Updated: Jul 3
The black box
When I went to medical school in the mid-1980s, we learned about the brain mostly in terms of neuroanatomy. We had to memorize the structures in the brain and spinal cord, and how they connected to the rest of the body through anatomical dissection and microscopic images. Neuroanatomy was and is still is, considered to be one of the most difficult classes within the gauntlet of any medical school curriculum. Before the advent of the book genre made famous by the “__ For Dummies” series, one of our favorite texts was “Neuroanatomy Made Ridiculously Simple.” For the record, the book helped, but it still wasn’t simple.
My main impression of the brain at that time was that it was an incredibly complex black box. Our understanding of how the brain worked was relatively crude, because what we knew about the brain had been gleaned through observation of deficits that we saw when the brain was injured or diseased. In other words, we only knew what we could see when the brain wasn’t working properly.
As I went on to clinical practice, the brain became ever more mysterious, as I encountered patients who had suffered from strokes or neurodegenerative processes like Huntington’s disease. Our neurology colleagues would often write long notes detailing findings from examination and imaging. Sometimes a diagnosis would be helpful, but mostly there were either no known treatments or the medicines were only marginally effective with strong side effects. Primary care providers and families were left to deal with the behavioral and care issues in a relative vacuum.
Our most powerful weapon in the fight against dementia is actually our mind
Neurosurgical conditions like brain tumours or brain bleeds were somewhat more satisfactory in the sense that surgery was often life-saving and usually helped to preserve function. Psychiatric conditions were perhaps the most frustrating in the sense that we knew the least about them. Milder conditions like depression and anxiety were considered easily treatable in the primary care setting. But more severe cases requiring hospitalization or psychiatric care were often whisked away for more intensive therapy, which was frequently not so effective.
De-stigmatizing mental health
So it’s perhaps not so surprising that we have a healthy fear of problems affecting the brain. In many Asian communities such as Hong Kong, mental illness is still strongly stigmatized, and conditions affecting the brain are often considered a shameful weakness that the family must hide.
Looking back at the history of brain health, there are multiple factors that probably contributed to our view of the brain as a black box. The biggest barriers to our understanding came from Nature’s own defenses. The first layer of defense against external injuries in mammalian brains is the sturdy mechanical protection afforded by our bony skulls. The next layer comprises a series of thick membranes which allow the brain to float in a bath of cerebrospinal fluid, serving as shock absorption as well as nourishment and communication. The blood brain barrier further insulates our brains against most toxins and infectious agents that may enter the bloodstream.
We were further handicapped by not having the technology to examine the brain in real time - CT scans and MRIs could only be done after the injury. Microscopic changes were only accessible through brain tissue biopsy which meant invasive surgery risking injury, and blood tests could only give us an idea of what was happening outside the brain. Electroencephalogram (EEG) electrodes were only marginally helpful in some research and treatment settings. The advent of functional MRI (fMRI) technology proved to be pivotal, but it has taken decades to fund and document findings in the brain, an effort that is ongoing. And the nature of science is such that the more we discover, the more questions we have.
How much stress is too much, and what can we do to mitigate against that risk
What’s become crystal clear is that it makes no sense to separate mental health and diseases of the mind from those of the physical body. We are learning that physical and mental health are inseparably linked at every level, even down to the molecular level. The fields of neurology, psychiatry and neuroanatomy frequently overlap and partner to create multidisciplinary teams or to forge new disciplines, such as neuropsychoimmunology.
Protect our brain
We are definitely at a tipping point in terms of understanding the importance of integrating physical and mental health. When it comes to brain performance and preventing dementia, it’s clear that both play critical roles.
The latest drug research on Alzheimer’s disease shows that we may be beginning to see some light at the end of the tunnel, but it’s also becoming clear that such treatments will not be silver bullet cures. They will most likely help to slow the progression of the degenerative process, but they won’t be able to eliminate Alzheimer’s disease altogether.
We can learn the skills to harness the power of our supercomputer minds
And thus risk reduction or prevention through lifestyle intervention remains a crucial strategy in our fight against this disease. We have seen that research supports the importance of lifestyle habits such as exercise, sleep and nutrition when it comes to preventing Alzheimer’s disease. Identification of risk factors such as diabetes and hypertension give us the opportunity to intervene and reduce potential injury to the brain.
I also always see the recommendation for “stress management” within the suite of lifestyle interventions. And this makes intuitive sense since we understand that too much stress is “bad for us,” But what’s not so easy to gauge is: how much risk does stress actually pose, how much is too much, and exactly what actions can be taken to mitigate against that risk?
In the Optimal Brain Performance curriculum, I teach that we must harness the power of our minds to protect our fragile and precious brain function:
We build resilience, which is the capacity to manage stress
We create freedom from stress by aligning with our purpose, or what really matters.
We learn how to cultivate neuroplasticity through brain training and creative flow.
Brain Health Index
I used to feel overwhelmed by all the potential risks that threaten the health of our physical brains. But as I learned more, I became ever more grateful for the wisdom of Nature’s design, with all her layers of protection. And I realized that our most powerful weapon in the fight against dementia is actually housed within the brain itself.
Our human minds are endlessly miraculous in their capacity to create solutions and automate, but they can also cause us tremendous stress through fear and worry about countless issues involving work, relationships, money, and so on. The Mind Mastery Program teaches us the skills to cut out the noise and drama, so that we can harness the power of our supercomputer minds.
I have created the Brain Health Index (BHI) as a screening tool in order to help you gauge your level of personal risk. The Index takes into account such factors as current brain function, satisfaction with proven lifestyle interventions, and familial risk.
I would love to have you check out the Brain Health Index Quiz HERE - it only takes about 5 mins to complete the quiz online.