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← Mind is everything | Dr. David Hendricks | TEDxTraverseCity

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Showing Revision 13 created 11/14/2019 by Peter van de Ven.

  1. (Announcer) Please welcome to the stage
    Dr. David Hendricks.
  2. (Applause)
  3. Tashi delek - that's how you say
    hello in Tibetan.
  4. Today I'm really happy to be here
  5. to share thoughts that have been
    on my mind every day since 1989.
  6. My talk today, I hope,
    you will find some benefit in.
  7. That's the basic motivation I have
    in talking to you today.
  8. The subject matter of my talk
  9. is going to appear to you today
  10. just to be a little bit
    on the academic side,
  11. and there's a reason for that.
  12. Before my own recovery,
  13. the only emotions
    that were easy for me to access
  14. were anger and depression.
  15. And one of the true gifts of my recovery
  16. was the ability to access
    a full range of emotional responses,
  17. and I haven't yet got the hang
    of all of the more tender emotions,
  18. so I tend to break into tears easily.
  19. So staying on the academic side
    is the best thing for a macho man like me
  20. so I don't break down in front of you.
  21. So, the other thing I want to say
  22. is that even though the presentation
    may seem at points academic,
  23. it has a deep soulful purpose
  24. because it's been my passionate
    intention over the years
  25. to try to relieve the suffering
    of addiction particularly,
  26. but also mental illness.
  27. Before I start,
    the last thing I'd like to say
  28. is that I'd like to dedicate
    this talk today
  29. to my old Buddhist teacher,
    who died last year.
  30. So Buddha said,
  31. "The mind is everything.
    What we think we become."
  32. Because I really believe that to be true,
  33. I'm often made really uneasy
  34. when I see the kind of crazy stuff
    that goes around in my own mind.
  35. But what's in my mind today
    is really more peaceful and calm
  36. than it was in the many years
    during my rough childhood,
  37. where my father was incessant
  38. in his attempts to shame me
    and break me down,
  39. and it's certainly clearer
    and better than it was
  40. during the uncontrollable anger
    of my 20 years as an alcoholic.
  41. I figured that if Picasso
    can have a blue phase,
  42. then I'm entitled to an alcoholic phase,
    which I'm glad is over.
  43. But at the end of that career,
  44. I really didn't believe that I would ever
    be able to have a normal life.
  45. But I joined AA anyway,
  46. and within one year of that,
  47. I met my Buddhist teacher
    and I began to meditate,
  48. and I began to practice
    the Buddhist philosophy of mind,
  49. which was the most profoundly useful
    psychological system I'd ever encountered.
  50. And then three years later,
  51. the unexpected miracle of a top-to-bottom
    revolution in my entire life occurred -
  52. something we call "sobriety in recovery."
  53. This has been a pivotal event in my life,
  54. and at the time that it occurred,
  55. it's become my fundamental
    motivation in life
  56. to try to help other people
    who suffer as I did
  57. to also achieve
    the same kind of redemption
  58. that I was lucky enough to achieve.
  59. So,
  60. what I would like to do is to see
    if there's any fundamental truths
  61. that we can bring out
    of my little miniature biography today,
  62. and I'd like to start in childhood.
  63. Recent brain imaging studies
    of maltreated children
  64. revealed extensive
    structural abnormalities
  65. in multiple regions of the brain,
  66. and enough damage to the brain
    so that the brain of these kids
  67. has actually reduced
    as much as 10% in size below normal.
  68. When you look at the painful images,
    these brain images, of these children,
  69. it's difficult to understand
    how they could ever have a decent life,
  70. but it wasn't until the publication
    of the Adverse Childhood Event Study,
  71. the ACE Study, a few years ago
  72. that what these kids were going to face
    in adulthood became clear.
  73. Now the ACE Study was a groundbreaking
    clinical epidemiologic study
  74. that did two things for the first time
    in the history of clinical research,
  75. and that is that it looked for -
  76. I'm going to put all this up
    so you have a chance to see it.
  77. For the first time
    in clinical research of this type,
  78. it looked for all
    of the types of adversity
  79. that kids could go through at one time.
  80. It's hard for me to believe
    it wasn't done before this -
  81. it was always fragmented -
  82. but in this study,
  83. all forms of adversity that children
    could suffer were looked at,
  84. and they were eight in number,
  85. and they include physical,
    emotional, and sexual abuse,
  86. witnessing the mother being abused,
  87. divorce or separation,
  88. and being raised by a parent that was
    criminal, mentally ill, or drug addicted.
  89. The study - the second thing that was done
  90. was that the study was done
  91. in a very large well-designed
    population of study subjects
  92. on whom med and psych records existed
  93. so that the results of the study
  94. accurately represent the experience
    of the entire U.S. adult population.
  95. 64% said that they had experienced
  96. at least one form
    of these eight forms of adversity.
  97. I've done my math
    about Millikan Auditorium.
  98. And I'm sorry to tell you,
  99. but it has probably already occurred
    to some of you looking at the screen
  100. that 230 of you also likely experienced
    one form of adversity growing up,
  101. and that 140 of you experienced
    two types of adversity -
  102. two of the eight -
    that's 40% of the US population,
  103. and 13% experienced four or more,
  104. like me or like 45 of you.
  105. So the first thing
    that we know from the ACE Study
  106. is that adversity is very common
    and that most of us in this room share it.
  107. What do you think the ACE Study
    would predict the likelihood
  108. that these suffering children
    would use drugs in adulthood?
  109. This is a graph that depicts
    on its vertical axis
  110. the likelihood of
    injecting drugs as an adult
  111. plotted against childhood experience
    on the horizontal axis.
  112. The way this works is that for those
    that report no adversity,
  113. the likelihood of injecting
    drugs is very low,
  114. but among those who have only one species
    of adversity during childhood,
  115. the risk triples,
  116. and for those that have two
    of any of the eight …
  117. or three …, or four or more …
  118. 80% of all addicted adults
    in the United States today
  119. come from this population of people
    that were abused as children.
  120. What would you guess about the likelihood
    of mental illness in their future?
  121. This is a bar graph that depicts
    a likelihood of committing suicide -
  122. surely, the ultimate marker
    of emotional suffering -
  123. in adulthood plotted
    against childhood experience.
  124. And again, the zero
    represents an ACE score of zero,
  125. that among those who had no reports
    of childhood adversity,
  126. the risk of committing suicide as an adult
    was very low - vanishingly small.
  127. For those that had one type of adversity
    in their childhood experience …
  128. two types …, three of the eight …,
  129. four …, five …, six …, and seven or more …
  130. In the article where these results
    were first published,
  131. the authors said
  132. that the linkage between being abused
    as a kid and killing yourself as an adult
  133. was so strong
  134. as to be unprecedented in the history
    of epidemiologic studies.
  135. And they further concluded
  136. that the vast majority of suicides
    in the United States every year
  137. are attributable to only one thing,
    and that is their abuse as children.
  138. So the 20th century
    closed on an extremely dark note.
  139. What we knew at that time
  140. is that adversity altered
    the structure of the brain of these kids,
  141. and that these structural alterations
  142. set the stage for emotional states
  143. that accounted for the majority
    of the suffering in the United States
  144. due to drug addiction and mental illness.
  145. But science made this picture even blacker
  146. when it said that once these
    suffering kids reach young adulthood,
  147. there wasn't anything
    anybody could do to help them,
  148. because by that time the brain
    had lost the capacity to ever change,
  149. essentially entombing them
    in their suffering.
  150. This is what I was taught
    in medical school,
  151. and I absolutely refuse to believe it.
  152. And it turns out that I was right
    not to believe it,
  153. because at the dawn of the 21st century,
    enough light shone in on this problem
  154. to reveal that the brain had had
    a science of its own all the time
  155. and had the capacity for radical change,
  156. and that it could do it even in adulthood.
  157. So what I'd like to talk to you about now
    is two major mechanisms that the brain has
  158. in order to restructure itself
  159. and to create different and new
    functional potentialities.
  160. This is a photo micrograph
    of the hippocampus,
  161. which is one of the most
    remarkable areas of the brain.
  162. And over the years of study, it's become
    my second favorite bodily organ.
  163. (Laughter)
  164. Sniggering?
  165. (Laughter)
  166. Okay, this is total transparency -
  167. my favorite bodily organ
    is my anterior insular cortex.
  168. (Laughter)
  169. Alright, so the thing
    that's remarkable about this -
  170. this is a beautiful picture -
  171. these green guys, all along here,
    are brand-new baby neurons.
  172. So one of the major resources
    the brain has to change
  173. is the birth of new brain cells.
  174. I love these little guys.
  175. If there was one place
    that they could do the most good,
  176. it would be here in the hippocampus,
  177. which is Grand Central Station
  178. of the brain's capacity
    to form new learning experiences
  179. and consolidate that
    into retrievable memory.
  180. And what happens, apparently,
    is that whatever we're required to do -
  181. to grow, to adapt
    to current life situations,
  182. like recover from
    mental illness or addiction -
  183. constitutes the marching orders
    for these little green guys
  184. to begin to migrate up
    into the body of the hippocampus,
  185. where all life's experiences
  186. are already encoded
    and find the right place to plug in
  187. in order to encode
    new learning experiences
  188. that can be remembered.
  189. And the second that they plug in,
    the brain has changed.
  190. And the second that these new neurons
  191. add their voice to the internal
    mental conversation,
  192. the vector of thought and feeling shifts.
  193. And the second that these
    new learning experiences are in place -
  194. and by new learning,
    I don't mean one plus one equals two,
  195. I mean important stuff,
  196. like I just discovered that I'm a pretty
    decent person after all -
  197. that experience
  198. immediately begins to compete
    with the messages from the past,
  199. and for all abused kids,
    the message is "you're a bad kid,"
  200. so that the "I'm a good person" message
  201. can come to dominate
    "I'm the bad kid" message,
  202. which is really hopeful and really cool.
  203. But what's also really cool
  204. is the second mechanism
    that I wanted to tell you about
  205. by which the brain changes,
  206. and that's a very complex
    molecular machine
  207. that exists inside the neuron
    in the brain, called epigenetics,
  208. which has the capacity,
    in response to current life experience,
  209. to physically move
    into the nucleus of the cell
  210. where it shuts genes off and on
    in order to help us adapt.
  211. So I'd like to tell you
    about a recent laboratory experiment
  212. that goes to the heart
    of what we're talking about here today,
  213. and it's an experiment
  214. that deprives rat pups
    of the maternal care that they need.
  215. When they don't get that,
  216. the epigenetic machine
    becomes aware of it,
  217. it physically moves
    into the nucleus of the cell,
  218. where it shuts off a gene
  219. that's responsible for the control
    of the stress reaction in the brain,
  220. and when that gene doesn't work,
    the brain can't control stress.
  221. So once a stress reaction begins,
    it can't be stopped.
  222. And this out-of-control stress
    is toxic for central nervous tissue:
  223. it kills brain cells, it reduces the brain
    in size and distorts its architecture.
  224. But you see, those are exactly
    the forces that were responsible
  225. for the abnormalities
    in the brain imaging studies
  226. of these maltreated children
    that we talked about earlier.
  227. The other thing that it does
  228. is it makes these rat pups
    act mentally ill.
  229. So this molecular and genetic
    configuration in the brain
  230. are the changes that drive the behaviors
  231. that we diagnose
    as post-traumatic stress disorder
  232. in clinical practice.
  233. But if later, the maternal care
    that these rat pups need
  234. is provided to them,
  235. the epigenetic machinery hears about this,
  236. this complex molecular machine
    moves back into the nucleus of the cell,
  237. where it switches the gene responsible
    for the stress response back on -
  238. stress comes under control,
    the brain is healed,
  239. and the rat pups stop acting mentally ill,
  240. and they get on
    with perfectly normal lives.
  241. And this is exactly analogous
    to the situation of maltreated children.
  242. And we learned from this
  243. that if we want to give
    to our patients in recovery
  244. the same epigenetic gift of healing
  245. that these rat pups enjoyed
    in this experiment,
  246. then we'd better be really careful
  247. about how we go about
    the process of repairing it
  248. in our patients in treatment.
  249. So in our treatment program,
  250. my wife and I
  251. try to provide as much as we can
    every one of our patients
  252. with two new parents -
  253. she and I.
  254. And we have a commitment to stick
    with them for a minimum of five years,
  255. and this is a period of time
    that science indicates
  256. that is necessary for these brain changes
    to come to completion.
  257. Okay, so where are we now
    in this conversation?
  258. We know that adversity changes the brain,
  259. and we know that these brain changes
    sets the mood in the brain
  260. and that these moods drive the processes
    of addiction and mental illness.
  261. But we also know now, in the 21st century,
  262. Western science teaches us
  263. that the physical brain
    is being changed all the time
  264. under the dynamic influences
    of epigenetics and neurogenesis.
  265. But whereas Western culture
  266. is really good about looking
    at the outside world
  267. and manipulating physical matter,
  268. our Western culture doesn't provide us
  269. with a very deep understanding
    of the nature of mind -
  270. the internal mental world,
  271. how to really pay attention
    to what's going on there,
  272. how to sort out the meaning
    of mental events,
  273. and how to guide these mental events
    for maximum growth,
  274. so that what happens is that a change
    is usually or often willy-nilly,
  275. and the results are half-baked.
  276. But,
  277. 20 centuries ago,
    Buddhist philosophy of mind
  278. had a very detailed and
    profoundly intelligent understanding
  279. of the nature of mind.
  280. It had techniques
  281. so that we could really pay attention
    to what was going on there.
  282. It had the ability
  283. to sort out mental events,
    understand their operational nature,
  284. and how to use them for maximal
    human growth and spiritual development.
  285. So, now I'm supposed to say, What now?
  286. So I'm going to say, What now?
  287. So, my wife and my professional partner
    are both Buddhists.
  288. We've been mental health
    and addiction treatment professionals
  289. for a decade,
  290. and so she and I decided many years ago
  291. that we were going to take
    a really close look
  292. at the Buddhist philosophy of mind
  293. and see whether or not we could
    integrate it into our treatment program
  294. so we could do a better job
  295. helping the people that came to us
    with these disorders.
  296. So, after many years of preparation,
    we left the United States a few years ago,
  297. and we traveled to the seat
    of the Tibetan people in exile
  298. in North India.
  299. And over about two-year period of time,
  300. she and I selected
    a specific Tibetan text,
  301. which was a text on human psychology
    from the Buddhist perspective,
  302. and then working separately,
    we each then translated that text
  303. over about a seven-
    or eight-month period of time.
  304. And this is a text that in Tibetan
    is "Sem dong sem jung" -
  305. it means "The mind
    and that which arises from mind,"
  306. or more loosely translated,
    "The mind and its functions,"
  307. or "Mind and mental functions."
  308. And after we translated it,
  309. then we had the good fortune to be able
    to study this translated material
  310. with Buddhist scholars who were respected
    for their mastery of this subject matter.
  311. So, when we finished,
  312. we came back to the United States
    and set up a treatment program
  313. in Traverse City.
  314. But before I tell you about that,
  315. I would like to share with you
  316. one more piece of evidence
    that's necessary to have
  317. before we're able to take
    all the pieces of puzzle
  318. that I've talked to you about today
  319. and put it together into an improved
    treatment methodology for these disorders.
  320. And this has to do
    with recent brain imaging evidence
  321. demonstrating that meditation
    has a profound positive impact
  322. on multiple regions
    of the central nervous system,
  323. including those areas of the brain
    damaged by childhood adversity.
  324. So that only after four hours
    of a sitting meditation practice -
  325. four hours of sitting in meditation,
    divided up over days or whatever -
  326. brain imaging technology
    shows a marked enhancement
  327. of the activation
    and the operational strength
  328. of those brain regions that are
    responsible for focused attention,
  329. what's called "mindfulness"
    in the lay press,
  330. and then after only 11 hours
    of sitting meditation practice,
  331. brain imaging proves
  332. that the actual density of living tissue
    in these brain regions has been increased,
  333. so they've been muscled up and bulked up
  334. so that their functional
    capacity has changed,
  335. so they can really pay attention
  336. to whatever you choose
    to focus your attention on.
  337. This is an example
  338. of sustained attention of the mind
    as distinct from the brain
  339. changing the structure of the brain and
    giving it enhanced functional capacity.
  340. But we had this experience all the time.
  341. The mind is always
    telling the brain what to do -
  342. so if I say wiggle this finger,
  343. the brain says, "Okay," and it finds
    the appropriate area in the motor cortex
  344. that controls the finger, the right nerve,
  345. and the finger wiggles.
  346. So what I'm suggesting
  347. is that if we became more astute
    about training the mind
  348. to find any area that we wanted,
  349. we could learn how to access
    specifically those regions in the mind
  350. that were damaged by childhood adversity,
  351. and by focusing and encouraging
    their sustained operation,
  352. beef them up to cure it.
  353. So this is the way this new
    treatment methodology works:
  354. We practice quiescent meditation
  355. until we beef up the areas of the brain
  356. that are responsible
    for focused attention
  357. until they become strong enough
    that we can use that as a tool,
  358. like a lens to look inside
  359. and to actually observe
    the arising of thoughts and feelings
  360. from moment to moment in our own minds.
  361. By enumerating a relatively short list
  362. of mental functions
    that mind is capable of performing,
  363. Buddhist psychology helps us here
  364. because as they arise,
  365. we can properly identify them
    and give them names.
  366. And what this does is
    facilitate bringing meaningful order
  367. to a realm of our inner mental experience
    that's often very confusing for us.
  368. The second thing that Buddhist psychology
    does to help us here
  369. is that it actually assigns a moral weight
    or value to these mental functions
  370. so that now we've got them sorted out
    and we've got them named
  371. and we know what's going on:
  372. we learned that they are bifurcatable
  373. into two mutually distinctive areas
    of functionality -
  374. harmful and beneficial -
  375. and we observed that when the harmful
    mental functions operate,
  376. it reduces our mental health
    and our happiness,
  377. but when the mental functions
    that belong to a beneficial domain of mind
  378. are operational,
  379. our mental health is increased
    along with our happiness.
  380. The third thing that Buddhist
    psychology does to help here
  381. is to give us efficient
    and useful techniques
  382. by which we can begin
    to modulate internal mental activity.
  383. We've sorted things out.
  384. We now see
  385. that they exist in the two categories
    of harmful and helpful,
  386. but now we can actually take a hand
  387. and we can develop
    the mental discipline that's required
  388. in order to recognize the incipient
    operation of negative mental functions
  389. and reduce their power over us,
  390. and to recognize the benefits
    of positive mental functionality
  391. and encourage and strengthen them.
  392. So, for example, if I am a person
    who has some training in these matters
  393. and I'm going through my day
  394. and I suddenly become aware
    that this person that I'm dealing with
  395. is really pissing me off,
  396. I see the arising of anger from the domain
    of negative mental functions,
  397. and I take a step back
    because I know I'm in danger -
  398. I don't want to be hurt,
    I don't want that person to be hurt,
  399. and I certainly don't want
    to have to suffer the mental consequences
  400. that will necessarily arise
  401. if I allow that motivation
    to motivate my behavior.
  402. If I have some training and control,
  403. I can switch my motivation
    and intentionality to the positive domain
  404. so only they can operate
    to motivate my behavior.
  405. When we have the subjective experience
    of positive emotionality,
  406. it is important to realize
  407. that that experience that we have
  408. is the end product of the result
  409. of a number of distributed
    different brain regions
  410. that are cooperating together
    in a tightly wired neural network
  411. to produce that sensation.
  412. So that means,
  413. just like the mind controls the brain,
  414. I can use the mind
    and learn how to command the brain
  415. to go into those neural circuits
  416. and navigate specifically
    to the brain regions
  417. that were damaged
    by a childhood adversity.
  418. Little kids who've been abused don't have
    any trouble feeling negative affect,
  419. but they do have trouble
    feeling positive affect,
  420. which means
  421. that it was precisely the domains of
    the brain responsible for positive affect
  422. that were injured by childhood adversity.
  423. So by using these techniques
    of Buddhist psychology,
  424. what I'm really doing
  425. is navigating to them
    by mindful attention -
  426. I am sustaining their operation,
  427. and we know that sustained operation
  428. beefs them up and make them
    stronger and stronger
  429. until such time as they begin,
    for the first time, to function normally.
  430. The first moment of
    normal functionality of these circuits
  431. is experienced objectively
  432. as the acquisition
    of sobriety in recovery.
  433. When I achieve sobriety
    in my own recovery efforts,
  434. it was a feeling like my soul was rising
    like a raft from the bottom of the ocean
  435. to stand up for the first time,
  436. and what came with it
    was a sense of enduring peace
  437. and a certainty I would never drink again.
  438. There wasn't any need to drink anymore
    because everything was working okay.
  439. So what's really happening here
  440. is that we're using
    a powerfully focused mind
  441. that we get from a meditational practice
  442. within an overarching
    construct and guidance
  443. of a Buddhist psychological system
    of mind, of understanding the mind.
  444. And what we're really doing is,
  445. for the first time, we have the ability
    to take conscious control
  446. of the brain's physical resources,
    dynamic resources for change,
  447. which is epigenetics and neurogenesis,
  448. and we direct them
    to heal the wounds of the past
  449. and to restore to us the right to be
    who we choose to be for the first time.
  450. Any of us can do this at any time;
  451. it doesn't matter where we stand
    on the continuum of human development.
  452. So you don't need to worry
    about the brain's capacity to change;
  453. all you have to do is to be really serious
    about training the mind,
  454. and it'll happen automatically.
  455. Buddha said,
  456. "Mind is everything.
    What you think you become."
  457. Thank you very much.
  458. (Applause)