Saturday, November 29, 2008

Area 25

I've been wanting to write about this for awhile, and now it's a quiet Saturday afternoon, after a day-long retreat, in which I broke "silence" not to talk but to post my new website. Still, I got a lot of meditation and dharma reading in, along with yoga, much needed, as I had cramps yesterday and today, too, though lesser than they would be because of the yoga.

So what is AREA 25?
Some of you already know, and those who know I've been reading a lot on neuroscience lately know that it's likely not a scifi or government conspiracy reference.

From Wikipedia (full name is Brodmann Area25, by the way):
"One study has noted that BA25 is metabolically overactive in treatment-resistant depression and has found that chronic deep brain stimulation in the white matter adjacent to the area is a successful treatment for some patients"

In fact, recent research has gone beyond that "one study" and numerous doctors and scientists are finding that BA25 is not just significant for those with "treatment-resistant" depression (and that deep brain stimulation they are citing is electro-shock therapy, by the way), but also that it plays a role in humdrum, ordinarily medicine-aided depression.

Here's the woman who made that link, named Helen Mayberg, on why the deep brain stuff works, and why the meds might work, too:
"There are a number of converging lines of experimental evidence. Both Cg25 [cingulate area 25] and the prefrontal cortex have emerged as critical regions mediating depression remission. A series of PET experiments have demonstrated both decreased subgenual cingulate activity and increased prefrontal activity with successful antidepressant treatment. [THIS MEANS THEY THINK THE TWO OF THESE ARE LINKED. SO AREA 25 AND THE LEFT FRONTAL CORTEX, HOME AND NEST TO WHAT CAN OTHERWISE BE CALLED "THE CRITIC"]

Of interest, although frontal changes appeared to be a correction of baseline underactivity, the subgenual cingulate changes are decreases below normative levels. The subgenual cingulate changes are seen not only with antidepressant medication, but also with response to ECT and even to placebo medication, suggesting an important role in clinical recovery. In fact, patients in our study who failed to respond to treatment showed no subgenual cingulate changes. In addition, subgenual cingulate activity has shown marked increases in activity during states of profound negative mood (ie, sadness) in nondepressed volunteers, suggesting a further critical role in regulating acute and chronic negative mood states in both healthy patients and those with disease. IN OTHER WORDS, EVEN YOUR REGULAR RUN OF THE MILL SADNESS SEEMS TO TRIGGER THE SAME SPOTS

We postulated a reciprocal set of changes in cortex and subgenual cingulate with DBS, namely, suppression of area 25 and disinhibition of frontal cortex, consistent with past findings of effective response to other antidepressants."

My therapist told me about this - actually, my prescriber, who caught on quickly that I love the science aspect of all of this, though of course my therapists often have to get me down from that tree to talk about my emotions. She pointed me to the pictures and articles, and drew her own diagrams for me. Here's a translation, totally layperson, of the above excerpt:

Area 25 is part of the limbic, or emotional, system. It's job is to sort of react and send out hormones when we are sad. No biggie. It's true for everyone, not just chronically depressed folks or folks who need meds. They've known about it for awhile. But what they didn't know is that it seems to have a really tight relationship with the left frontal cortex. This is the part of the brain which ostensibly distinguishes us from other animals. "We can think, we can reason, we can read", as the theme song for LAPR's "Bookworm" says. As most of us know, that reasoning can actually be a problem sometimes. However, as authors like Jill Bolte Taylor have made more and more popularly evident, it's not as simple as demonizing the logical mind. We *need* that order - it helps to tell us to put socks on before shoes, to cite her example, or, to "hey. no need to keep being sad. it's over now," in the case of this research. So what do they think "goes wrong" with depression?

Basically, Area 25 is on high drive. Because of childhood circumstances (which do affect how one's brain works, as we are not born without changing afterwards, and in fact, this area 25 is believed to not be fully formed until the mid-twenties, which explains how none of us over 30 would ever go back to that time period!), genetics, and all the other things that shape our brains and emotional reactions, some folks' Area 25 isn't "self-regulating". It doesn't turn off, connects ordinarily just slightly sad or frustrating circumstances into out and out depressions. But it's not just Area 25 at work.

What happens, they think, is that that pre-frontal cortex serves as a regulatory agent. If Area 25 (or other parts of the limbic system) get out of whack like I describe above, the pre-frontal should be there like a guard to shut it off. In "bad" scenarios it could shut it off with judgment "You are so depressed, you'll never get better, etc" and in the best of situations it is cleaner than that "Huh. There's no reason to feel this way. Ok. I'll let it go." But in folks who have temporary sadness to a high degree (including mourning) or those with ongoing depression, not only is Area 25 overactive, but the pre-frontal is disfunctional, not reacting, or reacting in a way which only contributes to the depression. It's a loop, a great feminine image, and the loop is off its sine wave and out in outer space.

She told me about all this and my mind was sparking all over. Then she continued:
"What they find also helps are two other things: exercise (ok, yep, I can see that) and any service activity or part of your life that can turn you "outwards". In other words, like anyone who suffers from depression will tell you, the sense is of constantly turning INWARDS - eating one's own tail, not being able to relate to the world, feeling totally f-ing alone. And this is part of the CHEMICAL experience."

"So volunteering, talking to a friend, reaching out to the world, taking a walk - these might not cure depression, but they help - CHEMICALLY?"
"Yes. That's what they think." she responded.

So wait. Buddhists have something like this, too. "If you want to be happy, help others," is a common saying. At first I hated this saying, seeing only self-sacrifice in it, but over time I've gotten a deeper - though still shallow - understanding that this could point to our inter-dependence, how there is no YOU and ME so of course if I am really helping "You" I can't help but help "Me". Ok, fine. But chemically changing the situation?

"Have you ever heard of Tonglen?" I asked her.
"No, I don't believe so."
"Here's how it works, or how it has worked for me. I am suffering, feeling a lot of pain, or someone I know is suffering, and I sit down and try to make real contact with that pain - visualizing black, dark, claustrophobia; feeling it in my heart. Then I try to send out spaciousness, whiteness, clarity. At first the practice felt like I was "faking it til I made it" but now when I do it I feel SO much better. For instance, if I am feeling depressed, I can realize I am not the only one, that others feel it, too, and that we could all stand to have a lot more space and openness. You begin the practice with you, then a close friend then a "neutral" (as Pema Chodron jokes, "space aliens" of your everyday life) then move onto someone you feel icky about, then someone you "hate". In other words, you reach out, out, out. Continuously. This certainly hasn't cured my depression, but it compliments meds and therapy, for sure, and really helps a lot "on the spot" to reset my buttons and help me to see the bigger picture."
"Sounds like loving-kindness, Metta," she said.
"Similar, only focused around direct pain, not just wishing everyone well."
We stared at each other for almost a full minute, then she laughed.
"You know about brain plasticity, right?"
"Of course," I answered, "Richie Davidson, on this campus, with other scientists, showing how meditation can actually CHANGE OUR BRAINS - amongst other activities."
"Wow. I had never heard of that practice. You realize what this means, right? That that - "
We both stared at each other some more.

So it can turn Area 25 back on. Help us to realize we are not alone, and realizing we are not alone is the key. The big key. The key to the city, to our hearts. Turn out and you will help what's going on inside. Wow, indeed.

AND THIS JUST IN - right after I published this post I went to "Shambhala Sun Space" which is a cool extension of the Shambhala Sun magazine, brand new, online, and they had THIS as a title article, on benefits of meditation:

My website is finally up!!!


Me, Dylan and our Macs finally made it happen!

A lovely way to keep abreast of schedules, recent reads and samples to show your friends. Please let me know how you do or do not like it! And there are subscription options on many pages, so you can know when I update them.

This will remain my personal blog - there's more of a teaching blog there, with schedules, exercises and occasional book reviews!

Thank you for all your support!


Wednesday, November 19, 2008

Using My Religion

"Use it or lose it" said the five individual nearly empty paint tubes hanging from her ceiling. Each one had one word, one color, and combined they made the rainbow of her religion. "I let those tubes dry out once," my former roommate and fellow artist Erika told me, when I finally asked her for an explanation, "and my rule is to not let that happen again."

For many years I was raised and surrounded in a mix of atheism and agnosticism. A highly intellectual pseudo-socialist family, my father favored pissing on McCarthy's grave to going to church. My parents were raised in godless families, so it didn't seem odd to them at all. And in Chicago, or the Chicago suburbs (in my dad's case) being without religion wasn't really an issue. But they were raising us in Appleton, a place where one of the first questions would be "what church do you go to?" even as an 8 year old.

So when my dad died and I needed to rebel in an angry way, I fell for the pastor's son, the pastor of a highly charismatic local pseudo-Neo-christian born-again church. I faithfully sang along, and wasn't too put off by the content because there wasn't much content to be had. Years later my partner would ask me "didn't you learn anything about the bible in church?" and I would have to say, "No. Actually. I didn't." I learned how to sing, how to believe in community (something my family was lacking for more reasons than religion) and how to fall in love, with a young man, of course, who would never requite it. I guess that's a bit like God.

I left after a few years - a whole other story - much to my mother's relief, who had declared when I told her I was taking "Jesus Christ as my personal Lord and savior" that I was ruining my life.

I had a friend in high school and just after named Mark (who recently has re-found me through Facebook, hi Mark!) and he was really interested in Buddhism. Someone I would call a "natural buddhist" who already was mostly there, and inclined to sitting silently in nature and considering the interdependency of all beings, anyway. I was resistent - I approached it with my mind and not my heart, and although I made a sign for my door which declared "Please do not enter - meditating" I didn't really use it for meditation, rather as a reason to keep my mother out. This would strike me as very funny years later, sitting on top of a mountain in Colorado during a month-long meditation retreat, as I struggled to finally grieve the death of my mother, that I had tried to keep her out with my non-meditation then, and couldn't, when the real practice came in, for the life of me not deal with her now. I, in fact, a little delirious with the ongoing practice and constant silence, laughed out loud, causing my fellow sitters to glare at me as I interrupted their own struggles with momentary relief from mine.

So, then, how do I use it and not lose it now? The funny thing is that if you truly believe in something, truly connect to it, it feels nearly effortless to do it. Wait - is that true? I think it might not be. It sounded nice to say it at the time, but I have struggled plenty - to remember to actually meditate, to remember the instructions, to sit down and write instead of washing the dishes or playing with the cats, to use all I have experienced in the last few years of practice, instead of letting it dry up in a tube, unused. But what I suspect is that now, I can never really lose it again. I think that's more what I meant to say. Once I have gone so far in, taken vows, sat so much, am teaching the principles day in and day out, stopping Buddhism would mean something like stopping my life, entirely. All of it. Every single second.

In class this week, in response to the question "If you were to make up a religion, what would it be?" one woman, a fellow Buddhist, answered "Green Buddhism" then proceeded to not mention the word buddhism again for pretty much the entire piece, until the very end. And yet the piece was very dharmic, very true to life and daily practice. When she self-consciously said she got off topic, I noted this and we both smiled. It's as if she - I - can't help but use it.

Tuesday, November 11, 2008

The Body

"It's better if you see the corpse," she argued with earnest. "When my mother died it was hard to see her face remade by the coroner, but at least I knew she was dead." They both grimaced and he held her, sorry again for the millionth time for all she had lost. She continued, more gingerly, less to explain than to express.
"With my father it was different. He had been sick for so long and he was dead in his bed. That's where I saw him. He looked pretty much the same as he had the last few weeks, the cancer addling his brain. Face slightly yellow, his teeth coated in disuse. But he still smelled like him, you know? Death doesn't begin to smell until at least a day in."
He wondered how she could talk about this with so much ease. He supposed this is how stories go - the shock at first makes it easy, then there's the pain, and after awhile it's like telling a gory story of losing a limb or even cutting your finger - once it's healed, or basically healed, it becomes just a story again.

"The only person I lost was a friend's brother in high school." She perked up - she thought he hadn't lost anyone to death, actually. "Jonas, he was the brother of John. Older by a couple of years and really messed up. Did a fair amount of drugs, was pretty depressed. Slunk through the hallways of high school like he was already a ghost. A returning senior - almost on his way out, if he would pass, that is." His voice got soft, eyes focused on the far wall of their bedroom. She shifted her body closer to his, listening with her legs to his warmth.
"Jonas, he came to school one day and said goodbye to his brother John, my friend, and his sister. Then he walked a few blocks away, went out into the middle of an intersection, and put a .22 in his mouth."
They both paused, took a few deep breaths. Sensational news come alive in this history of his life. Amazing.
"His brother and sister went to the principal immediately after he walked out of the building, so the cops were following him. They tried to talk him out of it - even his parents were there. Begging him not to jump off the building ledge of life. But their attention only aggravated him more. I guess he wasn't just crying for help, huh?"
Tears sprung up in the corner of his eyes and she kissed them away.
"He shot himself in the middle of an intersection, cars paused with reverence, not a one honking and no one screaming, his parents and teachers watching on. The funeral was closed casket, obviously."

The second of their two cats leapt onto the bed just then, surprising them out of the mystery of the story. Her calico sleek reset the tone as she snuggled in between what space was left behind his back and in front of her belly. She let out a satisfied sigh of comfort and the two of them smiled, weak with wonder.

What she didn't tell him is that the body of the house she grew up in still haunts her memory. Skeleton, walless, wild in the wind, burnt umber bones returning to the ground.

Tuesday, November 04, 2008


Today's the day. At 9pm last night, we got a message from my friend Tobi, who's in the Swingle Singers and lives in London. He was beat-boxing Barack Obama's name, already wanting to know the results. A German living in London and *he's* impatient. Try living here.

The last two elections I voted with my heart, which tends to be green or independent, over logic. Fact is this time I feel I can vote with both. I really *like* Obama. I sincerely do. I'm not old enough to have experienced Kennedy, but that's the feeling I get. Fresh new-ness with good potential. Maybe it's because I'm young but I'll take someone coming in with less experience and more integrity than someone on the way out with both. Of course McCain wasn't ever an option for me.

But others were. In the past I voted for Nader - just once. Then I realized he does better for the world by helping safety standards and would likely not make nor like being much of a president. Kucinich - who really addresses the needs of the poor and marginalized in a way that no "black" candidate in this race has. These have been the candidates for me. But I can safely say Obama is it this time.

Had an interesting conversation with a friend about "prejudice" as regards to racism in the North and in the South the other day. We were both defining prejudice as "pre-judging" but I have always thought of it as sort of post- and pre-judging, and talked about it that way in our conversation. "It's ignorance otherwise" if you pre-judge, but from a place of not knowing. says otherwise, all is included in prejudice: unfavorable opinion or feeling formed beforehand or without knowledge, thought, or reason.
2.any preconceived opinion or feeling, either favorable or unfavorable.
3.unreasonable feelings, opinions, or attitudes, esp. of a hostile nature, regarding a racial, religious, or national group.
4.such attitudes considered collectively: The war against prejudice is never-ending.
5.damage or injury; detriment: a law that operated to the prejudice of the majority.

Huh. I was all prepared to do a blog entry about how prejudice is both post and pre-judging, then it turns out the dictionary already accounts for that.

So instead let me get a bit more personal.
I used to work for a radical lefty bookstore, the kind of place that would have made my commie parents proud, if they were still around. There the issue was never which of the two majors you would vote for, but how to choose amongst the independents and get counted at all. They would likely say I have fallen from the fold, especially because I readily read the NYT for my news now, but the fact is in the beginning, from the beginning, with pre-judging, I was ready to vote for Obama - I THOUGHT - because of his race. That's right. Because of it. I didn't much care for Hilary, never have, and she totally lost me when she got screedy. Fact is I am picky, as I often am about women, I wanted a GREAT first woman president, not just anyone.

And the fact is that I DO think race is making a difference and will make a difference. Get him in there. Besides the fact that he's charismatic and strong, and real in the world, just having a face and voice that's not the same standard old white guy was enough to get me to vote for him from day one.

Now, of course, I am paying attention and choosing him over the others, and my others are not McCain, but the independents. I am choosing him not just because of his race or background, but because I just like the guy. I have since day one. First came prejudice, then personal preference. Sometimes prejudice is more beneficial than harmful.