2013/10/01

notes: Why Zebras Don't Get Ulcers

Why Zebras Don't Get Ulcers: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping - Now Revised and Updated

by Robert M. Sapolsky
See this book on Amazon.com


my take: (style influenced by the breathlessly wondrous Sapolsky)

Yes, it's all about the zebras, their lack of affinity for ulcers.

Yes, the book is a truly amazing (amusing, exhausting) chronicle of social- / neuro- biology, what we have learned / surmised / imagined about the nervous system, its basic anatomy / physiology and the way stress affects it (as well as the rest of the body, social group, culture, world) both short and long term (talk about consequences!); the related manipulative / corrective strategies of pharma, physicians, general and psycho-neurologists, clinical psychologists, arm-chair psychologists, alpha-baboons (executives), sociologists, artists, partners, healers, rumor-mongers, and general purveyors of social capital; the sociology, changing views, solutions. Genetics: questions of cause / effect, relationships, heritability, the future re medicine / sociology / profits to be made, heading off disasters of exuberant approach. Principles ("Homeostasis is about tinkering with this valve or that gizmo. Allostasis is about the brain coordinating body-wide changes, often including changes in behavior"). How all this resonates, from/through microscopic to footed-creatures, with a special fixation on humans. All that. Important, wonderful and often course-correcting stuff. (Source, myth, questions of how and why things get mangled.) Politics, geopolitics, (Biopolitics?) .... the idea (quaint, being that of one mid 19 C physician Rudolph Virchow) that "Medicine is social science, and politics nothing but medicine on a large scale... Physicians are the natural attorneys of the poor." The factors / considerations about how poverty might affect all this, and the important (spun, remembered, neglected) corollaries of how attitude, social and personal, might (rich, poor) be surprisingly / cynically relative.

All this. Delivered with humor and humility, questions ever begetting questions. ("Science is not meant to cure us of mystery, but to reinvent and reinvigorate it.")

Sapolsky really is one of my heroes.

But what I really learned from this book is exactly (especially the last paragraph) what I need to learn and apply. To ME. From his conclusion:

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Sometimes, coping with stress consists of blowing down walls. But sometimes it consists of being a blade of grass, buffeted and bent by the wind but still standing when the wind is long gone. Stress is not everywhere. Every twinge of dysfunction in our bodies is not a manifestation of stress-related disease. It is true that the real world is full of bad things that we can finesse away by altering our outlook and psychological makeup, but it is also full of awful things that cannot be eliminated by a change in attitude, no matter how heroically, fervently, complexly, or ritualistically we may wish. Once we are actually sick with the illness, the fantasy of which keeps us anxiously awake at two in the morning, the things that will save us have little to do with the content of this book. Once we have that cardiac arrest, once a tumor has metastasized, once our brain has been badly deprived of oxygen, little about our psychological outlook is likely to help. We have entered the realm where someone else—a highly trained physician—must use the most high-tech of appropriate medical interventions. 
These caveats must be emphasized repeatedly in teaching what cures to seek and what attributions to make when confronted with many diseases. But amid this caution, there remains a whole realm of health and disease that is sensitive to the quality of our minds—our thoughts and emotions and behaviors. And sometimes whether or not we become sick with the diseases that frighten us at two in the morning will reflect this realm of the mind. It is here that we must turn from the physicians and their ability to clean up the mess afterward and recognize our own capacity to prevent some of these problems beforehand in the small steps with which we live our everyday lives. 
Perhaps I’m beginning to sound like your grandmother, advising you to be happy and not to worry so much. This advice may sound platitudinous, trivial, or both. But change the way even a rat perceives its world, and you dramatically alter the likelihood of its getting a disease. These ideas are no mere truisms. They are powerful, potentially liberating forces to be harnessed. As a physiologist who has studied stress for many years, I clearly see that the physiology of the system is often no more decisive than the psychology. We return to the catalogue at the beginning of the first chapter, the things we all find stressful—traffic jams, money worries, overwork, the anxieties of relationships. Few of them are “real” in the sense that that zebra or that lion would understand. In our privileged lives, we are uniquely smart enough to have invented these stressors and uniquely foolish enough to have let them, too often, dominate our lives. Surely we have the potential to be uniquely wise enough to banish their stressful hold. 
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It's the wisdom of Sophocles: Bend, not break.

(and live to fight another day.)

Aha.

Yes -- he's on youtube and Ted.

This is the last lecture -- if you get time, watch it, even if just from 38 minutes on. The whole great wisdom of perspective and tolerance:

http://www.youtube.com/watch?v=-PpDq1WUtAw&feature=player_embedded#!

The original baboon stress doc:

http://www.youtube.com/watch?feature=player_embedded&v=eYG0ZuTv5rs

Ted:

http://www.ted.com/speakers/robert_sapolsky.html


Best, Deborah
Shared Notes & Highlights




Shared Notes & Highlights
300

  1. Deborah Conner highlighted:
    People with a strong internal locus of control (in other words, people who think they are the masters of their own ship—that what goes on around them reflects their actions) have far greater stress-responses than do those with external loci when confronted with something uncontrollable. This is a particular risk for the elderly (especially elderly men) as life generates more and more things beyond their control. As we will see in the final chapter, there is even a personality type whose tendency to internalize control in the face of bad, uncontrollable things greatly increases the risk of a particular disease.

  2. Deborah Conner highlighted:
    We have now seen some interesting contrasts between glucocorticoids and the catecholamines (epinephrine and norepinephrine). Chapter 2 emphasized how the former defend you against stressors by handing out guns from the gun locker within seconds, in contrast to glucocorticoids, which defend you by constructing new weapons over the course of minutes to hours. Or there can be an elaboration of this time course, in which catecholamines mediate the response to a current stressor while glucocorticoids mediate preparation for the next stressor. When it comes to psychiatric disorders, it seems that increases in the catecholamines have something to do with still trying to cope and the effort that involves, where overabundance of glucocorticoids seems more of a signal of having given up on attempting to cope.

  3. Deborah Conner highlighted:
    Joseph LeDoux of New York University, who pretty much put the amygdala on the map when it comes to anxiety, has constructed a remarkable model out of these findings. Suppose a major traumatic stressor occurs, of a sufficient magnitude to disrupt hippocampal function while enhancing amygdaloid function. At some later point, in a similar setting, you have an anxious, autonomic state, agitated and fearful, and you haven’t a clue why—this is because you never consolidated memories of the event via your hippocampus while your amygdala-mediated autonomic pathways sure as hell remember. This is a version of free-floating anxiety.

  4. Deborah Conner: Continue below
    Toward the end of the first chapter, I voiced a caveat—when I discuss a way in which stress can make you sick, that is merely shorthand for discussing how stress can make you more likely to get diseases that make you sick. That was basically a first pass at a reconciliation between two very different camps that think about poor health. At one extreme, you have the mainstream medical crowd that is concerned with reductive biology. For them, poor health revolves around issues of bacteria, viruses, genetic mutations, and so on. At the other extreme are the folks anchored in mind-body issues, for whom poor health is about psychological stress, lack of control and efficacy, and so on. A lot of this book has, as one of its goals, tried to develop further links between those two viewpoints. This has come in the form of showing how sensitive reductive biology can be to some of those psychological factors, and exploring the mechanisms that account for this. And it has come in the form of criticizing the extremes of both camps: on the one hand, trying to make clear how limiting it is to believe that humans can ever be reduced to a DNA sequence, and on the other, trying to indicate the damaging idiocy of denying the realities of human physiology and disease. The ideal resolution harks back to the wisdom of Herbert Weiner, as discussed in chapter 8, that disease, even the most reductive of diseases, cannot be appreciated without

  5. Deborah Conner highlighted:
    considering the person who is ill. Terrific; we’re finally getting somewhere. But this analysis, and most pages of this book up until now, have left out a third leg in this stool—the idea that poor health also has something to do with poor jobs in a shrinking economy, or a diet funded by food stamps with too many meals consisting of Coke and Cheetos, or living in a crummy overcrowded apartment close to a toxic waste dump or without enough heat in winter. Let alone living on the streets or in a refugee camp or a war zone. If we can’t consider disease outside the context of the person who is ill, we also can’t consider it outside the context of the society in which that person has gotten ill, and that person’s place in that society.

  6. Deborah Conner highlighted:
    while rank is an important predictor of individual differences in the stress-response, the meaning of that rank, the psychological baggage that accompanies it in a particular society, is at least as important. Another

  7. Deborah Conner highlighted:
    Peter Sterling, of allostasis fame, has written brilliantly about how our sources of pleasure have become so narrowed and artificially strong. His thinking centers around the fact that our anticipatory pleasure pathway is stimulated by many different things. For this to work, the pathway must rapidly habituate, must desensitize to any given source that has stimulated it, so that it is prepared to respond to the next stimulant. But unnaturally strong explosions of synthetic experience and sensation and pleasure evoke unnaturally strong degrees of habituation. This has two consequences. As the first, soon we hardly notice anymore the fleeting whispers of pleasure caused by leaves in autumn, or by the lingering glance of the right person, or by the promise of reward that will come after a long, difficult, and worthy task. The other consequence is that, after awhile, we even habituate to those artificial deluges of intensity and moment-ness. If we were nothing but machines of local homeostatic regulation, as we consume more, we would desire less. But instead, our tragedy is that we just become hungrier. More and faster and stronger. “Now” isn’t as good as it used to be, and won’t suffice tomorrow.

  8. Deborah Conner highlighted:
    This is the essence of play. You surrender some degree of control—

  9. Deborah Conner highlighted:
    There are extremely different ways of looking at the world, and researchers and clinicians from different orientations often don’t have a word to say to one another about their mutual interest in depression. Sometimes they seem to be talking radically different languages—psychodynamic ambivalence versus neurotransmitter autoreceptors, cognitive overgeneralization versus allelic variants of genes. What I view as the main point of this chapter is that stress is the unifying theme that pulls together these disparate threads of biology and psychology.
  10. Deborah Conner highlighted:
    Taylor argues convincingly that the physiology of the stress-response can be quite different in females, built around the fact that in most species, females are typically less aggressive than males, and that having dependent young often precludes the option of flight. Showing that she can match the good old boys at coming up with a snappy sound bite, Taylor suggests that rather than the female stress-response being about fight-or-flight, it’s about “tend and befriend”—taking care of her young and seeking social affiliation.

    more from the last chapter...


    In the face of terrible news beyond control, beyond prevention, beyond healing, those who are able to find the means to deny tend to cope best. Such denial is not only permitted, it may be the only means of sanity; truth and mental health often go hand in hand, but not necessarily in situations like these. In the face of lesser problems, one should hope, but protectively and rationally. Find ways to view even the most stressful of situations as holding the promise of improvement but do not deny the possibility that things will not improve. Balance these two opposing trends carefully. Hope for the best and let that dominate most of your emotions, but at the same time let one small piece of you prepare for the worst.


    Those who cope with stress successfully tend to seek control in the face of present stressors but do not try to control things that have already come to pass. They do not try to control future events that are uncontrollable and do not try to fix things that are not broken or that are broken beyond repair. When faced with the large wall of a stressor, it is great if there emerges one singular solution that makes the wall crumble. But often, a solution instead will be a series of footholds of control, each one small but still capable of giving support, that will allow you to scale the wall.


    It is generally helpful to seek predictable, accurate information. However, such information is not useful if it comes too soon or too late, if it is unnecessary, if there is so much information that it is stressful in and of itself, or if the information is about news far worse than one wants to know. Find that outlet for your frustrations and do it regularly. Make the outlet benign to those around you—one should not give ulcers in order to avoid getting them. Read the fine print and the ingredient list on each new form of supposed anti-stress salvation, be skeptical of hype, figure out what works for you.


    It is important to find sources of social affiliation and support. Even in our obsessively individualistic society, most of us yearn to feel part of something larger than ourselves. But one should not mistake true affiliation and support for mere socializing. A person can feel vastly lonely in a vast crowd or when faced with a supposed intimate who has proved to be a stranger. Be patient; most of us spend a lifetime learning how to be truly good friends and spouses.


    Some of these ideas are encompassed in Reinhold Niebuhr’s famous prayer, adopted by Alcoholics Anonymous: God grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. Have the wisdom to pick your battles. And once you have, the flexibility and resiliency of strategies to use in those battles is summarized in something I once heard in a Quaker meeting:


    In the face of strong winds, let me be a blade of grass. In the face of strong walls, let me be a gale of wind
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Beyond genes: Are centrioles carriers of biological information?

Date:
April 24, 2015
Source:
Ecole Polytechnique Fédérale de Lausanne
Summary:
Scientists have discover that certain cell structures, the centrioles, could act as information carriers throughout cell generations. The discovery raises the possibility that transmission of biological information could involve more than just genes. Centrioles may actually be carriers of information, which holds profound implications for biology and disease treatment.
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