As a neuropsychologist, I tend to think of people as information processors. This is not really quite as Mr. Spock as it sounds. I also believe that there is nothing more fascinating to contemplate than people. And I appreciate that we are much more than intellect - we are passionate, creative, graceful, powerful, sensual, complex, and always, unique. And we are also, hopefully, continually growing and changing.
But still, the brain is our control center, and it is an information processor - it takes in
information from our senses and makes sense of it,
enabling us to experience and respond to the world around us. Different areas of the brain process different kinds of information in different ways. Everything we do,
think, learn, feel, remember, is the result of information processing in
the brain. Neuropsychology
is the field of science concerned with understanding the information
processing that underlies higher-level brain function. It is
a specialized area of the field of neuroscience - the
study of the brain, and it encompasses both cognitive
neuroscience - the study of thinking, and affective neuroscience -
the
study of emotion. Clinical neuropsychology is the application of
the
science to the concerns of the individual.
Who we are -
our interests, our
abilities, our quirks and our shortcomings - is determined by how our
brains process information. Though we are rarely aware of it, our
thoughts and feelings are triggered by events in the world, whether
past, future, or of the present moment. Individual differences in how
we think, learn and behave can be understood in terms of differences in
the way our brains process information, or are "wired up." This is
determined both by genetics - traits that we inherit from our parents,
and by our life experiences, both positive and negative.
Although
we all have the same basic circuits in our brains, for each of us some
types of information processing are more efficient than others. Some of
us are good with words, while others are better at mechanical things.
Some of us have a knack for getting along with people while others are
not so socially skilled. Some people are talented athletes, artists or
musicians. Some people think and act quickly and some more slowly. And
most of us learn some things more easily than others. You can think of
your talents, or areas of strength, as reflecting the more efficient
information processing circuits in your brain, while your weaknesses
reflect processes that work relatively less efficiently than the others. Problems with
learning or behavior, such as
dyslexia or ADHD, can be understood in terms of a relative
weakness in particular processes.
Differences are
normal; we each have a unique set of gifts and challenges. Differences
become "disorders" only when they interfere with our ability to
function, in our work - whether school or job, or in our relationships
with others. This is sometimes due not to a particular cognitive weakness, but to a problem with a particular emotional process. Thinking and feeling are interdependent.
Without emotion there can be no thought or action (with the exception of reflexes, which don't really involve the brain). We need motivation - either positive (we want something), or negative (we want to avoid something) in order to pay attention, understand, remember or respond to whatever is going on. But, as most of us have experienced, too much emotion or too little is not a good thing for thinking. If we are too anxious we can't concentrate, and if we are not at least a little bit anxious about it, we won't get anything done. Similarly if we are too angry, afraid, embarrassed, etc, we do not function well. So imbalances in, or dysregulation of emotion or mood, which can result from a genetic predisposition or from stress or trauma, will also cause problems with learning or behavior.
The
names we give to disorders - the diagnostic labels - can be a useful shorthand to describe a
problem or suggest a treatment, and they are important when we do
research so that we carefully define what it is we want to look at. But
because they are based on observable symptoms, they often don't tell us
anything we didn't already know. For example "dyslexia" tells us that
the child has trouble reading, and "attention deficit/hyperactivity
disorder" or "ADHD" tells us that the child has trouble paying
attention. What we really need to know is where exactly the underlying
weakness in information processing lies.
In neuropsychological assessment, we measure
the relative efficiency of the various cognitive processes and the regulation and balance of the emotional processes, and map out that person's particular strengths and weaknesses. (This map is what I call a "ThinkPrint"). This gives us a better understanding of
the exact nature of their difficulty, rather than just a descriptive
label. Perhaps even more importantly, it identifies the person's
strengths. This understanding makes it easier to identify ways of learning or behaving that tap into more efficient processes and bypasses areas of weakness, improving functioning and reducing frustration. Identifying strengths allows teens and
adults to better direct themselves toward areas of study and careers in which
they will be mostly likely to be successful.
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It is foolish to try to separate our cognitive difficulties from our
emotional struggles. Clear thinking requires emotional balance - not an
absence of emotion but a healthy relationship with it. If we deny our
feelings, because of fears that we will become overwhelmed by them, that
we will be rejected by others because of them, we eventually forget how
to read them, how to know what it is we feel. And what we feel is the
only thing we can really know - it is the only absolute truth. The most
common causes of learning problems are emotional, not cognitive, and
cognitive dysfunction is characteristic of both anxiety and depression.
Neuropsychology,
then, must take a very whole-person perspective. As in the old story about the blind men and the elephant - each trying to determine what it is based on feeling only its trunk or its tusks, the medical and mental health professions fail us by
addressing only one aspect of ourselves or one area of our
difficulties. Clinical neuropsychology is unique in the amount of time
spent in the diagnostic process. Although this makes it expensive, it
also makes it very effective in getting to a real understanding of, and an effective solution to, the presenting problem.
Much of our frustration with others (and ourselves), whether
our child, our spouse, our student, results from
our having inappropriate expectations of them. It's not that they are not able to learn and change, but if we find that they repeatedly do the same thing the same way, and we are repeatedly surprised, disappointed or infuriated, it may be time to examine what it is that we don't get about them. Similarly, if it is ourselves we are repeatedly disappointed in, we probably have to change our understanding of how we really feel about what we are trying to do, and what might be getting in our way.
Differences are not only normal; our "differentness" is what is most valuable about us. As a community, local or global, we need
people who have different talents, different interests, and different
temperaments. We need those people who have a narrow range of interest,
who are constantly focused on their area of obsession, who would be
inclined to spend a lifetime studying some particular type of cell in
the body, or plant in the rainforest, or star in the galaxy. We need
people who are highly creative - artists, musicians and writers, as well
as people who are very systematic, like lawyers and accountants. We need people who
are very social and those who do fine without so much social contact.
And yet, unfortunately, our educational system seems to assume that all children can learn the
same way and be equally strong in all areas.
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The Center for Neuropsychology
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TCFN has been providing
diagnostic and treatment services since 1991 to individuals of all ages.
Services include:
Comprehensive Neuropsychological Assessment
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Child: To document intellectual and emotional
strengths and weaknesses, and to identify the underlying cause of any
learning, social, emotional or behavioral difficulty, in order to better
target teaching strategies, educational, remedial and therapeutic
programs and parenting, and promote positive development in the child
Transition
to College or Career: To identify intellectual and emotional
strengths and weaknesses in order to guide higher education and career
planning, to document conditions requiring testing accommodations and
educational support
Adult: To determine the nature and
extent of any suspected cognitive impairment and/or
emotional/personality disruption resulting from brain injury or illness,
and the relative contribution of neurologic, psychiatric, situational
and other factors
Cognitive Remediation -
Individual,
with Family Support: To learn strategies for improving day to day
cognitive function, by understanding neuropsychological deficits,
increasing organization, structure and support, minimizing stress and
optimizing wellness
Cognitive Psychotherapy -
Individual,
Couples, Family: To reduce the experience of negative emotions and
enhance cognitive and social emotional functioning by changing
understanding of, and responses to, difficult issues and situations
Parenting
Skills Training -
To increase understanding of your child's
neuropsychological profile, and learn ways to reduce negative behavioral
patterns and increase independent, productive activity and positive
social interaction
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