All In The Mind: the new book from the popular ABC radio program and podcast

INTRODUCTION

As a young child, I worried about walking to school on my own. I worried about my school performance and interactions with my teachers and peers. I worried about people who appeared to be less fortunate than I was. And I had other, free-floating fears about the future. At times this anxiety became overwhelming, so that I couldn’t face going to school and putting myself out into the world.

My mother also found it upsetting, but was unsure of how to help. I suspect it reminded her of the anxieties she’d experienced herself at different times of her life. Still, she arranged for me to have some counselling, and it helped me through that difficult period. Of course, since that time I’ve moved in and out of mental health challenges – seeking help when I felt I needed it, as well as providing understanding and support to my loved ones as they’ve experienced similar challenges themselves.

On reflection, I think that early experience was the thing that first aroused my fascination with the mind and human behaviour, and set me on a path I continue to travel to this day.

But there would be a few twists and turns in the road before that happened.

As a child I was also drawn to the natural world. Our family lived close to the ocean, and I would spend hours exploring the rock platforms and pools, hoping to catch glimpses of fish, octopuses, crabs, starfish and snails. My grandmother used to take my brother and me on walks in nearby bushland, pointing out the native plants and trees that were her passion and are now mine.

Dad was an engineer, and he instilled in me a curiosity about how things worked, an analytical style of thinking and an appreciation for logic. At the same time, my mother was a wonderful storyteller. When she was on a roll, she could really hold the room. She gave me a desire to tell stories too.

With parents like mine, you won’t be surprised to hear that I did well in English at school, but I was equally strong in science subjects. Fortunately, my selective girls’ school actually encouraged girls in the direction of a science career if they showed an aptitude.

That childhood fascination with the human mind had never left me, so when it came to thinking about university and a future career, I was intent on becoming a psychologist.

Fast-forward several years, and following uni I opted to travel and see the world. Finally, after some enriching travel and alternative living, it was time to find a career!

I was sitting in the food hall of a shopping centre, browsing the employment section of the newspaper, when an elderly lady sitting next to me peered over my shoulder and said: ‘Are you looking for a job? You should try the ABC. I’ve worked there for years and I love it!’

So I called in to the ABC offices that very day. The following Monday I was offered a temporary job in the Human Resources Department.

It wasn’t very stimulating, but I soon discovered that the ABC had a unit set up specifically to train women in broadcasting, called the Australian Women’s Broadcasting Co-operative. I began to spend my lunch hours in this women’s unit, where I picked up as much as I could from the wonderful, generous women working there. And guess who I ran into? Dodie Coates, the elderly woman from the shopping centre. She was still working enthusiastically in the women’s unit as a typist.

After a while, to my delight, I got a job in the unit as Broadcast Production Officer. I was thrown into radio broadcasting at the deep end, and it set me up for an intellectually nurturing lifetime career at ABC Radio National (RN).

A few years later, returning from maternity leave, I joined RN’s Science Unit, eventually becoming Executive Producer. Finally I was able to indulge my childhood love of the natural world, and be paid to do it!

In 2012, I was invited to take over All in the Mind – a program exploring every aspect of the brain, the mind and human behaviour – which had been hosted for a decade by the amazing Natasha Mitchell. It really was the perfect fit for me, combining my deep curiosity about how the human mind works with my great love of interacting with people.

I took tremendous delight in producing and presenting All in the Mind for the following nine years, until I left the ABC at the end of 2020.

Each week, our guests were a mix of scientists, academics, psychologists, psychiatrists, mental health practitioners and those with invaluable first-hand experience. As a producer, my aim was always to begin the program with a personal story if possible, then bring in the perspective of science professionals and academics. I’ve always believed that this interweaving of personal stories with the science is a powerful way to cast new light on important subjects.

I was always looking for topics I thought would offer the audience new perspectives, and hope within their own lives. So where did I find these topics? I’d read news stories, articles and books. I’d listen to speakers at conferences and public events. Colleagues and friends would make suggestions, and sometimes members of the public would write to me with their ideas.

Until the COVID-19 pandemic, I would interview people in person whenever possible, either in the studio or in their home, place of work or a similar environment. If the guest was interstate or overseas, I’d interview them studio-to-studio on an audio line.

It brought me great joy to converse with scientists, professionals and academics who were dedicated to their important work and keen to share their passion with me. Equally, what a privilege it was to speak to so many brave and inspirational people about their own experiences. I was deeply aware of how difficult it was for them to share their personal stories, but they had decided to take the leap and reveal themselves to me in the hope that others could learn and benefit from their journey. I am deeply grateful to all those who put their trust in me.

It is the incredible conversations I’ve had with all of these smart, sensitive and brave individuals that form the basis of this book.

* * *

The brain is perhaps the most important organ in our body, and yet in many ways it remains unfathomable to us. It’s the source of all our thoughts, feelings, hopes, dreams, memories, values, beliefs, habits and personality traits – everything that makes us who we are – but after millennia of thought and research, we’ve barely begun to unravel its mysteries.

In the fourth century BC, the Greek philosopher Aristotle thought the brain was simply a secondary organ that kept the heart from overheating, and a place where the spirits circulated freely. Around AD 170, the Roman physician Galen concluded that mental activity occurred not in the heart, as Aristotle had suggested, but in the brain. He posited that the brain’s four fluid-filled cavities, or ventricles, were responsible for our personality, memory and other brain functions.

In the 16th century, the Belgian anatomist Andreas Vesalius correctly argued against this idea. We now know that the ventricles are filled with cerebrospinal fluid, which nourishes the brain and protects it against physical impact. In 1791, the Italian scientist Luigi Galvani showed that electricity applied to nerves could make muscles contract – which suggested that electrical impulses were important in the nervous system.

The famous case of 19th-century American railroad worker Phineas Gage contributed to our knowledge about specific parts of the brain. In 1848, Gage had an accident in which an iron spike passed through his left frontal lobe. Though he survived, aspects of his personality changed, providing clues to the different functions of individual brain regions. (I’ll share a similar but more recent case in Chapter 3.)

By the early 1900s, with the development of microscope technology, anatomists could explore the smallest parts of the brain. The 1906 Nobel Prize in Physiology or Medicine was awarded to neuroanatomists Santiago Ramón y Cajal and Camillo Golgi for identifying nerve cells, or neurons, as the building blocks of the brain. In 1963, Alan Hodgkin, Andrew Huxley and Australian Sir John Eccles won a Nobel Prize in Physiology or Medicine for showing how neurons communicate via electrical and chemical signalling.

Since then, brain research has exploded, with rapid technological advances and scientific collaboration leading to extraordinary leaps in understanding.

According to Professor David Eagleman (whom I’ll introduce in Chapter 4): ‘We are moving faster and faster for two reasons. The first is that we have this terrific capacity as a human to rest on the shoulders of everything that has come before us … But the other thing is there are just many more humans now, so we’ve got almost 8 billion humans running around the planet, all resting on what has come before … And as soon as someone does something creative it spreads essentially instantly because of the internet and global communication. And so things are just taking off in an enormously rapid way.’

We are learning more and more, not just about how our brains work, but also about all the things that can go wrong. And gradually, the stigmas surrounding mental ‘abnormality’ are breaking down. We’re gaining more understanding of those whose brains are different – whether they want to be accepted for exactly who they are, or are desperate for relief and healing from a debilitating condition or illness.

As findings increase with the assistance of rapidly evolving technology, scientists are developing new and innovative approaches to mental health treatment. Crucially, society is becoming more aware of the need to consider the individual life experiences of people with mental health challenges.

The new global interconnectedness has also encouraged us to look beyond the narrow confines of traditional Western medicine. Many Eastern and indigenous cultures have traditionally viewed the body, mind and spirit as one, and applied this belief to the prevention and healing of disease. Until relatively recently, Western science has seen the body as being entirely separate from emotion and thought, which has reinforced the belief that everything can be cured by drugs and surgery. Things are changing now, with the increase in scientific evidence that the mind can play a role in healing the body. There’s a growing realisation that pharmaceutical medications, while life-saving for some people, are inappropriate for others because of intolerable side-effects.

This holistic approach is being applied not just to connect mind and body, but also to connect different fields of learning. We are seeing an emerging appetite for a multidisciplinary approach to mental health issues. Hope for the future rests in the growing knowledge coming from all fields of neuroscience, cognitive science, psychology, philosophy and contemplative thought. One field of study cannot provide all the silver bullets. Human beings work best together, sharing knowledge and resources and collaborating for a better future.

* * *

I believe this is a book that everyone needs to read.

Does my brain really have the power to change itself? What exactly is human consciousness? How can I improve my memory, and harness the full power of my creativity? What happens when I go to sleep, and can my dreams have an impact on how I live my life during the day? More awareness of how our brains and minds work would make all our lives so much richer.

However, many of us are more interested in what happens when they don’t work as they should. From ‘neurodiverse’ conditions like milder autism, to severe mental illness caused by deep trauma, most of us have felt the effects of problems in the brain – whether personally, or through someone we know.

Over the last few years, through the challenges presented by the global COVID-19 pandemic, on top of extreme weather events and increased living costs, we have seen an escalation in the number of people experiencing mental ill-health – some for the first time in their lives. Many others have lived with chronic conditions for years.

Countless families have been affected by the scourge of dementia – including mine, as I’ll reveal in Chapter 11. But there are also the conditions that people don’t mention. That work colleague who seems to be ignoring you may not be impolite – they may be suffering from an irregularity of the brain. (As I’ll explain in Chapter 9, this is exactly what happened when I met radio science guru Dr Karl.)

The first step towards accepting people’s differences, or assisting those who suffer, is to understand what they’re going through. So come with me now as I share some of the insights I’ve gained into a range of mental conditions by listening to people who’ve generously shared their stories – as well as what I’ve learnt from the scientists and medical practitioners working to make all our lives better by unlocking the seductive mysteries of the brain and mind.

Some points to note:

Words marked with an asterisk (*) are defined in the glossary at the end of the book.

References for each chapter can be found at the back of the book.

A number of the mental health conditions discussed in this book have resulted from experiences of serious trauma. There are sections of the book that include content some readers may find disturbing. This is particularly true of Part III: New Insights Into Debilitating Mental Conditions.

Part I

NEW INSIGHTS INTO HOW THE BRAIN AND MIND WORK

1

OUR CHANGEABLE BRAIN

Conversations with:

Dr Norman Doidge, psychiatrist and researcher, University of Toronto

Clark Elliott, brain injury sufferer and Associate Professor of Artificial Intelligence and Cognitive Science, DePaul University, Chicago

Deborah Zelinsky, optometrist, the Mind-Eye Institute, Chicago

Abbie Kinniburgh, corpus callosum agenesis sufferer

Maree Maxfield, Abbie’s mum

Honorary Professor Linda Richards, corpus callosum researcher, Chair, Department of Neuroscience and Edison Professor Neuroscience, Washington University School of Medicine in St. Louis

The fascinating field of neuroplasticity

John Pepper has Parkinson’s disease, a condition caused by damage to the brain cells that help us make automatic movements. This damage leads to difficulties with movement, balance and walking.

John wasn’t responding to conventional medication. But one day he decided to join his wife in a get-fit program. It made him pay very close attention to the individual movements involved in walking.

He found he could do these movements with a different level of awareness, using a part of his brain that was not damaged by Parkinson’s disease. He was using activity, thought and movement to stimulate dormant circuitry in his brain, which found other ways to overcome the problem. By being conscientious with his walking exercises, he saw remarkable improvement in his symptoms.

* * *

Michael Moskowitz is a physician and psychiatrist who suffered severe chronic pain after a series of accidents.

Michael read the scientific literature and found that there are about a dozen regions in the brain that cause us to feel pain. One of them processes both pain and our ability to visualise.

Michael’s solution was to force himself to visualise whenever he was in pain. After several weeks, his pain improved, and after several months, he could go up to 20 minutes without pain. At the end of that year, he felt no pain at all.

* * *

Canadian psychiatrist and researcher Dr Norman Doidge is inspired by stories like these. When he released his book The Brain That Changes Itself in 2007, it became an international bestseller, and the world learnt a new word: neuroplasticity.*

Since then, Doidge has continued to explore the powerful potential of this exciting field of research. I spoke to him in 2015, just before he released his second book, The Brain’s Way of Healing. He told me stories of patients suffering from conditions such as multiple sclerosis, autism spectrum disorder (ASD),* attention deficit hyperactivity disorder (ADHD) and traumatic brain injury. Incredibly, they’ve all succeeded in healing their brains without either medication or surgery.

Many of the stories of healing Doidge tells may sound almost miraculous to those still wedded, almost dogmatically, to a model that declared the brain can’t change under any circumstances. His point is that when we update that old model we see these improvements are not ‘miraculous’, but, in some cases possible, and they make scientific sense.

How neuroplasticity works

First, a few basics about the brain. It’s a bit like a powerful computer that controls our body’s functions. Extending from it is the spinal cord, a long bundle of nerves inside the spinal column. Together they make up the central nervous system, which allows messages to flow back and forth between the brain and the body.

The central nervous system is made up of millions and millions of microscopic neurons (as well as glial cells, which play a supportive role). Neurons are responsible for receiving sensory input from the world around us, and for sending motor commands to our muscles and the rest of our body. So, for example, if you see a car speeding straight towards you, your nerves and brain communicate so that you can jump out of the way.

When neurons are stimulated, they communicate with other neurons through electrical impulses that cause the release of neurotransmitters, chemicals that act as messengers. These neurotransmitters pass through the connection, or synapse, between the sending cell and the receiving cell. This process is repeated from neuron to neuron, making trillions and trillions of connections, and providing a web of fast and efficient communication throughout all parts of the brain and the body that allows us to move, think, feel and communicate.

When you learn new things, for example, the information needs to travel from one neuron to another, over and over. Eventually the brain creates pathways between neurons, so it becomes easier to recall the information and put it to use. If you think about learning to ride a bike, at first it is a challenge to steer, apply the brakes and watch the road all at the same time, but with practice, the neurons create a ‘bike riding’ pathway.

Early researchers believed that the creation of new neurons stopped shortly after birth. It’s now understood that the brain has the incredible ability to establish new connections, reorganise pathways and in some cases even create new neurons.

Canadian neuroscientist Donald Hebb introduced the theory of brain plasticity in his 1949 book The Organization of Behavior. It’s often summarised in the phrase ‘Neurons that fire together wire together.’ It means the brain is able to adapt to a changing environment by strengthening new connections and ‘pruning away’ the weaker ones.

Plasticity continues throughout life, but the young brain changes the most. We can’t help but notice how easily young kids seem to pick up a new language, learn to play a musical instrument, or master the ability to recite a comprehensive list of dinosaur species! When a child is born, each of their neurons has around 2500 synapses, but by the time they turn three, this number has increased to 15,000.

This number is halved in the average adult, because as we have new experiences some connections are strengthened, and others are removed. The neurons that are used frequently increase their connection strength, and the ones that are not used eventually die. This is known as synaptic pruning.

Keep in mind, too, that our degree of brain plasticity is believed to be influenced by our genetic makeup – so it’s the interaction between genetics and environment that shapes the brain’s plasticity.

There are two main types of brain plasticity. Structural plasticity* refers to the brain’s capacity to change its physical structure as a result of learning and experience. Functional plasticity* is the ability of the brain to transfer functions from an area of the brain that is damaged to other, healthy brain areas. It’s functional plasticity that has become one of the most groundbreaking areas of brain research in recent years. But the story gets even better than that.

The process by which new neurons are formed in the brain is called neurogenesis. This process is crucial when an embryo is developing, but it’s now known that it continues in certain brain regions throughout our life span.

The diversity of neurons in the brain comes from regulated neurogenesis during the development of the embryo, where stem cells (special human cells that have the ability to develop into many different cell types) differentiate and become any one of a number of specialised cell types.

Adult neurogenesis was first recognised in the 1960s, but it wasn’t until the 1990s that the scientific community accepted that neurogenesis in adult animals could play a substantial role in brain function. Taking up this idea, Professors Perry Bartlett and Linda Richards from the Queensland Brain Institute discovered in 1992 that the adult mouse brain contains neural stem cells. Since then, it’s been found that neurogenesis occurs in the hippocampus* and amygdala* regions of the adult human brain. This is an incredibly exciting discovery and the researchers believe this concept could hold the key to treating age-associated cognitive decline, neurodegenerative diseases including dementias, and other mental illnesses in the future.

The Ghost in My Brain: Clark’s story

Clark Elliott is a professor at DePaul University and an expert in artificial intelligence and cognitive science. He sustained a traumatic concussion injury following a car crash and told me that afterwards he felt like a zombie. He still looked like himself on the outside, but inside it was as if his real self had left his brain and had become a ghost outside his body. He was afraid he would never see his original self again.

Disconcerting things happened to him too. At one stage he couldn’t seem to get out of his chair, no matter how hard he tried. He unwittingly put his shoes on the wrong feet and walked around in them all day. He couldn’t understand jokes, and he had to learn to sleep with his eyes open because closing them would cause dizziness and nausea. Being a cognitive scientist, he wanted to understand what was happening to him – so in the years after his injury, he took over a thousand pages of notes detailing how he felt his brain was responding to the injury.

Finally, he realised he could no longer read or comprehend passages he had just written. Doctors couldn’t help him, telling him that he would never get better and he would simply have to learn to live with his symptoms.

Eight years after the accident, he could no longer cope. He was on the verge of losing his home, his job and the custody of his children.

As a last-ditch effort, inspired by Norman Doidge’s first book The Brain That Changes Itself, Clark began to research the potential of the brain’s neuroplasticity to heal his concussion. He stumbled across two brilliant researchers working at the cutting edge of brain plasticity: a cognitive restructuring specialist, Dr Donalee Markus, the founder of Designs for Strong Minds, and an optometrist, Deborah Zelinsky – the founder of the Mind-Eye Institute. Both practices are in suburbs of Chicago

In her practice, Zelinsky uses a neuroplastic technique she patented called the Z-Bell Test. She contributed to Clark’s recovery by prescribing a special pair of glasses (known as Mind-Eye Brainwear) that was not designed to sharpen his central vision. Instead, the lenses were to activate his peripheral vision and match the way he perceived visual signals with how he perceived auditory signals. She told me she’s helped many people who have a range of brain conditions, including ADHD, ASD* and learning difficulties by prescribing glasses designed for internal comfort rather than external eyesight and combining them with an individualised program of learning activities to rebuild dysfunctional visual skills.

As Clark explains, ‘using these special brain glasses that Deborah Zelinsky prescribed for me, she found healthy pathways in my brain and she started routing the input signals from my retinas through these parts of this healthy tissue’. He adds that ‘we can think of this as carving a dirt road through my brain, but through that healthy tissue’.

In the first few weeks of using these glasses, Clark felt like an eight-month-old child, rediscovering the world. He could feel new pathways again, but couldn’t quite make sense of them, because his brain wasn’t used to processing these signals through the healthy tissue. But it felt right, and he grew more used to it every day.

Clark also began treatment with Dr Donalee Markus, who’s worked for over 30 years in the area of cognitive restructuring. She helped Clark reinforce the new brain pathways that had been created with the therapeutic glasses, by getting him to do complex brain puzzles, connecting the dots and rediscovering relationships between shapes, to turn the ‘dirt roads’ through his brain into metaphorical ‘super-highways’ that once again allowed him to be a professor of artificial intelligence.

After many months of these brain plasticity treatments, he noticed that the ghost lurking outside his body was getting closer and closer, ‘and by the second week after its onset it was about six or seven feet away. By the third week it was just a few feet off my shoulder. I could never quite see it, but I could feel it. It was about as tall as I was, and shaped like a human. And in this moment I’ll never forget, after teaching class, I was about to put the key in my door and I thought, Oh, I get it, that’s me coming home.

‘I went into my office and put my head down on the desk and I just wept tears of joy that I could have this great gift again. And by the next day, Lynne, the ghost had entered me and I was once again fully human.’

Later, Clark used the notes he’d taken to write a book about his experience. And what else could he call it but The Ghost in My Brain?

Learning to compensate: Abbie’s story

When Abbie Kinniburgh was two years old, her parents discovered that she had a rare brain disorder. She was diagnosed with partial agenesis of the corpus callosum.*

The corpus callosum is a thick bundle of nerve fibres connecting the two hemispheres of the brain, which allows information to be transferred from one side to the other. It’s important to any brain functions that need to be integrated between the two sides of the body, and for other functions, like reading and language, where one side of the brain needs to dominate and the other to be inhibited.

Corpus callosum agenesis is a developmental disorder in which the corpus callosum is missing. This usually happens to the foetus at around 12 to 16 weeks. Around 1 in 4000 people are affected. Some of them may be born blind or deaf, or may never learn to walk or talk – but others can function quite well in their daily lives.

Throughout her childhood, Abbie didn’t notice any problems within herself, but her mother, Maree Maxfield, recalls being concerned.

As Abbie approached adolescence, she began noticing herself that she was different from others her age. ‘I started to get very anxious about everything, just social situations and being a bit behind my peers in what I was doing. I went from a happy little kid that didn’t have much worry to worrying about just about everything and not being very happy.’

As a teenager, she would still play with toys generally favoured by much younger children, and she had a need to be very organised and fastidious. Her peers began to exclude her, and the few friends she made were quite a bit younger than she was. She was a very slow writer and took a long time to process things, having to read passages over and over to understand them.

The doctors told her parents that she would probably never learn to read and write and would have lifelong learning difficulties. Fortunately, her mum and dad were both primary school teachers and kept encouraging her to aim high. ‘My parents just kept letting me do things as I was growing up … They thought, Well, we are going to just keep aiming at the highest and just keep pushing a little bit further each time, and it doesn’t matter if it takes a bit longer. So they never had the attitude of, Oh well, she won’t be able to do that so we’re not going to try.’

Abbie said this was very helpful for her, so she didn’t really notice how much the disorder affected her through primary school. With the continuous support of her parents and her own impressive inner strength, Abbie persevered through high school, and went on to study social work at university.

Now in her early 30s, Abbie still lives with a high level of anxiety* and a great deal of social difficulty. When I met her, she told me the most challenging thing for her was that people assumed that she didn’t have any challenges: ‘I often get told, Well, you look fine, you act fine and you fit into the norms, so you mustn’t have any challenges. So that’s often frustrating, because I have a lot of challenges that people don’t see. And the reason that I am so capable is because I’ve had 25 years to learn to fit in and cover it up, I guess, and I have been encouraged to do things, so I’m a lot better off than I could be.’

However, she’s now active in talking about her experience and spreading her knowledge so that she can help and support others with this disorder, through the grassroots organisation the Australian Disorders of the Corpus Callosum (ausDoCC). Describing herself and other sufferers, she says, ‘I think in a lot of ways we are very resilient and able to cope with adversity because we deal with it every day, almost.’

Abbie’s mother, Maree, is currently a PhD candidate, researching personal quality of life among adults with corpus callosum disorders.

Corpus callosum disorders and neuroplasticity

Honorary Professor Linda Richards of the Queensland Brain Institute specialises in corpus callosum study, and is grateful to Abbie for her dedicated participation in this research. Richards is interested in the way some people with a corpus callosum disorder – like Abbie – can cope quite well and lead full and productive lives in spite of the challenges they face. This has got Richards and her team intrigued about how the brains of these people compensate for their significant loss of brain connection.

Research has shown that the brain, when affected by a damaged or missing corpus callosum, creates plastic processes to compensate for the absence of the normal connection between the two brain hemispheres. Richards says some studies show that the fibres that would normally cross the corpus callosum actually find a new pathway in order to connect the hemispheres. This is why some people are able to function without a corpus callosum.

According to Richards, it’s an example of a different type of plasticity from what is usually understood. Normally plasticity is thought about at the level of connections between individual neurons – but this type is known as axonal plasticity. This is the growth of completely new fibres across an entirely different tract of the brain.

As she explains, ‘if we could understand how those plastic processes occur during brain development, to enable the brain to wire itself such that it can function in an optimal way, we may be able to repair the brain’.

For instance, ‘one of the processes might be the kind of stimulation that a young child receives as it is developing. And so some work from my laboratory actually has shown that stimulation, sensory input, from both sides of the body is very important for wiring the corpus callosum … And so if we can understand those processes it might be possible to help make sure that that kind of stimulation