Serotonin and dopamine are or at least should be, as much of a household name as Kellogs Cornflakes or Heinz Baked Beans. However, unlike cornflakes and beans, there is seemingly no end to how much they continue to find out about these little neurochemical critters! But is there a connection to these findings and hypnotherapy . . .
Reading through this research, you get to realise how difficult it is to observe these processes happening in real-time. So, it's exciting to know that as more effective and efficient methods of investigation and observation become available, even more, will be discovered in the future. So. hats off to these guys and all the others, patients included, that made it possible. At the same time, it reminds me of how remarkable hypnosis is, albeit its powers have been known but mostly remained obscure from many areas of mainstream health. One of my aims is to create an awareness of how brain function plays a role in the way life unfolds. In addition to that, how we can use hypnosis to manage aspects of brain function, including the ubiquitous structure of mind!
To start with I thought I'd talk about the main brain chemicals mentioned in this research. Then, from there, expand into where they are produced and how they play a part in the quality, bad and good, of our life.
Serotonin is predominantly produced in the Raphe Nuclei of the pons (brainstem) and is mostly known as a mood regulator but that's merely a fraction of its involvement in the brain. Conditions like depression, anxiety and stress disorders are often a result of low or dysregulated levels of serotonin in the brain. Hence why SSRIs (selective serotonin reuptake inhibitors) are used to elevate the level of serotonin. Reuptake is an endogenous process where the synapse/cell takes back (pinocytosis) any unused serotonin floating around in the synaptic cleft or the extracellular matrix. Reuptake inhibition effectively leaves the scraps for any nearby serotonin hungry cells/synapses to gobble up. Serotonin acts diffusely across most of the brain and also plays a role in many autonomic, endocrine and metabolic systems. From an observational perspective, I have noticed that not one of my clients, who was prescribed an SSRI or n SNRI (n = norepinephrine), was tested for neurotransmitter dysfunction, meaning, it basically a 'suck and see' method of treatment! The same appears to be the norm for TCAs (tricyclics) and MAOIs (monoamine-oxidase-inhibitors); sometimes they work and sometimes they don't!
Dopamine is mostly known as the brain's reward/pleasure system (although it's actually, reward/aversion - Via D1/D2 type dopamine receptors). This aspect of dopamine's response occurs mostly through the mesolimbic and mesocortical pathways. However, dopamine actually has a much larger role (approx. 70%) in motor control via the nigrostriatal pathway. A fourth, smaller, pathway is the tuberoinfundibular pathway which is part of the arcuate nucleus (median eminence) of the tubero-hypothalamic region. Dopamine here acts, inter-alia, as a prolactin-releasing factor inhibitor (via the hypophyseal portal system). Dysfunction here can lead to galactorrhea and/or amenorrhea, which can also occur in some aspects of eating disorders, e.g. anorexia/bulimia.
Parkinson's disease, mentioned in this research, is partly a consequence of low levels of dopamine in the pars-compacta region of the substantial nigra of the basal ganglia region of the brain, The substantia nigra (Latin for dark-substance) sits at the top of the upper midbrain and plays a role in fine motor movements, hence the rigidity/tremors of PD. Most of the brain's dopamine, however, is produced in the ventral tegmental area. This is nearby to the junction of the midbrain, diencephalon and cerebrum.
My intention, in mentioning all this anatomical stuff, is, in part, to give you an idea of how complex this stuff is. And that's not even taking into account what is happening at the intracellular level. Serotonin and dopamine are known as first messengers, formed in presynaptic vesicles through endocytosis. This, mostly, activates G-protein coupled receptors (second messenger transporter system channels) on the cell/post-synaptic membrane surface, which allows entry into the cytoplasm (cell gooey stuff). Once inside it initiates intracellular processes, the outcome of which is a thought, feeling or an action (behavioural response). It is important to understand that all feeling (emotion), thought and behaviour is a consequence of these extra/intracellular processes. So it can be helpful to understand these processes because we all have thoughts. Because we have thoughts, we often think they create the responses, whereas the thought is the response to some form of sensory processing, which can be direct or indirect.
Is, at that moment (real-time) responses to sensory phenomena that are happening and the indirect response, is a consequence of the activation of a sensory-memory of that event. For example, if you were experiencing a traumatic event, for real or on TV (real-time/post-event) or reading about it, it can create specific memories of the trauma. So, think of 9/11, imagine you were witness to one of the most horrific events of this century and because of that, you could have developed an immediate fear of planes, tall buildings, pollutants (the dust cloud) etc. That is a direct response to something real or at least perceptually so.
Happens later, having had no related anxiety for a long time, one day, on a plane, in a tall building, experiencing smoke or dust, you become anxious. As a consequence, you may have a panic attack, experience feelings of nausea, palpitations etc. It is highly possible that this is the subconscious sensory reactivation of memories, long forgotten (consciously), that are now expressing in a different context, e.g. in a restaurant, shop, park or a market. The brain now has to find a way of understanding what is happening and that's where our cognitive, logical, analytical systems come into play. This is a form of inverse classical conditioning, where the current, unrelated, sensory experience links to a stored memory of pain, doom or threat. It doesn't even have to be a dangerous situation, it merely has to stimulate the same emotional response! From that moment on, at least potentially, every time you experience a similar environment, it could then trigger the now adapted 9/11 memory and strong emotions arise!
So, when helping clients with anxiety/stress disorders or more challenging conditions like depression, serious consideration for their treatment is a must! Depression is more serious because, on top of the condition itself, it always involves relatively high levels of anxiety and stress. Therefore, my logic dictates that to treat serious conditions like these, one must research them thoroughly. If you don't know that much about them, what they are, how they develop, how they react to life etc. how can you effectively and efficiently treat them? In treating these conditions, it's rarely, if ever, a case of mystical hypnotic-powers, a wave of the wand, a puff of fairy dust. that brings about a lasting solution. That is why I have been studying the neurological processes involved these conditions for many years. Therefore, a good understanding of the systems involved in anxiety, stress and depression, all of which involve the fight or flight response, must be beneficial? However, I do not want to understate the power of hypnosis because it really can help clients get back their life!
So, what is psychological stress?
Before I explain this, I'd like to mention that other forms of stress, e.g. oxidative stress (free radicals), osmotic stress, allostatic load/overload), also play a part. Consequently, the systems involved in bringing about these conditions are extremely complex.
The systems involved in both acute and chronic stress are the sympatho-adrenomedullary system, which invokes the release of adrenal adrenaline and noradrenaline, which, among other things, increases the heartbeat. The HPA (Hypothalamic-Pituitary-Adrenal) Axis, invokes the release of ACTH (adrenocorticotrophin hormone), releasing glucocorticoids like cortisol, aldosterone etc. into the blood system. The effect of glucocorticoids on conditions like anxiety, stress, depression, is somewhat dependent on what type of brain receptors are activated. E.g. Type 1, mineralocorticoid receptors or Type 2 glucocorticoid receptors. Type 1 is mostly found in the hippocampus and Type 2 are diffuse throughout the brain, with high concentrations in the hippocampus, amygdala, hypothalamus, and prefrontal cortex.
Taking a closer look at the effects of stress is a good way of creating a better understanding of it.
Type 1 response, is mostly involved in 3 stress hormone feedback systems, effectively moderating the stress response. The brain knows that stress is only good if it's experienced at the right time, for the right reasons.
Type 2 also mediates feedback of brain processes relating to danger (stress) or the anticipation of it (anxiety), as well as many other of life's everyday functioning.
In acute stress, when the levels of these hormones are within limits and for reasonable periods of time, many systems are heightened and all should be well. However, over-stimulated, for too long and too often, chronic stress develops and things start to go wrong. This is when disorders develop and the reason these can take time to effectively treat is that they are viewed by the brain as survival (life or death) situations.
An anecdotal perspective, relating to these disorders, is, the brain thinks you are way too stupid to deal with this, so it takes over. Unless of course, you can see the intelligence in being too scared to eat in public, get in a lift or speak up at a meeting? Essentially the problem is a consequence of the very primitive nature of the defence system, it works on a shoot first, talk later basis. That means that it is usually only after the event, you become aware the danger isn't real, consequently, it makes no sense. However, from an emotional perspective (subconscious brain processes), it makes perfect sense. Therefore, your stress response confirms, to your logical rational systems, that you are in fact, too stupid and your journey continues!
Of course, you are not stupid, you are just the victim of two evolving brains (emotional/cognitive) that have different perspectives of safety and danger. A fear of flying is a good example. While a plane could crash, most probably, it won't, after all, flying is one of the safest forms of transportation! However, once your brain, via encoded implicit memories, believes the plane will crash, logical, rational thinking, cannot easily override those primitive responses! This is why going on courses where a pilot gives you all the logical and statistical evidence rarely helps. For example, in the Q and A', ask him, with all the statistical/evidential proof provided, can you guarantee the plane I board tomorrow, won't crash? You already know the answer and that is part of the problem! What is even more interesting, in a boring way, is that sometimes the fear of flying has nothing to do with flying!
Finding the causes the lie at the root of anxiety disorders can be quite complex because they are often buried with multiple layers of memory systems. Many of these memories first develop during childhood and are encoded within a child's brain, which is undeveloped, immature and often lacks the modality of efficient language. As such, the type of memory involved in fight or flight type responses is known as emotional memory, i.e. implicit (non-declarative), procedural memory. This type of memory does not require conscious processing, awareness or consent to activate. It is activated by a phenomenon called perceptual defence, by our sensory systems, all of which have strong links to the above systems; and some!
So, in bringing about a long-lasting solution to these problems, a thorough investigation of one's memories, can really help. How this comes about, through hypnosis, is quite remarkable and is somewhat akin to the process of sleep. A clue to the connection, is, Hypnos was the Greek God of sleep! During sleep, the brain goes into restful states, during which, memories are consolidated (making new long term memories) and reconsolidated (updating old memories). This occurs through varying states of neural oscillation (brain waves), e.g. Theta and Delta. Contrary to the long-held belief that hypnotists make changes in the subconscious mind, nothing could be further from the facts. For any change in thought, feeling or physical response (behaviour), to occur, physical processes have to happen in the brain. The vast majority of these process responses occur as a consequence of memories. In that sense, memories are akin to algorithms. That is why AI, Google, Fb et al, are effectively attempting to replicate the human brain's processes, albeit electrically though!
Therefore, during hypnosis, the hypnotic prescription (the words) is delivered into the brain by the hypnotist's voice, via the auditory cortices. Subsequently, the way in which the brain processes deep-structure language ultimately brings about changes to these first/second messenger processes. During which, new memories are initiated ((re)consolidated) and further stimulated as the treatment progresses. Scientific evidence to support this is seen in the way lab rats are conditioned to a fear response (footshock/bell paring) and later habituated (unconditioned). Classic fear conditioning (Pavlov's dogs) can occur in a few hours, habituation, a few days or longer.
Many clients with anxiety or stress disorders, I find that a large part of their issue relates to maladapted childhood experiences (memories), combined with current lifestyle factors. Most of these, fortunately, are not that serious, albeit they may feel that way to the client, consequently they often respond well and quickly to hypnosis. By quickly, I'm talking in terms of weeks, unlike other modalities, like psychotherapy, counselling etc. where it can run into months or even years! Of course, some of these conditions can be more serious, they may just take a few weeks longer!
Relating this to hypnosis-therapy is simple. Hypnosis, via therapeutic interventions and lifestyle adaptions, allows you to better understand the specific functioning in areas of your brain, and what we term the mind(s). From there to develop them towards creating and having a greater awareness of life, as it unfolds! Essentially it helps you to become more emotionally and cognitively functional. Oh, and by the way, life gets to feel a whole lot better too!
Hypnotherapy stands out as one of the most effective strategic life management methods there is, especially in its ability to promote clear thinking and good states of mental wellness. The behaviours that make life challenging are often a result of too much stress, too little or poor quality sleep and too little by way of mental and emotional clarity! So, to get or take back control of your mind and your life, it makes perfect sense to use a methodology that addresses the subconscious brain's role in perpetuating negative, vague and ambiguous states of mind. Hypnosis helps us to create calm relaxing states of mind that make life work better! If you would like to address any concerns you have in this direction, or, if you just want the ability to make your life feel better, then why not make an appointment for a Free Consultation? Hypnosis gives you the ability to have a good life!
My objective is to help people understand how and why we become illogically trapped into emotional experiences that may actually be happening but for reasons, we may never have imagined! If you want to know more about Hypnotherapy, why not make an appointment for a Free Consultation?
In first-of-their-kind observations in the human brain, an international team of researchers has revealed two well-known neurochemicals -- dopamine and serotonin -- are at work at sub-second speeds to shape how people perceive the world and take action based on their perception.
The discovery shows researchers can continually and simultaneously measure the activity of both dopamine and serotonin -- whose receptor and uptake sites are therapeutic targets for disorders ranging from depression to Parkinson's disease -- in the human brain. Furthermore, the neurochemicals appear to integrate people's perceptions of the world with their actions, indicating dopamine and serotonin have far more expansive roles in the human nervous system than previously known. Known as neuromodulators, dopamine and serotonin have traditionally been linked to reward processing -- how good or how bad people perceive an outcome to be after taking an action.
The study online today in the journal Neuron opens the door to a deeper understanding of an expanded role for these systems and their roles in human health.
"An enormous number of people throughout the world are taking pharmaceutical compounds to perturb the dopamine and serotonin transmitter systems to change their behaviour and mental health," said P. Read Montague, senior author of the study and a professor and director of the Center for Human Neuroscience Research and the Human Neuroimaging Laboratory at the Fralin Biomedical Research Institute at Virginia Tech Carilion. "For the first time, moment-to-moment activity in these systems has been measured and determined to be involved in perception and cognitive capacities. These neurotransmitters are simultaneously acting and integrating activity across vastly different time and space scales than anyone expected."
A better understanding of the underlying actions of dopamine and serotonin during perception and decision-making could deliver important insight into psychiatric and neurological disorders, the researchers said. "Every choice that someone executes involves taking in information, interpreting that information, and making decisions about what they perceived," said Kenneth Kishida, a corresponding author of the study and an assistant professor of physiology and pharmacology, and neurosurgery, at Wake Forest School of Medicine. "There's a whole host of psychiatric conditions and neurological disorders where that process is altered in the patients, and dopamine and serotonin are prime suspects." Lack of chemically specific methods to study neuromodulation in humans at fast time scales has impeded understanding of these systems, according to Montague, who is an honorary professor at the Wellcome Center for Human Neuroimaging at University College London and a professor of physics at the Virginia Tech College of Science.
But now, in first-ever measurements, scientists used an electrochemical method called "fast-scan cyclic voltammetry," which employs a small carbon fibre microelectrode that has low voltages ramped across it for real-time detection of dopamine and serotonin activity. In the study, researchers recorded fluctuations in dopamine and serotonin using specially designed electrodes in five patients undergoing deep brain stimulation electrode implantation surgery to treat essential tremor or Parkinson's disease. Patients were awake during surgery, playing a computer game designed to quantify aspects of thought and behaviour while the measurements were taken.
On each round of the game, patients briefly viewed a cloud of dots and were asked to judge the direction they were moving. The method, designed by corresponding author Dan Bang, a Sir Henry Wellcome Postdoctoral Fellow, and Steve Fleming, a Sir Henry Dale/Royal Society Fellow, both at the Wellcome Center for Human Neuroimaging at University College London, helped indicate that dopamine and serotonin were involved in simple perceptual decisions, outside of the traditional context of rewards and losses.
"These neuromodulators play a much broader role in supporting human behaviour and thought, and in particular they are involved in how we process the outside world," Bang said. "For example, if you move through a room and the lights are off, you move differently because you're uncertain about where objects are. Our work suggests these neuromodulators -- serotonin in particular -- are playing a role in signalling how uncertain we are about the outside environment."
Montague and Kishida, along with Terry Lohrenz, a research assistant professor, and Jason White, a senior research associate, now both at the Fralin Biomedical Research Institute, started working on a new statistical approach to identify dopamine and serotonin signals while still at the Baylor College of Medicine in Houston, Texas.
"Ken rose to the challenge of doing fast neurochemistry in human beings during active cognition," Montague said. "A lot of other good groups of scientists were not able to do it. Aside from the computation of enormous amounts of data, there are complicated issues to solve, including great, fundamental algorithmic tasks."
Until recently, only slow methodologies such as PET scanning could measure the impact of neurotransmitters, but they were nowhere near the frequency or volume of the second-to-second measurements of fast-scan cyclic voltammetry.
The measurements in the new study were taken at the Wake Forest Baptist Medical Centre and involved neurosurgical teams led by Adrian W. Laxton and Stephen B. Tatter.
"The enthusiasm the neurosurgeons have for this research is derived from the same reasons that drove them to be doctors -- first and foremost, they want to do the best for their patients, and they have a real passion for understanding how the brain works to improve patient outcomes," said Kishida, who oversaw the data collection in the operating room during the surgeries. "Both are collaborative scientists along with Charles Branch, the chair of the neurosurgery department at Wake Forest, who has been an amazing advocate for this work."
Likewise, Montague said, "You can't do it without the surgeons being real, shoulder-to-shoulder partners, and certainly not without the people who let you make recordings from their brains while they are having electrodes implanted to alleviate the symptoms of a neurological disorder."
Montague had read a study in the Proceedings of the National Academy of Sciences that prompted him to approach colleagues Bang and Fleming at University College London to tailor a task for patients to perform during surgery that would reveal sub-second dopamine and serotonin signalling in real-time inference about the external world -- separate from their often-reported roles in reward-related processes.
"I said I have this new method to measure dopamine and serotonin, but I need you to help with the task," Montague said. "They ended up in the study. The research really took a lot of hard work and an integrated constellation of people to obtain these results."
The research was funded by grants to various researchers from the Wellcome Trust, the National Institutes of Health including the National Institute on Drug Abuse, the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke.
- Dan Bang, Kenneth T. Kishida, Terry Lohrenz, Jason P. White, Adrian W. Laxton, Stephen B. Tatter, Stephen M. Fleming, P. Read Montague. Sub-second Dopamine and Serotonin Signaling in Human Striatum during Perceptual Decision-Making. Neuron, 2020; DOI: 10.1016/j.neuron.2020.09.015
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