A psychiatrist affiliated with Harvard Medical School, Schiffer has studied split-brain research and devised his own experiments to show that stress and anxiety are often felt more strongly in one hemisphere than the other. No simple "left brain good, right brain bad" dichotomy, it seems that those who have been affected by emotional trauma lateralize the effects, perhaps in an effort to maintain more-or-less-normal functioning. One hemisphere or the other gets stuck in the past, says Schiffer, and acts out through the patient's symptoms. His goal is integration of these two minds into a kind of team by using clever manipulation of sensory stimuli and other tools of cognitive science.
Of Two Minds is unusual in its acceptance of both scientific and emotional validity. Alternating reviews of the data with often heart-wrenching transcripts of therapy sessions, it offers a two-pronged assault on what seems to be a dual-natured problem. While it might not solve your "roommate problem" overnight, it may start you on the road to reconciliation. --Rob Lightner
From Publishers Weekly
Copyright 1998 Reed Business Information, Inc.
From Library Journal
Copyright 1998 Reed Business Information, Inc.
From The New England Journal of Medicine
Schiffer's theory stems from his work with patients. He has observed that patients appear to be dominated by different personalities at different times -- sometimes by mature, reasonable, patient, self-confident personalities, and sometimes by insecure, anxious, self-denigrating, primitive personalities. The notion of more than one personality in one person is not new. Clinicians have written about the "inner child" and the "unconscious mind" for a long time. However, Schiffer's approach is new -- he links the dual minds with the hemispheres of the brain.
Schiffer decided to try to communicate directly with a single hemisphere after learning of an experiment conducted in Germany. In this experiment, different emotional responses were elicited in normal persons when movies were directed to one hemisphere or the other. This experiment prompted Schiffer to construct two sets of eyeglasses: one with lenses that were opaque except at the extreme left side and one with lenses that were opaque except at the extreme right side. The glasses directed all visual input to a single hemisphere of the brain. Schiffer asked patients to put on one set of glasses and tell him what they experienced. He then asked them to put on the other set of glasses and tell him what they experienced. He observed that for a substantial number of patients, one set of glasses tended to have a calming effect, whereas the other set caused patients to feel depressed, edgy, anxious, or agitated. With the use of the glasses, Schiffer developed a psychotherapeutic approach that involved speaking directly to the troubled mind (hemisphere). Over time, he observed clinical improvement. Schiffer states, "The aim of `dual-brain' therapy is to mend the archaic, destructive ideas and emotions of the mind on the troubled side, to teach it that it is safer and more valuable than it learned during some traumatic experiences.... I teach patients how to recognize and listen for the mind in their troubled hemisphere, and then how to speak to it -- out loud!" On the basis of these experiences, he reasons that there are two minds, each with a distinct personality associated with one hemisphere, and that an imbalance between them is responsible for mental illness.
Schiffer postulates that major psychiatric illnesses can result from problems with brain laterality. For example, depression may stem from an experience in early childhood, a time of extreme vulnerability, defenselessness, and dependency. Trauma during this period, according to Schiffer, is retained in the mind of one hemisphere. Depression comes from the defensiveness and the despondency associated with the memory of this experience in the one hemisphere. Treatment involves communicating directly with the troubled hemisphere by using the eyeglasses in a healing manner. When both sides of the brain are healthy, the depression subsides.
Schiffer describes other major psychiatric conditions from the standpoint of the laterality of the brain. His psychoanalytic background leads him to emphasize early trauma in the pathogenesis of psychiatric illnesses, trauma that is visited on one hemisphere.
The science on which brain laterality is based is extensive. Several decades ago, Roger Sperry demonstrated the existence of distinct "minds" in humans and in animals in which communication between the hemispheres was disrupted. He received a Nobel prize for this work. As an example of the "split brain," Schiffer describes a patient of Sperry's who was awakened from a sound sleep by her left hand slapping her across the face. "The patient had overslept, and the right mind must have awakened, realized the time, and tried to rouse her."
This book is bold, interesting, and ambitious. At times, it makes scientific leaps whose logic is hard to follow. The descriptions of the neurobiology of depression, schizophrenia, drug addiction, panic disorder, and bipolar illness are somewhat superficial. The key biologic link between laterality and mental illness needs substantially more elucidation to be convincing. Thus, in the end, the book is more provocative than scientific, but it is well worth reading.
Reviewed by Robert M.A. Hirschfeld, M.D.
Copyright © 1999 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
From Kirkus Reviews
Excerpt. © Reprinted by permission. All rights reserved.
Chapter 1: Introduction
She is in despair. Her life is a shambles. She can't think straight, and the anxiety she feels seems to bury her. She has spent two weeks in bed, and there she cries most of the time. She doesn't know what has overtaken her. Nothing -- not her business failure, not the divorce she sought, not her new relationship -- seems even vaguely proportional to her distress.
My first contact with Carol was through her brother, who urged me over the phone to hospitalize her. "She's flipped out," he told me. I asked him to bring her over to my office instead.
Carol seemed to hide beneath her straggly hair, partially covering her naturally pretty dark eyes, now red from crying. She was handsome in spite of her condition. She was no longer crying, and she was cooperative and trying to be pleasant. Carol was in touch with reality. She clearly saw her distress but had no clue about what suddenly brought this great, escalating turmoil into her life several weeks ago. Her life for the past thirty years certainly had been troubled at times, but never before had she been in quite so much distress.
I liked Carol, and I think I had a good sense of the despair she had been experiencing. We seemed to make a good emotional connection. As we discussed her distress, I pushed her to try to see when she had felt this way before, and she discovered to her surprise that as a child she had experienced similar periods of distress.
I asked her to describe her family life in her childhood, and it became clear to us as she spoke that frequently she felt emotionally abandoned and betrayed by her parents. There was clearly a connection between her early distress and that perception of estrangement.
I wanted to see if her present despair might somehow parallel that of her childhood. She began to understand that about a month earlier, when her divorce became final and her business failed outright, she started to feel abandoned and unsupported emotionally. And just as she had as a child, Carol blamed herself, certain she was somehow bad, defective, or at the very least at fault, to warrant the perceived abandonment. Carol's present-day despair seemed related to the anxiety of feeling abandoned and metaphorically left to suffer a painful psychological death, compounded by the pain of believing she was so repugnant as a person as to deserve such treatment and its terrible consequences.
Carol was fighting constantly with her new boyfriend, a man she loved dearly and who loved her in return. She was continually accusing him of not loving her, and her behavior was becoming unbearable for him. She was effectively pushing him away, which only intensified her sense of abandonment. Remarkably, Carol was able to see and appreciate all this.
At this point, I said, "But I think there's another part of you that knows that Mike loves you."
"Yes, I know that."
At that point I explained my hypothesis because I didn't feel I could wait a few years for her to come to it in her own time. I wanted to bring some clarity and structure into the session right then. I told Carol that there was a part of her personality that was immature, troubled, and panicking, and it had been taking control of her life. I explained that she might also have another part of her personality, one more mature and grounded, but it was being pushed aside now. Carol told me that she could actually feel that struggle within; she had periods when she felt calm and in control, but then even those times were disrupted by overwhelming feelings of anxiety.
"I am going to talk with your troubled-sided personality," I told her. "I can see that this part of you is extremely frightened and upset. I know you [her troubled side] don't yet understand why you are so distressed, but I and your more mature side will help you to understand yourself. Right now, I want you to stop attacking Carol. I want you to let your mature side lead; otherwise your life will continue crashing off course." My tone was caring, firm, forceful.
To Carol's surprise, her symptoms suddenly abated, leaving her calm and in control. Although I didn't expect this remission to last more than a few minutes, its occurrence set out the blueprint for what was to follow in our work together. We interpreted her response as her troubled mind's listening and deciding to cooperate. It was in essence, I believed, her troubled mind's nonverbal response to what I had said.
I explained to Carol that I believe we have two minds, much as Steve Martin and Lily Tomlin are comically portrayed as living and struggling together within the head of one person in All of Me. In my view, Carol had a mature part that knew she was essentially safe and well regarded in spite of the business failure -- more of an insult to her pride than her pocketbook -- and in spite of the divorce she struggled so hard to achieve. But Carol had another mind that knew she was utterly alone and on the verge of a long-awaited destruction. She acknowledged that she had been living in that mind for the past month. Finally, I shared my idea that in life, these two parts of our mind can struggle or cooperate, and that apparently in the past month, her immature part had assumed a dominant role in her personality. In time Carol and I would explore why this switch occurred at this turn in her life, but for now I just wanted to offer a diagram for what had been happening to her and, from that map, a direction back to mental stability.
I next asked Carol to try on a pair of plastic safety glasses taped over the front so that she could see only out of the extreme right side of her right eye. She looked at me skeptically, as if I might need help myself. I simply asked her what she was experiencing. In a moment she said, with some surprise, that the glasses made her feel calmer and safer. I gave her a second pair almost identical to the first, and I asked her to try them on. The second pair limited her vision to the left side of her left eye. She told me almost immediately that she felt trapped and distressed. Her symptoms were recurring. I asked her to switch again to the first pair, and within seconds she was calmed by that pair.
With this strange exercise, which I will explain in great detail as we proceed, I wanted to help Carol see that the idea of an immature personality's taking over the control of her life was more than a metaphor, more than a vague hypothesis; it was a demonstrable, concrete phenomenon. When I suggested that we talk to the immature part of her from then on, Carol knew from her experience that we were not waxing poetic.
I began teaching Carol how to strengthen her mature mind and how to notice her troubled side -- how to listen to it, how to talk with it, how to get it to cooperate, how to get it to feel better. By the end of her fifty-minute session, her despair was gone. We had begun a therapeutic relationship, and she left with a new understanding and techniques for taking advantage of that insight. Carol wouldn't need hospitalization after all. Although I knew that her troubled side would reassert itself and that this respite would be brief, we had accomplished something dramatic and would be able to return to what we did.
Over the next month, the course of therapy was turbulent as Carol's immature side showed its strength and determination in fits and starts. But steadily we made progress, and after six weeks, she began, for the first time in several months, to feel almost completely like her old self again. By that time Carol could readily feel what she called "my troubled side," and she had become quite skilled at listening to her, disciplining her, and helping her with her fears. Eventually she easily related to this newly discovered troubled part of her, and she found that her relationship to this aspect of her own self was much like her relationships with other people. She