Neural Circuit Taxonomy

Neural network circuits

Brain stuff -- interesting to find out what might go on in that grey matter.

"Precision psychiatry: a neural circuit taxonomy for depression and anxiety"

By Dr. Leanne M Williams, PhD

Summary

"Although there have been tremendous advances in the understanding of human dysfunctions in the brain circuitry for self-reflection, emotion, and cognitive control, a brain-based taxonomy for mental disease is still lacking. 

As a result, these advances have not been translated into actionable clinical tools, and the language of brain circuits has not been incorporated into training programs. 

To address this gap, I present this synthesis of published work, with a focus on functional imaging of circuit dysfunctions across the spectrum of mood and anxiety disorders. 

This synthesis provides the foundation for a taxonomy of putative types of dysfunction, which cuts across traditional diagnostic boundaries for depression and anxiety and includes instead distinct types of neural circuit dysfunction that together reflect the heterogeneity of depression and anxiety. 

This taxonomy is suited to specifying symptoms in terms of underlying neural dysfunction at the individual level and is intended as the foundation for building mechanistic research and ultimately guiding clinical practice."

And from Wikipedia:

"Dysfunction in the salience network have been observed in various psychiatric disorders, including anxiety disorders, post-traumatic stress disorder, schizophrenia, frontotemporal dementia, and Alzheimer's disease. 

The AI node of the salience network has been observed to be hyperactive in anxiety disorders, which is thought to reflect predictions of aversive bodily states leading to worrisome thoughts and anxious behaviors. 

In schizophrenia, both structural and functional abnormalities have been observed, thought to reflect excessive salience being ascribed to internally generated stimuli.

In individuals with autism, the relative salience of social stimuli, such as face, eyes, and gaze, may be diminished, leading to poor social skills."

Cognitive Reframing: An Ambiguous Figure

Ambiguous images

"Ambiguous images" or "reversible figures" are optical illusion images which exploit graphical similarities and other properties of visual system interpretation between two or more distinct image forms. These are famous for inducing the phenomenon of "multistable perception." Multistable perception is the occurrence of an image being able to provide multiple, although stable, perceptions. Classic examples of this are the "rabbit-duck" and the "face or vase."

"Cognitive reframing" is a psychological technique that consists of identifying and then disputing irrational or maladaptive thoughts. Reframing is a way of viewing and experiencing events, ideas, concepts and emotions to find more positive alternatives. In the context of cognitive therapy, cognitive reframing is referred to as "cognitive restructuring." Cognitive reframing, on the other hand, refers to the process as it occurs either voluntarily or automatically in all settings.

Neuroscience: Default Mode Network

From yee Wiki: In neuroscience, the default mode network (DMN), also default network, or default state network, is a large scale brain network of interacting brain regions known to have activity highly correlated with each other and distinct from other networks in the brain.

The default mode network is most commonly shown to be active when a person is not focused on the outside world and the brain is at wakeful rest, such as during daydreaming and mind-wandering. But it is also active when the individual is thinking about others, thinking about themselves, remembering the past, and planning for the future. The network activates "by default" when a person is not involved in a task. Though the DMN was originally noticed to be deactivated in certain goal-oriented tasks and is sometimes referred to as the task-negative network,mit can be active in other goal-oriented tasks such as social working memory or autobiographical tasks.The DMN has been shown to be negatively correlated with other networks in the brain such as attention networks.

Evidence has pointed to disruptions in the DMN of people with Alzheimer's and autism spectrum.

The default mode network is known to be involved in many seemingly different functions:

It is the neurological basis for the self:

Autobiographical information: Memories of collection of events and facts about one's self

Self-reference: Referring to traits and descriptions of one's self

Emotion of one's self: Reflecting about one's own emotional state

Thinking about others:

Theory of Mind: Thinking about the thoughts of others and what they might or might not know

Emotions of other: Understanding the emotions of other people and empathizing with their feelings

Moral reasoning: Determining just and unjust result of an action

Social evaluations: Good-bad attitude judgments about social concepts

Social evaluations: Good-bad attitude judgments about social concepts

Social categories: Reflecting on important social characteristics and status of a group

Remembering the past and thinking about the future:

Remembering the past: Recalling events that happened in the past

Imagining the future: Envisioning events that might happen in the future

Episodic memory: Detailed memory related to specific events in time

Story comprehension: Understanding and remembering a narrative

The default mode network is active during passive rest and mind-wandering. Mind-wandering usually involves thinking about others, thinking about one's self, remembering the past, and envisioning the future.

Electrocorticography studies (which involve placing electrodes on the surface of a subject's scalp) have shown the default mode network becomes activated within a fraction of a second after participants finish a task.

Studies have shown that when people watch a movie, listen to a story, or read a story, their DMNs are highly correlated with each other. DMNs are not correlated if the stories are scrambled or are in a language the person does not understand, suggesting that the network is highly involved in the comprehension and the subsequent memory formation of that story. The DMN is shown to even be correlated if the same story is presented to different people in different languages, further suggesting the DMN is truly involved in the comprehension aspect of the story and not the auditory or language aspect.

The default mode network has shown to deactivate during external goal-oriented tasks such as visual attention or cognitive working memory tasks, thus leading some researchers to label the network as the task-negative network. However, when the tasks are external goal-oriented tasks that are known to be a role of the DMN, such as social working memory or an autobiographical task, the DMN is positively activated with the task and correlates with other networks such as the network involved in executive function.

A hitherto unsuspected possibility is that the default network is activated by the immobilization inherent in the testing procedure (the patient is strapped supine on a stretcher and inserted by a narrow tunnel into a massive metallic structure). This procedure creates a sense of entrapment and, not surprisingly, the most commonly reported side-effect is claustrophobia. This alternative view is suggested by a recent article that links theory of mind to immobilization.

On the Reading Table: NeuroTribes by Steve Silberman

Steve Silberman

NeuroTribes:

The Legacy of Autism and the Future of Neurodiversity

A groundbreaking book that upends conventional thinking about autism and suggests a broader model for acceptance, understanding, and full participation in society for people who think differently.

What is autism? A lifelong disability or a naturally occurring form of cognitive difference akin to certain forms of genius? In truth, it is all of these things and more -- and the future of our society depends on our understanding it. Wired reporter Steve Silberman unearths the secret history of autism, long suppressed by the same clinicians who became famous for discovering it, and finds surprising answers to the crucial question of why the number of diagnoses has soared in recent years.

Going back to the earliest days of autism research and chronicling the brave and lonely journey of autistic people and their families through the decades, Silberman provides long-sought solutions to the autism puzzle, while mapping out a path for our society toward a more humane world in which people with learning differences and those who love them have access to the resources they need to live happier, healthier, more secure, and more meaningful lives.

Along the way, he reveals the untold story of Hans Asperger, the father of Asperger’s syndrome, whose “little professors” were targeted by the darkest social-engineering experiment in human history; exposes the covert campaign by child psychiatrist Leo Kanner to suppress knowledge of the autism spectrum for fifty years; and casts light on the growing movement of “neurodiversity” activists seeking respect, support, technological innovation, accommodations in the workplace and in education, and the right to self-determination for those with cognitive differences.

NeuroTribes was the first science book to win the Samuel Johnson Prize. It has also won a California Book Award and a Books for a Better Life Award.

Mini Reviews

“Explores in fascinating, near-encyclopedic depth how autism has evolved… a gripping narrative written with journalistic verve.”
—The Guardian

“An essential resource. My own copy is already dog-eared.”
—Nature

“NeuroTribes is a sweeping and penetrating history, presented with a rare sympathy and sensitivity. It is fascinating reading; it will change how you think of autism, and it belongs, alongside the works of Temple Grandin and Clara Claiborne Park, on the bookshelf of anyone interested in autism and the workings of the human brain.”
— From the foreword by Oliver Sacks, author of An Anthropologist On Mars and Awakenings

“The monks who inscribed beautiful manuscripts during the Middle Ages, Cavendish an 18th century scientist who explained electricity, and many of the geeks in Silicon Valley are all on the autism spectrum. Silberman reviews the history of autism treatments from horrible blaming of parents to the modern positive neurodiversity movement. Essential reading for anyone interested in psychology.”
–Temple Grandin, author of Thinking in Pictures and The Autistic Brain

“NeuroTribes is remarkable. Silberman has done something unique: he’s taken the dense and detailed history of autism and turned the story into a genuine page-turner. The book is sure to stir considerable discussion.”
–John Elder Robison, Neurodiversity Scholar in Residence at The College of William & Mary and author of Look Me in the Eye

“Be prepared to overturn all prior knowledge you had about autism. With meticulous research, Steve Silberman has unearthed the surprising truths about the history of autism, uncovering the roots of the lie of the autism “epidemic.” Be prepared to share the deeply compassionate understanding that the author bestows on the many different individuals we now include in the autism spectrum. His empathy touches even the villains of the story, and this is both moving and apt when he advises us all to embrace diversity. This gripping and heroic tale is a brilliant addition to the history of autism.”
–Uta Frith, Emeritus Professor of Cognitive Development at University College London

“In this genuine page-turner, Steve Silberman reveals the untold history of autism: from persecution to parent-blaming, from Rain Man to vaccines, of doctors for whom professional ego trumped compassion, to forgotten heroes like Hans Asperger, unfairly tainted by Nazi links. It ends on an optimistic note, with ‘autistics’ reclaiming the narrative and defining autism in their terms — more difference than disability and an essential part of the human condition. Highly recommended for anyone with an interest in autism or Asperger’s, or simply a fascination with what makes us tick.”
–Benison O’Reilly, co-author of The Australian Autism Handbook

Sometimes People Suffer These Signs of "Hidden" Depression

The following "tells" are some of the most common in people dealing with "concealed" depression.

They are often quite talented and very expressive:

A lot of famous people have suffered from mental illnesses, and this suffering gives them deeper emotions. If you really think about it, this is in some form a source to their greatness. While we cannot always see it, their struggles are often reflected in their works. These people are able to bring something beautiful out of the darkness that consumes them.

They tend to search for purpose:

We all need a purpose in this life. We want to be sure that we are in some form doing meaningful things. People suffering from hidden depression are not exempt from this. They too want to know the reason for their existence. They are much more susceptible to feeling things like inadequacy and anxiety which leaves them searching for something they can never seem to achieve in their own minds.

Sometimes they make muted cries for help:

Sometimes we all need help. When we are not expecting someone to feel weak or to be down in the dumps, we don’t see their cries for help. However, if you notice their cries and can help them in any way, you are creating a very close and trust filled bond with them.

They interpret substances differently:

Someone who is dealing with depression usually knows what it is they can take to ease their pain in a sense. They know that caffeine and sugar will raise their mood and that some medicines can help them. They actually have to put a lot of effort into feeling better, unlike most people. It is not as simple as taking a Tylenol when you have a headache.

They often have a very involved perception of life and death:

People suffering from depression often face their own mortality in moments of despair and seek answers to life’s deepest questions. They tend to shift from one terrible mindset into another. Sure, not all depressed people deal with suicidal thoughts, but some do.

They have strange eating habits:

People with depression may not be able to eat much or at all when they are at their worst. That being said some of them may eat more when at their worst. It varies from person to person.

They have abnormal sleeping habits:

People with depression will often sleep for what seems like or may literally be days. Sleep at times can be impossible while other times could be the only thing left that the person can do. When a person is depressed they are dealing with a state of helplessness that will rock their world.

They have abandonment issues usually:

If you have dealt with abandonment then you know how terrible it can be. When someone walks out of your life it can be a devastating, but this impacts those with depression much more than other people. It causes them to be more and more secretive about their feelings and creates a fear within them of being abandoned by their loved ones.

They are professionals at coming up with ‘cover-up’ stories:

They are able to come up with believable elaborate excuses for the things they are going through. Like if they skip an appointment or don’t return your calls for days. They can easily change the subject when things like this come up and turn the attention away from their pain.

They might have habitual remedies:

There are several different lifestyle changes a person can make as an attempt to ease their minds. For instance, these people may do things like exercise, listen to music, go walking, and so forth.

They are aways making efforts to seem happy:

People suffering from depression learn to fake moods. They will often come off as happy and normal on the outside. When they let their inner struggles appear on the outside they feel as if they are bringing others down.

They seek love and acceptance:

People with hidden depression are not hiding their depression because they want to be dishonest, they are just working to protect their hearts. These people want to be loved and accepted just like everyone else.

They have trouble shutting off their brains.:

These people process everything going on in their lives at a fast speed. They over analyze the good and the bad making everything impact them much deeper. Their brains are like sponges absorbing everything that comes their way.

They hurt when other people hurt:

When other people are suffering it brings them down to their worst points. This sort of thing often triggers their emotional pain and can be crippling.

They always think of the worst-case scenarios:

While this is very stressful it can be beneficial from time to time. A high intelligence seems to be linked with depression, and they are able to respond to anything that comes their way. This makes them good problem solvers for the most part

Unusual Emotions That People Feel But Can't Describe

Internal Family Systems Therapy

Internal Family Systems Model (IFS) 

Internal Family Systems Model (IFS) 

Internal Family Systems Model (IFS) 

Internal Family Systems Model (IFS) 

From yee Wiki:

The Internal Family Systems Model (IFS) is an integrative approach to individual psychotherapy developed by Richard C. Schwartz. It combines systems thinking with the view that mind is made up of relatively discrete "subpersonalities" each with its own viewpoint and qualities. IFS uses family systems theory to understand how these collections of subpersonalities are organized.

Parts

IFS sees consciousness as composed of various "parts" or subpersonalities, each with its own perspective, interests, memories, and viewpoint. A core tenet of IFS is that every part has a positive intent for the person, even if its actions or effects are counterproductive or cause dysfunction. This means that there is never any reason to fight with, coerce, or try to eliminate a part; the IFS method promotes internal connection and harmony.

Parts can have either "extreme roles" or healthy roles. IFS focuses on parts in extreme roles because they are in need of transformation through therapy. IFS divides these parts into three types—managers, exiles, and firefighters.

Managers

Managers are parts with preemptive protective roles. They handle the way a person interacts with the external world to protect them from being hurt by others and try to prevent painful or traumatic feelings and experiences from flooding a person's awareness.

Exiles

Exiles are parts that are in pain, shame, fear, or trauma, usually from childhood. Managers and Firefighters try to exile these parts from consciousness, to prevent this pain from coming to the surface.

Firefighters

Firefighters are parts that emerge when exiles break out and demand attention. These parts work to distract a person's attention from the hurt or shame experienced by the exile by leading them to engage in impulsive behaviors like overeating, drug use, violence, or having inappropriate sex. They can also distract from the pain by causing a person to focus excessively on more subtle activities such as overworking, over-medicating.

Self

IFS also sees people as being whole, underneath this collection of parts. Everyone has a true self or spiritual center, known as the Self to distinguish it from the parts. Even people whose experience is dominated by parts have access to this Self and its healing qualities of curiosity, connectedness, compassion, and calmness. IFS sees the therapist's job as helping the client to disentangle themselves from their parts and access the Self, which can then connect with each part and heal it, so that the parts can let go of their destructive roles and enter into a harmonious collaboration, led by the Self. IFS explicitly recognizes the spiritual nature of the Self, allowing the model to be helpful in spiritual development as well as psychological healing.

The Internal System

IFS focuses on the relationships between parts and between the Self. The goal of IFS is to have a cooperative and trusting relationship between the Self and each part. There are three primary types of relationships between parts:

Protection

Managers and Firefighters protect exiles from harm and protect the person from the pain of Exiles.

Polarization

Two parts are polarized when they are battling each other to determine how a person feels or behaves in a certain situation. Each part believes that it must act as it does in order to counter the extreme behavior of the other part. IFS has a method for working with polarized parts.

Alliance

Two parts may be allied with each other if they are working together to accomplish the same aim.

Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy

This is another therapy for healing trauma that I learned about from reading The Body Keeps Score.

Bessel van der Kolk

From yee Wiki:

Sensory integration therapy is based on A. Jean Ayres' theory of Sensory Integration. Ayres' Sensory Integration (ASI) is a theory that describes:

How the neurological process of processing and integrating sensory information from the body and the environment contribute to emotional regulation, learning, behavior, and participation in daily life.

Empirically derived disorders of sensory integration and an intervention approach. “Sensory integration theory is used to explain why individuals behave in particular ways, plan intervention to ameliorate particular difficulties, and predict how behavior will change as a result of intervention."

Sensory integration theory originated from the work of A. Jean Ayres, PhD, OTR, an occupational therapist and psychologist, whose clinical insights and original research revolutionized occupational therapy practice with children. 

Dr. Ayres wrote "Sensory Integration is the organization of sensations for use. Our senses give us information about the physical conditions of our body and the environment around us...The brain must organize all of our sensations if a person is to move and learn and behave in a productive manner."

 Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy

Sensory Integration Therapy

Infographic: Psychological Lifehacks

Pattern Seeking: Finding Order in Chaos

From yee Wiki:

Apophenia /æpoʊˈfiːniə/ is the human tendency to perceive meaningful patterns within random data.

The term apparently dates back to 1958, when Klaus Conrad published a monograph titled Die beginnende Schizophrenie. Versuch einer Gestaltanalyse des Wahns ("The onset of schizophrenia: an attempt to form an analysis of delusion"), in which he described in groundbreaking detail the prodromal mood and earliest stages of schizophrenia. He coined the word "Apophänie" to characterize the onset of delusional thinking in psychosis. Conrad's theories on the genesis of schizophrenia have since been partially, yet inconclusively, confirmed in psychiatric literature when tested against empirical findings.

Conrad's neologism was translated into English as "apophenia" (from the Greek apo [away from] + phaenein [to show]) to reflect the fact that a person with schizophrenia initially experiences delusion as revelation.

In 2001 neuroscientist Peter Brugger referenced Conrad's terminology and defined the term as the "unmotivated seeing of connections" accompanied by a "specific experience of an abnormal meaningfulness."

Apophenia has come to imply a universal human tendency to seek patterns in random information, such as gambling.

Gaslighting

Gaslight, 1944

She hears footsteps from above, shuffling against the attic floorboards. A framed painting suddenly vanishes from a wall. The gas-fueled flames of the chandelier flicker and dim. 

She is certain it happened — but her husband assures her that she’s imagining it all. It’s her behavior that seems odd, he insists; perhaps she’s going mad? And, slowly, she begins to believe him.

This is the plot of the 1944 Ingrid Bergman film “Gaslight.” It is also the origin of a buzzword that has spread from pop culture to clinical psychology and back again.

This is a very specific accusation. To “gaslight” someone isn’t just to lie to them or to manipulate their emotions. It is a deliberate attempt to deceive someone into questioning their own perception of reality. (“Suddenly, I’m beginning not to trust my memory at all,” says Bergman’s character, Paula, as her faith in her senses begins to fray.)

Fortunately, some of our gaslighted heroines from fiction offer tips on how to break free of the cycle: 

Either it becomes so evident that something is wrong -- as in “The Shining,” where blood pouring out of the elevator is hard to ignore -- “or you need a witness, someone who is there to help you through it and point it out.

Move On -- If Only It Was That Easy -- But We'll Try...

From the International OCD Foundation website:

Obsessive Compulsive Disorder (OCD) is a mental health disorder that affects people of all ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and compulsions. 

Obsessions are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress.

Most people have obsessive thoughts and/or compulsive behaviors at some point in their lives, but that does not mean that we all have “some OCD.” In order for a diagnosis of Obsessive Compulsive Disorder to be made, this cycle of obsessions and compulsions becomes so extreme that it consumes a lot of time and gets in the way of important activities that the person values.

Here is one way to think about what having OCD is like:

Imagine that your mind got stuck

on a certain thought or image…

Then this thought or image got replayed in your mind

over and

over again

no matter what you did…

You don’t want these thoughts — it feels like an avalanche…

Along with the thoughts come intense feelings of anxiety…

Anxiety is your brain’s alarm system.  When you feel anxious, it feels like you are in danger.  Anxiety is an emotion that tells you to respond, react, protect yourself, DO SOMETHING!

On the one hand, you might recognize that the fear doesn’t make sense, doesn’t seem reasonable, yet it still feels very real, intense, and true…

Why would your brain lie?

Why would you have these feelings if they weren’t true? Feelings don’t lie…  Do they?

Unfortunately, if you have OCD, they do lie.  If you have OCD, the warning system in your brain is not working correctly.  Your brain is telling you that you are in danger when you are not.

When scientists compare pictures of the brains of groups of people with OCD, they can see that some areas of the brain are different than the brains of people who don’t have OCD.

Those tortured with OCD are desperately trying to get away from paralyzing, unending anxiety…

Beware of Gas Lighting

Gaslighting or gas-lighting is a form of manipulation through persistent denial, misdirection, contradiction, and lying in an attempt to destabilize and delegitimize a target. Its intent is to sow seeds of doubt in the targets, hoping to make them question their own memory, perception, and sanity. Instances may range from the denial by an abuser that previous abusive incidents ever occurred up to the staging of bizarre events by the abuser with the intention of disorienting the victim. The term owes its origin to Gas Light, a 1938 play and 1944 film, and has been used in clinical and research literature. 

Ingrid Bergman in Gas Light (1944)

Narcissistic Personality Disorder: A Few Key Points

Here are some key points to keep in mind when dealing with people with Narcissistic Personality Disorder:

 It’s not curable and it’s barely treatable. He/she is who he/she is. There is no getting better, or learning, or adapting. He/she’s not going to “rise to the occasion” for more than maybe a couple hours. So just put that out of your mind.

He/she will say whatever feels most comfortable or good to him/her at any given time. He/she will lie a lot, and say totally different things to different people. Stop being surprised by this. He/she won’t care. So if you’re trying to reconcile or analyze his/her words, don’t. It’s 100% not worth your time. Only pay attention to and address his/her actions.

3) You can influence him/her by making him/her feel good. 

4) Entitlement is a key aspect of the disorder. He/she will likely not observe boundaries. 

5) We should expect that he/she only cares about himself/herself and those he/she views as extensions of himself/herself, like his/her children. (People with NPD often can’t understand others as fully human or distinct.) He/she will have no qualms at all about stealing everything he/she can, and he/she’ll be happy to help others do so, if they make him/her feel good. He/she won’t view it as stealing but rather as something he/she’s entitled to do. 

6) It’s very, very confusing for non-disordered people to experience a disordered person with NPD. While often intelligent, charismatic, and charming, they do not reliably observe social conventions or demonstrate basic human empathy. It’s very common for non-disordered people to lower their own expectations and try to normalize the behavior. Do not do this and do not allow others to do this. If you start to feel foggy or unclear about why, step away until you recalibrate.

7) People with NPD often recruit helpers. These are referred to as “enablers” in the literature when they allow or cover for bad behavior, and “flying monkeys” when they perpetrate bad behavior on behalf of the narcissist. Although it’s easiest to prey on malicious people, good and vulnerable people can be unwittingly recruited. It will be important to support the good people around him/her if and when they attempt to stay clear or break away.

8) People with NPD often foster competition in people they control. Expect lots of chaos, firings, and recriminations. He/she will probably behave worst toward those closest to him/her, but that doesn’t mean (obviously) that his/her actions won’t have consequences for the rest of us. He/she will punish enemies. He/she may start out with a confusing combination of punishment and reward, which is a classic abuse tactic for control. If you seen others cooperating or facilitating this behavior in order to favor rewards, call them on it.

9) Gaslighting (where someone tries to convince you that the reality you’ve experienced isn’t true) is real and torturous. He/she will gaslight, his/her followers will gaslight. Learn the signs and find ways to stay focused on what you know to be true. Note: it is typically not helpful to argue with people who are attempting to gaslight. You will only confuse yourself. Just walk away.

10) Whenever possible, do not focus on the narcissist or give him/her attention. Focus on what you can change and how you can resist, where you are.