Brain 

The Tell-Tale Brain: A Neuroscientist's Quest for What Makes Us Human by V. S. Ramachandran (W.W. Norton) Drawing on strange and thought-provoking case studies, a neurologist in The Tell-Tale Brain offers insight into the evolution of the uniquely human brain.

Preeminent neuroscientist V. S. Ramachandran, the director of the Center for Brain and Cognition and a professor with the Psychology Department and Neurosciences Program at the University of California, San Diego, is at the forefront of his field. One of the most original and daring neuroscientists of our age, Ramachandran has spent much of his life's work expanding our understanding of the human brain. His pioneering spirit and innovative methods have resulted in Richard Dawkins dubbing him the Marco Polo of neuroscience. And Nobel laureate Eric Kandel hails Ramachandran as the modern Paul Broca, referring to the founding father of neurology. But if Ramachandran takes after anyone, it may just be Sherlock Holmes.

In this major new work, Ramachandran sets his sights on the mystery of human uniqueness. Taking readers to the frontiers of neurology, he reveals what baffling and extreme case studies can teach readers about normal brain function and how it evolved. Synesthesia becomes a window into the brain mechanisms that make some of us more creative than others. And autism gives readers a glimpse of the aspect of being human that is least understood: self-awareness. Tracing the strange links between neurology and behavior, The Tell-Tale Brain unveils a wealth of clues into the deepest mysteries of the human brain.

In The Tell-Tale Brain Ramachandran takes on some of the brain's deepest and most intriguing mysteries: What evolutionary developments made human brains so remarkably distinct from those of even our closest ancestors? How did language develop? What are the origins of art? What is the relationship between our subjective perceptions and external reality? What causes autism, and how might it be detected and treated? Why do we find certain things beautiful? How did language evolve? These are just a few of the fascinating neurological mysteries that Ramachandran tackles in his landmark new work.

Ramachandran doesn't tackle these mysteries in the abstract. He draws on years of working with actual patients, presenting readers with case studies like the following:

• A blind patient is asked by his doctor to touch a spot of light on the wall. After protesting that he can't see it, the patient makes what feels like a wild guess. He is right, and in further trials he succeeds time and again even though he cannot consciously see the spot.
• A patient with synesthesia a blending of the senses claims to feel strong emotions when she touches different textures: denim evokes sadness, silk calms her, and orange peel sends her into shock. To see if she is faking, Ramachandran measures her skin conductance an indicator of physical stress only to find that she truly does experience these reactions.
• A patient in a coma seems not to recognize his family or comprehend speech. But if his father calls him from a telephone in the next room, the patient becomes suddenly alert, recognizing his father and engaging him in conversation. When his father reenters the room, the patient lapses back into his semiconscious zombie state.
• Following the amputation of his right arm, a patient develops phantom limb syndrome; he still feels as if he has a right arm and even experiences pain in it. But watching a volunteer massage her hand makes him feel as if his own phantom hand is being massaged, relieving the painful cramp in it.

Through close observation, the occasional brain scan, and a few low-tech tests, Ramachandran in The Tell-Tale Brain reveals the neural mechanisms that underlie these seemingly inexplicable cases. In elegant deductive maneuvers, Ramachandran uncovers what these exceptional patients can teach us about the normal human brain.

For example, the first phenomenon described, known as blindsight, shows that vision is not entirely conscious, providing clues into the unconscious brain processes that occur without our knowing. In the second case, synesthesia becomes a window on the uniquely human ability to create metaphors as well as an indicator of why some of us are more creative than others. The splitting of the self in the third case reveals that consciousness isn't unitary, but rather arises from multiple layers of neural processes. And the experience of the fourth patient points to the existence of remarkable brain cells known as mirror neurons, which fire not only when one performs a particular action but also when one simply watches someone else perform that action.

As Ramachandran reveals, the implications of these case studies are extraordinary. Mirror neurons alone help explain empathy, the transmission of culture, and linguistic capabilities. Their unique strength in humans is most likely what enabled the human species to transcend the narrow instinctual drives of evolution and achieve civilization. Moreover, in one of The Tell-Tale Brain's most provocative chapters, Ramachandran suggests a link between autism and a deficiency in mirror neurons, opening the door for new methods of diagnosis and treatment.

Boldly asserting, right off the bat, that Homo sapiens is no mere ape, Ramachandran tells us why the day of neuroscience has dawned. A physician (like Oliver Sacks, a neurologist) as well as a researcher, Ramachandran uses his neurology patients predicaments to inspire inquiries into how we see and know, the origins of language, the mental basis of civilization, how we conceive of and assess art, and how the self is constructed. Always careful to point out when he is speculating rather than announcing research findings, he is also prompt to emphasize why his speculations, or theories, are not just of the armchair variety but can be put to the test because of what neuroscience has already discovered about the active structures of the human brain. Ray Olson, Booklist, starred review
Ramachandran has written an astonishing book. His humanity, humor and scientific genius inform every passage. The Tell-Tale Brain is a veritable Voyage of the Beagle through the terrain of brain science and psychology. Nicholas Humphrey, author of Seeing Red
A masterpiece. The best of its kind and beautifully crafted. Alluring story telling, building to a penetrating understanding of what it is to be uniquely human. Ramachandran is the foremost pioneer the Galileo of neurocognition. Allan Snyder, FRS, Director of the Centre for the Mind
Ramachandran is the modern wizard of neuroscience. In The Tell-Tale Brain, we see the genius at work, tackling extraordinary cases, many of which mark turning points in neuroscientific knowledge. In this utterly entertaining account, we see how these fascinating cases fit together, and how he uses them to explain, from a Darwinian point of view, how our brains, though evolved from those of other animals, become neurologically distinct and fundamentally human. Norman Doidge, M.D., author of The Brain That Changes Itself

No one is better than V. S. Ramachandran at combining minute, careful observation with ingenious experiments and bold, adventurous theorizing. The Tell-Tale Brain is Ramachandran at his best, a profoundly intriguing and compelling guide to the intricacies of the human brain. Oliver Sacks

Exhilarating. Kirkus Reviews

As entertaining as it is illuminating, The Tell-Tale Brain is a delightful tour of recent advances in neuroscience, enriched throughout by Ramachandran's engaging conversational style, wit, and insight. Ramachandran tackles the most exciting and controversial topics in neurology with a storyteller's eye for compelling case studies and a researcher's flair for new approaches to age-old questions. Tracing the strange links between neurology and behavior, this landmark work rewards readers with a wealth of new clues into the mysteries and the remarkable abilities of the human brain.

Shine: Using Brain Science to Get the Best from Your People by Edward M. Hallowell (Harvard Business Review Press)

Great managers serve others; they develop the shine in their people.

In Shine, bestselling author and ADD expert Edward Hallowell draws on brain science, performance research, and his own experience helping people maximize their potential to present a proven process for getting the best from their people.

The central question for all managers in these pressure-packed, confusing, unsettled times is how to draw the most from their talent. Finding the shine in someone, helping all ones people perform at their highest levels, isn't rocket science. It is brain science, but it has yet to be codified into a simple and reliable process that all managers can use. In Shine, Hallowell formulates such a code, the Cycle of Excellence. It is a process that he has created and honed over the past twenty-five years as a doctor, practicing psychiatrist, author, consultant, instructor at the Harvard Medical School and director of the Hallowell Center for Cognitive and Emotional Health. He explains peak performance and provides managers with a practical plan to bring the best from the people who work for them.

Rather than touting a single key idea for peak performance, the process he describes in Shine incorporates many ideas while drawing upon the latest research from diverse disciplines. The five steps in the Cycle of Excellence, and what they teach readers, are:

1. Select: How to put people into the right jobs so that their brains light up.
2. Connect: How to overcome the potent forces that disconnect people in the workplace both from each other and from the mission of the organization, and how to restore the force of positive connection which is the most powerful fuel for peak performance.
3. Play: Why play imaginative engagement catalyzes advanced work, and how managers can help people tap into this phenomenally productive yet undervalued activity of the mind.
4. Grapple and grow: How managers can create conditions where people want to work hard, and why making progress at a task that is challenging and important turns ordinary performers into superstars.
5. Shine: Why doing well shining feels so good, why giving recognition and noticing when a person shines is so critical, and why a culture that helps people shine inevitably becomes a culture of self-perpetuating excellence.

Each step is critical in its own right and translates into actions a manager or worker can do. Each step builds upon the other. The most common mistake managers make is to jump to step 4 and ask people to work harder; without first having created the conditions that will lead workers to want to work harder. There is no point in challenging employees to exceed their personal best if they haven't first been placed in the right job, found a safe and connected atmosphere within which to work, and been given a chance to imaginatively engage and contribute to the design of the task. This plan works because it brings together the empirical evidence on peak performance into one integrated series of steps that create the ideal conditions, the perfect tension in the violin string, for managers to propel their people to excellence.

According to Shine, a key to working the Cycle of Excellence is making the critical step of connection. When that is threatened, all the other steps go awry. Unless managers realize how crucial it is to create an emotionally stable, connected environment in the midst of the maelstrom of modern business life, they will and do sacrifice performance in the name of speed, cost cutting, efficiency, and what they perceive to be necessity. In such a context, deep thought disappears, only to be replaced by decisions based on fear. Frazzled becomes the order of the day.

As global competition and economic stress create problems for businesses of all kinds everywhere, managers who don't have a plan to stabilize operations will be compelled to revert to crisis mode, putting out fires all day, just hoping to survive. The managers who do best develop a method that enables their people to do their work without toxic stress. Most of the time, such plans and methods languish in a book on the shelf, and never get put into action. The method that actually gets used is some simple version of the carrot-and-stick approach: do this and you'll get that. Work hard or else.

Shine offers an alternative to panic or serial crisis management. Readers learn a method they can set in motion anywhere to bring out the best in any person, no matter what is going on in the wider world. Once readers understand the Cycle of Excellence as well as the ways it can break down, they will have a more effective plan for bringing out the best in people than simply wielding the fear of job loss or exhorting them to try harder. They will be able to creatively manage for growth, rather than manage for mere survival. They will know how to capture the positive energy and not let it blow them or their organization away.

With Shine, Hallowell gives managers at every level an exciting new way to think about leading their people. Its stories delight, and its message enlightens. An important book. Suzy Welch, Business journalist and Coauthor of the international bestseller Winning

In his newest book, Hallowell masterfully reinforces the positive reactions that can be created when you take the time to compassionately connect with people around you. His insightful and highly practical lessons are universal whether you are beginning your career, midway through, or sitting in the corner office. This is a must-read. Howard J. Breen, Former Chairman and CEO, MacLaren McCann WorldGroup and author, A Page from a CEO's Diary

If you read Shine, it will make your life and everyone with whom you interact shine as well. It's a must-read for anyone who cares about bringing out the best in people. Ken Blanchard, coauthor, The One-Minute Manager and numerous other books

Information overload, busywork, burnout: It's easy to feel like a bike chain that's jumped the sprockets. Hallowell's five steps to a better work environment can get you and your people back in gear and on the road to peak performance. Daniel H. Pink, author, A Whole New Mind and Drive

Brimming with Hallowells trademark candor and warmth, Shine is a vital new resource for all managers seeking to inspire excellence in their teams.

Brain Disabling Treatments in Psychiatry: Drugs, Electroshock, and the Psychopharmaceutical Complex, second edition by Peter R. Breggin MD (Springer Publications) Renowned psychologist Peter Breggin documents how psychiatric drugs and electroshock disable the brain. He presents the latest scientific information on potential brain dysfunction and dangerous behavioral abnormalities produced by the most widely used drugs including Prozac, Xanax, Halcion, Ritalin, and lithium.

For this edition of the book, the concept of brain-disabling treatment has been updated and expanded with the additional concept of medication spellbinding (intoxication anosognosia). The neuroleptic chapters have been updated to include much more material on the newer, atypical drugs, and well as new information on the neurotoxicity and cytotoxicity of all antipsychotic drugs. A massive amount of new information about antidepressant drugs and the stimulant drugs has resulted in an additional chapter on each drug.

The new edition concludes with two entirely new chapters on treatment--one on how to safely withdraw from psychiatric drugs and the other about psychosocial and educational approaches to very disturbed people, including 20 guidelines for therapy.

"Peter Breggin has written the definitive text for professionals and the public alike who really want to know the hazards, inadequacies and illusions of psychopharmacology. This book will be a foundation for those who specialize in medication-free treatment." -Kevin F. McCready, PhD Clinical Director, San Joaquin Psychotherapy Center "This book proves once again that Peter Breggin truly is the 'conscience of American psychiatry.' Breggin shows that the brain-disabling hypothesis of organic psychiatric treatments is overwhelmingly confirmed by clinical experience and the scientific literature. With astounding numbers of elderly, adults, and children on prescribed psychoactive drugs, Brain-Disabling Treatments in Psychiatry should be required reading for all medical interns, practicing physicians, and mental health professionals." -David Cohen, PhD Professor of Social Services, University of Montreal"

Excerpt:

Throughout this book, I use diagnostic terms such as attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder, and schizophrenia. If I were to express my scientific skepticism toward these terms each time I used them, the book would be marred by constant interruptions. Instead, I want to establish from the beginning that I am using these diagnostic terms only for the purpose of consistency with current usage in the various sources on which I am drawing, such as clinical studies, research reports, and Food and Drug Administration (FDA)-approved drug labels.

As the book will indicate, these diagnostic categories do not reflect valid diseases or illnesses comparable to Alzheimer's disease, stroke, or diabetes. Despite claims to the contrary, these psychiatric disorders have no proven genetic, chemical, or biological basis. They cannot be diagnosed with physical symptoms or laboratory studies.

Of course, no one denies that people can become highly irrational, lose touch with ordinary reality, or become suicidal or violent; but an extreme emotional response, however destructive, in itself does not demand an explanation rooted in biological dysfunction. Without any underlying medical disorder, human beings have the capacity for extreme psychological reactions, especially under stress.

Of course, genuine diseases or disorders of the brain, such as endocrine disorders or dementia, can change and disrupt human behavior. In this book and in Medication Madness (in press), I describe how psychiatric drugs cause brain disorders that lead to mayhem, murder, and suicide. Indeed, the FDA at long last has begun to confirm observations that I made long ago concerning antidepressant-induced mental and behavioral abnormalities. However, except for the brain dysfunction and biochemical imbalances caused by psychiatric drugs, there are no known abnormalities in the brains of people who routinely seek help from psychiatrists and

who become diagnosed with disorders like ADHD, schizophrenia, an major depressive disorder.

To label children with ADHD or to label adults with schizophrenia or major depressive disorder is to stigmatize them with damaging, discouraging labels and to encourage or coerce them to submit to biopsychiatric interventions such as drugs and electroshock. In my own psychiatric practice, I do not think in conventional diagnostic terms or tell patients that they have so-called mental disorders. Instead, I try to understand the life story of each individual—his or her personal biography—in all its subtle complexity. Often, I involve loved ones and family to help them understand each other. On this basis of genuine understanding, instead of cookie-cutter diagnoses, I am far more able to help individuals lead more satisfying, successful lives.

This book is aimed at professional audiences, but it is hoped that it is written with sufficient clarity and explanation to be read by nonprofessionals. The current edition has been very thoroughly revised, but the basic scientific thrust remains essentially the same. The past several years have confirmed the brain-disabling principle of psychiatric treatment, and many of the author's seemingly controversial conclusions have become more widely accepted.

A THOROUGH UPDATE OF THE SCIENCE

For this edition of the book, the concept of brain-disabling treatment has been updated and expanded with the additional concept of medication spellbinding (intoxication anosognosia). The neuroleptic chapters have been updated to include much more material on the newer, atypical drugs as well as new information on the neurotoxicity and cytotoxicity of all antipsychotic drugs. A massive amount of new information about antidepressant drugs and the stimulant drugs has resulted in an additional chapter on each drug.

The new edition concludes with two entirely new chapters on treatment—one on how to safely withdraw from psychiatric drugs, and the other about psychosocial and educational approaches to very disturbed people, including 20 guidelines for therapy. I am pleased to include how-to treatment information in the book for the first time.

GROWING CONFIRMATION OF THE
PREVIOUS EDITION

My observations that antidepressant drugs cause a spectrum of stimulant or activation effects—including agitation, hostility, aggression, and mania as well as crashing into depression and suicidality—have been elevated to the status of official dogma in the new Food and Drug Administration (FDA)-mandated changes in antidepressant labels. The concept that psychiatric drugs are neurotoxic is now a widely accepted principle in scientific research, especially concerning the antipsychotic drugs and mood stabilizers, and research has mounted up that demonstrates similar neurotoxic effects in all categories of psychiatric drugs. Many other medical experts have now joined in my criticism of the FDA's failure to do its duty and my concern about the corrupting influence of the drug companies on the theory and practice of psychiatry. Put simply, I am no longer quite such a lonely voice crying in the wilderness.

CONFIRMING THE LONGER VIEW
STARTING IN 1983

The lineage of this new edition began in 1983 with Psychiatric Drugs: Hazards to the Brain, a book that broke new ground with the first extensive review of the subject of neuroleptic-induced dementia. It also took a firm stand on the view that neuroleptics frequently cause tardive dyskinesia (TD) in young people. TD in children has become an accepted reality, and so that section has been reduced in size. Tardive psychosis is gaining increasing, if slow, recognition. Tardive dementia remains controversial—although it should not be—and an increasing amount of evidence supports my earlier observations on the cognitive deficits caused by neuroleptics. In addition, the neurotoxicity of psychiatric drugs is being studied more openly in laboratories.

In the 1970s, when I first began offering detailed critiques of psychiatric
drugs, the medical model, and the psychopharmaceutical complex, I was, in
many cases, breaking new ground, and initially, there were few supporters.
By the time of the first edition of Brain-Disabling Treatments in Psychiatry
in 1997, I could already cite many books that voiced strong criticism of
the biological model and physical treatments from a variety of perspectives
(Armstrong, 1993; Breeding, 1996; Caplan, 1995; Cohen, 1990; Colbert,
1995; Fisher et al., 1989; Grobe, 1995; Jacobs, 1995; Kirk et al., 1992;
Modrow, 1992; Mosher et al., 1989; Romme et al., 1993; Sharkey, 1994).
Especially in the last few years, an escalating number of authors,
many from within the medical establishment, have been offering strong

criticism of that conglomerate of powerful interest groups, and especially the dominating influence of the pharmaceutical industry (Abramson et al., 2005; Angell, 2004, 2007; Glenmullen, 2000, 2005; Healy, 2004; Jackson, 2005; Kean, 2005, 2006; Medwar et al., 2004; Moncrieff, 2006a, 2006b; O'Meara, 2006; Rost, 2006).

THE SITUATION IN PSYCHIATRY WORSENS

Although many of my critiques and criticisms of biological psychiatry and the psychopharmaceutical complex have a broader acceptance, in many ways, the situation has deteriorated as the strength of the drug companies has grown. In the process, my predictions about the growing power of the psychopharmaceutical complex have come true.

The last two decades have seen escalating reliance on psychiatric drugs, not only within psychiatry but also throughout medicine, mental health, and even education. In private-practice psychiatry, it is common to give patients a medication on the first visit and then instruct them that they will need drugs for their lifetimes. Family practitioners, internists, and other physicians liberally dispense antidepressants and benzodiazepine tranquilizers. Nonmedical professionals, such as psychologists and social workers, feel obliged to refer their patients for drug evaluations. Managed care aggressively pushes drugs to the exclusion of psychotherapy. Adult medications are increasingly prescribed to children. Hospitals force psychiatric drugs on patients against their will.

There is a successful movement within psychiatry, implemented in many states, that makes it easy to force clinic outpatients to take long-acting injections of drugs. Under these outpatient commitment laws, if the person refuses to come to the clinic, mental health workers can come to the home to administer the injections by force. At the same time, there is a movement to screen schoolchildren, and even preschoolers, for so-called mental illness. This potentially disastrous movement is driven by drug company money and aims at increasing the market for their products.

Laypersons have joined in the enthusiasm for drugs. Because of media support for medication as well as direct advertising and promotion to the public, patients frequently arrive at the doctor's office with the name of a psychiatric drug already in mind. Teachers often recommend children for drug evaluation or treatment.

This drug revolution views psychiatric medications as far more helpful than harmful, even as an unmitigated blessing. Much as insulin or penicillin, they are vigorously promoted as specific treatments for specific illnesses. Often, they are said to correct biochemical imbalances in the brain. These beliefs have created an environment in which emphasis on

adverse drug effects is greeted without enthusiasm, and criticism of psychiatric medication in principle is uncommon heresy.

Drug companies heavily promote that unproven speculation that the problems they treat are biological in origin and result from biochemical imbalances. Advertising slogans are used to justify the prescription of medications. For example, Janssen (2005), the manufacturer of the antipsychotic drug Risperdal, offers a section "About Bipolar Disorder," downloaded from its Web site in February 2006. It declares,

Mental illness is a medical illness, just like high blood pressure or heart disease.

The Janssen Web site goes on to say, "It is also thought that bipolar disorder may be caused by a genetic predisposition to the illness because it tends to run in families." Notice again that no claim to scientific veracity is made. But the repetition of these unscientific biochemical and genetic speculations nonetheless conditions people to believe that psychiatric drugs are specific treatments for genetic, biochemical disorders, much like antihypertensive drugs for high blood pressure or insulin for diabetes.

This book takes a decidedly different viewpoint from that of biological psychiatry. It provides theory and evidence that psychiatric drugs achieve their primary or essential effect by causing brain dysfunction and that they tend to do far more harm than good. I will show that psychiatric drugs are not specific treatments for any particular so-called mental disorder. Instead of correcting biochemical imbalances, psychiatric drugs cause them, sometimes permanently.

Health care providers and the general public have also been bamboozled by the much-advertised speculation that brain scans can demonstrate the existence of mental disorders, and even diagnose them. In reality, no psychiatric disorder is demonstrable or diagnosable by brain scan (Jackson, 2006a) or by any other medical or biological means.

This second-edition book discusses how to stop taking psychiatric drugs and presents 20 guidelines for therapy. Considerably more information on how to help disturbed and disturbing people without resort to drugs or electroshock is readily available elsewhere (Breggin, 1991a, 1992a, 1997; Breggin et al., 1994a, 1996, 2002). Chapters in Reclaiming Our Children (2000b), Talking Back to Ritalin (2001c), The Antidepressant Fact Book (2001a), and The Ritalin Fact Book (2002b) also deal with therapeutic approaches. The best overall summary of my approach to helping people can be found in The Heart of Being Helpful (1997b). Finally, Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide, and Crime (St. Martin's Griffin) can be viewed as a companion to this book, providing real-life cases of the devastating impact of these drugs on individual lives.

Medication Madness: The Role of Psychiatric Drugs in Cases of Violence, Suicide, and Crime by Peter R. Breggin MD(St. Martin's Griffin) describes how people taking psychiatric medication can experience abnormal behavioral reactions, including suicide, violence, emotional breakdowns, and criminal acts. Dr. Breggin explains his concept of “medication spellbinding”: individuals taking psychiatric drugs may have no idea whatsoever that their mental conditions are deteriorating and that their actions are no longer under control. He proves his argument by documenting dozens of cases from his practice and his consultations in legal cases. Reading like a thriller, the book also examines how the FDA, the pharmaceutical industry, and the medical establishment continue to oversell the value of these drugs, and he provides information on how to safely stop taking psychiatric medications. Medication Madness is a compelling and frightening read as well as a cautionary tale about our reliance on medicine to fix what ails us.

Does Stress Damage the Brain? Understanding Trauma-Related Disorders from a Neurological Perspective by J. Douglas Bremner (Norton) The compelling story of how stress affects the brain. Can what you see, hear, feel, and experience result in a permanent change in your brain? This provocative question arose from research discoveries by Douglas Bremner and others that showed that extreme stress may result in lasting damage to the brain, especially a part of the brain involved in memory called the hippocampus. Anyone who has experienced even moderate stress in their life will benefit from the insights in this clearly written, accessible book. It is a aid in self-understanding and in sympathy for others who have experienced various degrees of stress in their lives. It brings a balanced view of clinical insight to recently emerging  experimental and theoretical research.

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