Thursday, September 25, 2008

On the Nature of Insight

Having practiced insight/psychoanalytic therapy for many years, having been trained in a Freudian clinic where the doctors (mostly Viennese) were either students, patients or colleagues of Freud, the notion of insights was the untouchable touchstone. No one ever really questioned it or defined it. It was just a “given.” An article of faith, and when a say “faith” I mean faith—something with no proof, whatsoever. So let’s see what it is.

Mark Jung-Beeman, the name Jung should already prepare us, is a neuroscientist at Northwestern University who studies insight. He began searching the right hemisphere for clues to insight. Why there? Because the left deals with specific denotation while the right is largely concerned with connotation, the meaning, sense and feeling/emotional charge of something. Subjects were given puzzles to solve. Many did not. A few did and had an aha! Experience—an insight. Mind you, this was an intellectual insight. It wasn’t an insight about one’s own behavior and what feelings drove it. First there was an activity in the prefrontal area, thinking and calculating. This was the preparatory phase. The second phase was the right hemisphere; a small fold of tissue on the surface was activated just before the insight. In short, it takes two to tango; both hemispheres play and part in insight but, I submit, without a significant contribution of thre right hemisphere the insight remins cerebral and not life changing. Further, I believe, not yet proved, that the insight about feeling motivation must involve the right hemisphere which then provokes the left hemisphere into activity, hence, the insight. But if the insight defies evolution and begins with the left, thinking hemisphere, there will be not significant change in either symptoms or behavior.

What scientists are saying is that the nerve cells in the right hemisphere are more broadly tuned than the left with a further reach, more dendrites and longer axon branches.

This means, among other things, that neurons on the right are collecting information from a larger area of the cortex; and that means more input into the insight. Specifically, more feeling input, hence a deeper insight. The impetus, then, for the insight is right brain. And, as I have written, grosso modo, the right is the feeling brain, the left is the thinking brain. We need both but the brain must follow evolution and start with feelings. Thinking came along after, a long time after. We cannot expect the insight to be purely left brain.

But here is the crucial part. The researchers claim that to have insights we need relaxation, not a hyper-stimulated left brain, something that happens in insight therapy. The claim is that the drowsy brain is disorganized and open to new input—an insight. The sine qua non for an insight is a mind that is not too focused, a mind that wanders. Trying to force an insight, which is what happens in cognitive/insight therapy is counterproductive. We need to suppress the thinking brain at some point in order to gather up insights. This is exactly what does not happen in insight therapy. I know. I did it. Why are pre-psychotics so insightful? Their whole perceptual thinking apparatus is deranged. Scientific insights nearly always happen when the person is not focused but relaxed and reposed. So the almighty prefrontal cortex is not so “ay ay ay” after all, as my mother used to say. Again, there is not significant change with intellectual insight; only the belief that there is; a state of self-deception that endures so long as the person continues to go back for more insights, often the same ones. We have two sides of the brain, and we need them both if we are to change. Here is what Jonah Lehrer says of all this: “The brain is an infinite library of associations, a cacophony of competing ideas, and yet, as soon as the right association appears, we know.” (see. “The Eureka Hunt.” New Yorker. July 28, 2008) He describes a “rush of gamma (very fast) waves on the right. Then the epiphany. Once you have both sides participating it all seems obvious. But suppose you are an intellectual, a scientist, heavily left-side dominant, then it never seems obvious; something like a feeling insight is out of reach and non-comprehensible. The therapy of feelings arouses only suspicion and distrust. And when you speak of pre-verbal imprints all is lost.

With right brain input the prefrontal area leaning against the inside of the forehead goes into action and correlates and corroborates it all. It is the final switchboard where it is all plugged in. And it has input and export to many areas of the brain so it has an overall impact. It can work “bottom-up.” Feelings first then thoughts and comprehension. When that area is too active it can shut-down many feeling areas and block insight—a top-down event. And that is what happens in insight therapy; using the top level to contain and repress feeling areas so that profound insights never happen. The person is content with intellectual ones. So it all depends on whether the top pre-frontal area can turn on versus suppress feelings. Real insight depends on a turn-on. And that means suppression for a brief time of cortical rumination. What Lehrer says is that when the right hemisphere generates the necessary association, the pre-frontal cortex is “able to identify it instantly, and the insight erupts into awareness.” (page 45) A more accurate description of what happens in Primal Therapy does not exist. So an insight is a matter of reconfiguring information; putting it all together, feelings and their understanding. That is the kind of insight we cannot undo. We can undo the intellectual insight because it is not anchored.

What we would need eventually is a MEG study (real-time magnetic resonance) to measure where insights are and where they come from. We will need to perfect our machinery before we can do that. But, happily, we have our human machinery that offers a good number of answers. Let us trust it and evolution and we won’t go wrong.

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