Brain and Mind
Preacher: Reverend Andrea Abbott
June is national Alzheimer’s and Brain Awareness Month. It is also National PTSD month and National Brain Injury month, so we know that there is something besides weddings going on in June. The Alzheimer’s Association uses our church one evening a month for a caregiver’s support group. This group also is concerned with dementia and other brain related disorders and I am very proud that they have found a home here.
I am very glad that this group meets here because support for caregivers of those with Alzheimer’s disease and dementia is so needed. These diseases have a growing impact on our society. They are the sixth leading cause of death in the U.S., affecting five million Americans, which could rise to sixteen million by 2050. One in ten Americans has Alzheimer’s of dementia and one in three seniors die from them.
The shadow of the threat of these conditions grows for most people as they age. If I forgot my car keys when I was thirty, I didn’t pay much attention. Now, when I have to go back for them, I find myself counting the number of times I have done this and also noting the times that I have left a purse behind or forgotten to take my purchases with me when I leave a store. I ask myself where am I on this timeline and I know I’m not the only one to do so. As with most other disabilities, our susceptibility to this one increases as we age.
If the news about Alzheimer’s disease and dementia are worrisome, it is also true that the increase may reflect some positive changes. If these are conditions of old age, then it may be that the increase is occurring because more of us are living longer. Also, it may be that we are more aware of these problems because we are more willing to talk about them. We no longer hide people away in shame or write them off a senile. We seek treatment and as much help to keep people functioning as well as they can.
If this is true for Alzheimer’s and dementia, it is also true for PTSD. Since the Iraq and Afghanistan conflicts, the military has begun to open up about the effects of war on those who have seen combat. I am very proud that people in this church were part of the effort locally to raise awareness of the treatment of veterans with PTSD. Just as war has birthed all manner of technologies, so has this led to greater awareness of PTSD in the general population, not just among those who have seen combat. This awareness has enabled people and their families who suffered from the effects of trauma able to get help. PTSD affects seven to eight percent of the population. About eight million adults will have PTSD at some time in their lives.
June is the month in which we are asked to be aware of these two conditions but many other situations affect either us or those we love, situations that can be located in the brain, situations that seem far more mysterious and frightening than the ailments that affect our bodies. Autism is on the rise, six to fifteen percent each year, affecting one in sixty-eight people in the U.S. or over 3.5 million.
Mental illness will affect one in five Americans, according to NAMI and the recent increase in heroin addiction in this area reminds us to be aware of the rise in substance addiction of all sorts.
As with dementia and PTSD, it may be that some of this increase, this avalanche of frightening statistics, may be the result of greater awareness of different mental conditions and a decrease in the stigma attached to these disorders. It may be that we no longer are as afraid of censure. It may be, and I hope it is, that we have become less judgmental, less self-righteous. Perhaps it is that we are more enlightened as we learn more about the brain and come to see that each of these conditions are, like heart disease or diabetes, illnesses, not immorality.
Brain, Mind. Soul. Some people think of these three words as synonyms, roughly meaning the same thing. For some only the word ‘brain’ has any validity. The other two words are in the realm of fantasy, used to name something that has no objective existence. Since neither the mind nor the soul have ever been seen, they inhabit a different realm than the anatomical term, brain, which can be seen and measured and dissected, its parts and each of their functions, increasingly revealing its secrets. However we use these words, we know that all of them have something to do with how we see ourselves and others as people.
As I have mentioned, the apparent rise in brain disorders may have something to do with the fact that we know more about the brain now than we ever have. With this knowledge, we are more aware that difficulties in human actions may have their origin in the brain and we understand more the problems and difficulties people have in terms of the disorders within their brains, not as a moral issue. It leaves us, however, with some basic questions about free will and the role people can play in determining their own fate. There is both good and bad news here. If people are constrained by brain disorders or limitations, there is more understanding that we are capable of change and growth far longer than was formerly thought.
In the past, our knowledge of the brain was based on what we could observe of human behavior. Experiments were devised to try to isolate different aspects of behavior and study them or experiments were run with mice or pigeons since there are simply some things you should not ask people to do. Autopsies of people with abnormal conditions gave some information as well. All these efforts gave insight but it wasn’t until the development of MRI’s and CAT and PET scans that the parts of the brain in a living, functioning human were revealed and able to be observed as they functioned.
Perhaps one impediment to understanding our brains is that we have always placed the brain in a special category, as if it was not somehow connected to the rest of our bodies, as if it was made of different “stuff” than the rest of flesh and blood. Our brains were where we lived and the rest of us was there to transport them from place to place. Now we know that, though it can seem like that, our brain is an organ like our other organs, subject to the same genetic influences, stresses and incidents that affect everything from our lungs to our big toes.
When we were first learning about the brain, in the age of machines, we began to understand it as a sort of machine. Now that we are in the age of computers, we think of our brain as a sort of computer and we use many of the same words to describe it, reset, process, delete. Both analogies are just that, analogies, ways of thinking, but they are misleading because our flesh and blood brains are still capable of using the information that they receive from the senses in much more complex and subtle ways.
It is this ability that brings us to the next word—mind. Perhaps another word that could be used is consciousness. It is the way that the brain receives information of the world around it and turns it into thoughts. Thoughts such understanding that we exist, as Descartes famously remarked. Thoughts about our place in the universe. Thoughts about thinking itself. Thoughts that some other animals may have but many do not appear to. Thoughts like “democracy” and “freedom” and “love is the doctrine of our church”. Thoughts that turn into the Empire State Building or an opera or a medical discovery. This is what our minds can do.
But our minds can also do things that aren’t good as well. Our minds can trip us up, give us obsessional thoughts, give us false memories, make us see or hear things that aren’t there, lead us to turn on ourselves. How could we do otherwise? We rely on our brains to deal with information and our minds to let us use that information. How can we not believe what our minds are telling us, even when we are told that these thoughts are wrong? What can we trust if we can’t trust our own minds? This is the dilemma for people who suffer with brain disorders. What they think is so real.
We have, indeed, learned much about the brain and we have begun to work on the link between the brain and the mind. However, there is still much, much more that we need to know. As with all good science, we have found out how much we don’t understand. We have also found out how difficult it is for humans to study themselves. We need our minds to study our minds. We keep getting in our own way.
Despite this, research continues. As Ron Powers, author of the book No One Cares About Crazy People says, this is the best time to have a brain disorder because we know so much more than we used to. Still, despite new knowledge, in many ways we have not come as far as we might hope. The title of the book I just mentioned was taken from a memo from an aide to the then Milwaukee County Executive, Ron Walker, who later became governor of Wisconsin, in which he advised the executive not to worry about funding for the mentally ill. Cleary, this callousness is a problem today but there has never been a time in which many have cared about crazy people.
In this country and much of Europe, the old madhouses in which the inmates were chained and slept on straw were replaced by the asylums of the early nineteenth century. This reform, in which the Unitarian Dorthea Dix and the Universalist Benjamin Rush played notable parts, did provide better conditions and kindlier treatment at first but eventually the asylums themselves became as horrible as the madhouses they replaced. Abuse of patients was unchecked and the treatment they did receive was often sadistic, even lethal. Frontal lobotomies, insulin shock, electric shock and other assaults on people’s bodies seldom had any verifiable medical rationale. There was no one to take the part of the helpless patients, often poor or cast off from their families.
The advent of psychotropic drugs was supposed to usher in a new era for sufferers of brain disorders and yet this was a double-edged sword. As drugs increasingly calmed patients, the states that funded the large asylums decided that they were too expensive to maintain and so the patients were sent out into their communities. Though there was supposed to be funding to set up community centers and provide them with housing, that funding was often used for other purposes or was totally inadequate for the needs of people who had lived out much of their lives in institutions. The rise in the homeless population and in the prison population was the result of deinstitutionalization as bewildered former inmates were given incomprehensible instructions about their own care and then left to sink or swim.
Ironically, as a result of a series of lawsuits, mental health services in prison are now almost as good as or sometimes better than services in communities. In most places, those with brain disorders face a bewildering hodge podge of agencies that compete with each other for small amounts of funding. The services that exist are fragmented and inaccessible, particularly in rural areas such as ours. There are still few resources for all but the wealthy or very well insured.
For most people with major brain disorders life will always be difficult. Most people with long term brain disorders will always be poor and many will be homeless and homeless people who have no address find it difficult to maintain medication or services. But, as the title I referred to indicates, no one does care about crazy people.
Perhaps one of the reasons that no one cares about crazy people is that the stigma about brain disorders still exists. Horror films, Halloween costumes, jokes, language in general with terms like ‘maniac’ and ‘psychopath’ used loosely continue to make people with brain disorders marginalized. Headlines highlight the actions of a small number of such people ignores the fact that most people with brain disorders are not dangerous except to themselves and are more likely to be preyed upon by other, presumably normal people.
Why do brain disorders exist? Why have they not vanished as we have evolved? Could there be some evolutionary advantage hidden in these disabilities? There are gifts as well as problems associated with brains and minds that function differently from what we laughingly call the norm. Creativity, sensitivity, high intelligence, the ability to see what others can’t see, those are often descriptions of people with schizophrenia, autism, bipolar disorder and other such issues. Children with Down’s syndrome are often very loving and kind. And, as an Alzheimer’s caregiver reminded me, people who have lost memory are often more able than most to live in the present, a state that we may spend many hours of meditation seeking. It seems that diversity in minds is as necessary as other kinds of diversity to let us find new solutions to problems and new ways of being. Neurodiversity is as necessary as crop diversity. In a sense,people whose thought processes are not the norm are sacrificed for the good of the rest.
What about the last word I have used for this sermon? What does that word, Soul, mean to us? Since we are U=U’s that word will have as many different meanings as there are people here, but allow me to tell you what it means to me when we are discussing the brain and the mind. If the brain is the physical organ whose function it is to process information and if the mind is what makes the processes greater than the sum of the parts and turns it into the whole of consciousness, then for me the soul is something that goes beyond both of those. We have phrases such as ‘lost my mind’ or ‘out of his mind’ or ‘she’s not herself’ or ‘not in my right mind’ phrases which imply that the mind is not the whole of the person, that there is something more than the brain or the mind that is always ourselves, despite our mental state. In the same way, when we meet a person we have not seen in a long time, there is always something about that person that stays recognizable, no matter how their outward appearance has changed. I found this out at my fiftieth high school reunion last year. Though I didn’t recognize everybody immediately, once I did I could still see in those wrinkled faces and under the grey hair the six year old, the twelve year old, the seventeen year old I had known. Something in us is imperishable. Something in us goes on, no matter what our mental state, something like an eternal flame that is there when all else has changed. This is what I mean, at least in part, by the soul. Perhaps it’s what we mean in the first principle when we talk about worth and dignity, something that exists in everyone but defies explanation, a force, a vitality, a center, but something that links us to each other even as it manifests uniquely in us. This is the something that some think may go on when even the body is gone. Something as natural and as inexplicable as beauty or truth or love.
I’d like to close this sermon with the responsive reading you have been given on your way in. Let’s say these words together. And then, when we have finished, I invite you to share your thoughts on the brain, the mind, the soul with me and each other.