Ask Dr. Rick About:

The Body

What causes goose bumps?

I don’t know much about goose bumps except that they are a vestige – “piloerection” – of ancient sympathetic nervous system (SNS) responses to stress, typically used to have the hair of an animal stand up so as to look larger and more threatening. Thus people get goose bumps sometimes when they are scared. Of course, the SNS can also activate with positive arousal, such as the experience of goose bumps during meditation.

What is the role of the heart in our experiences?

To begin with, I think it’s easy to make category errors in confusing the metaphorical and the physical heart. The heart sounds warm and fuzzy while the brain sounds gushy or “head-y.” So it’s tempting to ascribe heartfelt feelings/inclinations to the physical heart even though it’s actually the brain that (still somewhat mysteriously) constructs those feelings and inclinations as experiences in our field of awareness.

As to the physical heart and the brain, there is interesting research on heart rate variability from Dacher Keltner, Heartmath, and other sources. I think sometimes there is an overemphasis on the heart’s influence on the brain and thus our experience of things like warm and loving feelings. Still, clearly there are feedback loops in which cardio-pulmonary processes regulate neural and thus mental activity. In effect, through Heartmath or related methods (e.g., metta practice in Buddhism, devotional practices in Hinduism), one can use the mind to affect the brain to affect the physical heart, which in turn affects the brain, which causes the mind to feel more peaceful/loving/happy. I have not seen research to this effect, but it is certainly plausible that changes in a person’s mental state – such as becoming more loving – involve functional and structural changes in the neuro-fabric of the heart.

Polyvagal theory is also a tremendous resource that indicates linkages between the heart and lungs and the “social engagement system.”

Is an unconscous lip tick a brain/nervous system issue and is there anything I can do to correct it?

It sounds like you have a tic – and the medical fact is that almost everyone, me included, has these little motor habits. The most important thing is to try not to be anxious, stressed, or self-conscious about them. This secondary “collateral damage” cost of the tic is usually the worse thing about them, so try to relax, accept yourself, and keep things in perspective.

Additionally, if you want, you could talk with a therapist specifically about it. Perhaps it increases when you feel tense or there is some other trigger you could be mindful of. Then, as you notice the trigger, you could deliberately bring attention to that part of your body and interrupt the pattern of the tic, and perhaps also disengage from the trigger itself.

From a brain science perspective, tics are perfectly normal, simply a motor habit that gets accidentally acquired. The key to changing them is to disrupt them and acquire a different motor habit such as simply speaking in a normal way without the lip movements.

What suggestions do you have for recovering from a head concussion?

I am no specialist in head injury, but what I have seen myself or heard from people with more experience includes:

  • Take a concussion really seriously.
  • Avoid any further blows to head, even seemingly minor ones.
  • Work with licensed, experienced professionals who really listen to you and take the concussion seriously.
  • Explore neurofeedback.

Overall, treat your brain with kid gloves, such as minimize stress, prevent or reduce inflammation in general, eat brain health foods (e.g., refined fish oil or flax oil), avoid toxins (e.g., stand upwind when pumping gas), and encourage authentic emotionally positive experiences.

Can we use the HEAL method during movement practices? And will this have greater and more lasting benefit?

The HEAL process and the practices within it can be applied to any experience – including somatic and emotional experiences during movement, yoga, dance, Chi Gung, etc. – to increase its registration in the nervous system and thus the lasting gain from it. People may understandably value certain states such as those had while moving compared to other states, such as those had while sitting, and thus look for ways to have them. But once that more beneficial state is occurring, the question remains as to how much durable value it will leave behind in the body in the acquisition of beneficial traits.

Just because a state of being is more somatically or emotionally rich – such as during yoga or somatically oriented psychotherapies – does not necessarily mean that it will lead to more lasting beneficial changes in the body. We need to add the installation phase of learning, which produces lasting change for the better. The installation phase of learning is like the forgotten step-child in psychology, coaching, and human potential trainings – which is why it’s been a primary focus on mine: getter better at installation is where the greatest opportunity lies for steepening the growth curves of most people.

Can consciousness may be located in the body through the fascial system?

In reflecting on the super and perennial question of the nature of consciousness, it helps me to bring this lofty topic down to earth in our close kinship with other animals with a nervous system, such as the birds and squirrels I see out the window of my home office. They are clearly seeing and hearing, feeling pain and pleasure. They are aware of their surroundings, and thus conscious in that sense. The fact that their experiences are simpler than ours does not mean they do not exist. So we can ask of them, what is the basis – the causes and conditions – for their experiences? (By “consciousness” I mean simply the combination of experiences and the field of awareness in which they occur.)

Experiences are intangible. We cannot touch or weigh or box up an experience of the color red. But they still exist. Since they are intangible, they do not have a location per se (a huge and useful point). But their causes and conditions do.

Within the ordinary universe – the “natural frame” – there are many causes and conditions that enable, foster, and shape the experiences of a squirrel . . . or a human typing now on a keyboard. Everything that keeps the body going (food, air, water, etc.) is a factor, plus the environment, culture, society, and all the way back to the Big Bang. Causes and conditions located all over the place.

Within the body, what is happening in various systems such as musculoskeletal tissue certainly affects the experiences a squirrel or person is having. In particular, what is happening in the nervous system, especially its headquarters the brain, strongly influences our experiences – and thus our consciousness.

In fact, the immediate physical basis of experiences such as hearing, seeing, remembering, imagining, thinking, sensing, feeling, wanting, suffering, and awakening is the nervous system. It is a necessary condition for experiences such as these. Without the nervous system, there would be no natural experiences.

As long as it is intact and metabolically active, the brain is the necessary and sufficient basis for experiences.

Taking all this into account, in my view, while experiences and consciousness do not have a location, their causes do. We can assess the influence of different kinds of causes in various ways. Science is certainly not currently able to measure quantitatively and “weight” the influence of various causes on experience. Still, it seems obvious that the primary location of the causes of the consciousness of a squirrel is its brain. And the same is true for every human.

This does not mean ignoring other causes and conditions located elsewhere. It is not either-or, it’s yes-and. And it does not mean conflating the physical location of the brain with metaphors like “heady,” “Spock-like,” “in your head,” “top-down,” etc. The primary location of the causes and conditions of sensations in the big toe as well as experiences of tender lovingness . . . is the brain. So if we care about tender lovingness and other important experiences, well, it’s useful to learn about the brain!

Can you tell me more about the physical health benefits of taking in the good?

Taking in the good has two kinds of benefits: explicitly, it internalizes key positive resources in emotional memory, and implicitly, it involves being active on your own behalf. (Similar sorts of benefits are found with other practices in my book.) Studies have shown that key inner resources such as “an attitude of gratitude,” positive emotions, and skills with your thoughts and feelings all have significant mental and physical health benefits. For example, these resources calm down the stress response, which strengthens your immune system. They also lift well-being and protect against depression.

Further, when you are active on your own behalf, this reduces what’s called “learned helplessness.” You are being a hammer instead of a nail inside your own mind.

Can intense positive emotions be harmful?

There is good research that energizing positive emotions – called “vitality affects” – have particularly beneficial effects on long-term health and thus longevity. Of course, sustained extremes of exuberance bordering on mania are debilitating, but that is rarely a concern since emotional states (distinct from moods) are fairly short-lived. An openness to and gentle encouragement of the causes of energized positive feelings such as joy, hilarity, delight, awe, passionate love, bliss, fascination, and physical pleasure have been important sources of my own healing, well being, and spiritual growth.

Why pursue happiness practices like the ones you suggest rather than pouring 100% of one’s energy into work that saves/elongates lives?

My small answer to your big question is in three parts. First, it is of course not either-or, one can both pursue mental interventions that increase mental health while also pursuing physical interventions that increase physical health. Second, happiness practices and other mental interventions are very effective in increasing physical health, in terms of addressing the stress and lifestyle factors that are a major source of disease burden, especially in the developed world. Third, mental interventions are good for physicians and other healthcare providers themselves, in terms of improving decision-making and reducing burnout.

Are brain supplements backed by scientific evidence of their effectiveness?

I appreciate your comment, and share your stickler-ness! As to supplements, there is considerable published evidence for the efficacy of nutrients such as essential fatty acids or B-vitamins as supports for mood if there is a deficiency. There is also considerable research support for supplementing 5-hydroxytryptophan for mild to moderate depression.

As context, you may know of the recent high profile finding in Great Britain that there was no research evidence at all for about half of all medical practices. This does not mean that the practices are bad; as you know, absence of evidence is not evidence of absence. But it does suggest that there is double standard in insisting on research evidence for nutrients the body has evolved to metabolize but not insist on research evidence for off-label uses of medications that are artificial molecules the body did not evolve to metabolize.

Also as context, in America medical error is the third leading cause of death, about 200,000 fatalities a year here, the great majority due to problems with medications. By comparison, the risks of things like essential fatty acids or B-vitamins are vastly smaller.

Personally, I have known people who are dogmatically holistic as well as people who are dogmatically anti-holistic. In my own case I try to find the path between the two.

Do you have any research reference for the impact of the “hand on heart / belly” practice you use?

It’s a great question, and to my knowledge not one study has been published about this practice, in terms of either its purported psychological or physiological effects. Personally, I try to be careful to claim that there is any such research.

This said, as you may have heard, there is a saying that “the absence of evidence is not evidence of absence.” Just because there is no study about something does not mean it does not work.

I find the hand on heart practices to be plausibly beneficial; certainly many people report such benefits. And there is much evidence that the touch of others is beneficial . . . so perhaps touching oneself in a region of the body that is so associated with soothing and kindness might have similar benefits. And who knows what might be happening with energy systems that science has not yet identified.

Can you suggest something to help me breathe mindfully?

Many people have difficulty using the sensations of breathing as an anchor for their attention during meditation, or even generally. Sometimes it is because body sensations in general or breathing in particular have gotten associated with painful, even traumatic, experiences. Other times there’s no trauma history but something about the breath just doesn’t work for a person.

No worries, actually: in meditation, the point is not the object/anchor of attention, the point is the quality of sustained presence of mind moment after moment – along with related helpful factors such as self-compassion, acceptance, and learning along the way from one’s experiences. So you could shift to any number of other, often common, objects of attention, such as a word or phrase (e.g., “peace,” “may we be happy,” “om”), an image (e.g., a candle, a picture of a saint, a memory of a beautiful meadow), or sensations in other parts of the body. And you could also do meditation while walking slowly.

If you still want to explore breathing, what I do is have a general awareness of my torso and whole body while breathing rather than focusing on any particular spot, and without trying to regulate breathing in any way. Move out to the body as a whole, and let the sensations of breathing come to you as it were, receiving them without effort. Meanwhile, there is a natural relaxation, letting go, warm-heartedness, and growing sense of well-being, contentment, and peace.

Is there a connection between our emotional state and the physiology of our voices?

I don’t know of any specific research about emotional states affecting vocalization, or vice versa, but I assume there must be multiple studies about these subjects. Stephen Porges has some powerful ideas about the vagus nerve, soothing, and the innervations of this nerve complex into the middle ear so that certain sounds have a particularly calming and reassuring effect; he has one of the interviews in the free Hardwiring Happiness video series I did, that you might like. Also, material on experience-dependent neuroplasticity suggests that positive experiences will over time alter neural structure and function for the better.

What advice do you have for a young man who feels insecure about his body and wants to connect with women?

I suggest you get a good therapist and work through these issues. You describe what sounds like “body dysmorphic disorder,” a catch-all term for irrational beliefs that some or all of one’s body is ugly, broken, tainted, etc. Also, under their exterior, many young men have the same self-doubts as you do, including about intimate parts of their body. I know I did.

I also suggest, with respect, that you think in terms of connecting with young women as a kind of ladder, let’s say twelve steps, with a happy marriage at the twelfth step and casual conversation as the first step. Take it one step at a time. Get comfortable at one step, and then gradually open to moving just one step higher. Don’t focus on steps way above you.

In this context, notice and allow young women to have a positive response to you at the step you’re on. Take in this positive response and the good feelings it creates in you. Use this ‘taking in’ (see my book, Buddha’s Brain, for more on this practice) to fill you up gradually, bringing confidence and slowly healing your old pain and insecurity.

In my model of the ladder, here are the steps (don’t take this too seriously, I don’t):

  1. casual conversation
  2. friendly encounter, like having a real good talk and sense of connection
  3. specific get together, like going to get a cup of coffee after class to keep talking and hanging out together [note that up through this step, things can still be totally platonic, though maybe there is a brewing sense that some chemistry, some warmth for each other, maybe some attraction, could be possible]
  4. clearly warm vibes or event that goes beyond platonic connecting: could be a depth in conversation, or doing something together that goes beyond casual friends like having dinner together or going to hear a band together [note that so far there has been no physical contact other than maybe a casual touch on a shoulder or arm for emphasis while talking, or a casual friend hug]
  5. basic affectionate touch: could be holding hands in a movie or while walking around campus at night, or cuddling on a couch at a party, or a quick kiss
  6. extended kissing
  7. foreplay
  8. sex
  9. being a couple
  10. living together
  11. engagement
  12. marriage

This is about wise view, seeing reality clearly and not being deluded by the legacy of beliefs from childhood. And it’s about being receptive, receiving the gift of women being drawn to you. And they are drawn to you already even if you don’t see it.

What are the limitations of visualization and “harnessing the power of the mind” for health?

As a psychologist, I am not giving medical advice. In that context, as a general statement, it is clear that mental factors such as stress on the one hand and gratitude or feeling cared about on the other can play a significant role in a person’s health journey . . . much as purely physical factors such as infection or cancer or effective medications can play a significant role as well.

Speaking personally, I try to approach my own health issues on both levels, mental and physical, based on sensible and individualized methods that have reasonable evidence, including the evidence of whether they are actually producing results for me.

Additionally, as an individual choice, I also include what could be called the spiritual level, distinct from the natural processes within our big bang universe, which include our thoughts and feelings, hopes and dreams . . . as well as our organs and DNA. Others may not want to do this, and I respect that choice.

I have no problem with people who include the possibility of spiritual factors in their healing of a medical condition. I do think it is foolish to do this in a way that excludes or minimizes the role of the physical level in our healing. We have real bodies, they are full of real cells and molecules and microbes, and this physical stuff really matters, and modern medicine has many effective ways to deal with it. Sure, doctors can make mistakes, and we need to be aware of the financial incentives such as from pharmaceutical companies that tilt medical treatments toward certain approaches and away from others. I turn to doctors who listen carefully, don’t patronize, individualize their approach to me rather than “one size fits all,” and recognize the potential usefulness of complementary and holistic methods. But I would not want to use the spiritual level to crowd out sensible, standard medical interventions.

Dr. Ramani Durvasula is a licensed clinical psychologist, author, and expert on the impact of toxic narcissism. She is a Professor of Psychology at California State University, Los Angeles, and also a Visiting Professor at the University of Johannesburg.

The focus of Dr. Ramani’s clinical, academic, and consultative work is the etiology and impact of narcissism and high-conflict, entitled, antagonistic personality styles on human relationships, mental health, and societal expectations. She has spoken on these issues to clinicians, educators, and researchers around the world.

She is the author of Should I Stay or Should I Go: Surviving a Relationship With a Narcissist, and Don't You Know Who I Am? How to Stay Sane in an Era of Narcissism, Entitlement, and Incivility. Her work has been featured at SxSW, TEDx, and on a wide range of media platforms including Red Table Talk, the Today Show, Oxygen, Investigation Discovery, and Bravo, and she is a featured expert on the digital media mental health platform MedCircle. Dr. Durvasula’s research on personality disorders has been funded by the National Institutes of Health and she is a Consulting Editor of the scientific journal Behavioral Medicine.

Dr. Stephen Porges is a Distinguished University Scientist at Indiana University, Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland. He is a former president of the Society for Psychophysiological Research and has been president of the Federation of Behavioral, Psychological, and Cognitive Sciences, which represents approximately twenty-thousand biobehavioral scientists. He’s led a number of other organizations and received a wide variety of professional awards.

In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological states in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders, and has had a major impact on the field of psychology.

Dr. Porges has published more than 300 peer-reviewed papers across a wide array of disciplines. He’s also the author of several books including The Polyvagal Theory: Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation.

Dr. Bruce Perry is the Principal of the Neurosequential Network, Senior Fellow of The ChildTrauma Academy, and a Professor (Adjunct) in the Departments of Psychiatry and Behavioral Sciences at the Feinberg School of Medicine at Northwestern University in Chicago and the School of Allied Health at La Trobe University in Melbourne, Australia. From 1993 to 2001 he was the Thomas S. Trammell Research Professor of Psychiatry at Baylor College of Medicine and chief of psychiatry at Texas Children's Hospital.

He’s one of the world’s leading experts on the impact of trauma in childhood, and his work on the impact of abuse, neglect, and trauma on the developing brain has impacted clinical practice, programs, and policy across the world. His work has been instrumental in describing how traumatic events in childhood change the biology of the brain.

Dr. Perry's most recent book, What Happened to You? Conversations on Trauma, Resilience, and Healing, co-authored with Oprah Winfrey, was released earlier this year. Dr. Perry is also the author, with Maia Szalavitz, of The Boy Who Was Raised As A Dog, a bestselling book based on his work with maltreated children, and Born For Love: Why Empathy is Essential and Endangered. Additionally, he’s authored more than 300 journal articles and book chapters and has been the recipient of a variety of professional awards.

Dr. Allison Briscoe-Smith is a child clinical psychologist who specializes in trauma and issues of race. She earned her undergraduate degree from Harvard and then received her Ph.D. in clinical psychology from the University of California, Berkeley. She performed postdoctoral work at the University of California San Francisco/San Francisco General Hospital. She has combined her love of teaching and advocacy by serving as a professor and by directing mental health programs for children experiencing trauma, homelessness, or foster care.

Dr. Briscoe-Smith is also a senior fellow of Berkeley’s Greater Good Science Center and is both a professor and the Director of Diversity, Equity, and Inclusion at the Wright Institute. She provides consultation and training to nonprofits and schools on how to support trauma-informed practices and cultural accountability.

Sharon Salzberg is a world-renowned teacher and New York Times bestselling author. She is widely considered one of the most influential individuals in bringing mindfulness practices to the West, and co-founded the Insight Meditation Society in Barre, Massachusetts alongside Jack Kornfield and Joseph Goldstein. Sharon has been a student of Dipa Ma, Anagarika Munindra, and Sayadaw U Pandita alongside other masters.

Sharon has authored 10 books, and is the host of the fantastic Metta Hour podcast. She was a contributing editor of Oprah’s O Magazine, had her work featured in Time and on NPR, and contributed to panels alongside the Dalai Lama.

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