Need Some Resilience? A Few Zaps of Electricity Might Help

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Fighting spirit, grit, heart: researchers say that they may all be within our reach with just a zap of electricity to a specific spot in the brain.

So far, however, the electrical stimulation is too invasive to transform slackers into marathoners, but the latest research raises fascinating questions about how we might manipulate the brain to spur qualities like resilience— and about the limits of such technology.

The study, which was published in Neuron, is part of ongoing research on patients with intractable epilepsy, who need to have electrodes implanted in their brains to discover the source of their seizures. The electrodes allow doctors to stimulate various areas of the brain to test their functions, and identify seizure-producing regions that might be removed with surgery. The setup also provides researchers with a unique opportunity to study the inner workings of the brain.

“We’re not only reporting the precise location of the population of brain cells that are important for a virtue like the will to persevere, but also using modern imaging technology to map the connected network of brain regions that work together toward this aim,” says lead author Josef Parvizi, associate professor of neurology at Stanford.

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The researchers didn’t set out to find the “willpower center”— in fact, the brain has no such thing since most behaviors are the product of a system of nerve networks. But as doctors stimulated a region known as the anterior midcingulate cortex (aMCC), one patient reported a strange experience.  “He said something is happening in my chest and my heart rate is up,” Parvizi says.

The patient also said he felt as though he were driving into a storm and had to psych himself up to face the danger, using the first example that came into his mind. But the mood wasn’t negative.  “It was more of a positive thing like.. push harder, push harder to try and get through this,” he reported.

The researchers stimulated another patient in the aMCC, whose surgery also required testing in the region. He, too, reported a similar feeling of needing to persevere through a hardship though he did not give a precise example. He said, “I can’t give up” and “I have to fight it… to make it through.” When asked if he might feel like this while driving, he first joked that his epilepsy doesn’t let him drive any more. But back when he could drive, he said it wouldn’t be a feeling he had when facing a small challenge, but instead if there was “a major accident… It’s the major things that if you give up on, you’re in trouble.” While the first patient said the feeling was mostly positive, however, the second also experienced worry and irritation.

“It’s really a novel observation about an area that’s very important in all sorts of conditions that involve tolerance of distress,” says Dr. Benjamin Greenberg, associate professor of psychiatry at Brown University and chief of outpatient services at Butler Hospital in Rhode Island, who was not associated with the study.

The research also included brain imaging of the two patients, which traced the networks that lit up when they had these sensations. Some of the activated regions have also been connected to addiction, depression and obsessive-compulsive disorder (OCD).

Given that those conditions involve problems with motivation, the link makes sense. In depression, motivation can disappear entirely and even getting out of bed can seem an insurmountable challenge. During addiction and obsessive-compulsive disorder, the will to engage in the addictive or compulsive behavior is excessively strong— but not the ability to refrain.

“That element of pushing harder is so crucial for our survival,” says Parvizi.  In order to better treat those disorders, he says, researchers will need to investigate the activated region more closely.

Greenberg notes that if the work is validated, and the aMCC is indeed a reliable conduit to engaging will power or resilience, stimulating it could be helpful in many different conditions in which people need to fight against their own desires and tolerate distress while doing so. “The other thing I liked about it was that this concept doesn’t respect diagnostic categories,” he says.

While researchers are working on noninvasive techniques to electrically stimulate the brain, for now, areas deep inside the brain like the aMCC are not accessible without surgery— so we’re not going to see “willpower implants” any time soon. In cases where depression and obsessive-compulsive disorder are severe, chronic and intractable, however, deep brain stimulation or surgery to remove dysfunctional areas can be effective— and Parvizi’s type of stimulation-mapping could guide such treatment to improve outcomes.

Even if the technique turns out to be a reliable way of improving resilience, is zapping the brain to increase stick-to-itiveness such a good idea? Can such a quality be doled out like a drug, or is such a strategy a form of cheating, and an evasion of responsibility? Greenberg says that some medications already have a similar, if not as immediate effect— many patients report, for example, that antidepressants restore their resilience and will to live. “I see it all the time,” he says, “Our job should be to try to help people who are suffering with these illnesses to make choices that are authentic for themselves. Nothing distorts your experience and ability to express your will more than one of these illnesses.”

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Francis Shen, an associate professor at the University of Minnesota School of Law and expert on law and neuroscience cautions that the study included only two participants and that simply because patients feel more motivated, doesn’t mean that they will act on that motivation. “It’s really hard to know exactly how changing the brain will change behavior,” he says.

But as brain stimulation techniques become more precise and less invasive, the question of what has been called “cosmetic neurology,” will become more difficult— just as it has done for drugs that can be used either to treat illness or enhance performance, like stimulants for ADHD or anabolic steroids. “I think direct brain interventions like these should be regulated with careful attention to our traditional concerns of safety and efficacy,” Shen says.

In the meantime, we’re stuck with more traditional forms of motivation, such as coaching and talk therapies—which aren’t as innovative, but they often work.

2 comments
LI-NYOCDTHERAPIST
LI-NYOCDTHERAPIST

Fortunately there are far more effective approaches than 'coaching and talk therapy', which do nothing for OCD. In my work I use only Exposure-and-Response-Prevention behavioral therapy. It's the 'gold standard' and has been for almost 30 years. Outpatients come once a week for instruction in how to do the voluntary 'exposures' which take about 10 minutes, four times every day. By the end of each week the client no longer feels any need to respond with compulsive behavior (which can include washing, checking, touching, asking for reassurance, or worrying, reviewing an event or excessive praying). Compulsions can be thoughts, not just actions, and the person does not appear to be doing anything unusual, but is unable to concentrate because s/he is totally preoccupied with internal mental compulsive rituals. I call this expression of OCD "obsessions without visible compulsions"; it originally was called "pure-o" (obsessions) because people didn't know compulsions could also be thoughts. The same therapy is effective for this. With correct instruction and daily practice, recovery can happen in just a few weeks for a child, or a few months for an adult. Read ocd.hereweb.com for more.