Wednesday, February 27, 2008

Controlling the Brain

The brain is a fascinating organ. It seems like the more we study it, the less we understand. In other words, the brain confuses us! Just yesterday the BBC had a news article on their health pages regarding depression. The doctors and hospitals participating in a large study rather convincingly claim that our modern pharmaceutical cash cows, Selective Serotonin Reuptake Inhibitors or SSRIs don't work in a majority of people. A dummy pill or placebo was found almost equally effective. The drug manufacturers have made us believe that feeling sad or having the blues is an illness whereas in fact it is a very normal part of what and who we are. A century ago a woman's menstrual period was considered an illness, as was a wakeup time erection for younger males. I don't offhand remember what the suggested treatment was for the ladies but for the gentlemen a bagful of ice was recommended. This time we are made to believe that feeling good and happy at all times is normal. The people who were given sugar-coated dummy pills in the large study in the United Kingdom noticed often an immediate improvement in their moods simply because they felt their "problem" was being addressed. The ministry of health in that country now wants to invest in thousands of new talk therapists and get people to exercise, an almost guaranteed mood lifter. SSRIs cost the system billions, the therapy would be a fraction of it and a brisk walk outdoors is totally free. Knowing how powerful the drug companies are, I don't expect much coverage on this topic here.

As I have seen it in my family, major depression does exist and is a very serious disease, as is a true bipolar condition. However, the latter term is used too freely, like ADD in active children, and people are made to think that having ups and downs is abnormal. Our souls are like the weather: one day it is sunny, the other it rains (unless you live in a desert). People who have too much sunshine in the summertime welcome the beginning of the rainy season. We are like plants; we need both the light and the water to grow and to survive. We don't quite understand what causes the various form mental illness although through trial and error we have discovered ways to lessen the symptoms. Some older drugs such as tricyclics (amitriptyline, nortriptyline) and tetracyclics (mirtazapine, maprotiline) seem to work often for true depression, although they rather toxic and make one drowsy. Lithium, another toxic substance, is very valuable for manic-depressive illness. And what we used to think as a cruel treatment, electric shock therapy, can make a deeply depressed person feel better instantly. We have learned to administer the amount of electricity needed to short out the brain's own electrical connections and one no longer is in a danger of biting through his/her tongue. Usually this treatment is done under light anesthesia so the patient has no unpleasant association or memory.

The word "memory" brings me to one of the first topics on my blog which will have its third birthday next month, about two hundred entries later, most of them essays. Some early ones I had to remove because of a settlement, but I will probably repost them once I officially retire. I wrote about memorization in March of 2005 and have since observed and learned more on the topic. I also watched the New York Philharmonic play in North Korea and was somewhat disappointed that the conductor, Lorin Maazel, had to use a score for the rather simple but beautiful Korean folk tune "Arirang", beloved by both the North and South Koreans. Out of respect and as a sign of courtesy I would have expected the maestro to memorize the short piece. Well, he is up there in years and perhaps the music is remote to his heart, so I'll let go of that. The fact that he and the management of the NY Philharmonic were able and willing to go to Pyongyang was brave. It probably brought our two nations back to the time of Bill Clinton's second presidency when Madeline Albright was able to charm the North Korean leader with her wit and sincerity in 2000. Anyway, this reading in North Korea reminded me of an American conductor who for years needed a score to conduct our National Anthem.

Since my rather nasty concussion I still continue to have short term memory problems with names, words and, worst of all, music. I have had to think about how memorization works. I also have students who really fear playing from memory to the point it becomes next to impossible. Interestingly, many of these young adults were at ease with memorization when they were younger. My explanation is that back then they didn't analyze their skills or doubt their ability. A lot happens when a young person grows up. Most of the child prodigies disappear or come back as a shadow of their former self, such as was the case with Yehudi Menuhin, or some present ones whom I decline to name. The more sensitive, and thus artistic, a young musician is, the more likely he/she is to have self-doubts.

I have tried different methods with students. Usually fast virtuoso pieces are the least problematic as one doesn't have the time to think about the notes and one uses an automatic muscle memory. Slower works are another story, especially ones where a motive returns many times and is always slightly different. Some of the most difficult music for a violinist to memorize is certain solo Bach. The Fugues are tricky as is the Chaconne, but even the Allemande of the d minor Partita presents a challenge to many. As logical as Bach is, patterns could go many different ways. Even Pablo Casals, after spending decades of the cello suites, got stuck in a movement and managed to end up at the half way point repeatedly. According to my violin-maker-teacher who was present, the great cellist had to leave the stage and come back with the music, apologizing to the audience. Some violinists are aided by watching their fingers as they know what note each digit represents, similar to a pianist looking at the keyboard, yet others find this method confusing. Recently I noticed that a rather new student, who had to play a concerto movement from memory for a college audition, was staring at the wall and constantly getting lost. I asked if she had ever tried looking at her fingers or her bow. She replied that she used to do that, but then at some "master class" the know-it-all person had told her it was all wrong and that she ought to stare into nothingness! We have to be careful what we tell the young ones as often their mind is like a sponge and they remember things they shouldn't and forget others that are of value. This student's playing improved immediately and then I asked her to completely close her eyes and concentrate. What a difference that made! Not only did the memory issue disappear but also her sound and intonation improved like by magic. Others have also done well with their eyes closed. Performing this way they can inhabit their own private world while playing. As they cannot see the audience they are less likely to be frightened and ideally nothing should distract them.

Of course playing blind doesn't work for everyone. One needs to see the conductor or the pianist's fingers in a tricky piece. I have to visualize the music in my mind and read it, especially now after my head injury. This of course can be done in the "blind mode" and I would do so except that the neurological damage to the nerves of my feet make me very uncertain about my balance and I need a visual input to tell myself I'm properly upright. Although I do it differently from before, performing from memory is no longer an issue for me, but I need to know every note of the concerto or other composition intimately. I advise students to learn the music, not just memorize the markings. If they have a piano and are able to play it with enough ease, I encourage them to play the piece on the keyboard. Experimenting with completely different fingerings, reversing bowings, all that is helpful.

Now I have to remember to quit writing as this story is becoming too brainy. Do I need a pill to do that?

Image from Science and Consciousness