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Healing Brain Seminar: June 1983

Two continuing medical education symposia

Nutrition, the Brain, and the Mind
June 3, 1983 New York City

The Brain's Control of Weight:
Theories and Implications for Treatment of Obesity
June 4-5, 1983 New York City

Also: NON-DRUG MANAGEMENT OF HYPERTENSION
A Workshop with James Lynch, Author of The Broken Heart
June 11-12, 1983
New York City

Sponsored by Continuing Education, Pacific Medical Center, San Francisco and the Institute for the Study of Human Knowledge

It is commonly thought that the brain is isolated from the activities of the body, especially that of food consumption. This is not so: the food that we eat has intimate effects on the brain, on our appetite, our mood, our ability to sleep and to think. In a long series of recent experiments researchers have shown how food constituents change the chemistry of the brain and alter mood and thought.

As food affects the brain, so the brain also precisely regulates food and eating. Each year there are new diets, each year they come and go, a new one at the top of the best-seller list. This demonstrates that weight is a problem in our society and also that we don't seem to be able to control it.

Recently many researchers have developed a new theory: that there is a "set" point for our weight, which is under control of lower brain centers, relatively inaccessible to conscious control.

The implications may be dramatic: weight loss may be more difficult than we think, we may be "set" to weigh more than we would like, many of the problems associated with overweight may be due to overeating. In this light, what are the important causes and the important treatments of obesity and what are the solutions? In two symposia we examine the new research on the role of the brain in regulating weight and the role of food in affecting the brain.

NUTRITION, THE BRAIN AND THE MIND

Friday, June 3
Morning Session

Food for Thought: An Introduction
Robert Ornstein, Ph.D.
It is commonly thought that the brain is specially insulated from the workings of the body. However, it has been recently found that the brain is far more responsive to its "internal environment" than has been previously thought.

Tryptophan and Other Amino Acids: Effects on Human Sleep
Ernest Hartmann, M.D.
We have compared the effects of tryptophan with the effects of other naturally occurring amino acids. Overall, there is no question that L-tryptophan produces subjective sleepiness and that it has at least some sleep-promoting effects found by objective sleep laboratory studies: it reduces sleep latency or time to fall asleep.

Afternoon Session

Foods and Food Constituents That Alter Human Mood, Performance and Pain Sensitivity
Harris R. Lieberman, Ph.D.
Recent research has demonstrated that foods and food constituents can effect human mood, performance and pain sensitivity. This research will be discussed and the biochemical basis for such effects explained. The possible clinical applications of these findings will also be noted and relevant clinical studies examined including those on human depression and pain sensitivity.

Behavior as a Common Focus of Toxicology and Nutrition
Bernard Weiss, Ph.D.
The disciplines of behavior science, toxicology, and nutrition intersect because foodstuffs serve as one of the major routes of toxic exposure, and, also, because nutrient in-take may enhance or blunt the impact of some toxic agents. The potential of our food supply to produce behavioral toxicity will be surveyed in the context of toxic metals, industrial contaminants and food additives.

Nutritional "Imprinting"
G. Harvey Anderson, Ph.D.
In a series of studies, it has been found that the diet fed to pregnant mothers (rats) can affect the offspring's brain chemistry (serotonin) and their food preferences. The findings and the implications will be discussed.

THE BRAIN'S CONTROL OF WEIGHT:
THEORIES AND IMPLICATIONS FOR TREATMENTS
OF OBESITY

Saturday, June 4
Morning Session

The Brain, the Mind and Weight Control:
Introduction to the Symposium
Robert Ornstein, Ph.D.
Our weight seems to be regulated by an intricate series of mechanisms which keep weight on a course that we consciously do not like. People say "I've lost hundreds of pounds in my life" - the implication being that weight is always gained back, or "It doesn't matter how much I eat - I am just naturally fat" or, "I can gain weight just looking at food." Recent research indicates that these cliches are true. Their implications for brain states and weight control will be introduced.

Setpoint: A Model for Brain-body Interaction in Regulating Fat Storage
William Bennett, M.D.
From human experience and animal research, a theory of eating behavior and energy regulation can be constructed. This theory argues that direct, voluntary control of weight has very limited influence.

Afternoon Session

All lectures by
Janet Polivy, Ph.D., and Peter Herman, Ph.D.

Dieting and Binge Eating
Binge eating characteristically follows chronic dieting; we conclude that dieting causes bingeing, in as much as it disrupts normal regulatory patterns and renders the dieter susceptible to bouts of overeating unconstrained by natural satiety inhibitions.

Medical Consequences of Overeating
Many of the problems commonly attributed to overweight are more reasonably attributed to overeating. Overweight is to be understood with reference to the amounts needed to maintain a natural weight -not to caloric quotas or other person's relative consumption.

Natural Weight, Dieting and Eating
Dieting begins as an attempt to suppress weight below its regulated level, or "setpoint." To do this the dieter must develop an artificial eating style based on diet calculations. This style is often counterproductive; the dieter should permit natural regulatory processes to regain control of weight and eating.

Social, Cognitive, and Physiological Control of Weight and Eating
We propose a general mode of regulation incorporating both physiological and non-physiological influences. In the dieter, non-physiological influences gain predominance, with the unfortunate consequences we have discussed earlier.

Sunday, June 5
Morning Session

The Causes of Obesity
Albert Stunkard, M.D.
There are many types of obesity and many causes. Six of these causes will be discussed: genetic, developmental (including fat cell anatomy), brain disorder, physical inactivity, psychological and social. Newer work on three types of neurotransmitters involved in brain mechanisms for integrating these inputs will be discussed: biogenic amines, intestinal hormones and endogenous opiates.

Desirable Weight and Longevity- Status of the Controversy
Reuben Andres, M.D.
Severe obesity is clearly associated with a large number of harmful consequences, including early death. The lower levels of obesity at which these risks first become manifest are uncertain. This limit may well be expected to differ with age as well as sex. The construction then of a valid and simple desirable weight table is a difficult and perhaps impossible undertaking. Data on one of the "end-points" of obesity, total mortality, will be presented as an example of some of these complexities.

Afternoon Session

The Treatments of Obesity
Albert Stunkard, M.D.
Treatments of obesity will be discussed in terms of a recently proposed typology of obesity-severe, moderate, and mild. Points of discussion will include surgical treatment of obesity, the treatment of moderate obesity combining dietary and behavioral measures under professional auspices, and the treatment of mild obesity by behavior therapy under lay auspices. The results of drug therapy, psychoanalysis, hypnosis and jaw-wiring will be briefly discussed.

Implications of Setpoint Theory for Treatment and Research Strategies
William Bennett, M.D.
The setpoint model has radical implications for management of weight "problems". It is not a defeatist approach but does call for some serious retrenchment.

Panel Discussion:
The Brain's Control of Weight

A Two-day Workshop in Transactional Psychophysiology
with James J. Lynch, Ph.D. and Sue A. Thomas, R.N., Ph.D.

A New Non-drug Approach to the Management of Hypertension

June 11-12, 1983

Human Dialogue and the Healing Process

Human dialogue is crucial to our health and well being: it can significantly influence the functioning of blood pressure, heart rate and blood flow. This workshop examines the link between communication and blood pressure, and demonstrates the applicability of this information for the treatment of hypertension.

Hypertension is a pervasive problem within our modern society, and its diagnosis and treatment have classically focused on organic causes and therapies.

We have developed an entirely new and successful approach to hypertension based on our studies of the links between human communication and changes in blood pressure. This approach is called Transnational Psychophysiology (TP). Our studies have revealed that even the most routine conversations can significantly change blood pressure, and that hypertensive individuals are especially sensitive to dialogue. Recognition of the fact that physiological responsiveness is an inherent part of human communication led us to develop a new therapeutic approach to help restore our bodies to healthy functioning. This approach focuses on the links between human dialogue and changes in blood pressure. Patients who quite literally had previously "talked" their way into hypertension have been shown how to use human dialogue in a way that can also lower their blood pressure.

This workshop provides participants with the essential concepts for the diagnosis and treatment of hypertension in the context of our new treatment approach. Participants will obtain a broader understanding of the psychophysiologic mechanisms of hypertension, and a grounding in new tools for treating this disorder. Participants also will be given an opportunity to gain "hands-on" experience using latest computer technology and diagnostic techniques.

WORKSHOP OUTLINE

1) Pathophysiology and dynamics of essential hypertension and pharmacological management.
2) Human communication and blood pressure. Cur-rent studies linking communication to major changes in the cardio-vascular system.
3) Introduction to Transactional Psychophysiology (TP) Therapy.
4) The psychophysiological and psychodynamics of TP therapy.
5) Psychophysiological assessment and evaluation of a person presenting with hypertension.
6) Case presentations of the treatment approach with hypertensive patients.
7) Comparison of Transactional Psychophysiology with other therapies (pharmacological psychotherapy, biofeedback, yoga, meditation).
8) Introductory practice sessions throughout workshop for small groups in the use of TP therapy.

Faculty

G. Harvey Anderson, Ph.D., is Professor and Chairman in the Department of Nutrition and Food Science, Faculty of Medicine, University of Toronto and is the author of numerous papers on the effects of maternal nutrition on the offspring.

Reuben Andres, M.D., is Professor of Medicine at Johns Hopkins University and Clinical Director, National Institute on Aging and Chief of Clinical Physiology Branch, Gerontology Research Center, NIA.

William Bennett, M.D., is Associate Editor of the Harvard Medical School Health Letter and has worked for a number of years as a science and medical writer. His latest book The Dieter's Dilemma reviews the emerging evidence on setpoint theory in the regulation of body fatness.

Ernest Hartmann, M.D., is Professor of Psychiatry, Tufts University School of Medicine and Senior Psychiatrist and Director of the Sleep Research Laboratory, West-Ros-Park Mental Health Center, Boston and Lemuel Shattuck Hospital, Boston.

Peter Herman, Ph.D., is Associate Professor of Psychology, University of Toronto and Research Associate, Psychosomatic Medicine Unit, Clarke Institute of Psychiatry, Toronto, Ontario, Canada. He is coauthor of Restrained Eating and Breaking the Diet Habit: A Natural Alternative.

Harris R. Lieberman, Ph.D., is a research scientist at the Department of Psychology, M.I.T. One of his primary research interests is the effect of foods and nutrients on various aspects of human behavior. His other areas of interest include human neuropsychology and visual perception.

James J. Lynch, Ph.D., is Professor of Psychology, University of Maryland and author of The Broken Heart: The Medical Consequences of Loneliness.

Robert Ornstein, Ph.D., is Professor in the Department of Human Biology, Stanford University, and President of the Institute for the Study of Human Knowledge. His major interests include the function of the two hemispheres of the brain and perception and communications in the human sciences. He is author of The Psychology of Consciousness and The Mind Field, and coauthor of On the Psychology of Meditation.

Janet Polivy, Ph.D., is Associate Professor of Psychology and Psychiatry, University of Toronto and Research Associate, Psychosomatic Medicine Unit, Clarke Institute of Psychiatry, Toronto, Ontario, Canada. She is coauthor of Restrained Eating and Breaking the Diet Habit: A Natural Alternative.

Albert Stunkard, M.D., is a Psychiatrist who has been half of his sixty years in the study and treatment of obesity. During this time he has published 200 scientific articles and books on all aspects of the topic and has become a recognized leader in the field. He is former chairmen of the Departments of Psychiatry at the University of Pennsylvania and Stanford and is the only person to be twice honored-for his research on obesity-by the annual research prize of the American Psychiatric Association. He is the author of The Pain of Obesity and Obesity.

Sue A. Thomas, R.N., Ph.D., is Clinical Director, Psychophysiology Clinic and Assoc. Professor, School of Nursing, University of Maryland; author of numerous papers on hypertension and cardio-vascular disease.

Bernard Weiss, Ph.D., is Professor of Psychology, and Professor in the Center for Brain Research, and Deputy Director, Environmental Health Sciences Center, University of Rochester Schools of Medicine and Dentistry. His research is on behavioral toxicology and behavioral pharmacology, including: heavy metals, organic solvents, axonopathic agents, air pollutants, psychotropic drugs, food additives.

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