Building a Better Brain for Empathy, Connection and Wellbeing
Image credit: Little, Brown Spark
Known as the Empowering Neurologist, Dr. David Perlmutter has long championed a holistic approach that focuses on healthy eating and physical activity to achieve optimal brain health. Beyond diet and physical exercise, however, myriad interconnections between our modern lifestyle and disease risk are coming to light. For instance, much research in recent years has shown an association between social isolation and heart disease. Chronic stress and inflammation have been correlated with structural brain changes that impact critical cognitive functioning. In his latest book, “Brain Wash”, Dr. Perlmutter teams up with his son, internal medicine specialist Dr. Austin Perlmutter, to reveal the science behind why certain habits of modern living harm our brains and wellbeing. Perlmutter and son also offer hopeful insights and stories to inspire change.
Parvati Magazine: “Brain Wash” is a clever play on words! What is meant by this, and how does it relate to the “disconnection syndrome” that you refer to in your book?
David Perlmutter: Yes, we did hope to put a spin on the typical meaning of “brain wash.” The idea is that we can consciously clear out damaging influences from the modern world, and rewire our brains for the better, allowing us to build brains and bodies that promote enduring wellness. We believe that modern humans are deeply disconnected from lives of sustainable health and happiness, and that this is perpetuated by our reliance on short-term fixes and an us-vs-them mentality that exacerbates all our issues. We call this rampant problem “disconnection syndromes”. At a neurological level, much of this issue can be conceptualized by appreciating the critical role of the prefrontal cortex, a part of the brain that allows us to understand and care about others, and engage in reflective thinking. The prefrontal cortex helps us regulate more impulsive, reactive, anxious, and aggressive parts of the brain which include the amygdala. A fundamental cause of disconnection syndrome is when the prefrontal cortex loses its connection to this more primitive part of the brain, basically removing the adult from the room and predisposing us to poor choices and a lower quality of life. The empowering part of the story is that our simple lifestyle choices change the connection between these two parts of the brain. This means that our day-to-day choices will either promote disconnection from the prefrontal cortex or enhance connection and pave the way for empathy, compassion, reflection, and better decisions.
Parvati Magazine: Recent studies suggest a link between internet addiction and mental illness. Do these studies determine whether one causes the other? Given the variety of online content, does the research indicate that some forms of content can be more pathogenic than others?
David Perlmutter: The research connecting modern technology use (social media, internet in general, screen time) with mental health outcomes has been rather diverse in methods and in outcomes. It’s still too early to say with any certainty whether people with mental illness have a higher likelihood of developing problems with, for example, internet use or if pathological internet use might increase the risk of developing mental health issues. There is, however, some data to support the idea that certain types of digital exposure may be more problematic than others. For example, one study suggested that passive social media use (just scrolling, looking at other people’s content) was associated with more depressive symptoms, while actively using social media (engaging with other people) was associated with less depressive symptoms. We also know that lots of modern media can induce stress, anxiety and fear, taking us away from good mental health, so this is something we definitely need to be mindful of. Maybe most important though is that when we’re spending hours a day engaging with digital technology without a plan or purpose, we’re not spending that time doing the things we know are linked to better mental health, like exercising, spending time with a friend, or getting out into nature.
Parvati Magazine: For this book, you collaborated with your son, Austin. It was refreshing to have both your perspectives. What role do you see for medical training, patient empowerment, and greater education as a whole in addressing disconnection syndrome?
David Perlmutter: When Austin and I started writing this book, the general question we posed was: why, despite all our modern day resources, are people still so unhappy and so unhealthy? One of the central problems we identify is a misalignment between what we say we care about and what we actually do. We know we want to have more joy, and to live healthier lives, but our decisions don’t reflect it. And when, despite our knowledge, we make bad choices, we blame ourselves. We are living in a state of chronic, preventable unhealthiness and chronic, preventable unhappiness. We call this disconnection syndrome. We think it’s time for a new way of approaching this problem. It starts by understanding that all the good information in the world is useless, unless we’re able to put it into practice. And one of the main ways we can increase the odds that we follow through is by building a brain that allows us to follow through.
When it comes to how this changes the approach to patient care and medical training, we think that it’s clear that simply telling patients to be healthier is not enough. It makes it their fault if they can’t do what the doctor says, instead of asking why they can’t. We think it’s time for patient care to include a framework that targets better decision-making and brain function. And of course, this should be generalized to people outside the provider’s office. We all need it.
Parvati Magazine: In recent years, there have been more reports about the effect of changing planetary health on the human brain, including stress that leads to changes in the prefrontal cortex. At the same time, these changes in the prefrontal cortex have also been associated with reduced empathy. Can you comment on this? Where do you see the potential for positive change?
David Perlmutter: This is such a critical subject. The medical literature has shown us that chronic stress is incredibly harmful to the entire body; for example, it’s linked to the development of heart disease, diabetes, autoimmune disease and dementia. But what we’re looking at here, which is relatively newer research, is that chronic stress may be changing our brains by disabling our prefrontal cortex and increasing activation of the amygdala, and this could spell disaster for our health, happiness and relationships. For example, data suggests that more stress correlates with decreased brain matter in the prefrontal cortex in people. And more stress in childhood is linked to increased aggression and weakened connection between the prefrontal cortex and the amygdala.
When humans experience the stress response, we engage the “fight or flight” program, which focuses us on figuring out how we can survive. This means we’re more likely to see the world as threatening, and less likely to have the mental real estate to work on seeing things from other people’s perspectives. While there is some data suggesting that women may have the opposite reaction under acute stress, the overall concern is that chronic stress seems to disable the prefrontal cortex and activate the amygdala, which could predispose us to acting from fear and anxiety, keeping us from forming meaningful relationships with others or from seeing the bigger picture and experiencing empathy for other people around the world.
Parvati Magazine: In your “Brain Wash” program, you prescribe time spent in nature as an antidote to our current state of high anxiety and social disconnection. In which way do you see MAPS, the Marine Arctic Peace Sanctuary, helping to transform today’s societal disconnection syndrome?
David Perlmutter: Empathy takes on many forms. Typically, we consider empathy as an expression of concern for another person. But in its wider interpretation, empathy embodies concern for our future selves, our communities, and even our planet. Research demonstrates a correlation between activation of the prefrontal cortex and pro-environmental behavior, with other science proposing that nature exposure helps reset the prefrontal cortex so it can stay focused on important tasks. So, in a wonderful feed-forward cycle, nature exposure is linked to pro-environmental behavior—through the mechanism of re-engaging connection to and activity of the prefrontal cortex. This is why and how nature exposure fosters reconnection. Any opportunity we have to be reminded of our interconnection with the natural world around us fosters our ability to engage empathy, make more thoughtful choices, and participate in joy and happiness.
In that the Marine Arctic Peace Sanctuary represents the largest marine protected area in history, supporting this organization will clearly offset the pervasive influences around the world that would have us believe that we exist apart from nature. As Chief Seattle reminded us, “Man did not weave the web of life, he is only a strand of it.”
David Perlmutter, MD, FACN, ABIHM is a Board-Certified Neurologist and Fellow of the American College of Nutrition who received his MD degree from the University of Miami School of Medicine. He is recognized internationally as a leader in the field of nutritional influences in neurological disorders.
Austin Perlmutter, MD, is a board-certified internal medicine physician. He received his medical degree from the University of Miami and completed his internal medicine residency at Oregon Health and Science University. His academic focus is in understanding the decision-making process, how it is influenced by internal and external factors, and how it changes our health and illness outcomes.