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THE MOLECULE OF MORE
Doctors try to maximize the benefits and minimize the
harms by getting the dose just right. They want to suppress
excess dopamine activity in the salience circuit without
overly suppressing the control circuit, which is responsible
for long-term planning. The goal is to give just enough med-
ication to block 60 to 80 percent of the dopamine recep-
tors.
Additionally, when a dopamine surge occurs, signaling
something important in the environment, it would be nice
if the antipsychotic molecules got out of the way, just for
a moment, to let the signal get through. If you’re playing a
video game, trying to defeat the boss, or applying for a new
job, it would be nice to experience
a little excitement to cre-
ate the motivation that pushes things forward.
Older antipsychotic medications don’t do this very well.
They stick hard to the receptor. If something interesting
happens and dopamine spikes, tough luck. The medication
has latched on so tight, no dopamine can get through, and
that doesn’t feel good. Being cut off from natural dopamine
surges makes the world a dull place and makes it hard to find
reasons to get out of bed in the morning. Newer drugs bind
more loosely. A surge of dopamine knocks the drug off the
receptors, and the
this is interesting
feeling gets through.
DRINKING FROM A FIRE HOSE
In schizophrenia the brain short-circuits, attaching salience to ordinary
things that ought to be familiar and therefore ignored. Another name
for this is
low latent inhibition. Typically,
latent is used to describe things
that are hidden, such as “a latent talent for music” or “a latent demand
for flying cars.” The way it’s used in the phrase
latent inhibition is some-
what different. It’s not that a thing starts out hidden, it’s that we
make it
hidden because it’s not important to us.
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CREATIVITY AND MADNESS
We inhibit
our ability to notice things that are unimportant so we
don’t have to waste our attention on them. If we’re distracted by how
clean the windows are as we walk down the street, we may miss the
Don’t Walk sign at the intersection. If we attach equal significance to
the color of a person’s tie and
the expression on his face, we may fail
to observe something very important to our future well-being. If you
live next to a fire station, even the sounds of sirens will be inhibited
after your dopamine circuits realize that nothing ever happens when
they start to wail. Someone visiting your home might say, “What’s that
sound?” And you answer, “What sound?”
Sometimes our environment is so enriched with new things that
latent inhibition is unable to pick and choose what is most impor-
tant. This experience can be exhilarating or frightening depending on
the situation and the person who is experiencing it. If you’re in an
exotic foreign country, there’s not
much to inhibit, and it can cause
great pleasure but also confusion and disorientation—culture shock.
Author and journalist Adam Hochschild described it this way: “When
I’m in a country radically different from my own, I notice much more.
It is as if I’ve taken a mind-altering drug that allows me to see things I
would normally miss. I feel much more alive.” As the new environment
becomes familiar, we adjust, and eventually master it. We separate out
the things that will affect us from those that won’t, and latent inhibition
returns, making us comfortable and confident in our new surroundings.
We can once again separate the essential from the nonessential.
But what if the brain is unable to make this adjustment? What if
the most familiar place feels like an alien environment? This problem is
not confined to schizophrenia. A group of people living with this con-
dition created a website called the Low Latent Inhibition Resource and
Discovery Centre. They describe the feeling this way:
With low latent inhibition, an individual
can treat familiar
stimuli almost in the same manner as they would new stimuli.
Think of the details you notice when you see something new
for the first time and how it grabs your attention. From that all
kinds of questions may arise in your mind. “What is that, what
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THE MOLECULE OF MORE
does it do, why is it there, what does it mean, how can it be
utilised” and so on.
A visitor to the website described her experience in a comment:
I’m losing my mind! There is just too much info in my head,
and I get very little sleep. I can’t stand to look at anything
else! I’m tired of being an observer! I’m tired of seeing
everything! . . . I want to go to the deep woods and see
nothing,
read nothing, drop all technology, watch nothing,
hear nothing. I want no clutter, nothing moved, nothing
changed. I want to sleep without dreams that give me answers
to problems that put me back to work as soon as I get up! I’m
tired and don’t want to think anymore!
We see milder forms of low latent inhibition in the creative arts. Here’s
a simple example from the children’s classic,
The House at Pooh Corner.
Winnie-the-Pooh, who is a poet, recites some verse to his small friend
Piglet about Tigger, a boisterous new
arrival to the Hundred Acre
Wood. Piglet is a timid animal, and he points out how big Tigger is.
Pooh thinks about what Piglet said, then adds a final stanza to his poem.
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