Posts Tagged ‘Southwick’

Altruism: Doing What is Right

March 14, 2020

This post is based on content in a book, Resilience: The Science of Mastering Life’s Greatest Challenges by by Steven Southwick and Dennis Charney. In 2003, a team of University of Massachusetts researchers led by Carolyn Schwartz reported that altruism, or what some call social interest, was associated with better life adjustment, better marital adjustment, and less hopelessness and depression. Both giving and receiving help from others predicted better mental health, although giving help to others was a stronger predictor. The researchers found that social interest moderated life stress and predicted physical health status. They developed the theory that the association between social interest, better mental health, and reduced stress may be related to a shift in attention from the self to others, enhanced self-confidence and self-acceptance, a reframing of one’s own disease experience, and a greater perceived meaning in life.

The authors write that altruism also appears to foster resilience among children who have survived highly stressful environments. In Israel, longitudinal study of physically abused children, Hanita Zimrin and colleagues found that those children who adapted well over time were more likely to assume responsibility for someone else, like a sibling or pet, than were those who fared poorly. In Emily Werner’s classic study of children living in poverty on the Hawaiian island of Kauai, children who helped others in a meaningful way (by assisting a family member, a neighbor, or some community member) were most likely to lead successful lives as adults.

The flip side of altruism is narcissism. Narcissistic individuals see themselves as the center of things, and constantly believe that they deserve more attention, understanding, and assistance than others. David Brooks in his book The Road to Character cites a survey by the Gallup Organization that “asked high school seniors if they considered themselves to be a very important person. In 1950, 12% said yes. In 2005, an astounding 80% said yes. Jean Twenge and colleagues in a book titled the Narcissism Epidemic reported that today’s young people score 30% higher on a test called the Narcissistic Personality Inventory than their peers did 20 years ago.

To put this in the context of resilience, the relationship is the more altruistic the more resilient. And the more narcissistic, the less resilient. In other words, focusing on others, enhances resilience. Focusing on oneself can virtually eliminate resilience. A good example of this is Donald Trump. He has been consistently diagnosed for having the narcissistic personality disorder. Trump’s focus is entirely on himself. It is quite obvious that Trump puts himself before the country he is supposed to be leading. And he has virtually no resilience. He takes offense at extremely small matters, and responds with nicknames and insults one would expect from a schoolyard bully.

Practical Applications: Learning to Face Fear

March 13, 2020

The title of this post is identical to the title of a section in a book, Resilience: The Science of Mastering Life’s Greatest Challenges by by Steven Southwick and Dennis Charney. The authors write, “Fear is ubiquitous. No one escapes its grip. Fear even strikes individuals who are widely admired for their courage. South African dissident Nelson Mandela reported that during his years of imprisonment and struggle against oppression, ‘I learned that courage was not the absence of fear, but the triumph over it. I felt fear myself more times than I can remember, but I hid it behind a mask of boldness. The brave man is not he who does not feel afraid, but he who conquers that fear.’”

With regard to learning and practicing the skills necessary to master the fear, West point instructor Col. Thomas Kolditz advises us to focus on our breath: “Of all the autonomic responses to the adrenalin rush—including heart rate, respiration, skin conductivity, and muscle tension—the one that we can best control consciousness is respiration. Deep controlled breathing is largely incompatible with the other elements of the fear response. Physical relaxation can get to the point where mental relaxation, and therefore outward focus, be re-established and maintained.”

Most people find it easier to face fear in the company of other people, especially those whom they know and trust. This helps in various ways. It may increase our ability to make a realistic approach of the feared situation. It may also reduce physiological stress responses, such as elevated heart rate and blood pressure, hyperventilations, and stomach “butterflies.” People tend to feel more confident and are better able to cope with problems by finding constructive solutions rather than avoidance with supportive friends or colleagues by their side.

Spiritual insight can fight fear. One practitioner writes, “I see fear as energy. I try to come into the body and feel where it is lodged, and breathe into it and allow it to flow. If it is not moving, I turn to my spiritual practices, which include chanting, meditation, body movement and yoga, to help the stuck energy move. Once it is moving, the essential self underneath—the inner spirit—is more accessible and the fear has no more power over me. Making the decision to face my fear rather than repress or run from it is half the battle. I believe we all have the capacity to do this; however, we need to know that we have the choice.

In his book Mindfulnesss in Plain English, the Buddhist monk Bhante H. Gunaratana notes that mindfulness and meditation require attention to reality. He writes: Meditation is running straight into reality. It does not insulate you from the pain of life but rather allows you to delve so deeply into life and all its aspects that you pierce the pain barrier and go beyond suffering…

In order to observe our fear, we must accept the fact that we are afraid. We can’t examine our own depression without accepting it fully. The same is true for irritation and agitation, frustration and all those other uncomfortable emotional states. You can’t examine something fully if you are busy rejecting its existence.

To deal with Fear Gunaratana writes, “Observe the fear exactly as it is. Don’t cling to it. Just watch it rising and growing. Study its effect. See how it makes you feel and how it affects your body. When you find yourself in the grip of horror fantasies, simply observe those mindfully. Watch the pictures as pictures. See memories as memories. Observe the emotional reactions the come along and know them for what they are. Don’t try to repress the memories or the feelings or the fantasies. Just step out of the way and let the whole mess bubble up and flow past. It can’t hurt you. It is just a memory. It is only a fantasy. It is nothing to fear,”

Thich Nhat Hanh, a famous Buddhist monk who was nominated for the Nobel Peace Prize in 1970 for his role in the Vietnam War Paris Talks, recognizes that all of us are afraid. He writes, “Fear is always there within us: the fear of getting old, the fear of getting sick, the fear of dying, the fear of being abandoned by our loved ones. It is very human to be fearful and to worry about it.”

But he also understands that hiding from fear is not the answer. “If you try to run away, instead of confronting or embracing your ill-being, you will not look deeply into its nature and you will never have the chance to see a way out. That is why you should hold your suffering tenderly and closely, looking directly into it, to discover its true nature to find a way out.”

He continues, “The Buddha advised us to invite these fears to the upper level of our consciousness, recognize them and smile at them. To do so was the daily practice for monks and nuns in the time of the Buddha, as it is for monks and nuns now. Every time your fear is invited up, every time you recognize it and smile at it, your fear will lose some of its strength. When it returns to the depth of your consciousness, it returns as a smaller seed. That is why the practice should be done even day, especially when you are feeling mentally and physically strong.

There are many healthy memory posts on meditation and mindfulness. Just enter “meditation” or “mindfulness” into the search block at healthymemory.wordpress.com
If you are not familiar with the relaxation response, it might be good to begin with the “relaxation response”

The Neuroscience of Extinction

March 12, 2020

This post is based on a book, Resilience: The Science of Mastering Life’s Greatest on Challenges by by Steven Southwick and Dennis Charney. The process of overcoming a learned fear is called extinction. It involves the brain structures that were discussed in earlier posts on this book (amygdala, prefrontal cortex (PFC), and hippocampus). To extinguished a fear-conditioned memory, a person must be exposed to the fear-inducing stimulus in a safe environment, and the exposure needs to last long enough for the brain to form a new memory. The new memory conveys that the fear-conditioned stimulus is no longer dangerous in the present environment. Brain imaging suggests that extinction may involve a strengthening of the capacity of the PFC to inhibit amygdala-based fear responses.

One therapy, flooding or direct exposure, requires prolonged exposure to the memory of the traumatic event. The therapy consists of “extended exposure to moderate or strong fear-producing cues. In their imagination, patients are asked to recount the traumatic experience with eyes closed and in as much detail as possible, describing sights, sounds, smells, and sensations, as well as what they were thinking and feeling. These sessions are recorded, and the client listens to the recording repeatedly on subsequent days. In the in-vivo component, clients “gradually confront safe situations that evoke moderate levels of anxiety and then follow up with confrontation of more fearful situations.

As extinction involves new learning, and the protein molecule known as the NMDA receptor is critical to learning, Barbara Rothbaum and colleagues gave the NMDA receptor partial agonist D-closerine (DCS) with exposure therapy. DCS is a drug that activates the NMDA receptor which then enhances learning of the new memory. This study supported the conclusion that these treatments fostered the desired extinction. Unfortunately, this type of treatment has not always resulted in success, but the prospect of augmenting extinction-based therapies, like prolonged exposure, with medications that affect learning is positive.

Cognitive processing therapy (CPT) also involves confronting fear. It uses the Socratic method of teaching, in which the teacher poses questions and the student, by answering them, learns new ways of understanding. CPT focuses on emotions such as anger, humiliation, shame, guilt, and sadness, which trauma survivors often experience in addition to fear and anxiety. It is not uncommon for trauma victims to believe that they could have done something to prevent the traumatic or acted more heroically to minimize harm, even if in reality such actions would have been impossible. They tend to blame themselves and to imagine that others blame them as well. For example, a crime victim may have unrealistic beliefs such as, “I shouldn’t have gone to the ATM that night.” A therapist using CPT asks questions aimed at helping the patient to arrive at the more realistic conclusion that he or she could not have predicted that a robber would chose that particular ATM on that particular evening, and that the fault lies with the thief, not with the victim.

One does not necessarily have to undergo therapy to transform or extinguish a fearful memory. It takes courage, but one can try to confront the fearful event and through repetitions extinguish the fear. So the best response to falling off a horse might be to get back on.

The Neuroscience of Optimism

March 11, 2020

This title of a book, Resilience: The Science of Mastering Life’s Greatest Challenges by by Steven Southwick and Dennis Charney has a chapter titled Optimism. This post is on the neuroscience of optimism section in this book.

The three brain regions that play a central role in optimism are : the prefrontal cortex; the amygdala; and reward systems including the anterior cingulate cortex (ACC), ventral-segmental area, and the nucleus accumbens. The prefrontal cortex is the brain’s executive center; it is essential for guiding behavior, regulating emotions, and understanding the difference between potential rewards and punishments. It is also necessary for imagining the future and setting goals, which are functions directly related to optimism. The prefrontal cortex enables us to engage in optimistic processes such as hoping for the best and imagining a bright future, anticipating and preparing to meet a challenge, and making plans to achieve and enjoy success.

The second brain area involved in optimism is the amygdala. The amygdala plays a role in triggering “raw emotions” such as fear or excitement. In this way the amygdala plays a role in our ability to experience positive emotions. There is evidence that the amygdala plays an important role in imagining future emotional events including positive events.

The reward circuitry—the ACC, ventral-segmental area, and nucleus accumbens also appear to play a role in optimism. These are associated with the rewarding effects of social attachment, eating, sex, and other pleasurable stimuli. Not surprisingly, reward circuitry is generally active when we are engaged in behaviors we enjoy. Acute stress tends to reduce activity in these circuits. The neurotransmitter associated with reward is dopamine. Alice Isen and her colleagues have found that dopamine improves cognitive flexibility and perspective-taking. These researchers, along with others, believe that the broadened perspective and flexible cognitive style that accompany positive emotions may be related to increased dopamine.

Psychologist Tali Sharot along with colleagues instructed subjects to imagine both positive (winning an award) and negative (ending a romantic relationships) future events while undergoing fMRI in order to understand how the brain generates the positive bias that characterizes optimism. When participants imagined a positive future event, activation of the amygdala and the ACC increased. The greatest activation of these regions occurred in participants with the highest scores on a measure of dispositional optimism, the LOT-R (Life Orientation Test-Revised).

Richard Davidson and his colleagues have found that optimism is associated with high activity in the left prefrontal cortex with prolonged engagement of subcortical reward circuitry. On the other hand, depression has been associated with low prefrontal activity and inability to sustain reward circuitry activation. Heller and his colleagues have said that the ability to savor and sustain positive emotion is “critical to daily function well-being and to health.

The authors conducted research in which fMRI was used to examine emotional responses to negative stimuli among three groups of women: 14 women who have been sexually assaulted and developed PTSD, 14 who had been sexually assaulted and had not developed PTSD, and 14 who had never been assaulted. Each participant was shown 60 emotionally negative pictures during the study. Immediately before viewing each negative picture, participants were given one of three instructions: to “enhance,” to “diminish,” or to “maintain” their emotional response to that picture. Non traumatized healthy controls were best able to decrease their emotional response to negative pictures as measured by subjective ratings and degree of PFC activation. Unexpectedly, the trauma-exposed resilient group had greater PFC activation following the “enhance” instruction than did the trauma-exposed PTSD group. The authors conclude that these findings suggest that the ability to focus effortfully on negative emotional responses and engage cognitive/linguistic ares of the brain in order to manage, diminish or extinguish the negative emotion may be an important component of resilience.

The authors offer these four ways to become more optimistic:

Focus attention on the positive things around us.

2. Intentionally think positive thoughts and do not dwell on negative thoughts.

3. Reframe the negative and interpret events in a more positive light.

4. Behave and take action in ways that build positive feelings.

Optimism

March 10, 2020

This title of a book, Resilience: The Science of Mastering Life’s Greatest Challenges by by Steven Southwick and Dennis Charney has a chapter titled Optimism: Belief in a Brighter Future. It begins, “Optimism ignites resilience, providing energy to power the other resilience factors. It facilitates an active and creative approach to coping with challenging situations….Optimism is a future-oriented attitude, a confidence that things will turn out well.” They believe that good things will happen to them, and that with hard work, they will succeed.

Shelly Taylor and other psychologists have identified two styles of optimism: dispositional optimism, which is also called trait optimism, pervades the individual’s outlook and tends to be stable from one situation to another; and situational optimism, in which the individual may feel hopeful and expect a favorable outcome in one situation but not in another. Even under adverse circumstances these people manage to build on whatever small glimmer of optimistic thinking the can find.

The authors make the point that blind optimism does not work. They note that optimism as a resilience trait does not mean blindly ignoring life’s problems or viewing the world through “rose-colored glasses.” Realistic optimists pay close attention to negative information that is relevant to the problems they face. However, they do not remain focused on the negative. They tend to disengage rapidly from problems that appear to be unsolvable; they know then to cut their losses and turn their attention to solvable problems.

Diane Coutu discusses the importance of playing close attention to negative information in the context of business success: “That’s not to say that optimism doesn’t have its place: In turning around a demoralized sales force, for instance, conjuring a sense of possibility can be a very powerful tool. But for bigger challenges, a cool, almost pessimistic, sense of reality is far more important…Facing reality, really facing it, is grueling work. Indeed, it can be unpleasant and emotionally wrenching.”

Psychologist Sandra Schneider writes that realistic optimism is qualitatively different from the blind variety: “A realistic outlook improves chances to negotiate the environment successfully, whereas an optimistic outlook places priority on feeling good. But are realistic and optimistic outlooks necessarily in conflict?” She points out that in many cases, optimism and realism don’t conflict, but “there remain ‘optimistic biases’ that do involve self-deception, or convincing oneself of desired beliefs without appropriate reality checks.” Justin Kruger and David Dunning write that it tends to lead to “an underestimation of risk, an overestimation of ability, and inadequate preparation.”

Helen Keller, who was both blind and deaf is a most remarkable case. She believed that her own brand of optimism was the product of years of deprivation. After suffering what was called “brain fever” when she was 19 months old, she suffered five years suffering “outbursts of passion”, screaming, daily (and sometime hours) temper tantrums and fits of violent and uncontrollable behavior. Fortunately in 1887 a most remarkable individual entered her life, Anne Sullivan. She taught Helen to understand letters and words, traced her hand and then to read Braille. Her progress was so rapid and extraordinary that within a few years she became a “phenemon,” reaching widespread publicity and meeting with world dignitaries, including Alexander Graham Bell and President Grover Cleveland.

After four years of study at the Cambridge School for Young Ladies, she applied to Radcliffe College. Keller was informed only a day or two before the entrance exam that the mathematic portion would be given in a style of Braille unfamiliar to her, so that she had to learn an entirely new set of symbols over night. She wrote,”I do not blame anyone. The administrative board of Radcliffe did not realize how difficult they were making my examinations, nor did they understand the peculiar difficulties I had to surmount. But they unintentionally placed obstacles in my way, I have the consolation of knowing that I overcame them all.”

A portion of her essay “Optimism” follows:
“Most people measure happiness in terms of physical pleasure and material possession. Could they win some visible goal which they have set on the horizon, how happy they would be! Lacking this gift or that circumstance, they would be miserable. If happiness is to be so measured, I who cannot hear or see have every reason to sit in a corner with folded hands and weep.”

and

“A man must understand evil and be acquainted with sorrow before he can write himself an optimist and expect others others to believe that he has reason for the faith that is in him. I know what evil is…I can say with conviction that the struggle which evil necessitates is one of the greatest blessings. It makes us strong, patient, helpful men and women. It lets us into the soul of things and teaches us that although the world is full of suffering it is full also of the overcoming of it. My optimism then does not rest on the absence of evil, but on a glad belief in the preponderance of good and a willing effort always to cooperate with the good that it may prevail. I try to increase the power God has given me to see the best in everything and everyone, and make that Best a part of my life.”

One could easily call Helen Keller the most resilient person who has ever lived, so she constitutes proof that optimism does increase resilience. Barbara Fredrickson has developed what she calls the broaden and build model of positive emotions. She differentiates the functions of negative and positive emotions and notes that negative emotions such as anger, fear, and disgust help us to survive by preparing us for danger. They do this by activating the sympathetic nervous system, which increases physiological arousal. This “fight-flight” reaction narrows your visual focus and tends to restrict our behavior to those that are essential for attacking or fleeing.

Fredrickson also notes that positive emotions, in contrast, have been shown to reduce physiological arousal and to broaden our visual focus, our thoughts, and our behavior. Experiencing positive emotions results in an accompanying broadening of attention and behavior. Consequently, their thinking tends to become more creative, inclusiive, flexible, and integrative. Experiments have shown that inducing a positive mood (by showing participants a funny movie, or reading them a funny story) increases people’s scope of attention, their ability to solve problems actively, and their interest in socializing, and in strenuous as well as leisurely activities. So by broadening attention and action, positive emotions can contribute to our creativity, physical health, relations with family and friends, our ability to acquire new knowledge, and our psychological resilience.

There are many healthy memory post on optimism. The can be found by entering “optimism” into the search block at healthymemory.wordpress.com.

Bouncing Back

March 9, 2020

The title of this post is identical to the title of a section in a book, Resilience: The Science of Mastering Life’s Greatest Challenges by by Steven Southwick and Dennis Charney. The complete title is “Bouncing Back is a Choice—but the Choice is Easier for Some.” Many of us have learned that stress is bad. But when stress can be managed, it tends to be very good and even necessary for health and growth. The mind and body weaken without it. So if we can learn to harness stress it can serve as a catalyst for developing greater strength and even greater wisdom.

But the authors acknowledge that building resilience and bouncing back is easier for some than for others. People who are either temporarily or permanently unable to think clearly or regulate their moods will have difficulty putting into practice the advice in their book. For example, someone who is experiencing an episode of major depression will be handicapped by the sadness and sense of hopelessness, lack of energy, and loss of interest in life that characterize this disorder. Another example is someone who has suffered a traumatic brain injury may have particular difficulties with cognitive strategies and/or emotional challenges. The authors advise people with these kinds of serious conditions who want to practice the skills associated with resilience to work with a professional who is trained in dealing with their specific condition.

Even for those who do not suffer from these problems, the path to bounce back is steeper for some than for others. Those with resources such as financial security, a high level of education, an interesting and rewarding career, and strong social networks are able to leverage these resources, whereas people who lack resources may fall into what psychologist Stevan Hobfoll calls a “loss spiral.” A family that loses its home in a hurricane will have no place to live, while another family has the option to move in with relatives, and yet another family will be fortunate enough to own a second house.

The authors conclude, “When we advocate for resilience, we believe that most of us can choose to fight back after a trauma and attempt to right ourselves. However, we must emphasize with some people who lack access to support and resources that make it easier, or even possible, to do so. This does not mean that those with scarce resources should give up, but rather recognize that they will have a more difficult road to travel. Understanding these limitations may allow us to be more patient with ourselves or with others who are striving to recover from trauma.”

Nevertheless there are practices and ways of thinking and living that help inoculate us from trauma, so that we are resilient and bounce back quickly. These practices and ways of thinking will be presented in the following posts based on this book.

Neuroplasticity

March 8, 2020

This post is based on portions of a book, Resilience: The Science of Mastering Life’s Greatest Challenges by by Steven Southwick and Dennis Charney. There have been many previous healthymemory posts on this topic. Neuroplasticity refers to “the ability of the nervous system to respond to intrinsic or extrinsic stimuli by reorganizing its structure, function, and connections.”

For many years the brain was thought of as a fixed organ, but neuroplasticity means brain plasticity. Brain structure is highly plastic, and like muscles in the body, the brain can be strengthened or weakened depending on how it is used. When cells in the brain are actively used, they transmit their messages more efficiently and form more connections with other cells. However, when brain cells are not stimulated, they die and are pruned away. The well-known adage, use it or lose it, applies to the brain in spades.

Since the mid-1990s, brain changes in professional musicians have been identified and related to the instruments they play. Researchers have found that in professional players of string instruments (violin, viola, cello, and bass) “the cortical representation of the digits of the left hand (the fingering hand) was larger” than in control subjects, whereas the right hand (which holds the bow and is not involved in fingering) did not display such differences. Ruger, Lindenberg, and Schlaud studying brain activity in string players as well as keyboard players and non musicians found differences in the structure of not just gray-matter motor areas, but also in the white-matter fibers that connect brain areas. In string players these were larger in the right hemisphere (controlling the left hand), but inn keyboard players they were large in both brain hemispheres Choi and his colleagues studied wind instrument players and found enlargement in areas of the brain responsible for lip movement. Moreover, the greater the number of years of musical training, the more pronounced the brain changes.

Research on mindfulness-based stress reduction, a practice related to the mindfulness meditation, is part of some traditional Eastern religions. Omar Singleton and his colleagues used magnetic resonance imaging (MRI) to examine the brains of volunteers before and after an eight-week program of mindfulness-based stress reduction, “defined as the nonjudgmental awareness of experiences in the present moment.” They found an increase in the size of certain brain regions that produce neurotransmitters such as serotonin and norepinephrine, that are critically involved in regulating arousal, attention, mood, reward, and learning. Moreover, these volunteers scored higher on an assessment of psychological well-being after the eight-week program.

Each of us has, to some degree, the power to change the structure and function of our brain. As noted by well-known author Deepak Chopra, MD and Harvard neuroscientist Rudolph Tanzi, Ph.D., “Neuroplasticity is better than mind over matter. It’s mind turning into matter as your thoughts create new neuronal growth. Activity is the key. By repeatedly activating specific areas of the brain, we can strengthen those areas.

Epigenetics

March 6, 2020

This post is based on portions of a book, Resilience: The Science of Mastering Life’s Greatest Challenges by by Steven Southwick and Dennis Charney. A common question that arises when discussing many topics is the nature nurture issue. That is how much of a person is determined by that person’s genes and how much by the environment. That is a naive question that is difficult to answer for two reasons. One is that there is natural confound here, and that is how to distinguish the effects of genetics and the environment. IQ measurements can be separated mathematically into a genetic component and an environmental component. Although this can be done mathematically it cannot be done empirically as these two components are confounded.
There is a true anecdote illustrating this confound. It tells of two sisters who are identical twins, yet one is academically and socially successful, whereas the other has the autistic spectrum disorder.

Epigenetics is the study of how genes are read out or expressed. It matters not if you have fantastic genes, but the information in these genes is not manifested. A variety of internal and external environmental events, such as stress, social support, and fear, can trigger biochemical reactions, such as methylation, that then turns genes on or of. Moreover, these processes are dynamic and potentially reversible. So when a gene is “turned on” it directs the making of gene products, such as proteins. But, when a gene is “turned off” these gene products are no longer produced.

Zang has conducted studies showing that if a mother rat provides only low levels of licking and grooming to her pups, which is analogous to neglectful parenting in the rat world, the pub will exhibit increased susceptibility to stress throughout their lives. But attentive maternal care, as reflected by high levels of licking and grooming, can contribute to later stress resilience. These effects of maternal licking and grooming appear to be mediated, at least in part, by epigenetic changes in gene expression. Research conducted in Michael Meaney’s laboratory has shown that variations in maternal care have been associated with variations in expression of glucocorticoid receptors and hippocampal sensitivity to stress. According to Nestler, similar epigenetic effects of maternal care, as well as other lifetime experiences, on later vulnerability or resilience to stress are likely to “hold up in humans.”

The authors write, “A variety of environmental events, including stress, social interactions, and drug use, can cause epigenetic changes in gene expression. Although much remains to be learned, the rapidly expanding field of epigenetics may soon help us to better understand the origins of stress vulnerability and discover ways to manage it. It may also help us to better understand resilience and the mechanisms by which training can enhance factors associated with resilience (e e.g. exercise, social support, cognitive reframing). And as noted by psychopharmacologist Steven Stahl, “psychotherapy can now be conceptualized not only by its classic psychodynamic principles, but also indeed as a neurological problem capable of inducing epigenetic changes in brain circuits, not unlike the ultimate actions of psychotropic drugs.”