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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Noa on November 11, 1999, at 13:22:27
Last week I posted a message about this article about neuroscience findings of brain laterality and emotions. I found the site for the online version, in case anyone is interested.
http://search.washingtonpost.com/wp-srv/WPlate/1999-11/02/095l-110299-idx.html
Posted by PL on November 11, 1999, at 14:26:09
In reply to Article on Brain Laterality and Emotions, posted by Noa on November 11, 1999, at 13:22:27
Good article. Wouldn't it be great one day if doctors could scan your brain and hand you a scrip to make you well; or scheudle an operation to cure you?
Posted by Bob on November 11, 1999, at 19:27:03
In reply to Re: Article on Brain Laterality and Emotions, posted by PL on November 11, 1999, at 14:26:09
> Good article. Wouldn't it be great one day if doctors could scan your brain and hand you a scrip to make you well; or scheudle an operation to cure you?
Not the old "bottle in front of me/frontal lobotomy" thing ... except now, it depends on whether the bottle is half empty or half full, and which half at that.
Bob
Posted by Noa on November 11, 1999, at 21:43:11
In reply to Re: Article on Brain Laterality and Emotions, posted by Bob on November 11, 1999, at 19:27:03
Bob, you are definitely in left brain mode.
Posted by noa on November 11, 1999, at 22:01:40
In reply to Re: Article on Brain Laterality and Emotions, posted by Noa on November 11, 1999, at 21:43:11
This article has been thought provoking for me. First of all, it speaks to me about the way my moods are so distinct and separate. My sense of my self when depressed and my sense of my self when not depressed are so separate, and I am trying to integrate them more.
Second, when I am having strong feelings, I have a hard time verbalizing them, even internally. My therapist will ask what I am thinking and I'll tell him it is like seeing all these thought fragments fly around in front of me and I can't seem to land any of them, to see what they are saying. I "know" them or feel them, but they are nonverbal. This week, this happened, and he asked if I could try to describe a fragment. All I could see what the image of a photo of me as an infant being held by my mom. I was able to describe it clearly, and that led to a great discussion about family issues, etc. Having read this article, I now think that it makes sense. When I am having these overwhelming anxious, depressed feelings, it is my right brain in action--pictures, not words.
I gave my pdoc a copy of the article. I joked with him about how maybe what I need is targeted treatment on my corpus collosum, to bring my right and left together some more, so they won't be so isolated from each other, like totally changing the channels. He said it was no joke, that someday, they will do minor laser procedures to treat various brain disorders. Tomorrow (this is why he canceled the appointment I originally had for tomorrow)he is going to the NIH course on psychopharm for pdocs and he said he will gladly share any new info with me next month.
Posted by Bob on November 11, 1999, at 23:35:23
In reply to Re: Article on Brain Laterality and Emotions, posted by noa on November 11, 1999, at 22:01:40
Hmmm ... left brain mode associated with emotions? Most illogical, but fascinating ....
So much for my Spock imitation.
Noa, you ever read Drawing from the Right Side of the Brain? It's one of the "mythic" texts of those in the educational community who like to focus on hemispheric differences in learning styles. I was actually reading it a long time ago because I wanted to learn how to draw. It *did* have some interesting activities trying to teach the reader how to "switch" modes from left to right.
I also identify with your language difficulty in describing your depression. The best I've ever been able to come up with is metaphors. I'm always dancing around the topic lnguistically instead of zeroing in on it.
Bob
Posted by Adam on November 11, 1999, at 23:35:42
In reply to Article on Brain Laterality and Emotions, posted by Noa on November 11, 1999, at 13:22:27
Thank you for posting the article, Noa.
Starting around the time I was 15 I began to develop a preoccupation with the shape of my face. I have
a slightly longish nose and a bit of a receding chin, but am "normal" looking in all respects and even
"cute" to some (aren't we all:)) Anyway, with time I became increasingly uncomfortable with my own reflection.
I began to develop a positive loathing for the shape of my face, and a near constant preoccupation with it.
I started spending whatever time I could checking my reflection in private, holding mirrors at different
angles or using two mirrors to check a profile, while in public averting my gaze if I saw myself in a
refelctive window or the boy's room. I became fearful of what others thought of me, of my appearrance, if
they might be disturbed or disgusted by my deformity. It consumed hours of my time. I lived with this
for roughly seven years, and it is still a wonder to me that I ever dated or dared to go out in public some
times. It hurt some of my relationships, because if I did feel close enough to someone to talk about my fear,
I often sought reassurance that I was OK, and this was often distressing and bizarre to the people I opened up
to. It was torture. To have this combined (and doubtlessly contributing to) depression made me feel suicidal
sometimes.I briefly sought psychatric treatment while in college, but didn't discuss much of my disorder. After graduating,
I started a job at the National Institutes of Health. I was living alone in a new city (D.C.), feeling badly at
times, and started seeing another psychiatrist. For the first time really I opened up about my illness, and
described my preoccupation with my face, which made me so uncomfortable I literally was squirming in my seat.
After a few brief visits he concluded that I was severly depressed and partially delusional, that I probably was
suffering from a form of psychosis and felt I should try an antidepressant and a neuroleptic. I walked out of his
office with a prescription for Tofranil (which I had tried briefly before)and some other drug I can't remember now
and didn't go back. I spent the next week in a state of near shock. Me, psychotic.About few weeks later I attended a talk (given as part of a summer lecture series for student interns at the NIH)
given by Dr. Judith Rapoport on obsessive compulsive disorder. Body dysmorphia wasn't discussed, but I felt such
a surge of recognition for some of the things she described I was beside myself. I had no idea, had never heard
of OCD before, had not the slightest inkling of how significant my being there would be to me. After the talk I
immediately went back to my lab, got out a phone directory, found out where Dr. Rapoport was. I met with her the
next day and within a month I was enrolled in a study at the NIMH on OCD. (Susan Swedo, MD was the PI) Part of
the study involved brain imaging (PET and MRI), other neurological tests, and behavioral therapy. It was, I think,
a lifesaving experience.Though I am a little disapointed that OCD isn't diagnosed today at least in part using some of the imaging methods
that were utilized in the study, at least it and other phsysiological probes of mental disorders (such as the work
Noa cited)are being utilized in research, and hopefully will make it to the clinic before too long. I can think of
no other branch of medicine where potent drugs that can profoundly affect our biochemistry are prescribed on a regular
basis using only a series of questions as a diagnostic guide. Granted it was 1992, but that I could be diagnosed as
psychotic and prescribed a medication whose side effects included tardive dyskinesia based solely on one man's
impressions (I was never even given a standard diagnostic questionnaire) for an illness I did not have is astounding.
What would have become of me if I had not seredipetously been at Dr. Rapoport's talk I don't know. To this day I know
of no robust physiological test (besides maybe for thyroid or cortisol, which provide little useful information
in most cases) that the average psychiatric practitioner has at his or her disposal to help adequately treat a
neurological disease. We need such tests incredibly badly.
> Last week I posted a message about this article about neuroscience findings of brain laterality and emotions. I found the site for the online version, in case anyone is interested.
>
> http://search.washingtonpost.com/wp-srv/WPlate/1999-11/02/095l-110299-idx.html
Posted by Noa on November 12, 1999, at 2:52:19
In reply to Re: Article on Brain Laterality and Emotions, posted by Adam on November 11, 1999, at 23:35:42
WOW, Adam.
THanks for telling your story.
I also hope for a time when either the knowledge gained from imaging research is used to develop more specific diagnostic screening tools, or that using the imaging technology to directly screen for disorders, will be routine.
Where are still far from that. Notice how small the study's N is. The imaging technology is still so expensive that the studies are only looking at small numbers, which to me is problematic in two ways. 1. the studies are still small enough to be vulnerable to criticism about generalizability, and 2. the prospect of using the imaging techniques in the clinical setting to diagnose disorders is still a long way off.
But the fact that this type of research is coming out with such fascinating info thrills me.I read Rappaport's book The BOy Who Couldn't Stop Washing. Very interesting.
BTW, how did you find Rappaport as a doc to work with given how high profile she is? Was access an issue?
Posted by noa on November 12, 1999, at 2:56:45
In reply to Re: Article on Brain Laterality and Emotions, posted by Noa on November 12, 1999, at 2:52:19
Bob,
re: left side--who knows, but I was thinking about your verbal agility and your "activation". On the other hand, the emotions, as you say, and the humor, are more rightish, no?
Actually you strike me as someone who is usually very able to pull together both left and right stuff--strong feelings, verbal skills, activation, logic, fund of knowledge, etc.When I am having strong feelings, negative ones, which predominate, not just depression (depression is my inept "rescuer", ie shutdown mechanism), I lose all verbal skill. I cannot integrate left and right. I tend to dwell in one or the other exclusively.
Posted by jamie on November 12, 1999, at 2:57:11
In reply to Article on Brain Laterality and Emotions, posted by Noa on November 11, 1999, at 13:22:27
It's interesting if you use a mirror to reflect one side of a person's face so both sides are the same you get a totally different face. Switch the mirror to the other half and yet another totally different face emerges. The left side and the right side of face are quite different. I suppose it's easy to envision the brain is similarly different on both sides.
When surfing through some of those psychotropic nootropic antiaging herbal sites I remember reading about an herb that has the effect of linking the two halves of the brain. The result is enhanced creativity, enhanced verbal skills. I don't remember what herb/drug it was though. But it supposedly allowed both sides of the brain to work better as one unit rather two distinct units. An example given was a boss who gave the herb to a secretary who then developed incredible office, verbal, and creativity skills she didn't previously have. Anyone else read about this?
Posted by Noa on November 12, 1999, at 3:00:09
In reply to Re: Article on Brain Laterality and Emotions, posted by noa on November 12, 1999, at 2:56:45
I have heard of that book, and related workshops. Nevre paid them much mind, but now I will.
Also makes me rethink some of the eastern traditional stuff like tai chi or yoga, and related new age trendy stuff, that have you doing a lot of physical crossing the midline, repetetively. I bet it helps integrate left and right brain functions.
Posted by Adam on November 12, 1999, at 11:12:02
In reply to Re: Article on Brain Laterality and Emotions, posted by Noa on November 12, 1999, at 2:52:19
In the case of OCD, the diagnosis is usually pretty clearcut, from what I understand, but there
are exceptions, and also people who don't respond to standard treatments. It is for them that
other diagnostic stratgies might be really important, I believe. I also feel that, in general,
the less subjective the diagnosis, the better. There is certainly somthing to be said for the
"art" of medicine, and I know from experience that some doctors just have an intuitive gift that
makes them brilliant diagnosticians. But since that's not true of everyone, I think the less
we need to rely on intuition the better. If depression, OCD, psychosis, etc. are all (at least
at some level) fundamentally physioligical/biochemical conditions, then they must have physiological
and bichemical markers that doubtlessly could be detected if we knew where to look. If those
markers could be correlated to a particular treatment strategy, then hopefully it would take some
of the guesswork out of selecting the right drug and/or psychotherapy.Dr. Rapoport was actually never my physician. Access to her was facilitated somewhat in that I had
some inside information (her exact location and personal phone number at the NIH, for instance).
She really didn't need to spend much time with me to point me in the right direction, and after that
I only saw her a couple more times in passing. My "physician" actually was Dr. Susan Swedo (who is
no longer at the NIMH, I guess) and my therapist was Dr. Charles Mansueto, a psychologist specializing
in behavioral therapy and the treatment of OCD/OCD spectrum disorders. Dr. Mansueto is in Silver
Spring, Maryland, and in his circles is quite well known, from what I understand.I never, ever would have been able to afford the services of Dr. Mansueto if I had not been enrolled in
a study. As I said, this was luck almost entirely. I can only say I was extremely fortunate to
be in the right place at the right time.
> WOW, Adam.
>
> THanks for telling your story.
>
> I also hope for a time when either the knowledge gained from imaging research is used to develop more specific diagnostic screening tools, or that using the imaging technology to directly screen for disorders, will be routine.
> Where are still far from that. Notice how small the study's N is. The imaging technology is still so expensive that the studies are only looking at small numbers, which to me is problematic in two ways. 1. the studies are still small enough to be vulnerable to criticism about generalizability, and 2. the prospect of using the imaging techniques in the clinical setting to diagnose disorders is still a long way off.
> But the fact that this type of research is coming out with such fascinating info thrills me.
>
> I read Rappaport's book The BOy Who Couldn't Stop Washing. Very interesting.
> BTW, how did you find Rappaport as a doc to work with given how high profile she is? Was access an issue?
Posted by Sean on November 12, 1999, at 16:25:27
In reply to Article on Brain Laterality and Emotions, posted by Noa on November 11, 1999, at 13:22:27
> Last week I posted a message about this article about neuroscience findings of brain laterality and emotions. I found the site for the online version, in case anyone is interested.
>
> http://search.washingtonpost.com/wp-srv/WPlate/1999-11/02/095l-110299-idx.htmlThis subject is one of deep personal interest as
I've experienced a number of lateralized physical
symptoms during various mood/anxiety states. I
would often mention this to my doc hoping it would
somehow help hium specify what was going on in my
particular case, but he usually shrugged them
off. Of course he isn't a researcher and the
literature is not very developed on this topic
yet.One article I read (in PUBMED somewhere) talked
about a sticky hemispherical switch for bipolar
people. They compared some kind of eye reaction
latency between bipolar and normals, apparently
finding some significant differences in how the
brain processes certain stimuli. I think this
topic will emerge as a major player in mood
disorders, even if it is a secondary symptom of
the disorder and not the cause.Bye!
Sean.
Posted by Noa on November 12, 1999, at 17:14:13
In reply to Re: Article on Brain Laterality and Emotions-Noa, posted by Adam on November 12, 1999, at 11:12:02
my therapist was Dr. Charles Mansueto, a psychologist specializing
> in behavioral therapy and the treatment of OCD/OCD spectrum disorders. Dr. Mansueto is in Silver
> Spring, Maryland, and in his circles is quite well known, from what I understand.
>
I remember that he was featured in the W.Post Sunday Magazine a few years ago. He apparently had used an unconventional form of therapy with an adolescent girl, that involved some desensitisation to the "forbidden" intrusive thoughts that she was developing compulsive rituals to rid herself of.
Posted by Noa on November 12, 1999, at 17:17:36
In reply to Re: Article on Brain Laterality and Emotions, posted by Sean on November 12, 1999, at 16:25:27
> One article I read (in PUBMED somewhere) talked
> about a sticky hemispherical switch for bipolar
> people. They compared some kind of eye reaction
> latency between bipolar and normals, apparently
> finding some significant differences in how the
> brain processes certain stimuli. >
> Sean.That is really interesting.
It makes me think maybe that is why EMDR is purported to work-rapid side to side eye movement to somehow link the hemispheres--verbal, logical, reasoning, goal oriented, and emotional, nonverbal, illogical. Hmmmm....
Posted by Bob on November 12, 1999, at 22:54:03
In reply to Re: Article on Brain Laterality and Emotions-Sean, posted by Noa on November 12, 1999, at 17:17:36
My interest in Drawing from the Right Side of the Brain came out of a seminar sponsored by my dorm council back in undergrad. I never got beyond second grade in terms of my people-drawing skills. The woman running the seminar had us sitting across from a partner, and asked us to draw one eye. Mine looked like the typical almond-shaped full-circle-iris sort of thing I'd been drawing for 15 years or so. Then, she had us draw it again, working with us on some (literal) visualization stuff ... *really* taking a look at what we were seeing and questioning the automatic definitions and concepts that popped up when we processed that sound we associate with "eye". My second drawing looked like nothing I had ever drawn before.
I've done some Tai Chi (and I really should sign up for these yoga classes being offered just down the block from me). The great thing about Tai Chi for me was that it felt like my mind separated from my body, as if the physical movement was an anti-distraction and my mind just wouldn't focus on it. But now that you mention it, it kinda was more like my logical mind was left behind on its own. My visual abilities, my body sense, all of this seemed heightened. It was really cool watching my classmates and staying in synch with them, only by seeing their shadows on the floor, reflections in the glass, never actually looking directly for this stuff.
As for having good cross-talk (thanks, Noa!) maybe that explains something. Like I always say, I think we have our gifts as well as our disorders. Mine is tied to intuitive leaps. I'm the schmoe who doesn't say a word when playing charades while the rest of my team is shouting out all sorts of things, until I just blurt out the answer, half the time halfway out of the blue. Always used to irritate my friends to no small end ....
Bob
Posted by Adam on November 13, 1999, at 13:49:31
In reply to Re: Article on Brain Laterality and Emotions, posted by Bob on November 12, 1999, at 22:54:03
I've wondered about the brain laterality thing myself and how it might be tied to
my emotions. I have the penmanship of a second-grader at best, the spelling skills
of a sixth-grader, maybe, and I can't draw a straight line to save my life. The way
I write the small letter "e" literally makes people laugh because I do it "backwards."
I remember in undergrad getting a perfect grade on my first O-Chem exam and a C on my
second one because the second one focused on stereochemistry. In physics you could
pick me out of a blurry picture pretty much because I was always the guy waiving his
hand around in the air trying to get the right-hand-rule to work. I never had a
problem grasping the concepts, but the execution sometimes could be extremely
frustrating, and it was my O-Chem professor who pulled me aside because he figured
something was amiss. I wasn't comfortable with the idea of "dyslexia" because for the
most part I did fine, typed everything into a word processor anyway, and if it took
me two hours to do the assignment instead of one, I just took the two hours. I didn't
want to be given extra time on exams because I didn't feel I was all that impaired,
but as I grew in understanding of depression and OCD as potentially stemming from
differences in the structure of my brain, I wondered if all of it, the spacial
difficulties, the endless loop of OCD, and the emotional troubles, might stem from
a single source that manifests itself in a variety of symptoms. In other words,
"depression", "OCD", maybe "dyslexia", all appearing in the diagnostic manuals as
separate and unrelated, are all intimately related in the structure of my brain, and
have the same genetic source. Very wild speculation, but something I've thought of.
Posted by Bob on November 13, 1999, at 22:07:52
In reply to Re: Article on Brain Laterality and Emotions, posted by Adam on November 13, 1999, at 13:49:31
Hey Adam, don't sweat that right hand rule stuff -- it's all relative anyway.
Bob
Posted by Adam on November 14, 1999, at 14:10:52
In reply to Re: Article on Brain Laterality and Emotions (A), posted by Bob on November 13, 1999, at 22:07:52
True, but in the stultifying world of undergraduate science I was always forced to
conform to a particular frame of reference. :)> Hey Adam, don't sweat that right hand rule stuff -- it's all relative anyway.
>
> Bob
This is the end of the thread.
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