[Music]
[Applause]
so six months ago I gave birth to my
second child Dylan and as a mom and as a
neuroscientist I can’t help but see my
son through two lenses as a bundle of
joy and a science experiment in diapers
it’s fascinating to witness his identity
emerge at each stage of development the
brain is sculpted like clay by our
experiences over the course of our lives
with the genes providing the raw
material as well as a few preformed
contours and as our neurons begin to
wire up the clay hardens but never
completely so there’s always room for
change a baby is born with billions of
neurons with trillions of connections
that are eventually pruned away with the
most salient connections retained and
the less of the rest allowed to wither
identity in a way like information is a
matter of differentiation of defining
ourselves by what were not or by what we
do or don’t reach for that’s my son at
around 18 months a toddler can pass the
mirror test this is the first outward
sign of self recognition if when placed
in front of a mirror
they rub a red mark that was covertly
placed on their face this is evidence
that they recognize the image as
themselves rather than someone else
that’s actually my daughter Hannah at
two months passing the mirror test way
ahead of schedule
and the other species that are known to
pass the mirror test are gradates
dolphins orcas Magpies and a single very
precocious elephant so self recognition
and identity formation in humans is
reinforced as language emerges so babies
go from identifying nouns like mommy
doggie dolly to adding possessive
pronouns my doggy my mommy my dolly and
later they begin to identify themselves
with adjectives right I’m smart I’m
friendly I’m endowed with magical
superpowers identity is clearly a verb
not a noun formed as our brains interact
with our environments so today I’m gonna
talk to you about how our brains make us
who we are and one way I explore this is
by studying psychiatric and neurological
patients with disorders of identity
because when the brain goes wrong it
gives us an idea of how it’s working the
rest of the time when we take it for
granted so here’s an extreme case this
is a man who in his mid-40s developed
pedophilia which is unusual usually it
manifests earlier but in this case the
night before he was going to be
sentenced for molestation he checked
himself into a hospital for severe
headaches they did an MRI and they found
that he actually had a large tumor in
his right prefrontal cortex specifically
in the orbital prefrontal cortex the
part of the brain just above the eye
sockets and it’s involved in our
personality and impulse control and this
made sense because the man had stated
that whenever he tried to restrain
himself the pleasure principle overrode
so they surgically removed the tumor and
his symptoms went away
he was allowed to return home where he
was living with young stepdaughter
things were fine until about a year
later the symptoms came back and sure
enough the tumor had grown back so a lot
of neuroscience is about correlation
right showing that certain brain areas
are active during certain behaviors or
thoughts but in this case we’re talking
about causation changes in the brain
directly causing changes in personality
and
havior another condition that i study
that has problems with impulse control
is borderline personality disorder now
this is characterized by people who have
instability in their self-image in
relationships in their emotions and they
also have a lot of impulsivity things
like reckless spending and driving and
shopping and self-harm substance abuse
binge eating now this might sound like a
typical weekend for Justin Bieber but we
have to resist the temptation to make
these armchair diagnoses people with
borderline personality disorder make for
dramatic film and television stories but
they’re suffering and so are the people
around them
so I actually conducted a study where I
compared people with borderline
personality disorder to patients with
orbital prefrontal cortex lesions like
the man I just spoke about on a series
of neurocognitive and personality tests
because they both seemed to display
similar symptoms and what I found is
that orbital prefrontal cortex
dysfunction is the driver of the
impulsivity in the borderline patients
what this means is that we can begin to
target treatments at the underlying
neural circuitry that drives the core
symptoms of borderline personality
disorder like their impulsivity or their
emotional dysregulation rather than
treating the overarching disorder itself
so the more we understand about how the
brain works the better we can treat
disorders of identity the final
condition I’m going to talk about is
dissociative identity disorder and this
used to be called multiple personality
disorder and it occurs when
psychological processes that are
normally integrated become segregated
and it creates a feeling of
disintegration or fragmentation and a
person’s identity so it’s at the extreme
ends of a continuum of dissociation we
all experience mild forms of
dissociation so when you’re for example
engrossed in a really good book and you
lose your sense of time and place itself
or you return home after a very long
drive and you realized your mind was
wandering and you don’t really remember
any of the drive in a way self-driving
cars
they’ve been around for quite some time
but this disorder can be very disturbing
to people but but Association itself can
also serve an adaptive function it can
be a defense mechanism against trauma
right it can help people separate out
these anxiety provoking memories or
emotions so they can function adaptively
in their daily life
but at the very extreme and when people
there are cases where people actually
have their identities separate out into
these different dissociative identity
states
they usually have a traumatic identity
state where they have access to their
own disturbing traumatic memories and a
neutral identity state where they have
selective amnesia for those memories now
this disorder used to be thought of it
didn’t psychologist didn’t take it for
they thought it wasn’t made up but
actually neuroscience can confirm that
it’s a real disorder with an underlying
physical basis that can’t be faked at
the neural level so for example one
study showed that when they looked at
people in these different identity
states they had different physiologic
reactions
to memory scripts that were being read
to them when they were in these
different states so when they were in
the traumatic identity State and they
had access to the traumatic memories and
the memories were read to them they
would get increased heart rate
they’d have galvanic skin response
increase and they would have emotional
reactions but they didn’t have this when
they were in the neutral state so that
means who we are might be determined by
how our brain reacts then when they did
neuroimaging they found that when people
were in the neutral identity state it
created a broad areas of activation in
the brain all these areas here in red
and when they were in the traumatic
identity state there were far fewer
areas of activation so what does this
mean it means that suppressing traumatic
memories actually takes more Act brain
activation than remembering them and
being in a dissociative identity state
is like being in a
different brain state or you can think
of it like running a virtual PC on a Mac
computer so this is actually a EEG of a
patient who could see in one state and
not see in the other we should claim
this now try it for yourself keep your
eyes open and try not to see okay it’s
virtually impossible but in this case
they looked at brain activation in her
primary visual cortex in response to a
flashing checkerboard image that she was
viewing and what they found is this
pattern on the left was her activation
and her visual cortex in response to the
flashing checkerboard pattern but in the
on the right you can see that when she
was in her blind state she did not have
any reliable visual cortex activation in
response to this image so she really
couldn’t see now this means that the
suppression of visual information is
happening very early in the sequence of
processing in the brain perhaps even at
the level of the thalamus and I actually
tried to bring her into my lab so I can
run some tests on her but she recovered
she integrated her identities which was
really good for her but not for my study
but what her case her case reveals the
brain’s plasticity right many of these
conditions are amenable they respond to
therapy so they either resolve
completely or people can learn a ways to
adapt and live with their symptoms we’re
all malleable right we can change if you
change your thoughts and behaviors it
can change your brain and ultimately
change who you are and understanding the
brain allows us to influence it more
directly so before I finish I want to
give you a taste of what’s currently
achievable with brain computer
interfaces so we’re learning how we can
actually go in and change who we are
with the press of a button
via neural prosthetics so for example
deep brain stimulation is a common
treatment for people with movement
disorders like Parkinson’s but it’s now
being used to treat people with with
refractory or treatment-resistant severe
depression and obsessive-compulsive
disorder
so these are what the electrodes look
like and what they look like when
they’re implanted and now remember this
is a sort of last resort deep brain
stimulation is used when they’ve failed
medications when they failed
psychotherapy even electric shock
therapy so you can think of electric
shock therapy is like turning your
computer off and on again if there’s a
problem where as deep brain stimulation
is like force quitting a specific
application it’s much more targeted now
you might still think this is harsh this
is neurosurgery but actually the
alternative used to be to go in and and
lesion the brain damage it but in this
case with deep brain stimulation it’s
reversible it’s adjustable it doesn’t
damage the brain and amazingly about 40
to 50 percent of people with treatment
resistant depression and about 60 to 70
percent of people with treatment
resistant obsessive compulsive disorder
shows significant improvement after deep
brain stimulation this is actually a
patient in the operating room when they
first turn on the the electrodes her
whole face lights up and she says she
feels happy then when she doesn’t know
it they turned the electrodes off and
her she actually goes right back down to
a flat effect so again this is going
from correlation to causation right
we’re directly stimulating the brain to
manipulate people’s emotions so be nice
to neuroscientists because we have our
finger on the button and these simple
electrodes are just the Model T Ford of
what’s to come as our understanding of
the brain improves so our ability to
treat disorders and also to design
cognitive enhancements and and brain
computer interfaces that could
potentially increase the processing
speed of our brain expand our memory
capacity or attention span manipulate
our thoughts and emotions even decrease
our need for sleep now this might sound
great but there are also ethical
considerations right who can afford the
implants will they be sort of just
cosmetic like Botox injections for the
brain or will the effects give us a real
will they enhance us give us a kind of
performance like my kind of performance
enhancing drugs for athletes
and if so are there gonna be two classes
of citizens right enhanced and
unenhanced and what if someone can hack
into your neural implant and manipulate
your thoughts and behaviors right so
these are right now academic debates but
my children might actually have to
confront these questions firsthand so my
my six month old son and three and a
half year old daughter the half-heart is
very important they’re still in the
early stages of brain development but
it’s exciting to imagine the advances
that neuroscience will make by the time
their prefrontal cortices are fully
developed in about two decades and the
possibility to enhance their mental
capacities not that they would need it
of course but in the meantime these
discoveries are already allowing us to
to understand ourselves better and to
come up with improved treatments for
disorders of the brain the brain is both
delicate and robust no it’s easily
damaged but it’s impressively able to
heal and each of us regardless of age or
state of health is midway through a
process of self-discovery and self
creation as our brains are continually
interacting with our environments and
being shaped by them and they’re being
kind of guided by our genes and forming
our identities so each of us is a work
in progress until our very last breath
and this this perspective helps me go
through life with more compassion and
appreciation for the people I mean so if
I have a really good interaction I
remind myself it’s their brain I’m
loving and if it’s negative I remind
myself that myself that we’re not all
wired the same and this helps me
interact with everyone from impulsive
teenagers to demanding three majors to
people with severe identity and
personality disorders who I can help
treat as a clinician or researcher and a
mom so remember you are your brain but
you also have a role in shaping it happy
sculpting
[Applause]
[Applause]
so six months ago I gave birth to my
second child Dylan and as a mom and as a
neuroscientist I can’t help but see my
son through two lenses as a bundle of
joy and a science experiment in diapers
it’s fascinating to witness his identity
emerge at each stage of development the
brain is sculpted like clay by our
experiences over the course of our lives
with the genes providing the raw
material as well as a few preformed
contours and as our neurons begin to
wire up the clay hardens but never
completely so there’s always room for
change a baby is born with billions of
neurons with trillions of connections
that are eventually pruned away with the
most salient connections retained and
the less of the rest allowed to wither
identity in a way like information is a
matter of differentiation of defining
ourselves by what were not or by what we
do or don’t reach for that’s my son at
around 18 months a toddler can pass the
mirror test this is the first outward
sign of self recognition if when placed
in front of a mirror
they rub a red mark that was covertly
placed on their face this is evidence
that they recognize the image as
themselves rather than someone else
that’s actually my daughter Hannah at
two months passing the mirror test way
ahead of schedule
and the other species that are known to
pass the mirror test are gradates
dolphins orcas Magpies and a single very
precocious elephant so self recognition
and identity formation in humans is
reinforced as language emerges so babies
go from identifying nouns like mommy
doggie dolly to adding possessive
pronouns my doggy my mommy my dolly and
later they begin to identify themselves
with adjectives right I’m smart I’m
friendly I’m endowed with magical
superpowers identity is clearly a verb
not a noun formed as our brains interact
with our environments so today I’m gonna
talk to you about how our brains make us
who we are and one way I explore this is
by studying psychiatric and neurological
patients with disorders of identity
because when the brain goes wrong it
gives us an idea of how it’s working the
rest of the time when we take it for
granted so here’s an extreme case this
is a man who in his mid-40s developed
pedophilia which is unusual usually it
manifests earlier but in this case the
night before he was going to be
sentenced for molestation he checked
himself into a hospital for severe
headaches they did an MRI and they found
that he actually had a large tumor in
his right prefrontal cortex specifically
in the orbital prefrontal cortex the
part of the brain just above the eye
sockets and it’s involved in our
personality and impulse control and this
made sense because the man had stated
that whenever he tried to restrain
himself the pleasure principle overrode
so they surgically removed the tumor and
his symptoms went away
he was allowed to return home where he
was living with young stepdaughter
things were fine until about a year
later the symptoms came back and sure
enough the tumor had grown back so a lot
of neuroscience is about correlation
right showing that certain brain areas
are active during certain behaviors or
thoughts but in this case we’re talking
about causation changes in the brain
directly causing changes in personality
and
havior another condition that i study
that has problems with impulse control
is borderline personality disorder now
this is characterized by people who have
instability in their self-image in
relationships in their emotions and they
also have a lot of impulsivity things
like reckless spending and driving and
shopping and self-harm substance abuse
binge eating now this might sound like a
typical weekend for Justin Bieber but we
have to resist the temptation to make
these armchair diagnoses people with
borderline personality disorder make for
dramatic film and television stories but
they’re suffering and so are the people
around them
so I actually conducted a study where I
compared people with borderline
personality disorder to patients with
orbital prefrontal cortex lesions like
the man I just spoke about on a series
of neurocognitive and personality tests
because they both seemed to display
similar symptoms and what I found is
that orbital prefrontal cortex
dysfunction is the driver of the
impulsivity in the borderline patients
what this means is that we can begin to
target treatments at the underlying
neural circuitry that drives the core
symptoms of borderline personality
disorder like their impulsivity or their
emotional dysregulation rather than
treating the overarching disorder itself
so the more we understand about how the
brain works the better we can treat
disorders of identity the final
condition I’m going to talk about is
dissociative identity disorder and this
used to be called multiple personality
disorder and it occurs when
psychological processes that are
normally integrated become segregated
and it creates a feeling of
disintegration or fragmentation and a
person’s identity so it’s at the extreme
ends of a continuum of dissociation we
all experience mild forms of
dissociation so when you’re for example
engrossed in a really good book and you
lose your sense of time and place itself
or you return home after a very long
drive and you realized your mind was
wandering and you don’t really remember
any of the drive in a way self-driving
cars
they’ve been around for quite some time
but this disorder can be very disturbing
to people but but Association itself can
also serve an adaptive function it can
be a defense mechanism against trauma
right it can help people separate out
these anxiety provoking memories or
emotions so they can function adaptively
in their daily life
but at the very extreme and when people
there are cases where people actually
have their identities separate out into
these different dissociative identity
states
they usually have a traumatic identity
state where they have access to their
own disturbing traumatic memories and a
neutral identity state where they have
selective amnesia for those memories now
this disorder used to be thought of it
didn’t psychologist didn’t take it for
they thought it wasn’t made up but
actually neuroscience can confirm that
it’s a real disorder with an underlying
physical basis that can’t be faked at
the neural level so for example one
study showed that when they looked at
people in these different identity
states they had different physiologic
reactions
to memory scripts that were being read
to them when they were in these
different states so when they were in
the traumatic identity State and they
had access to the traumatic memories and
the memories were read to them they
would get increased heart rate
they’d have galvanic skin response
increase and they would have emotional
reactions but they didn’t have this when
they were in the neutral state so that
means who we are might be determined by
how our brain reacts then when they did
neuroimaging they found that when people
were in the neutral identity state it
created a broad areas of activation in
the brain all these areas here in red
and when they were in the traumatic
identity state there were far fewer
areas of activation so what does this
mean it means that suppressing traumatic
memories actually takes more Act brain
activation than remembering them and
being in a dissociative identity state
is like being in a
different brain state or you can think
of it like running a virtual PC on a Mac
computer so this is actually a EEG of a
patient who could see in one state and
not see in the other we should claim
this now try it for yourself keep your
eyes open and try not to see okay it’s
virtually impossible but in this case
they looked at brain activation in her
primary visual cortex in response to a
flashing checkerboard image that she was
viewing and what they found is this
pattern on the left was her activation
and her visual cortex in response to the
flashing checkerboard pattern but in the
on the right you can see that when she
was in her blind state she did not have
any reliable visual cortex activation in
response to this image so she really
couldn’t see now this means that the
suppression of visual information is
happening very early in the sequence of
processing in the brain perhaps even at
the level of the thalamus and I actually
tried to bring her into my lab so I can
run some tests on her but she recovered
she integrated her identities which was
really good for her but not for my study
but what her case her case reveals the
brain’s plasticity right many of these
conditions are amenable they respond to
therapy so they either resolve
completely or people can learn a ways to
adapt and live with their symptoms we’re
all malleable right we can change if you
change your thoughts and behaviors it
can change your brain and ultimately
change who you are and understanding the
brain allows us to influence it more
directly so before I finish I want to
give you a taste of what’s currently
achievable with brain computer
interfaces so we’re learning how we can
actually go in and change who we are
with the press of a button
via neural prosthetics so for example
deep brain stimulation is a common
treatment for people with movement
disorders like Parkinson’s but it’s now
being used to treat people with with
refractory or treatment-resistant severe
depression and obsessive-compulsive
disorder
so these are what the electrodes look
like and what they look like when
they’re implanted and now remember this
is a sort of last resort deep brain
stimulation is used when they’ve failed
medications when they failed
psychotherapy even electric shock
therapy so you can think of electric
shock therapy is like turning your
computer off and on again if there’s a
problem where as deep brain stimulation
is like force quitting a specific
application it’s much more targeted now
you might still think this is harsh this
is neurosurgery but actually the
alternative used to be to go in and and
lesion the brain damage it but in this
case with deep brain stimulation it’s
reversible it’s adjustable it doesn’t
damage the brain and amazingly about 40
to 50 percent of people with treatment
resistant depression and about 60 to 70
percent of people with treatment
resistant obsessive compulsive disorder
shows significant improvement after deep
brain stimulation this is actually a
patient in the operating room when they
first turn on the the electrodes her
whole face lights up and she says she
feels happy then when she doesn’t know
it they turned the electrodes off and
her she actually goes right back down to
a flat effect so again this is going
from correlation to causation right
we’re directly stimulating the brain to
manipulate people’s emotions so be nice
to neuroscientists because we have our
finger on the button and these simple
electrodes are just the Model T Ford of
what’s to come as our understanding of
the brain improves so our ability to
treat disorders and also to design
cognitive enhancements and and brain
computer interfaces that could
potentially increase the processing
speed of our brain expand our memory
capacity or attention span manipulate
our thoughts and emotions even decrease
our need for sleep now this might sound
great but there are also ethical
considerations right who can afford the
implants will they be sort of just
cosmetic like Botox injections for the
brain or will the effects give us a real
will they enhance us give us a kind of
performance like my kind of performance
enhancing drugs for athletes
and if so are there gonna be two classes
of citizens right enhanced and
unenhanced and what if someone can hack
into your neural implant and manipulate
your thoughts and behaviors right so
these are right now academic debates but
my children might actually have to
confront these questions firsthand so my
my six month old son and three and a
half year old daughter the half-heart is
very important they’re still in the
early stages of brain development but
it’s exciting to imagine the advances
that neuroscience will make by the time
their prefrontal cortices are fully
developed in about two decades and the
possibility to enhance their mental
capacities not that they would need it
of course but in the meantime these
discoveries are already allowing us to
to understand ourselves better and to
come up with improved treatments for
disorders of the brain the brain is both
delicate and robust no it’s easily
damaged but it’s impressively able to
heal and each of us regardless of age or
state of health is midway through a
process of self-discovery and self
creation as our brains are continually
interacting with our environments and
being shaped by them and they’re being
kind of guided by our genes and forming
our identities so each of us is a work
in progress until our very last breath
and this this perspective helps me go
through life with more compassion and
appreciation for the people I mean so if
I have a really good interaction I
remind myself it’s their brain I’m
loving and if it’s negative I remind
myself that myself that we’re not all
wired the same and this helps me
interact with everyone from impulsive
teenagers to demanding three majors to
people with severe identity and
personality disorders who I can help
treat as a clinician or researcher and a
mom so remember you are your brain but
you also have a role in shaping it happy
sculpting
[Applause]
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