Chapter 1

Historical Perspective

One of the most remarkable paradigm shifts that has occurred during our lives has been the
recognition that most of our behavior is inherited. Eccentric, compassionate, outgoing, irritable,
and so on: Traits such as these travel in families from generation to generation. And as we all
know, inheritance equals biology. Figure 1.1 shows the relationship between shared genes and
the likelihood of developing schizophrenia if a relative has the disease.
Perhaps even more remarkable is the power of inheritance to interact with the environment to
dictate our personality. Bouchard and others have studied this eloquently by looking at
personality characteristics in monozygotic (identical) and dizygotic (fraternal) twins reared
together and apart. Using personality tests to assess five major personality traits, they found more
correlations for monozygotic twins compared with dizygotic twins regardless of whether they
were raised together or apart (see Table 1.1). In other words, the monozygotic twins reared apart
shared more personality characteristics than dizygotic twins reared in the same household. Their
overall conclusion was that these personality traits are strongly influenced by inheritance and
only modesty affected by environment. (The lay press unfortunately summarized this research as
“Parents Don't Matter.”)
Figure 1.2 shows a remarkable example of identical twins separated when 5 days old, raised in
different households “one in Brooklyn, the other in New Jersey who met for the first time at the
age of 31. Both are firemen, bachelors, with mustaches and metal frame glasses. Not only do
they have the same mannerisms but they also laugh at the same jokes and enjoy the same
hobbies. Yet, they were exposed to entirely different environmental influences throughout their
lives.
Our individuality ”who we are, how we socialize, what we like, even our religious beliefs—may
be influenced more by the brain we are born with and its predetermined development than by the
experiences we have along the way. We are not excluding the importance of environment in
molding our character, particularly the negative influence of trauma. It is just that our brains are
more programmed than we previously believed.
The brain has not always been of interest to humankind. Most ancient cultures did not consider
the brain to be an important organ. Both the Bible and Talmud fail to mention diseases related to
the brain. Egyptians carefully embalmed the liver and the heart but had no use for the brain; they
scooped it out and threw it away. (If there really is an Egyptian afterlife—those poor pharaohs
are spending eternity without a brain.)
But, first, how did we go from ignoring the brain to where we are now?
Thomas Willis ”after whom the Circle of Willis at the base of the brain was name ”was the first
neurologist. In the 17th century, he moved us into what one author has called the Eurocentric
Age. Before Willis and actually for a considerable time after him “physicians based their
understandings of illness on the writings of the great physicians from antiquity. Willis took the
unusual approach of describing a patient's behavior,
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then examining the brain after death and making correlations.

FIGURE 1.1 As the shared genetic profile with someone having schizophrenia increases, the risk
of developing schizophrenia also increases. (Adapted from
Gottesman II. Schizophrenia genesis. New York: WH Freeman; 1991.
)
He was the first to coin terms such as lobe, hemisphere, and corpus striatumâ”terms that we still
use. Comparing the human central nervous system (CNS) anatomy with that of animals and
conducting postmortem dissection of interesting cases, he made surprisingly accurate
conclusions about higher brain functions versus lower brain functions. For example, he deduced
that human functions such as memory were likely to reside in the outmost banks (gray matter)
of the cerebral hemispheres because these areas were smaller in animals and damaged in
individuals with severe
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head injuries who had lost memory. He believed that the brainstem likely controlled basic
functions such as breathing and heart rate. However, he also thought that the white matter was
the seat of imagination—so he was not entirely on target, but he started the process of matching
structures with behaviors.