Good morning.
You know, I was going to tell you all what a pleasure it is for me to be here today at this fascinating conference, but then I wondered whether it would lead to a discussion of the brain chemistry and number of synaptic responses involved in my very expression of delight at being with you.
But I think I'll risk it.
What a wonderful conference this is; what a fascinating subject, and what a delight it is to be here, to learn, and to explore the science of emotion. The title alone evokes the excitement of the scientific discoveries that are shedding new understanding not only about what we feel, but also about how we feel. We are learning more about the fine lines between health and illness that result from the interplay between brain and mind. And we are learning about how mind can affect body -- the linkage between mental and physical health.
This challenging conference topic also reminds us that who we are -- the very center of what we call our selves -- is a product of the complex interelationships among what we think, what we feel, and the environment that surrounds us. And, it reminds us that in our relationships with those around us, our actions and emotions are interpreted and responded to by others based on their own storehouse of feelings and experiences developed over their lifetimes. Finally, it reminds us that our experience of the world isn't based only on brain -- the thinking analytic us --, but on mind -- the feeling, experiencing us.
The more I think about where knowledge has taken us in so short a time, the more awe-struck I am. Just stop and consider. In this decade alone, neuroscientific research will explain more about the complex relationship between mind and brain in health and illness than has been known in the history of humanity.
And this is just one example of where science has taken the field of mental health research. .
In truth, I can't begin to tell you how exciting and incredibly rewarding it has been to serve as President Clinton's mental health policy advisor. Not only because I have the opportunity to participate in events such as this, where we learn about and help promote cutting-edge scientific discovery about the neurosciences during this proclaimed and remarkable decade of the brain. And not only because of the remarkable advances by researchers supported by the NIMH and other parts of the NIH.
But also because I have had the opportunity to explore just how mental health care professionals working on the front lines of mental health service delivery in our nation's communities are translating the products of the virtual explosion of knowledge to improve the lives of millions of Americans who experience the symptoms of mental illnesses.
But just as important, perhaps even more important, my involvement in the field has been rewarded each time I have seen the faces of women, children and men whose lives have been touched by mental illnesses -- individuals of all ages with these disorders, their partners, their parents, their children. I have been moved by their courage, have been awed by their resilience in the face of sometimes daunting odds, and have cheered their stories of recovery and triumph. And I well recognize that these personal individual triumphs, in large part, are a product of three decades in which the mysteries of the mind have been unveiled through advances in neuroanatomy, neurobiology, neuroimaging, and sheer human will.
It's rather interesting how far we have come and yet how far we need to go. When I stop to think about mental illnesses, it seems that these disorders may be among the last to be freed from fear and misunderstanding in the hearts and minds of the public. Let me give you an example of what I mean.
When I was growing up, the word cancer could barely be mentioned. People whispered about it, gave it nicknames like "the big C", or, even worse, simply said nothing at all. A friend, a relative, a neighbor, simply disappeared, succumbing to a disease that was never mentioned.
Today, however, the fear and stigma that surrounded cancer have been dispelled, from breast and ovarian cancers to prostate and colorectal cancer. Why? Scientific advances that have improved early diagnosis, enhanced treatments, and prolonged life. In fact, I heard recently that another generation of medications are about to enter trials, medications that can make cancer a treatable, manageable disease with which people can live long and productive lives.
That's what the advances in neuroscience are all about, too. Over the last few years, as new medications and psychotherapeutic treatments have proven beneficial to people with mental illnesses, I have seen a chink in the walls of suspicion, fear, and ignorance about mental illness. The walls are begin to crumble, just as they have for countless other illnesses, such as cancer. We have learned a great deal about the role genetics may play in some mental problems -- like some forms of Alzheimer's disease and bipolar disorder. We've also learned that depression isn't a moral failing or a sign of personal weakness; it's a real and treatable problem. We've learned that poor parenting isn't the cause of schizophrenia and that treatments do exist for even the most severe of mental illnesses. And consumers and their families are speaking out about mental illnesses as never before, sharing their stories, demystifying these illnesses. This past weekend's historic "Walk the Walk, for lives touched by mental illness" at Freedom Plaza here in Washington-- an event that I was proud to be an honorary co-chair -- served as a just one more reminder to Washington DC and the Nation that the walls of fear and stigma need to come down.
And the chink in the wall comes not a moment too soon. After all, of the millions of Americans who will experience the symptoms of mental illnesses in any one year, only a fourth seek services. The result is measured not only in lost productivity, but also in individuals lost to their jobs, their communities, their families. And the problem extends far beyond our shores. As some of you may know, the World Health Organization found that 5 of the 10 leading causes of disability worldwide are emotional or mental problems. Moreover, within the next decade, depression alone will be the second leading cause of lost years to disability, not only in the industrialized world, but in the developing world as well.
And if those statistics don't get your emotions going, I'm not sure what will!
But let's take a step back and ask what's the connection between the growing acceptance of mental illnesses as real and treable diseases and the focus of this conference -- the science of emotion? Its a very simple one. The study of one illuminates the other. The light shed on knowledge of one clarifies the other. It's the same connection that has allowed cancer to progress from a disease wrapped in fear and mystery to one that is confronted, battled and, for a growing number of Americans, beaten.
The connection is the growing body of scientific knowledge about mind and brain, and the concomitant growth of public understanding about both mental health and mental illnesses. More simply put, our increasing knowledge changes how we feel about mental illness, altering our emotional responses to it in both the abstract and the concrete.
But how we perceive mental illness is just one small piece of the picture. As we've heard so far in this ground-breaking conference and will hear further as the day progresses, there is a profound relationship between mind, brain, and environment in the conduct of all aspects of our daily lives. How our brains are "wired" biochemically, we have learned, color our perceptions of our environment, shade our responses to events, and tint our future experiences as well.Stop and consider how powerful and central emotions are in our lives. A child cries, and a parent rushes, concerned, to see what the problem is. Laughter replaces concern when the child is found simply to be in need of a hug. After surviving an unannounced and unexpected tornado, a family is haunted with fear with each passing storm, waking in the night at the clap of thunder. We laugh, we cry; we fight and we hug. And each event adds to the tapestry of our life experience.
The capacity for human emotions probably arose as part of our evolutionary fight for survival, but it seems as if the spectrum of our emotions extends far beyond that of other species. Our emotions give color and meaning to our environment; our environment, and our interactions within it, add to our emotional lexicon. After all, we don't have just a few basic words to describe our emotions -- happy, sad, angry, afraid. No. Instead, each word has an entire thesaurus of synonyms and antonyms to shade those emotions.
Imagine, for a moment, what life might be like in the absence of emotion. Certainly, there would be fewer words in our dictionaries; less color in our lives. We have some glimpses in the history of literature, primarily in science fiction. Consider Brave New World, where all emotion was firmly controlled and also where love was entirely forbidden. Consider 1984, where emotions were carefully controlled: Big Brother decreed "hate minutes," during which time only one emotion -- uncontrolled rage -- was permitted. The thought police were designed not only to control thought, but also mind -- emotion.
For most of us, the concept of a world without emotion is chilling. William James observed that our "individuality is founded in feeling."
But just what is it about humankind that makes emotions -- whether smiles or frowns, tears of joy or of mourning -- so terribly important? Why do we have emotions in the first place? What makes our emotions so seemingly individual? And what about the expression of emotions may carry an individual from what some call "healthy" to what may be called "unhealty" or "ill?" Those are the questions that guide the search of today's researchers in the science of emotions.
Efforts to understand our emotions -- to separate mind and brain -- are centuries old. But the search for many years looked outside the body, beyond either the brain or the mind. Emotions -- seated in the heart, not the head -- were perceived as the result of mysterious interventions by outside forces. The Greeks spoke of humours -- bile, blood, and phlegm. They also believed the elements of earth, wind, fire and water to be of importance. Both humors and elements needed to be in balance in the body for health to be maintained, whether that health was of body or its translator, the brain.
Plato, it is said, suggested that the origins of inappropriate emotions found in mental illnesses were partly moral, partly divine, and partly environmental. He observed that they arose as the result of love, great trouble, or as a gift from the Muses.
In the middle ages and even as late as the 17th and 18th centuries among the general public, possession, demonology, and deviltry were believed by many to be the source of the inappropriate emotions associated with mental illnesses. Is it surprising that individuals whose emotional wiring resulted in depression, mania, schizophrenia or other problems that are now known as mental illnesses, were cast into prisons, labeled as witches, exorcized and ostracized?
Today, we know that our emotions are not the product of mysterious interventions by outside forces and that the brain, not the heart, is the generator that powers those emotions. Further, we know the tremendous power that brain and mind can work on the human body -- the interrelationships between physical and mental well-being. Through the research ongoing today, we may very well soon learn about specific errors in emotional signals in the brain that occur in mental illnesses:
And with that knowledge, still further inroads can be made not only in the treatment of these illnesses, but posssibly in predicting and preventing them in the first place.
But the science of emotion helps explain mental health as well as illness. By demonstrating the fine neurochemical line that may actually separate mental health from illness, it is also helping to demystify and destigmatize mental illnesses.
Ralph Waldo Emerson once observed "we are intent on meteorology to find the law of the wind to the end that we may not get our hay wet. I also wish a Farmer's Almanac of the mental moods that I may farm my mind."
Today, that Farmer's Almanac is being written. And with it, the masters of science -- some of whom are participating at this conference today -- are helping to disclose the meaning of mood, of emotions, and why we need so very many words to describe the state of our mind. In doing so, they are elucidating the science of the brain that spells the differences between health and illness of the mind. And the result, I am convinced, will do more than enlighten us. It will do more than explain why we feel. Critically, the result of the work being described at this conference will help lead to still further breakthrough treatments for the citizens not only of this Nation, but the world, whose lives are touched by mental illnesses.
I am grateful that you've given me the opportunity to share my thoughts on this fascinating and incredibly hopeful direction in the discovery of ourselves.
Discovering Ourselves: The Science of Emotion
National Alliance for the Mentally Ill
Dartmouth Hitchcock Medical Center
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