Customer Reviews

A User's Guide to the Brain: Perception, Attention and the Four Theaters of the Brain

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"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."

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.

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.

I really enjoyed User's Guide. The book is insightful for readers of (almost) all levels of education. Ratley takes the reader artfully through the processes of perception, attention and behavior. I rarely read a book written for a popular audience that is readable and accurate. While fulfilling the message of the book you also are treated to a clear understanding of how important perception is to each individual's life. You will begin to understand many problems people suffer from who do not have "normal" perception and what is being done to help those people. I really liked this book. Kevin Hogan...

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.

I found reading this book to go fairly slowly, yet every time I thought it would get boring so that I could skip a section, it became fascinating instead! This is a very dense book, yet it is not boring. The author, a Harvard psychiatry professor, states at the beginning that he is writing this book for everyone and that everyone will be able to understand it. He does a good job of explaining all of the complex concepts, of which there are many in connection with the study of the brain.

The book is an up-to-date explanation of the current knowledge and research about the brain. The new knowledge deepens our understanding and adds insights into brain function and its affect on our lives. The more we know about how the brain works, the better we can understand the problems caused by malfunctions in the brain. Numerous case studies are presented to show how new knowledge has helped us better understand specific brain problems that might have been previously categorized or "lumped" into some almost unrelated illness. In some cases, new knowledge helped the patient to solve debilitating problems and lead a much improved life.

Ratey goes into a lot of detail. In the chapter on perception, he explains that the nostrils are placed above and close to the mouth to help us avoid eating poisonous things, even if we don't realize the danger until the very last possible moment before putting the item into our mouth. He includes lots of similar little tidbits of information that seem like standard knowledge but are new; I know I never learned them! We should all know everything in this book! A new finding about learning can help everyone. Researchers at Johns Hopkins recently found that learning a new motor skill is solidified best if the skill is learned and then practiced again after 5 or 6 hours, with no further new skill learning in between. I sent this bit of news to my college daughter who is learning to play the piano!

Ratey seems to cover all the newest studies on a wide range of aspects of the brain. He goes into detail about the parts of the brain responsible for various functions. The major sections of the book are development, perception, attention and consciousness, movement, memory, emotion, language, and the social brain. There is a lot of discussion about the amygdala in the sections on emotions. I feel that I would need to reread some of this to understand it thoroughly, as parts of the brain are mentioned which I previously knew nothing about, ie, the anterior cingulate gyrus, which plays key roles in emotions. The neurotransmitters are given their due, too, though medications are not discussed in detail.

Ratey stops short of chemical terms with subscripts (those gamma chemicals), which is where I usually become overwhelmed. I can absorb the information in this book with effort. I think that a psychiatrist would find this book a useful way to glean a summary of the current status of the research on the brain. I think a psychiatrist should want to know everything in this book! Some sections and even some short passages might be of particular interest to some patients, too. For someone with a strong medical/psychiatric background and interest in the subject, this well-written book might be a worthwhile page-turner, with important new information and clarification of emerging concepts.

Just shy of 400 pages this is a book I want the smart women to read. Yes, men should read it to, but I simply feel that as a woman some people, often other women are put off by women with great brains.

Ten Chapters that cover Development, Perception, Attention and Consciousness, Movement, Memory, Emotion, Language, The Social Brain, The Four Theatres, Care and Feeding.

And his notation beginning on page 114 about the Triage mind as medical professionals often say we (we who are in the circle of friends and colleagues) have, is about Arouse, Orient, Detect, Execute is utterly engrossing. And on page 251 where he speaks of the popular fad of Emotional intelligence as an attract concept because it can provide a convenient scapegoat for today's epidemics of violent crime, marital strife and teen age drug abuse as a start, is wise and telling.

On page 274 he gives a simple lateralization concept test that the reader can take to see how the right and left brain react differently to action combined with verbal work. Was happy to see that the suggestion of a trusted friend that I was equally righ-left brained was true (laughing) and that yes, I am linguistically ambidextrous as well.

In discussing the Four Theatres he also reminds the reader that it is regaining popularity amongst medical professionals. The First being Perception, the Second is Attention and Consciousness and issues involving Cognitive issues like survival skills. The Third is Brain Function and the Fourth is Identity and Behavior.

In Care and Feeding he speaks about the real importance of reading to children at an early age and continuing to read books etc that challenge the brain and not simply fill it with mush.

And exercise! On page 359 he gives some excellent insight into how important exercise is to a healthy min. And as he notes "Obviously, exercise improves the body, but some of the most exciting new findings point to the positive effect exercise can have on mental health. First of all, it increases the amount of blood that gets to the brain. And it has been shown that it can augment the number and density of the blood vessels in the areas that need them the most: the motor cortex and cerebellum. Thus, in addition to its well-known effect of increasing blood vessels and improving circulation in the heart, it seems that exercise or activity has a similar effect on the brain."

Better self-esteem he notes is also a known effect of exercise and that females of all ages who regularly take part in sports and exercise have a more positive self image and less depression as well.

He then notes there have been more than 1,000 studies on the effect on mental health. That short sessions of vigorous aerobic exercise, usually lasting for several weeks seem to have the most helpful effect on moderate to mild forms of depression. He notes a 1994 Harvard study that found men who burn 2500 calories a day in aerobic activity which can be running walking fast, etc., were 28% less likely to develop clinical depression than less active men.

He also notes that vigorous exercise also involves learning complex movements that also challenge the brain. And then on page 316 he speaks of the importance of movement in general, and how it effects motor skills. And that inactivity and stagnation can hasten the decline of mental abilities.

And lastly he speaks of mental work outs and how important it is to think outside the box and read things that are different and that will cause the neurons to work. That people who are doing new things and trying new things, constantly reading and not watching TV or staying in ones comfort zone are the ones who live the fullest and mentally healthiest lives.

Before reading this book I did know not very much about the brain. Dr Ratey's analogies and metaphors were very well thought out and helped me to understand the brain and the way it works in a way I had never understood it before. Thanks for making such a difficult and complicated subject so clear!

Honestly, I expected a dry, but informative book. John J. Ratey takes on neuropsychology with stories and examples that anyone can understand. Diversity, folks, includes more than just race, gender, and age. It's also about creating dynamic, effective groups by bringing together people that perceive and process information differently. Don't skip over this one if you're in HR, management, or lead teams.

"A User's Guide to the Brain" is an intriguing essay on the mind, as the subtitle implies: Perception, Attention and the Four Theatres of the Brain. Written in 2001, the 401 pages over ten chapters is more of Dr. Ratey's personal memoirs and anecdotes written in the first person than a medically written essay without any interjected opinions or afterthoughts, which is more of what I was hoping to find. Dr. Ratey, however, makes several claims and refers to several papers without the much needed citations that allow the reader to follow in the doctor's footsteps.

For example, on page 109, Dr. Ratey states, "There are countless reports in history about people with an extraordinary ability to know where they are going: pathfinders, guides, mariners, pioneers..." Being more of a general statement, it would not be reasonable for the reader to expect the author to cite the "countless reports," but in the next paragraph, Dr. Ratey states, "Joseph Kirschvink and researchers at the California Institute of Technology have identified the same kind of magnetite particles in human brain tissue." At the end of this statement, a footnote or an endnote should follow immediately, or at least an APA reference that allows the reader to investigate the claim further. It seems that the author's unwillingness to cite his sources means he expects his readers to believe whatever he says, and I understand I make take a few unhelpfuls for that, but when it comes to making a claim about a study, find or statistic, professional writing demands that such claims be backed up with a footnote, endnote or bibliographic reference. For general knowledge, a writer could do it all day long. But with medial science, no way.

Another example of a missing citation: page 263, paragraph 2. "Researchers Jenny Saffran and colleagues at the University of Rochester reveal a study showing that infants' learning ability may greatly exceed previous expectations." Which study? No reference, no citation, no follow-up possible.

On page 373: "One recent advance that seems straight out of science fiction is transcranial magnetic stimulation (TMS)...Twelve patients diagnosed with OCD were given the stimulation at several different points on their skulls. The patients found that stimulation to the frontal lobe on the right side of the head resulted in a reduction in compulsions and an improved mood." Right there, at the end of that sentence, there needs to be a citation or link to the aforementioned "transcranial magnetic stimulation."--otherwise, as the author states, it might just _be_ science fiction. It's not? No? Then cite the source. In the very next statement, Dr. Ratey even mentions indirectly that his omissions are intentional: "More research needs to be completed before we truly understand the possibilities of this new technology." Dr. Ratey, it is your job as the writer to do that research. The reader's job is to be excited with your presentation and follow your work, not to do your work for you.

The missing citations are more of the fault of the editors at Pantheon books. I'm surprised the manuscript ever got past the senior editor. Until the myriad of missing citations are put into a revised first edition of "A User's Guide to the Brain," unfortunately, Dr. Ratey's work here cannot be accepted as conclusive. To avoid work, Dr. Ratey included a "suggested reading" list in the back, which conveniently frees him of his responsibility as an author. This type of text would be much improved and vastly more accepted if it were strictly a third person narrative. Otherwise, it's mostly hearsay, although we would like to believe Dr. Ratey has no intention to deceive his audience, credibility demands that no non-general claims are left unsubstantiated.