Dr Alan Gijsbers. The challenge to ISCAST Issues in neuroscience ◦ Reductionism ◦ Mind-body as...

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Transcript of Dr Alan Gijsbers. The challenge to ISCAST Issues in neuroscience ◦ Reductionism ◦ Mind-body as...

Neuroscience, Addiction and the

GospelDr Alan Gijsbers

The challenge to ISCAST Issues in neuroscience

◦ Reductionism ◦ Mind-body as seen through the emotions ◦ Addiction and emotions◦ Emotional maturity and relationships

Interaction between emotions and reason

OUTLINE

Has dispassionate individualistic rationalism robbed the Gospel of vital elements?

Do the results of neuroscientific reflection point to a different way forward?

Does addiction management suggest a different way of evangelism?

GOSPEL MINISTRY

Scientific tent-makers in secular Australia

Scientifically sound, theologically able,

spiritually discerning

Creating an open dialogue between

science and faith to their mutual enriching

By that dialogue encouraging people to

come to the light of the world.

A VISION FOR ISCAST

Complexity vs reductionism

Mind/body issues via the emotions

Addiction and its meaning

Addiction and relationships

Insight and its lack in our patients

NEUROSCIENTIFIC ISSUES

Contains within it a number of sciences from Basic neurophysiology and neuropharmacolologyNeurologyNeuroimagingNeuropsychology Biological psychiatry Psychology PsychiatrySociology Spirituality

NEUROSCIENCE

“you, your joys and sorrows...are no more than a vast assembly of nerve cells and their associated molecules...the idea that man has a disembodied soul is as unnecessary as the old idea that there was a Life Force.”

Crick, F 1994 The Astonishing Hypothesis New York Simon & Schuster.

Quoted in Jeeves MA, Berry RJ. Science, Life and Christian Belief: Apollos 1998:135

Alan Gijsbers RMH Addiction Medicine

REDUCTIONISM

Emergent systemsYou cannot understand water by looking only at

hydrogen and oxygen

You cannot understand wetness by only looking at a water molecule

You cannot understand a waterfall by looking at a drop of water.

There is a degree of autonomy about each layer – though the layers above are dependent on the layers below.

Alan Gijsbers RMH Addiction Medicine

COMPLEXITY

ENGEL’S BIOPSYCHOSOCIAL MODEL American Journal of Psychiatry 1980;137:535-544

P erson[E xp erien ce an d B eh aviou r]

Tw o-p erson

F am ily

C om m u n ity

C u ltu re -S u b cu ltu re

S oc ie ty-N a tion

B iosp h ere

Alan Gijsbers RMH Addiction Medicine

S u b atom ic p art ic les

A tom s

M olecu les

O rg an e lles

C e lls

T issu es

O rg an s /O rg an sys tem

N ervou s sys tem

P erson[E xp erien ce an d B eh aviou r]

Emergence

Supervenience

Meaning

Top-down as well as bottom-up causation

LAYER RELATIONSHIPS

At the next level new systems emerge which were not predicted from the level below

Each new level brings a new way of seeing reality, eg chemistry to biochemistry, biochemistry to model making, L-dopa receptor considerations to Parkinson’s disease.

Alan Gijsbers RMH Addiction Medicine

EMERGENCE

Used to describe the events surrounding the death of Mr Glover from a heart attack ◦ Coronary occlusion ◦ Intervention of employer ◦ Unsuccessful arterial puncture ◦ Cardiac arrest◦ Defibrillation

Alan Gijsbers RMH Addiction Medicine

ENGEL’S SYSTEMS ANALYSIS

Fatman, 21 Kt. Dropped on Nagasaki 8 September 1945

AN EXAMPLE OF TOP-DOWN CAUSATION

Alan Gijsbers RMH Addiction Medicine

A MORE BENIGN VERSION OF TOP-DOWN CAUSATIONAlan Gijsbers RMH Addiction

Medicine

NEUROBIOLOGY OF EMOTIONS

“Move out”

Ecstasy – similar concept

Sense of transport outside of ourselves

Subjectivity seems central but...scientific research sees it differently...

EMOTIONS - definition

“The movements of expression give vividness and energy to our spoken words. They reveal the thoughts and intentions of others more truly than do words, which may be falsified.”

Charles DarwinThe Expression of Emotions in Man and Animals

The modification of neural activity that animates and focuses mental activity.

Created by physiological activity that selects certain streams of information over others, shifting the body and mind to higher or lower degrees of activity, agitating the circuits that create scenarios and selecting ones that end in certain ways. The winning scenarios are those that match goals programmed by instinct and the satisfaction of prior experience.

Wilson EO. Conscilience 1998:123-4.

What are the Emotions?

Animal neural systems that control “emotional behaviour” and associated physiological responses.

Emotional systems are said to have evolved as “behavioural (sensorimotor) solutions to problems of survival.”

Emotional responses do not require feelings.

Joseph LeDoux. Emotions viewed through the brain.In Russell RJ, Murphy N, et al. Neuroscience and the person. 1999.

THE SCIENCE OF EMOTIONS

Responses to dangerFreeze

○ Physiological responses to this freeze which support or are a consequence of the freeze behaviour

○ Further responses which will anticipate subsequent events (eg flight/fight)Reaction, Action, Habitual action.

○ Feelings are a late accompaniment in brains that are conscious, and lead to considered action

EG

James-Lange Theory of Emotion

Stimulus

Physiological Response

• Visceral

• Muscular

Mental Perception

Damasio’s Schema of Emotions

Emotionally Competent Stimulus

Triggering the emotion

Execution of the emotion

Emotional state

Thoughts that follow

Feelings: intentionality of the above

Feelings are not the function that emotion systems were designed to perform(!)

Emotion systems did not evolve to produce feelings

Emotional feelings are what happens when emotion systems are present in brains that are conscious.

The problem of feelings is another aspect of the mind-brain problem.

Joseph LeDoux. Emotions viewed through the brain.In Russell RJ, Murphy N, et al. Neuroscience and the person. 1999.

BASIC NEUROSCIENTIFIC VIEW

How can neural networks and synapses give rise to such a rich inner emotional life [intentionality, qualia] as we humans experience?

HENCE WE ARE DIRECTLY INTO THE MIND-BODY PROBLEM

4 Opposites

Joy sadness

Anger fear

Anticipation surprise

Trust disgust

One Model of Basic Emotions

http://www.fractal.org/Bewustzijns-Besturings-Model/Nature-of-emotions.htm

ROBERT PLUTCHIK’S MODEL OF EMOTIONS

MULTIPLICITY OF EMOTIONS (From GFR Ellis ) Damasio suggests primary emotions are:  

P1. happiness P2. sadness P3. fearP4. anger P5. surprise P6.disgust

(acceptance and expectation are not in this model )

and characterises developmentally emergent secondary emotions as: 

S1: embarrassment, shame, guilt S2: contempt, indignation S3: sympathy, compassion S4: awe/wonder/elevation, gratitude, prideS5: jealousy, envy.

 

Disorganised interruptions of mental activity

“Rule your feelings, lest your feelings rule you” (Pubililius Syrus C1)

A disorganised response, largely visceral, resulting from a lack of an effective adjustment

EMOTIONS – NEGATIVE DESCRIPTIONS

Dylan Evans. Emotion: The science of sentiment. OUP 2001

An organizing response because it adaptively focusses cognitive activities and subsequent action.

Processes that arouse sustain and direct activity

EMOTIONS POSITIVE DESCRIPTIONS

Dylan Evans. Emotion: The science of sentiment. OUP 2001.

Plato: emotions are obstacles to intelligent action.

Locke’s Punctual self.

Hume’s “Reason is the slave of the emotions.”

Romantics: conflict between cold reason (society) and warm heart (nature). Hence back to nature.

NEGATIVE RELATION OF EMOTIONS TO REASON

Adapted from: Dylan Evans. Emotion: The science of sentiment OUP 2001.

Emotions are vital to individual and social existence

Emotions the thread that weaves together the fabric of society.

It is rational to be emotional. No science of the mind is complete without

also addressing the heart. Thinking more clearly is not opposed to feeling

more deeply. Emotions are a universal language that binds

humanity together into a single family.

POSITIVE RELATION OF EMOTIONS TO REASON

Dylan Evans Emotion: The science of sentiment OUP 2001

Reason the arbiter of action which are implemented by the will to the control of feelings

Fact - faith - feeling train

“Reason is the slave of the emotions” – Hume◦ Reason steers; emotions drive – emotions as

energy◦ Emotions commit; reason justifies – reason as

rationalisation

RELATION OF THE EMOTIONS TO REASON

Affective Neuronal Darwinism (AND)- GFR Ellis and JA Toronchuk

Edelman’s Neuronal Darwinism

Panksepp definition of the basic emotions

AND combines these two views into a meta-theory

1: Neural DarwinismBiological Complexity is generated in each individual by a developmental process based on reading the genetic information stored in the sequence of bases in DNA: - Creates a highly structured organism out of differentiated cells - Influenced by information from the environment.

- [Gerald Edelman] Principles of Darwinian natural selection apply when utilising genetic information in each individual for brain development (hence Neural Darwinism): - both because the stored information is far too little to control brain

development by itself, Cf. the Human Genome Project: 45,000 genes but 1013 cells and 1011 neurons

- even if read mtultiple times and in different combinations - and because this allows the brain to optimally adapt to the local

environment

2: Affective Neural Group Selection

• In the cortex, broad functional areas are determined; then neurons send out random connections to other neurons

• Those that have a positive survival value are strengthened, others are killed off or allowed to decay [hence Neural Darwinism: Edelman and Tononi]

• A value system is required to decide which should be regarded as `positive’ or `good’ from a survival viewpoint

• This is provided by the primitive emotions whose seat is the pre-cortical area of the brain, sending out neuro-transmitters characterised in detail by Panksepp [ Affective Neuroscience]

‘The initial set of relatively non-specific synaptic connections are refined to produce a precise pattern of connectivity’- Neurotransmitters alter gene expression

From Edelman and Tononi

Value system

Neurotransmitters spread to entire brain

Source is in the Limbic system

Noradrenaline, Dopamine, Serotonin

The value system originates in the limbic (affective) system

Instinct

Emotion

Intellect

The basic (primitive) values

The basic emotional systems identified by Panksepp (1998), based on structures in the limbic system, are the following:

E1: The SEEKING system: general motivation, seeking, expectancy E2: The RAGE system: rage/anger E3: The FEAR system: fear/anxiety E4: The LUST system: lust/sexuality E5: The CARE system: providing maternal care/nurturanceE6: The PANIC system: panic/separation, need of care E7: The PLAY system: roughousing play/joy

On the present view: it is the basic emotional systems [particularly the SEEKING system] that underlie brain development and intellect- relates to evolutionary development and to animal behaviour

The basic hypothesisHypothesis: The basic emotional systems E1-E7 identified by Panksepp, together with inputs from the endocrine and immune systems, are necessary and sufficient to provide the value system of neural Darwinism identified by Edelman and Tononi. 

On this view, the primary emotions E1 to E7 characterised above [with endocrine and immune system inputs] become the lynch-pin linking neurophysiology to experience and the social and physical environment. They link macro-events to neural micro-structure by top-down action from the macro to the micro scale.

Consequently they are a key both to brain physiological development and to evolutionary development of secondary emotions and higher cognitive functions. The assumption is that nothing else is left out: this is the total value system.

Hence Hardwired emotions send out connections

to the higher centres

Those circuits that are used remain and those that are not used wither

Emotions expressed in a social environment drive the development of those higher connections.

Peter Hobson“The Cradle of Thought: Exploring the origins of thinking” OUP 2002

How...the creative, flexible and imaginative thinking that characterises humans emerges in the course of human development.

How a baby develops a subjective mental capacity – seeing bodies and apprehending minds

Integrating the body with the mental and the individual with the social

“Teach these souls to fly”

Artificial Intelligence

“Any thinker needs the appropriate kind of body and capacity to feel and act in order to connect with the world that contains the object of thought...It is not just that computers do not have the right kind of relations with things around them – it is also that they do not have the right kind of relations with each other. If computers want to think they had better get a social life.”

Vaillant’s Positive Emotions Faith, love, hope, joy, forgiveness,

compassion, awe and mystical illumination are important limbic system drivers of human flourishing

Are parasympathetic and soothing as opposed to the negative emotions which are sympathetic and arousing

Are long-term and reach out: negative emotions are immediate and protective

Positive emotions create relational bonds which build community rather than the negative emotions which protect the immediate relations

Humans thus seen are members of community rather than individuals and the emotions (especially the positive emotions) are designed to build community and the individual in that community

Limbic is lyricalLexical is lame

Clinical observations on neurological patients show that reasoning is impossible without intact emotional neurological apparatus.

Hence Descartes’s error was not only separating the mind from the brain but reducing the mind to pure reason rather than the integration of reason and emotion.

Antonio Damasio. Descartes Error: Emotion, reason and the human brain. Penguin 1994.

DAMASIO’S CLAIM

Emotions and reason can be seen as in partnership rather than in conflict

Emotional maturity arises out of good relationships

Emotional maturity creates good relationships

HENCE

Emotional dysregulation is a particularly common problem in addiction

Patients coming off addictive agents often feel terrible, not just because they are withdrawing but also because they need to come to terms with the emotional state they were escaping by their drug taking

AODs make me feel good: stopping AODs makes me feel bad.

WHILE NEUROBIOLOGISTS PONDER...

Hyper-hedonia

Emotional dysregulation

Emotional incontinence

The conflict of many and varied emotions

“What can stop that committee in my

head?”

THE CLINICAL PHENOMENA

Emotional incontinence can often be traced to poor relationships ◦ In childhood◦ In adult life

A lot of my clinical approach includes exploring the person’s feelings about their 4-fold relationships to themselves, others, the environment and the divine.

EMOTIONS AND RELATIONSHIPS

Kenotic love in creation as well as in the coming of Christ

(Moltman, Polkinghorne, Ellis)

Broken relationship with God because of sin (Adam and Eve) – and its flow on effect towards others (Cain and Abel)

The God of love seeks and saves a people for Godself so that all the families of the earth may be blessed

RELATIONSHIPS ARE CENTRAL TO THE GOSPEL - I

The transforming love of God – restoring us to God and to each other

Creating a new community of love united to each other and to the truine God

RELATIONSHIPS ARE CENTRAL TO THE GOSPEL - II

God’s love is supremely shown in the life of Jesus by the way in which he sought out the outcast and transformed them from within...

And by his atoning death on the cross whereby he bore our sins that we might be liberated and enjoy God’s freedom

That transforming love does not leave the sinner unmoved or unchanged

GOD’S TRANSFORMING LOVE

That transforming love is expressed in a community in which old barriers have been broken down and all those who are Christ’s are one with one another.

Eph 3:14-21

“There is no fear in love, for perfect love casts out fear”

1 John 4:18

GOD’S LOVE

“The notion of an unchanging, passionless God is a view more in tune with a philosophical view of monotheism rather than with the dynamic, relational, trinitarian understanding of God who is essentially love expressed in the incarnate Jesus Christ.”

Edgar B. The Message of the Trinity IVP 2004:61.

Αγαπη: “A passionless condition of strenuous benevolence”

Charles Taylor The Secular Age

Love virtually synonymous with obedience

ADH Mayes. New Century Bible Commentary Deuteronomy. Eerdmans.1979:176

Nygren: “Too often we have confused ερος and αγαπη”

Quoted in P Ramsay. Basic Christian Ethics Westminster/John Knox 1950:

WHAT IS CHRISTIAN LOVE?

Love, joy, peace, Patience, gentleness, goodnessMeekness kindness, continence

All have affective components but cannot be entirely characterised only as emotions

There are aspects of decision, commitment, and spontaneity – but there is also an affective component

HAVE WE MISSED SOMETHING?

When applying the concept of kenosis some of my patients they say, “I always do that .” – they however do not have the same courtesy returned to them.

Shattered self-esteem drives this distortion of relationships

True love is a mutuality of kenosis... There is an element of self-assertion in true

kenotic love

KENOTIC LOVEA MISCONCEPTION

Guilt, shame, are central to the burden of many people in my practice

Dealing with unjust treatment suffered in relationships is a major issue for them

A lot of my patients have been more sinned against than sinning

Forgiveness, atonement, restoration, accepting injustice and moving on are daily issues in counselling addicts

GOSPEL RELATIONAL ISSUES

“Bashing yourself is not a way of changing your behaviour”

Forgiveness is great, but it is hardest to do it to yourself

Forgiveness by itself is not enough – how do I move on? How can I forget?

I had a fear of emotion, I am gradually learning to accept how I feel and to live with that...and be gentle with myself

FROM MY PRACTICE

Is there something in Augustine’s famous

“Thou awakest us to delight in thy praise for thou hast made us for thyself and our heart is restless until it repose in thee.”

Is there something in John Newton’s

“solid joys and lasting pleasures none but Zion’s children know”?

Word, deed and transformed life The congregation as the hermeneutic of the

Gospel of the Kingdom

Emotions as well as reason Relationships as well as proclamation Community as well as individual Recognising and working with the defence

mechanisms Loving people into the Kingdom

SPREADING THE GOSPEL

In reading the two books, God can cast new light from one to the other forcing us to reinterpret the way we perceive God’s word in these books.

In neuroscience, emotional research resonates with theological insights suggesting that Gospel ministry is the ministry of a transformed community which proclaims God’s love in word and deed and which proclaims the Gospel...Affectively!

CONCLUSION

“Whoever believes in me as the Scripture has said, rivers of living water will flow from within them.”

John 7:38