In his Discourse on Method (1637), René Descartes famously penned “Je pense donc je suis” (I think therefore I am), which became one of the bedrocks of modern Western philosophy. We are possessive of our thoughts (i.e. intellectual property). We strongly identify with, and generally assume, not only the supremacy, but also the primacy of our thinking mind. In fact, our democratic political system and the current market economy assume that voters and consumers make their political and economic choices based on careful and rational evaluation of all the relevant factors on issues to protect and promote their self-interest. Recent election results in the United States and the slumping economy following the financial bust in 2008 offer hints that this assumption might need reexamination, and that emotions perhaps play an equally or more important role in driving our decisions.
Alzheimer’s disease is the most common type of dementia that occurs in people older than 65 years of age. Despite strong efforts in medicine and growing societal awareness about the disease, Alzheimer’s currently has no known cure….
Emotion certainly plays a much more important role in driving the lives of Alzheimer’s patients, as the disease primarily attacks their cognitive faculties. Alzheimer’s disease is the most common type of dementia that occurs in people older than 65 years of age. Despite strong efforts in medicine and growing societal awareness about the disease, Alzheimer’s currently has no known cure, and patients require long-term and skilled nursing care. The patients’ declining cognitive ability—with symptoms ranging from short- and long-term memory loss, inability to recognize even the closest family members, to language breakdown—their emotional reactions—which include confusion, irritability, and aggression—as well as their altering mental states make caring for Alzheimer’s patients difficult and draining. With the constant breaking down of mental structures and loss of memory, how does one help, communicate with, and regulate behaviors of someone in this state?
Given that no known treatment option exists that can reverse the progression of Alzheimer’s disease, care of patients today mostly consists of administering medications that seem to have a slowing effect on mental degeneration, providing support for basic needs, and safeguarding them from behaviors that are potentially harmful to themselves and others. These care objectives, under resource constraints, translate to many of today’s common Alzheimer’s patient care practices such as constant supervision, physical containment (within a closed facility), and use of anti-psychotic drugs (to calm and regulate disruptive behavior) that are mainly depressive in nature.
… despite the decline and loss of even the most basic cognitive abilities such as language, patients seem to “remember” their likes and dislikes….
A December 2010, The New York Times article describes a set of emerging Alzheimer’s care practices that aim to achieve the same care objectives using positive emotional stimuli and reinforcement, instead of locked doors and anti-psychotic drugs. Beatitudes (Phoenix, Arizona), a pioneering nursing facility and others following its footsteps observe that despite the decline and loss of even the most basic cognitive abilities such as language, patients seem to “remember” their likes and dislikes—at least the things they liked before the onset of the disease seem to generate positive emotions in them. Further, when patients have positive emotions, they seem to calm down, and their symptoms seem to be subdued.
One of the main methods that Beatitudes uses to improve the emotional states of its patients is to give them comfort food whenever possible. Comfort food improves patients’ conditions and lessens the need for behavior control because it satisfies one of human beings’ most primal needs. Even patients with the most severe case of cognitive degeneration can receive the message: “It feels good, therefore I must be in a place where I’m loved,” remarked a staff member at Beatitudes.
The results at Beatitudes are very positive. Patients grow accustomed to using the toilet again instead of wearing diapers; a patient that has been using a feeding tube at another institution stopped using it at Beatitudes, and eats so well that she no longer needs insulin injections. Beatitudes has virtually no “sun-downing:” confused, agitated, and sometimes aggressive behavior common for Alzheimer’s patients, especially during evenings.
After six minutes, patients could hardly remember the films, but … patients retained the emotional state they experienced during the film….
In one of the studies The New York Times article cited, researchers at University of Iowa showed patients with Alzheimer’s-like amnesia films that evoke tears and sadness or laughter and joy. After six minutes, patients could hardly remember the films, but a survey conducted thirty minutes after the film showed that patients retained the emotional state they experienced during the film. In fact, patients with more severe memory loss seemed to retain the emotional state longer and more strongly.
The article describes more humane, and perhaps, more effective methods in Alzheimer’s patient care, but it also points to something interesting about our minds—that emotions are at least equally important, if not more important, than our thoughts as driving forces in our lives. The emphasis Western culture and modern education place on rational thinking means that most of us are probably more comfortable with and have a better handle on our thinking mind and thoughts than on our emotions. However, if we are more a mixed soup of our emotions than we are a collection of our thoughts, shouldn’t we get a better understanding on this part of our mind?
Yogacara Buddhism, for example, is a strand of Buddhist teachings and practices that examines emotions (as well as thoughts) as objects of a layer of our consciousness (just as sounds are objects of our hearing faculty and awareness).
Attempting to better understand this deeper and less tangible layer of our mind has long been the quest of philosophers, psychologists, and Buddhist practitioners; Yogacara (which can be translated as ‘nothing but the transformation of consciousness’) Buddhism, for example, is a strand of Buddhist teachings and practices that examines emotions (as well as thoughts) as objects of a layer of our consciousness (just as sounds are objects of our hearing faculty and awareness). This is an area that we will explore widely and deeply as part of our discussions on this blog.
Source:
The New York Times
“THE VANISHING MIND: Giving Alzheimer’s Patients Their Way, Even Chocolate” by Pam Belluck