dr.lawrence chu

Sunday, April 13, 2008

Neurological Deficit

A person with no repertoire of memory for she had never used his hand since she was born. She had never fed himself, never used the toilet by himself for over sixty years. This person, even though she has elementary sensory in his hands, has no power to integrate these sensation to the level of perceptions, an existential dilemmas with a pair of unless hands. Oliver Sacks, a renowned neurologist had uncovered this mystery as he argued that this blind but intelligent lady could have been over protected and inactivated her hands all over her life. By surprise, Oliver suggested to the nurse to show less than the usual alacrity in feeding this woman. Amazingly and gradually, this woman is able to move her hands.

2nd Case

Oliver Sack's student, Dr.Jonathan Cole in (A Man who mistook his wife for a hat (1998):"Many patients with phantoms suffer 'phantom pain' or pain in the phantom. A patient with persistent phantom leg pain, anaesthesia of the spinous ligament with Lignocaine caused the phantom to be anaesthetised briefly, but that electrical stimulation of the spinal roots produced a sharp tingling pain in the phantom, whist stimulation of the spinal cord higher up reduced the phantom pain".

3rd Case

The labyrinth in the inner ears consists of semicircular canals containing liquid which monitor the motion of the body. However, the balance of the body is controlled by the integration of 1) Labyrinthine, the proprioceptive and the visual. A patient can still be in a balancing mode even the labyrinthine element to be lost before proprioception and the visual because this triple system, can compensate for others as long as our vestibular and the proprioception systems are still intact. We will not be tilted even we close our eyes.Proprieception is able to compensate the defects from inner ears, the labyrinths.

4th Case

Global aphasia could render patients incapable of understanding words, but nevertheless, they would understood most of what said to them. This is partly because natural speech does not only consist of words, but it consists of utterance, which is suffused with tone, expression, facial, emotion, and body language. Though understanding of words can be destroyed, one cannot lie to aphasia as the expression that goes with words, the spontaneous, involuntary expressiveness which can never be simulated or faked.On the contrary, Agnosia patients who have lost their expressive, emotion, feelings, timbre, and the entire character qualities but words are perfectly maintained. For example, a patient may lose the ability to detect if a voice was angry, cheerful or sad. One has to compensate this word expression deficit by looking at the faces of the people while they talk.Agnpsias are associated with disorders of the right hemisphere while aphasias are associated with the deficit in right hemisphere.

5th Case

A disease of excess, an opposite of deficit, are inherently hyper active, generative, and monstrously as well. It can be over-growth, abnormal, over excited, tended to disintegration and uncontrolled, over-powered by impulse, image and will, possession by a physiology gone wild. Oliver quote in one of his studies:'I have too much energy...Everything is too bright, too powerful, too much. It is a feverish energy, a morbid brilliant'

Saturday, April 12, 2008

Disconnection of Relationship in Couple Relationship or Family Relationship

Disconnection of Relationship in Couple Relationship or Family Relationship
According to the attachment theory of Daniel Siegel (The Mindful Brain, 2007), a cold and distant pair of parents created an emotionally isolated childhood which may have the long lasting effect on the adulthood. Without the attunement of emotion, the child is programmed to see things through the lens of left mode of processing, and slowly adapts into a culture of a deprived caring environment. The absence of emotional communication in the child's family has further deprived his right hemisphere from interactive nutrients and move his/her development toward the left hemisphere of logical and linear thinking under the sense of his/her internal world.

As Decety and Chaminade (2003) affirm:Our ability to represent one's own thoughts and represent another's thoughts are intimately tied together and have similar origins within the brain. Thus it makes sense that self-awareness, empathy, identification with other, and more generally, intersubjective processes, are largely dependent upon the right hemisphere resources, which are the first to develop.With the insufficient of the right hemisphere emotional development, one may turn into rigidity for couple relationship. When it happens, the couple relationship may go strain. One is able to repair the impaired relationship by practicing mindfulness, a form of internal attunement which enables the brain to be flexible, reflective, receptive, self-observant, reflexive, COAL (curiosity, openness, acceptance, an love), COHERENCE ( Connection, openness, harmony, engagement, receptivity, emergence, noesis, compassion, and empathy, FACES (Flexible, adaptive, coherent, energized, and stable) (The mindful Brain, Siegel, 2007).

Mindful awareness promotes neural integration. One needs an integrated mind to stay a healthy life.

Tuesday, April 01, 2008

1st April 2008 April Fool

I didn't realize that today is April Fool until my daugther fooled me a while ago. Being a fool can be a blessing sometimes especially human race is driving at the edge of competitiveness. We are always trained to program ourselves at all times so that we are able to be competitive. As such, most of the time, our perception is preoccupied with the top down approach from our neuron network. That what we called a bias mind.

To disengage from a top-down approach, one has to practice a mindfulness mediation, a term coined by daniel J.Siegel. "Activation of the middle prefrontal region (orbitofrontal and medial prefrontal cortices) is able to de-automate and disengage us from top down influences, such as prior expectations and our own emotional reactions' (Siegel, page 110 The mindfulness brain, 2007).Lazar (2005) found those who practices mindfulness have thicker middle prefrontal region and insula region. When there is a bodily limbic reaction, it triggers to our mirror neurons network, and later transmitted to insula, a gateway to middle prefrontal region.

Siegel (2007) claimed that 'Mindfulness involves a curious, open, accepting, and loving (COAL) stance toward awareness of awareness'. Siegel (2007) continues to argue that 'Mirror neurons and superior temporal regions create representations of intention by responding to goal-directed actions or expression. Since brain is an anticipation machine, this superior temproal regions activate with 'biological motion' that move with human intention.

SIMA (sensory implications of motor action) acts as resonance circuit that enable the brain to prime itself for the next anticipated event. SIMA links the mirror neuron systems, perception and motor action together for synchronization and coordination in our social life.SIMA can be in a form of priming, not a prefrontal planning process, Stern (20030) called it 'Horizon of Future". It is not a pre-plan, but a moment by moment awareness, and the timing is reported in an order ot 10s of milliseconds. SIMA creates a state of neural integration with mental sensation of coherence, and this is what Siegel suggests "intrapersonal attunement'.


Finally, compassionate is about feel to feel, and emphatics is about mind to mind understanding.