Go Wild

by John J. Ratey

  This is where van der Kolk slides from the biological evolution that has dominated our discussion so far to the idea of cultural evolution. His reasoning is this: Humans have dealt with terror and psychic injury for as long as there have been humans, and certainly as long as there have been lions, and more certainly as long as there have been wars. So we have developed time-tested—no, deep-time-tested—methods of coping. Van der Kolk looks for these methods, and he finds them in places you might expect, all in line with his foundation tenets of moving rhythmically together, controlling breath, and feeling the vibrations of voice. He practices yoga himself and prescribes it for others. He likes the ancient Chinese practice of qigong, a form of ritualized movement. Meditation, certainly. Many forms of dance, and chanting. He pays particular attention to theater, citing examples such as successful projects in troubled high schools, where students—many of them the victims of violence—write, rehearse, and stage musical theater as a means of recovering from the damage. One such project, called Shakespeare in the Courts and headed by the actor Tina Packer, specializes in Shakespearean theater, summoning as it does the primal cadence and earthiness of Anglo-Saxon words like “murder,” “father,” and “blood” to tap and relate emotional content in public.

  There’s nothing new about any of this. Van der Kolk points to the roots of Western theater in Greek tragedy, performances of which were filled with more public venting of emotion than modern theater is today. He believes that these rituals developed in what were then unarguably violent societies for many of the same reasons this sort of thing works in a modern context. The elements align nicely with what we are learning about emotional trauma and the intricacies of our visceral nervous system. Breath control, rhythm, whole-body movement, narrative, social ties and cues—all of these are physical impulses that travel at the literal core of our being.

  Besides, he says, “people cannot rhythmically move together without beginning to giggle.” Laughter trumps trauma.

  BEYOND STRESS

  There is a word, an overused, worn-out, imprecise, deflated word, that comes up when we talk about danger and challenge. “Stress? We shouldn’t use the word,” says Porges. “I think it’s a bad word.”

  And now we’ve gone and done it, opened a can of worms that is in fact going to cause us to backtrack on another word, one that has served us well in our discussion so far. But once you deflate the idea of stress, then you also begin to undermine the notion of homeostasis, which is precisely what we need to do now. Homeostasis? Old hat. Last week’s news. Think, instead, allostasis.

  The fact that some enterprising folks in the tech world began marketing a new sort of household thermostat makes this distinction easy to analogize. Homeostasis is like a thermostat—in some cases, it behaves exactly like one. Exert yourself on a hot day and your body temperature rises above its set point of 98.6; you begin to sweat so that evaporation and cooling return you to your set point. This is homeostasis, the body’s mechanism for maintaining stability at set points, such as heart rate, respiration, blood pressure, hunger, thirst, and on and on. And it’s just like the sort of thermostat that hangs on the wall. Set a temperature and a furnace or an air conditioner kicks in appropriately to maintain it. Or at least that’s how it worked for a hundred or so years.

  But the newer, high-tech thermostats actually remember changes you make in room temperature according to conditions, not through a simple memory and program. They actually learn, remember, and predict your behavior. So they know when you get up on a cold day, and they turn up the heat in advance, just as you would do.

  This, argues the new thinking, is more in line with how your body works, only your body is even more sophisticated—because unlike the thermostat on your wall, humans have big brains. The neuroscientist Peter Sterling laid out the difference in the introduction to a key paper on the topic, offering the beginnings of an idea that is providing some needed traction for our thinking:

  The premise of the standard regulatory model, “homeostasis,” is flawed: the goal of regulation is not to preserve constancy of the internal milieu. Rather, it is to continually adjust the milieu to promote survival and reproduction. Regulatory mechanisms need to be efficient, but homeostasis (error-correction by feedback) is inherently inefficient. Thus, although feedbacks are certainly ubiquitous, they could not possibly serve as the primary regulatory mechanism.

  A newer model, “allostasis,” proposes that efficient regulation requires anticipating needs and preparing to satisfy them before they arise.

  Put another way, homeostasis can deliver only stability, and in life, stability is literally a dead-end strategy. The only stable condition of a biological organism is dead. Your body’s systems must allow for growth, which means more than simply adjusting for existing conditions. Your vital systems must roll with the punches today and build capacity to absorb future punches.

  We have already seen the fundamental design feature of this at work, and it goes beyond the example of the high-tech thermostat. A thermostat controls one system in your home, but your body is made up of a series of interlocking systems: circulation, digestion, immune, nervous, endocrine, and so forth. Sterling points out what any designer of an efficient car already knows. If each of those systems needed its own energy reserves and capacity to meet all needs at all times independently, the whole system would be inherently overdesigned and inefficient. Better, then, to allow energy borrowing between the systems, just as we have seen. Fight, flight, or freeze shuts down the digestive and immune systems simply to allow the muscles to use that energy instead.

  Yet that same principle explains exactly why it makes no sense to treat a particular malfunction or disease by considering only one system. The overload that is producing the problem may be in another part of the body altogether, which is why “psychological” problems like PTSD show up as digestive issues and can be treated in the body. Or why, for that matter, Carol Worthman’s contention that we pay for sleep deprivation in the currency of stress is true. The body is making adjustments throughout the system to meet immediate needs, and all of this is checked and balanced by the brain. At the same time, though, this system is looking to the future, both short-term, in seasonal cycles, and long-term, in changes in the conditions of life.

  One example of a short-term systemic change comes as days lengthen in the spring. At this time of year, we react to increasing sunlight by producing skin pigment that protects us from increasing sunlight later in the year. Another example is that most mammals store fat as winter approaches.

  But long-term regulation seems even more critical in light of the issues that have concerned us throughout this book, and we have already seen examples of just how long-term we might mean by this. Remember the research that concluded that the best predictor of obesity in children was low birth weight. The fetus senses the conditions that produce low birth weight in utero as a predictor of a lifetime of scarce resources, and so his body adjusts by becoming good at storing fat. This is not a disease or a malfunction, really, but an adaptation. But remember, too, that an important predictor of an infant’s low birth weight is his mother’s low birth weight, meaning the body is setting in those adaptive processes across generations.

  We always assume that the method for transmitting traits across generations is genetic. For a long time, science has made much of genetic predisposition, and certainly genes play a role in governing our lives. But it is also true that much was made of genes because at the time we happened to know a lot about genes; that is, we were looking for the car keys where the light was best. In recent years, though, a whole new field has exploded on the scene: epigenetics, which is the study of gene regulation, how it is influenced by environment, and how it is inherited across generations. Much will be illuminated by this line of inquiry, but it has already pointed to one key mechanism, and, in fact, we have already seen it in action in a couple of areas we have talked about.

  Remember Sue Carter’s worries about oxytocin doses to infants
based on the research that showed how young voles given nasal doses of oxytocin had weird relationships as adults? Her explanation was a “downregulation” of receptors. That is, the voles’ bodies still produced the oxytocin, but the brain had adjusted to the excess by turning down the sensitivity of special cells that detect the signals—thus, downregulation. Sterling identifies this as a key mechanism in allostasis: the body’s ability to adjust to variations in the environment, a recalibration of its instruments.

  His paper on this says: “Thus, when blood glucose is persistently elevated and triggers persistent secretion of insulin, insulin receptors eventually anticipate high insulin and down-regulate. The system learns that blood glucose is supposed to be high.” This is the smoking gun for insulin resistance, the very issue that lies at the heart of our worst health problems, like obesity, diabetes, and heart disease. It is our bodies’ collective response to a long-term change in the conditions of life wrought by industrial agriculture and processed food.

  Yet wrapped in this sort of adaptation for change is the mechanism for growth, and it, too, is rooted in what we might call stress. This is the process at work in every long run uphill or in every set of bench presses that reaches for a new personal record. We build muscles by tearing them down, stressing them beyond their limits. The body reads this as a need for more muscle to meet these new conditions of your life, and so the body builds it. And this works the same way in the brain: brain-building chemicals build new cells and make existing cells stronger.

  Yet Sterling’s paper refines this line of thought by pointing out that the brain is not simply executing all of these controls on autopilot, but is in fact engaging our consciousness and sense of well-being in the entire process. The brain is wired with what he labels a set of carrots and sticks that move each of us to adapt and respond along with the rest of the body. Pain is a part of this—surely a big stick—but more intriguing is the degree to which all of these circuits for adaptation are tied directly to our brain’s dopamine circuits, the pleasure circuits and the brain’s reward system. Sterling makes the same argument we heard from Robert Sapolsky when we talked about meditation. That is, we get the greatest pleasure not out of a predictable reward but out of an unexpected one. We take pleasure in challenge and get more mindful and focused at the same time by dopamine, which is the carrot pulling us along to overcome the challenges of survival, short-and long-term.

  The flip side of this is anxiety, the stick that pushes us in elemental fears, the most common and elemental fear being, at least in evolutionary times, concern over where your next meal is coming from. The relief arrives in a squirt of dopamine that is the result of answering that concern every day. Sterling writes this: “Sensitivity to dopamine also declines because dopamine receptors, anticipating high levels, have down-regulated. This may explain Goethe’s famous remark, ‘Nothing is harder to bear than a succession of fair days.’”

  Yet in engineering a society that is nothing so much as a succession of fair days, we have removed the dopamine reward, and so we go mindlessly looking for ways to replace it. Some of us climb mountains or ride roller coasters. More commonly, though, the void gets filled with a suite of addictions, especially to drugs and alcohol, which play to the dopamine circuits, now governed by downregulated receptors that leave us asking for more.

  All of this suggests that the strategy for coping is not removing stress, or what we call stress, from our lives. Rather, as we have argued throughout, the real problem, the killer, is the chronic, unrelenting, unremitting series of regular events that wears us down. You can skip a night’s sleep now and again. It may, in fact, even be good for you to do so. But not day after day. You can tolerate and even thrive on astounding variety and variability in your diet, even enjoying an occasional slice of chocolate cake, but the daily, unrelenting dose of Big Gulp Cokes will kill you. Every runner knows you build strength on rest days. Dealing with a lion every now and again makes you better at dealing with lions. Allowing your life to surmount occasional challenges is inoculation—almost literally—against future stress.

  This brings us back to a central point in this book: variety. Remember, we argued from the beginning that the hallmark of the human condition is our ability to tolerate and thrive and in a wide variety of conditions—the Swiss Army knife model. So if our tolerance for variety is so great, how can we argue that modern life, with all its apparent variety—wheat, sugar, agriculture, iPads, noise, and the rest—is killing us? Much of that answer lies in deciding who each of us is.

  The neuroendocrinologist Bruce S. McEwen and the researcher Linn Getz build on Sterling’s idea of allostasis by using it to form a strategy of personalized medicine that involves employing specific and complex information about each individual to decide on interventions for problems. This idea has some currency in mainstream, medical-model medicine, but usually it is couched in terms of genetics. An individual’s course of treatment would depend on sequencing his genome to decide his genetic predisposition to disease and its cures.

  Yet McEwen and Getz argue that this ignores epigenetics and life history and that those influences are if anything more important. Specifically, they argue that there is such a thing as “orchid” children and “dandelion” children, individuals sorted by their specific tolerance for variability and challenge as shaped by the events in their lives. Dandelion children thrive anywhere; orchids are hothouse flowers. How far one goes in the direction of novel challenge and how attentive one needs to be to a safe, familiar base is a matter of where one falls on the orchid-dandelion continuum, and this is true for adults as well as children. But over time, with effort, one can move toward the dandelion end of the scale. This is growth. This is building resilience by inoculation against stress. This is re-wilding.

  The idea summons an image we used to introduce this book, the common scene employed in teaching students of child development: mother and toddler alone in a room, toddler clinging to mother to draw strength and foundation and courage, and then using that base to leave mother to explore, to be challenged, and then being surprised in fear and retreating to mother for reassurance. And then, if mother is good and does her job well, toddler explores again and grows.

  This is not just for toddlers. The evolutionary conditions that shaped us are that base of comfort and strength, the mother. Gather that strength and then venture forth to explore the variety and wonder of the world, the wild. And when it jolts you, pull back, rest, and grow among people you love and trust. Whether you’re stressed or relaxed, well-being is not about always being safe or fed or comfortable. Rather, it is learning to walk the line between the two, to balance, to move back and forth between them with ease and grace. Well-being comes from learning to talk to the lions.

  10

  Personal Implications

  What We Did and What You Can Do

  Indeed, the sources of our happiness are complicated, rooted as they are in the complexity of our bodies, but also, as we have argued, in the complexities of the twists and turns of our individual life stories, all of which forces the conclusion that there is no single prescription for well-being. Given this, the temptation is to paraphrase our favorite advice on writing from the great journalist A. J. Liebling: The only way to live is well, and how you do that is your own damned business.

  But this is a cop-out of sorts. There is a better way to deal with this matter of personal prescription: Our bodies and minds are endowed by evolution with marvelous systems tuned to attend to our happiness. Our task is to learn to listen to those systems and stay out of their way. As we argued in the beginning: if this grail of well-being is so elusive, so unattainable, then why can hunter-gatherers who have never heard of the scientific marvels that we have cited here achieve what we are after without even really trying?

  Yes, living organisms are complex, but now it’s time to shift gears and deliver, as we promised, some synthesis of all of this that you might use in your own life. Both authors have learned through years of public
appearances that audiences will often ask a pointed question that eliminates the cop-out of not offering a prescription: “Yeah, but what do you do?”

  There are a lot of scientific uncertainties and dueling studies that plague this issue. But the simple and necessary realization is that in all really interesting questions of science, there is no such thing as certainty. And yet there is a certainty that each of us must live a life, and each of us must make the choices that guide that process.

  We—each of the authors—did not hatch and assemble the ideas that brought us to this point solely from within the confines of research, inquiry, conversation, and logic. These notions came to us like most: after years of living. This book is not an academic exercise for either of us, but rather a product of living our real and textured lives. So, each in his turn, we are now going to give you some parts of our personal stories, especially recent parts, when we used our own bodies as laboratories for exploring these ideas. The truth is, our lives changed greatly during the process of writing this book—changed for the better. And we think that our experiences might offer some guideposts for your own explorations.

  JOHN RATEY

  Probably like many of you reading this, my life can be described as hectic, overscheduled, too much to do with too little time. In addition to running a psychiatric practice in Cambridge, Massachusetts, I teach, lecture around the world, write books and papers—and if that isn’t enough, I have a bicoastal relationship with my wife, Alicia, a television producer in Los Angeles, which sends me on planes back and forth between the coasts.

  Over the years, I have certainly been guilty of getting too little sleep, grabbing a hot dog and a soda on the run, being too wired after spending hours at the computer returning email, checking the news, the latest science reports, and even the New England Patriots scores. In the city jungles of Boston and L.A., “nature” is not readily available, and certainly finding quality time to spend with my tribe, recently made bigger by the important addition of my very first grandchild, hasn’t always been easy.