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by Robert Scaer
W. W. Norton, 2012
Review by Roy Sugarman, Ph.D, on Mar 26th 2013
Scaer is a neurologist with 40 years of experience from Louisville, Colorado. He begins with a chapter on the amazing capacity of the body and brain, and how resourceful we can be…if we choose to activate these mechanisms. The first part of the book develops two of the keys, namely the brain and body message systems, and secondly the organizing sensations and movement. This covers the brain mechanisms for sensing the internal and external worlds and responding to them. Part two covers two more keys, namely the autonomic nervous system and the emotional brain; three keys are in part three, having left the ‘unconscious’ brain behind in part two, namely the keys of neuroplasticity, and the brain and then body in stress and trauma, which is the field Dr Scaer (not Scare, but a good name for this kind of work!), and the final key is healing the wounded brain and body.
The book begins with the obligatory introduction to the central nervous system, and rapidly moves to a focus on the sensorium, and how we organize movement, with the exercise of tandem walking given as a small exercise to try, and then the hemispheres themselves are discussed.
The second key then ties the above together, entitled organizing sensations and movement, and the role of motor memory and procedural memory (skills).
The next part looks at how our ‘unconscious’ brain runs the show in his words, I think most researchers not preferring the non-conscious brain as a term, as the unconscious brain sounds to most of us like a person in a coma. This part covers the autonomic nervous systems’ functions, and the idea of a homeostatic, self-regulating organism, with balance thus the epitome of everyday body and brain health.
Key four is the emotional brain, and he goes into quite a great deal of detail in terms of the actions and interactions of amongst others, how the somatic markers of the body represent our non-conscious emotions, and then the amygdala, the hippocampus, and other areas which modulate emotions, namely the anterior cingulate, the insula, the orbitofrontal cortex and the ventral vagus nucleus, the Xth cranial nerve. From this very valuable discussion comes more of the same, this time in relation to the reward systems of the dopaminergic neurons.
Key five discusses neuroplasticity and neurogenesis, and predictably the hippocampus, namely the most plastic area of the brain given it has to be responsive to incoming messages and involved in their meaningful processing along with many other areas of the brain. A very short section of a page or two on epigenetics could have been expanded on, and of course given his personal predilections as a trauma specialist, this is key six.
Here, he first takes on the brain in trauma, and in the next chapter, the body, drawing on the previous chapters and what he has said so far on the subject, and the role of the various physical entities within the brain and then the body. He gives some exercises here and also in other places in the book for the individual to try to become more mindful of how past memories can corrupt the present. He discusses how some conditions of body and brain interact with each other to produce the conditions, eg fibromyalgia and the concept of kindling of the senses.
Key number eight involves finally how we can repair the wounded body and brain. He discusses several somatic based therapies which seem to appeal to his sense of integration of trauma as a body and brain phenomenon, given they are one and the same thing as he has discussed earlier and throughout. Here, he focusses on a few concepts, one of which is the need for empowerment, attunement, ritual, alternating sensory stimulation of the hemispheres, motor acts of completion and repair of perceptual boundaries. He describe several therapies in that regard, opining that many of these have several or all of the elements he is looking for in a treatment for trauma, but only one, eye movement training, EMDR, has a sufficient evidence base.
It is impossible to expand on the above discussion in regard to this book without simply précising chapter content, but I have pretty much covered what the book will introduce to you.
There have been a lot of books purporting to bring neuroscience into the lay public view, mostly with only a small introduction to the limbic system and some lip service to the neurotransmitter or endocrine system, before departing on some less neurological theme, but this book, coming from a practicing neurologist stays constantly on the brain and body in a consistent theme, and rather than being 8 invented approaches to health, each of the Keys he produces covers another aspect that is vital to understanding the functional interplay of body and brain, mostly around traumatic experience which is his particular hobby horse, and he does this effectively.
Although written for laymen, this book does not patronise, and some learning has to take place while reading the book, so that a learning curve is needed to fully comprehend the conclusions he will draw about interventions. Some experiential exercises are also useful, and overall he has produced a good response to the editor of the series who asked him to put this together, using the metaphor of the series, 8 keys. These are not so much 8 things to do, as I have noted, but 8 areas to think of and so inform yourself as to how this whole homeostatic system regulates, and how it goes wrong. I don’t think many who start to read this book will appreciate the anterior cingulate or parts of the Vagus before they start, but they should at the end if they pay attention.
The book could go a little deeper into the processes of repair, but as he notes he is not a psychotherapist, where some of these evidence based treatments are most likely to be found, and he acknowledges that.
All in all a small but helpful book for most, even those involved in the practice of psychological interventions in trauma, or those not in the field, but just wanting to know more.
© 2013 Roy Sugarman
Roy Sugarman, PhD, Director of Applied Neuroscience, Athletes Performance Arizona USA