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65 of 66 people found the following review helpful:
5.0 out of 5 stars
A revolution in the making, April 21, 2002
This review is from: A User's Guide to the Brain: Perception, Attention and the Four Theaters of the Brain (Hardcover)
"Mental problems, from hot temper to laziness, from chronic worry to excessive drinking, all have roots in the biology of the brain." (p. 357) This is a report on a revolution taking place in neuroscience, psychiatry, psychology and kindred disciplines. The old paradigms are crumbling under the onslaught of a new understanding of how the brain really works. Harvard Medical School psychiatrist John J. Ratey's "guide" (it's more than that) is an admirable exercise in bringing us up to date on what is happening in brain science--what we suspect, what we know, and how this knowledge is affecting clinical practice. In a sense Ratey's book is a report on a new paradigm. It is biology-based and relies first and foremost on the physiology of the brain and body as they have developed over time. Gone are the artificial constructs of Freudian psychology and the very limited black-box psychology of behaviorism. The new psychology is based on opening that black box and looking inside. Of course what we find there is enormously complex, and we are, to use Ratey's expression (p. 124), "still on the first step of a very long staircase." Yet, because of the growing power of neuroscience to study and access the living brain in ways that were impossible just a few years ago, we are entering an exciting time, full of hope and wonder. As Dr. Ratey explains in "Acknowledgments," this book began as a cooperative research effort by many people toward writing a "primer on the brain for mental health professionals." Then it was suggested by Pantheon editor Linda Healey that a smaller version "that would try to instruct the public at large" be written. A professional science writer, Mark Fischetti, was hired and schooled. The result is a book written in an engaging and very readable manner. However, its organization--neat and reasonable as it is--actually detracts from the book's effectiveness because the most interesting and helpful chapters are near the end. I realize that Ratey and his editors and writers came to the conclusion that the material in the last three chapters, "The Social Brain," "The Four Theaters," and "Care and Feeding" could be better appreciated after having read the more fundamental material in the first seven chapters. Nonetheless I believe that a lot of people who would benefit from this very fine book will not get to those chapters. Too bad. Ratey's metaphor of the four theaters is a powerful tool for incorporating and understanding the new paradigm, while the final chapter gives us some very excellent advice on how to live fully while keeping the brain and our systems healthy. Consequently I would propose that when Dr. Ratey updates this book (and I hope he will; there is so much happening in neuroscience that some of the information here will be dated in just a few years) that he structure the book so that it begins with Chapter 9, "The Four Theaters," followed by Chapter 8, "The Social Brain," and then the first seven chapters, concluding with the advice in Chapter 10, "Care and Feeding." For the reader, I recommend reading Chapter 9 first so that you can immediately share in the excitement that is at the heart of the book. The "theaters," by the way, should be understood as "theaters of operations" and not theaters where movies might be shown. (Originally Ratey had used "kingdoms of the brain" as his metaphor.) The theaters are (1) perception; (2) attention, consciousness and cognition; (3) brain function (memory, emotion, movement, etc.); and (4) behavior and identity. He sees a flow of consequence (like a river) from perception to attention to function to behavior. He argues persuasively that the brain is a holistically operating entity that is constantly being changed by its interaction with the environment, a dynamic organism that is forever learning, making new perceptions and adjustments. Things can go wrong in any one of the theaters and what happens in any theater affects the other theaters down river (and even up river). What I found particularly interesting is the new approach to diagnostics and therapy this understanding affords. A good example is on pages 347-349 where Ratey tells the story of Theresa who was slow to learn, unsocial and awkward in sports. Instead of some disorder out of DSM-IV being plastered on her forehead, Ratey found that she had a perception problem, and he demonstrated how her social and functional problems stemmed from that "first theater" problem. Ratey emphasizes freeing the patient from self-doubt and personal blame for whatever the problem may be, and always looks for a biological cause first. Some bits of wisdom from the best chapter in the book, from pages 353-355: "Modern medical practice tends to regard patients' self-evaluations as too tainted by subjectivity, but this is a grave error." "It is quite beyond the average patient's ability, within the framework of...insight-oriented therapies, to pinpoint the true source of unhappiness and frustration." "Prozac is hardly a remedy for the self-blame, lost opportunities, and intellectual insecurity of a lifetime compromised by unrecognized perceptual and cognitive deficits." "We have to begin to think of the brain as a self-organizing ecosystem, one of such staggering complexity and delicate balance that almost any aspect of a patient's life may be relevant to a diagnosis or essential to treatment." "[T]he clinician's duty...includes devoting more time to looking for what is good in patients' lives, for the strengths and talents that are not yet being fully realized, and for the secret pleasures and sources of happiness that they have never allowed themselves." "We in psychiatry continually risk mistaking our labels for the disorders themselves." "The brain's processes can be utterly transformed by self-discovery and the right pursuits in life."
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54 of 57 people found the following review helpful:
5.0 out of 5 stars
Its YOUR brain! Use it or lose it!, January 26, 2001
This review is from: A User's Guide to the Brain: Perception, Attention and the Four Theaters of the Brain (Hardcover)
Do yourself a favor and read this book. Even better, do your doctor a favor and give a copy of this book to her or him. It's your brain, and you want to know how to care for it, tune it, nurture it and protect it. This sophisticated book -- up to date in the year 2001 -- and in remarkably clear and plain English -- and in amazing detail -- will tell you much that you need to know. And provide you a framework within which you can integrate future knowledge. When the next edition comes out, within a few years, you will want to read that one too. January 1, 2001 marked the end of 'The Decade of the Brain' -- ten years of brain-based research focusing upon neuroscience, neuroanatomy, neurophenomenology, psychopharmacology, psychiatry and neural functioning. While this massive undertaking has been somewhat overshadowed by even more massive investigations of the human genome, it is likely that advances from brain research will have a greater impact on your life and your health. Dr. John Ratey, a Harvard Medical School professor and author or co-author of other well received previous books on neuropsychiatric conditions (eg, 'Driven to Distraction'), explains why and how, and in language that you can read even if you didn't study biology in college. Yet he never speaks down to the reader -- I am a professional medical educator myself, and I am sufficiently impressed by the breadth and depth of this book that I will recommend it to my students and colleagues. Growing knowledge about the brain is transforming our understanding of ourselves and our world, and Dr. Ratey is able to convey this information to the reader through lively descriptions and stories and through enlightening clinical vignettes. The book is organized in a manner that is straightforward and incremental. Starting with 'perception', chapters go on to encompass 'attention and consciousness', 'movement', 'memory', 'emotion', 'language' and 'the social brain'. These are well written and informative and never boring or abstruse, with plenty of case examples taken from Dr. Ratey's practice or from autobiographical and biographical stories in the literature. For example, Temple Grandin is a middle-aged woman with an active professional and social life who overcame many limits of her well-diagnosed autism by self-observation, tenacity, and a disciplined, original, self-determined approach to her disorder. Another example, Rickie, is the daughter of an eminent psychiatrist who was frequently hospitalized for schizophrenia until it was discovered that this diagnosis was simply incorrect. Instead, Rickie suffered from an unusual perceptual problem which could be sufficiently remedied with special glasses so that she could begin a career as a rehabilitation counselor and also marry and raise children. Stories such as these are not only wonderful and humane, they are well told and instructive and the insights gleaned from them are used by Dr. Ratey to teach us about the brain, how it works, what can go wrong, what can be done about it, and most importantly, what we can do about it. The brain, the reader learns, is certainly not a digital computer. It is an organ that provides us with access to a world and to other people as well as with the capacity to move through this world and to interact with it. The systems of the brain shape our emotions, our actions and reactions, and our identity. Furthermore, it is now very clear that our brain can be molded and cared for by us, its 'user', in a manner that can enrich our lives and expand our possibilities and potentialities. Or, with poor care, constrict these possibilities. The book ends with a section on the four 'theaters' of the brain, a framework for understanding that encompasses traditional medical as well as more holistic approaches to healing. Finally, there is a section on the 'care and feeding' of the brain that is as practical as it is profound. You will benefit from this book. Your brain will benefit as you --the user -- come to understand better how this miraculous organ works and what you can do to keep it going and to enhance its performance. Besides, you will enjoy a book that is a masterful and humane read.
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37 of 38 people found the following review helpful:
4.0 out of 5 stars
A User's Guide to the Brain, March 23, 2001
This review is from: A User's Guide to the Brain: Perception, Attention and the Four Theaters of the Brain (Hardcover)
Ratey explores and explains the brain in his newest book. Along the way, he introduces us to Temple Grandin, an autistic-savant with a photographic memory, a group of nuns that have historically remained mentally and physically active past the age of ninety, and other interesting characters. These characters, their stories and Ratey's style of writing are what make the book work. Let's face it: for such a dynamic organ, most of the books written about the brain tend to be better at curing insomnia than at providing useable information. "I have decided," writes Ratey in the introduction, "that I will have to replace much of the technical language about the brain with a language more akin to what the brain itself uses." Ratey should be commended for his ability to translate. The book is still full of technical information, presented in analogies and metaphores that are easily understood. Personal stories provide a very human feel. Ratey divides the brain into four theatres: Perception, Attention/Consciousness, Function, and Identity/Behavior. Each of these are explained and illustrated, with attention given to each areas specialty. Most interesting is his pairing of Attention and Consciousness. According to Ratey, these two are intertwined and may actually be the same thing. This is remarkable because we don't know that much about consciousness, yet understanding it is essential to understanding ourselves. "After all," Ratey says, "without consciousness little else that the brain could do would matter." As a person with ADHD, I found this link between consciousness and attention very interesting. As I learned more about my brain, I realized that I was learning much more about myself.
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