Development, Part 1

A User's Guide to the Brain: Perception, Attention, and the Four Theaters of the Brain
by John J. Ratey, M.D.

John Ratey, bestselling author and clinical professor of psychiatry at Harvard Medical School, here lucidly explains the human brain's workings, and paves the way for a better understanding of how the brain affects who we are. Ratey provides insight into the basic structure and chemistry of the brain, and demonstrates how its systems shape our perceptions, emotions, and behavior. By giving us a greater understanding of how the brain responds to the guidance of its user, he provides us with knowledge that can enable us to improve our lives.

In A User's Guide to the Brain, Ratey clearly and succinctly surveys what scientists now know about the brain and how we use it. He looks at the brain as a malleable organ capable of improvement and change, like any muscle, and examines the way specific motor functions might be applied to overcome neural disorders ranging from everyday shyness to autism. Drawing on examples from his practice and from everyday life, Ratey illustrates that the most important lesson we can learn about our brains is how to use them to their maximum potential.

Chapter 1

She was doing it again. That young woman who periodically showed up dressed in a Western shirt and kerchief was standing in front of the automatic sliding doors at the Safeway supermarket. She'd look intently straight ahead, take five abrupt steps toward the doors, and try to restrain herself from walking through until they had fully opened. Sometimes she couldn't stop herself and nearly slammed right into the glass. Other times she'd wait long enough and then lunge through. Regardless, she'd back out and do it again. And again. Regular shoppers at the Phoenix, Arizona, store would hesitate beside her, then scurry past, eyeing her while trying not to stare. Once inside they'd shake their heads and make the usual comments: "Must be insane." They didn't know that Temple Grandin would go on to earn a doctorate in animal sciences and become an internationally recognized expert in animal handling. Or that she was autistic.

Temple had a normal birth, but by the time she was six months old she'd stiffen at her mother's touch and claw to free herself from her mother's hug. Soon she could not stand the feeling of other skin touching hers. A ringing telephone and a car driving by her house while a conversation was going on inside caused such severe confusion and hurt in the toddler's ears that she would tantrum, hitting whoever was within reach.

When she was three the doctors said that Temple had "brain damage." Her parents hired a stern governess, who structured the child's day around physical exercise and repetitive play such as "marching band." Occasionally the routine allowed Temple to focus on what she was doing, even speak. She taught herself to escape the stimuli around her, which caused pain in her overly sensitive nervous system, by daydreaming in pictures of places far away. By the time she reached high school she had made great progress. She could handle some of the academic subjects, and sometimes she could control her hypersensitive reactions to the chaos around her, primarily by shutting down to reduce the constant anxiety and fear. This made the other kids regard her as cold and aloof. She grew agonizingly lonely and would often tantrum or engage in pranks to combat her feelings of rejection. The school expelled her.

When she was sixteen Temple's parents sent her to an aunt's cattle ranch in Arizona. The rigid daily schedule of physical work helped her focus. She became fixated on the cattle chute, a large machine with two big metal plates that would squeeze a cow's sides. The high pressure apparently relaxed the animals, calming them enough for a vet to examine them. She visualized a squeeze machine for herself to give her the tactile stimulation she craved but couldn't get from human contact because the stimulation from physical closeness to another person was too intense, like a tidal wave engulfing her.

By this time Temple and her doctors had realized that she had a photographic memory. She was an autistic savant. When she returned to a special school for gifted children with emotional difficulties-the only school option left-her advisors allowed her to build a human squeeze machine. The project got her hooked on learning mechanical engineering and mathematics and on problem-solving, and she excelled at them all. She built a prototype, and would climb into it and use a lever to control the degree and duration of the pressure on her body. Afterward, she would feel relieved, more empathic, and more in touch with feelings of love and caring, even more tolerant of human touch. She started controlled experiments with the device and became skilled in research and lab techniques-which provided the impetus to apply to college.

Temple's state of hyperarousal and her inability to manage environmental stimuli impaired her ability to cope with the normal surroundings of her family or peers. The repetitive exercises as a child, the squeeze machine, and her academic successes gradually gave her the ability to control her offending behavior. Yet by her late twenties she still had had no success in creating social relationships. She was in a constant state of stage fright. She would get so anxious about approaching someone that she would literally race up and knock the person over, unable to restrain her muscles as she got emotionally energized. If she did manage to stop in time she would stand collar to collar, talking three inches from the person's face, an instant turnoff.

Then Temple put it all together. Walking up to someone in a socially acceptable way was the same as approaching the automatic doors at the supermarket. Both had to be done at the same relaxed pace. So she started showing up at the Safeway. She practiced approaching the doors for hours on end, until the process became automatic. The exercise helped. She found that she could approach people properly if she visualized herself approaching the doors. The doors were like a physical map; they provided a concrete visual picture of an abstract idea about approaching social interactions carefully.

Temple used another rehearsal technique to learn how to negotiate with people, a stressful interaction that usually sent her reeling. She read the New York Times's accounts of the Camp David peace talks conducted by President Jimmy Carter with Egypt's Anwar Sadat and Israel's Menachem Begin. She read every word and memorized them at once; being a savant came in handy. She played the conversations over and over again in her brain, like watching an internal videotape, and used them to guide her own conduct when negotiating with real people.

Today Temple Grandin, at fifty-one, leads a fulfilling professional and social life. It is twenty-five years since her training in front of the Safeway doors, and she has learned to pay attention to certain stimuli while ignoring others so that she does not become overly aroused. She also takes low doses of an antidepressant drug that alleviates her pent-up discomfort even better than the squeeze machine.

Temple resorted to a host of unusual practices to rewire her faulty brain circuits in order to control her conduct. She developed the circuits that enabled her to approach the supermarket doors, and then used these newly trained circuits to help position herself with relation to other people. She mastered each technique with practice, made it automatic, and then applied the newly imprinted pattern to other cognitive skills. Temple developed in adulthood the brain circuits her physical childhood development did not provide.

Excerpted from A User's Guide to the Brain by John J. Ratey, M.D. Copyright © 2002 by John J. Ratey, M.D.. Excerpted by permission of Vintage, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

About the Author

John J. Ratey, M.D., is an associate professor of psychiatry at Harvard Medical School. He has lectured extensively and published many articles on the topic of treating adults with ADD. Dr. Ratey is the author of A User's Guide to the Brain and the co-author of Driven to Distraction. He lives in Cambridge, Massachusetts, where he has a private practice.