We found that children with autism vary tremendously in the extent to which they look at the eye region of the face. The more they look at the eye region of the face, the more accurate they are in detecting what facial expression is actually being portrayed. That’s because the eyes convey a lot of emotional information. We observed a striking association between how long the children looked at the eye region and how accurate they were in detecting the emotions of the face.
We also observed that the less they were looking at the eye region of the face, the greater the activation in an area of the brain that is particularly concerned with the detection of threat signals called the amygdala. Those children with autism that were showing extremely high activation of the amygdala were the ones who were showing less focusing on the eye region of the face and who were the least accurate in detecting the emotions of the face.
The conclusion we drew is that those are the kids who find these kinds of relatively innocuous faces to be threatening, so they actually avert their gaze, and by averting their gaze they fail to detect important information that is conveyed in the face.
BW: You write, “Genes load the gun but only the environment can pull the trigger.” So nature and nurture work together?
RJD: Yes, and I would say that our modern understanding of the way genes and environment interact indicates that they’re irrevocably enmeshed. You cannot talk about one without the other. I introduce the field of epigenetics in the book, which pertains to how genes are actually regulated. One of the most important findings is that the extent to which genes are actually turned on or turned off is a continuum, and that is at least in part determined by the environment, by our experience, by our training. The idea that you can actually segregate genes and environment is just a convenient myth, but it’s not really the way biology works. One of the conclusions from this view is that we can all take more responsibility for the shaping of our brains.
BW: Explain what you mean by the statement, “The embodied mind is bidirectional.”
RJD: There’s a continuous two-way dialogue between the brain and the body. Bidirectional means that there are signals going from the brain to the body, to help regulate the body, while there are also signals going from the body that provide upstream information to the brain and modulate its activity. So the state of our body will influence the state of our brain, and the state of our brain will influence our body. One of the important implications here is that diseases which we previously thought of as only physical, like asthma, are actually also diseases of the brain, and it gives us a new window of opportunity in terms of therapeutic intervention. I think it’s important, however, to understand that the brain doesn’t cause asthma; it simply influences asthma, which provides a very important window of opportunity.
BW: “Neurally inspired behavioral therapy” is the way forward, and you talk about cognitive behavioral therapy and mindfulness training. You have practiced meditation for many years and have studied the brain activity of monks in the Himalayas through your connection with the Dalai Lama. Can you speak about the differences between the two interventions and what situations might call for either?
RJD: It’s important to put this in the framework of emotional styles and the very central idea of the book. Because of emotional styles, it is very unlikely that one size will fit all with respect to any kind of treatment. Because people are different in how they respond to life’s slings and arrows, the idea that one kind of treatment is going to be good for everyone is empirically disconfirmed by thousands of studies. With any kind of treatment, there’s always a group of people who don’t show a good response to that treatment. Emotional styles provides an opportunity to better understand why certain people may be benefitted by certain kinds of neurally inspired behavioral therapies while others may be benefitted by other kinds of interventions.
Cognitive therapy is centrally focused on changing the way a person thinks about his or her beliefs. It is a way to reframe a particular instance of adversity. Rather than believing that something bad happens because you’re a bad person, you can reframe it by thinking that maybe it happened because of some feature in the environment, or that occasionally bad things happen to everyone, and this is not anything about me.
BW: Will that really affect the neural channels?
RJD: It will affect the neural channels when it is done systematically. One important feature of any of these kinds of behavioral interventions is the critical importance of practice — of training. This is one of the key insights of neuroplasticity. The idea that you can go to a therapist for 45 minutes a week and, based upon that 45 minutes a week, change the brain, in my view as a neuroscientist, is ridiculous. Cognitive therapy and mindfulness training, although coming from completely different arenas, both recommend very strongly practice on a daily basis and homework.
Mindfulness is training in nonjudgmental awareness. It is paying attention on purpose nonjudgmentally. The nonjudgmental component is very important and involves training the person to become aware of thoughts and feelings that may arise but not be immediately hijacked by them and judge them as good or bad — to just observe them. Through the process of observation, watching them arise and fall away, some of the charge and ensnarement that often surround those kinds of thoughts and emotions become less intense.
BW: What’s the next step for your work? What do you envision for people?
RJD: I think there’s certainly a lot more research that needs to be done, particularly around issues involving changes in gene expression, epigenetics. In terms of the general public, one of the things that is unquestionably true is that for many skills, the brain is more plastic early in life compared to later. It doesn’t mean that plasticity ends, but it means that it’s less malleable. There are many examples of this, but one common example is learning a second language. We know that if that language is learned early in life, it can be learned more easily and with more facility than later in life.
And that’s likely true of other skills as well. In the area of social and emotional learning, for instance, that’s likely true. If that’s the case, then introducing simple practices in the K-12 school curriculum may be an extremely effective way to build better habits of mind, catalyzing and nourishing virtuous characteristics in our next generation of citizens. I think, in terms of social needs, this is an extraordinarily important enterprise and can potentially be a very cost-effective way to help transform our society and our emotional behavior toward a continuum that involves more compassion and caring and less narcissism and greed. I think there’s an incredible opportunity here.
A secondary note, given the intense national concern about the cost of health care, is the possibility of the regular practice of some of these neurally inspired behavioral therapies and mindfulness actually reducing health care utilization.
That’s a hypothesis, and the evidence is not in, although snippets exist that point to that direction. Even if it’s just the few percentage points, it will make an enormous difference in the bottom line, and every insurance company in America will want to jump on the bandwagon and support this. I think we will see a massive shift in our culture which I think will affect many different domains and will be enormously helpful in a time of real national need.
This article was originally published in Brain World Magazine’s Summer 2012 issue.
