing their attentional abilities and practices.
Perhaps the most important insight of my career in attentional medicine is the awareness that people with ADD become depressed in typical ways because they overuse norepinephrine/stress systems and dopamine pleasure systems. “Your Brain At Work” talks about how these systems are routinely activated in anyone seeking high performance, and is simply wonderful on the best ways to use these systems, and on the pitfalls that can occur when these systems are used in unconscious, unenlightened and ineffective ways.
It’s loaded with lots of other great stuff, too. Anyone who reads and masters the material in these books (both written very, very readably) cannot help but change and grow. Cannot help it.
3. Left and Right (sort of)
Blink by Malcolm Gladwell (2005)
The Happiness Hypothesis by Jonathan Haidt (2006)
Thinking Fast and Slow by Daniel Kahneman (2011)
There are three very popular books that address the contrast and interaction between our two different styles of processing information. All three, in different ways, address the issue of the relationship between the parts of the self. At the very, very base of experience we operate in two ways, consciousness and self consciousness one might say, we have two “sets” of “selves,” (Kahneman uses the metaphor of the boy riding an elephant to describe it; such an elegant useful construction) and the cultures of mankind have been describing this dichotomy in thinking and behaving as long as ideas have been recorded, from the Atman and The Brahmin of Hindi culture, to “The Picture of Dorian Gray”. “Inner” “Intuitive” “Unconscious” “Body” selves have been exalted and vilified both. Call it left brain and right brain (a useful but not truly fully localizing shorthand), inner self and outer self, conscious and unconscious, logical vs. emotional, goal vs. process, digital vs. holistic, judging vs. experiencing, there is almost an infinite set of dichotomies.
There are infinite dichotomies, all right, all wrong, throwing dust at an invisible statue. Just in the past decades have the deeper structural nature of these dichotomies been correlated with human behaviors, experience, activities and most importantly, ability to grow, learn and change.
All three of these books are fascinating and illuminating in their way; and they provide a backdrop for the endeavors of therapy; therapy should at least somewhat be focused on integrating the parts of the self, about breaking down the barriers and creating effective “complex selves” in which “left brain verbal logical self-conscious” aspects are present alongside and working effectively with “right brain experiential authentic spontaneous” aspects. All three make clear the need for and utility of understanding and integrating the parts of our selves.
The Mindful Brain by Daniel J Siegel (2007)
The Brain That Changes Itself by Norman Doidge (2007)
On a brain structure level the way that we integrate different aspects of ourselves is called neuro-plasticity, the way in which our brain lays down and thickens some pathways and prunes others depending on what we pay attention to.
“Brainlock” is a book that integrates a Buddhist “observing” of thought with an understanding of neuro-plasticity to create a program that does in fact, as proven by functional MRI, decrease the hyperactivity of the occipito-frontal cortex, the error detection system that is over-stimulated in OCD.
In the “Mind and the Brain” Schwartz discusses a range of fascinating conditions that are neuro-plastic in nature, from tinnitus and torsion dystonia to dyslexia and the rehabilitation of strokes (stroke rehabilitation has indeed been revolutionized by the understandings I first encountered here in 2002; now we tie the good hand behind the patient’s back to force the re-creation of neural pathways). The somewhat later Doidge book is not dissimilar; both these books are more medical/neurological than specifically psychiatric, broad surveys of the many surprising ways the brain “learns”, both normally and in response to trauma and challenge, now that we know that the meaning of “learning” of necessity implies changing the pathways, connections and structures of our brain.
“The Mindful Brain” is different, quite lovely, a personal and scientific exploration of the effects of meditative practices on a particular person, an especially well educated and well prepared person as he transforms himself from a student of meditation in to a practitioner and then into a teacher, in the hopes of assisting those he has signed on to help.
Siegel’s work is deeply annotated, and very inclusive, categorizing types of integration broadly if briefly and showing how they can be applied to both pathological and developmental issues; he recounts his successes. Not always an easy read.
5. Eastern references
Mindfulness in Plain English by Bhante Henepola Gunaratana (2011)
Awakening the Buddha Within by Lama Surya Das (1998)
Living the Mindful Life by Charles Tartt (1994)
In the each of the sections above, some of the books speak to esoteric practices more than others — ” Buddha’s Brain”, “The Happiness Hypothesis” especially so. The five books immediately above in this section are all more or less practical guides to beginning personal experiential study. “Be Here Now” is the original from the 70’s by a guy named Richard Alpert, who studied and took acid with Timothy Leary, went to India to study meditation and came back Ram Dass, setting himself up as a meditation teacher at the Cathedral of Saint John the Divine on the Columbia University campus for several decades. His “Journey of Awakening” is a panoramic overview of all the different ways people seek transcendence. “Living the Mindful Life” is written by Charles Tartt a man who is both a Buddhist and a follower of Gurdjieff, the Armenian spiritual explorer who first attempted to separate the consciousness and mind building neuro-plasticity exercises from the religious traditions that spawned, cherished and preserved them. “Awakening the Buddha Within” is by a Brooklyn boy who made his own journeys in the 90’s,; very accessible, as is “Mindfulness in Plain English”.
6. Ego State Therapy
Ego States: Theory and Therapy by John and Helen Watkins (1997)
The Courage to Love By Stephen Gilligan (1997)
Healing the Divided Self by Claire Frederick and Maggie Philips (1995)
These three books describe a type of therapy that comes out of the Ericksonian community, a guided visualization “family therapy” for the self, used widely by non MD’s in the American west for treating profound PTSD of all sorts. It is to me a profoundly neuro-plastic endeavor, creating and shaping “healthier” and “broader” new selves. It is my insight and understanding that many adults with ” relatively” minor trauma, adults who grew up with ADD and Asperger’s and Bipolar illness and social anxieties, are in fact “dissociated” by it, dissociated in ways that create the problems with executive functioning, with procrastination and disorganization, that are so much the substance of my work (We don’t do what we should, we do what we shouldn’t). Ego state therapy can be astoundingly effective.
Well that seems like enough. Eighteen titles written in the last 20 years. Anyone who reads all these gets an official “Attention Doctor” tee shirt and a brass figamagee with oak leaf cluster.
Please feel free to get in touch about any of this reading, or, as usual, if you’d like treatment that is broadly informed by the neuroscience contained therein.