brain and language t-198

8/13/2019 Brain and Language T-198

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Brain and Language

Borderl ine Personality DisorderBorderline personality disorder (B PD ) is one of th emost common mental disorders, more frequent infemales than in males. Peop le afflicted by borderlinepersonality disorder fail to establish their own iden-tity and develop life plans. They are emotionallyunbalanced and impulsive, have frequent tempertantrums, and are almost constantly angry. Theyhave poor self-control and may spend more moneythan they can afford, buying things they don't need.They tend to go to extremes in their social relation-ships, shifting from great admiration to total rejec-tion. They are often self-harmful, illogical, andparan oid. T hey have a low self-image, are frequentlydepressed, and fear loneliness but are unable todevelop litsting relationships in m arriage and career.People \\.it11 BPD tend to be accident-prone and tobe cnrelcss drivers, and they som etimes practice self-n~ uti lati on . hey may indulge in petty crimes such ascheating ; ~ n d hoplilting. Usually underachievers,they are overdependent on and overdemanding oftheir fr iends and relatives, ulhom they try to man ipu-late. Many becom e drug and alcohol addicts, or haveno self-discil>line n ciiting. Many b orderline patientsthreaten suicide: some of them are suicidal.tiology

The borderline personality disorders are related togenetic predisposition. There is no clearly estab-lished hereditary transmission of this disorder, butmost probably some individuals are born with a pre-disposition to poor stress tolerance and inadequateability for self-control. Childre n w ith this kind ofpredisposition are extrenlely sensitive to parentalattitudes. If the ch ild's paren ts, expecially themother, act in a self-cor~trndictingmanner, shiftingfrom o\ler.protection, attachment, and affection tohateful and punitive behavior, the child developsfeelinas of overattachment and admiration for themother, combined wit11 freyuent resentment anddepression. The child is prevented from developinga persistent self-image and self-control, and is at themercy of the accep ting-rejecting mo ther.

sychotherapyTherapists must b e aware of these patients ' continu-ous and unjustified angry moods, blaming of othersfor tru e o r imaginary misery, lack of social relations,extreme fear of separation and loneliness, and self-defeating and self-mutilating behavior, all of whichare sym ptoms of bo rderline personality disorder.

Peop le afflicted with borde rline personality disor-der are difficult patients. They frequently regress, arevery demanding and sometimes suicidal, an oftenelicit negative feelings in their psy cho therapists.

Psychotherapy with borderline patients needs tobe supportive and reali ty oriented, preventingregression and suicide attempts. Quite often psy-chotherapy with borderline patients becomes moreguidance than therapy. enjamin B lVoltnan

Brain and LanguageO n the basis of ob servation s made in the clinic, largeportions of the central part of the cerebral cortexhave been shown to b e involved in the interpretationand expression of language in hum ans. In broad o ut-lines, the relationship betw een a variety of brain svs-tems and aspects of language has been reliablyestablished. Nonetheless, many specifics of theserelationships remain obscure due to individual dif-ferences and to incom plete knowledge.

Before the relationship between brain and lan-guage can be explo red, i t is necessary to define whatis me ant b y language. Animals are often able to com-municate fairly precise messages. Such communica-tions have been referred to as language, e.g., thelanguage of the bees or ape language. Also, thoughthe term language is derived from the Latin root"lingua," referring to tongu e, gestural sign languagehas been stt~ die d xtensively, and comparisons havebeen made between such productions in apes andhuman s. O n th e other h and, l inguists , whose domainis the study of human language, insist on a morerestricted definition, in which the structure of thecomm unication becomes the central interest.

Definition is important. Thus, i one is primarilconcerned wich communication or its loss due to

~ -1 9 8 a b RIBRAM, K.H. (1996) Brain and Language. PRIBRAM. K.H. (1996) Brain. Motivation,and Emotion. In B.B. Wolrnan (Ed.) Encyclopedia of Psychiatry, Psychology an dPsychoana/ysis, 1 New York: Henry Holt Co., pp. 83-85; 85-86.


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rain and Language

brain injury, on e finds a region su rrounding the syl-vian fissure of the left hemisphere of the brain that,when damaged, results in co~nmunicationdifficul-ties. Some localization within this territory can beascertained: toward the front of the reg ion, difficul-ties are apt to be with expression; toward the rear,they are more likely to entail comprehension.

Th e linguist can refine these ra ther gross relations.Linguistic an alysis shows tha t lesions in the an teriorpart of the region superior to the sylvian fissure areapt to produce difficulties in processing functionwords (words that make fluency possible in con-structing sentences). By contrast, lesions of the pos-terior part of the region inferior to th e sylvian fissureimpair com prehension because of a loss in the abilityto process con tent wo rds (w ords that refer to objectsand events).Language as studied by linguists has other attri-butes: sem antic, pra g~n atic , and syntactic. T hesemantic aspects are concerned with ostensive defin-itions: what utterances designate in the world ofobjects and events. Damage to the part of the cere-bral cortex behind and above the sylvian fissure hasbeen shown to impair the semantic aspects of lan-guage, leaving intact.,comprehension dep end ent onthe internal meaning of utterances (e.g., a knife isused to cut with is understood, bu t when given theword and asked to select a picture of a knife, thepatient is unable to m ake the connection).

The pragmatic aspects of language deal withrhetoric, with prosodics, and with the social effec-tiveness with which the language is used. The termprosodics refers to intonation an d to pauses used fo reffectiveness. Intonation has been shown to berelated to the right hemisphere; impaired expressionanteriorly, and impaired comprehension posteriorly.Appropriate pausing appears to be processed by theleft hemisphere, anteriorly, and is related to fluencyand the use of function words.

The syntactic aspects of language are pro-grammed by the centrally located region of the cere-bral somatosensorymotor cortex that surrounds theRolandic fissure. It is syntax that brings together thesemantic and pragmatic aspects of language. Syntac-tic procedures provide the skill necessary to makelanguage com prehensible and fluent.

All of the above is most applicable to ordinarilyright-handed males rased in a culture of Indo-European languages. Left-handers may adhere tothis scheme o r Inay reverse or scramble hemisphericlocalization. Females suffering iron1 strokes showmore rapid and complete recovery, suggesting thattheir language processes are less restrictedly local-ized than those of males.

A persistent problem in localizntion hiis beendelineating the location of the lesion responsible forexpressive aphasia. Initially, Pierre Paul Brocapointed to the third frontal convolution of the leftcerebral hemisphere, anterior to the localization ofthe representation of the tongue. However, anincreasing number of patients with disturbances influency have been found urhose left third frontalconvolution is intact. Ordinarily , such patients canbe shown to have a fairly deep lesion in the neigh-borhood of the third fr,?ntal convolution or some-what more posteriorly, invading the territory of thetongue representation. Several possible explanationspresent themselves: expressive aphasia is due to 1) acombination of impaired regulation of tongue andthroat m ovement (dysarthria) plus a m ore estensivefronta l involvenlent in proc essin g. function w ords,leading to loss of fluency and rhetoric; 2 ) aninvolvement of the uncinate fasciculus, which con-nects the inferior part of the frontal lobe with thepolar part of the temporal lobe, including the amyg-dala; or 3) critical involvement of the basal ganglia(head of the caudate nucleus, and/or the nucleusaccumbens).

This particular problem is bu t on e of many of thistype. Thus, despite a good deal of knowledgeregarding the relation of brain an d behavior, seriousgaps in knowledge remain. Emphasis has beenplaced by neurologists on disconnection syn-dromes to account for som e of these gaps. The ideais that complex sym ptomatology is produced by dis-connections betw een cortical areas, due to severingof corticocortical fiber tracts. In monkeys, however,even radical disconnections of corticocortical tractsproduce remarkably few, if any, effects. By contrast,disconnecting the cortex from the basal gagliaresults in dramatic difficulties, mirroring thoseobtained by extensive resections of that cortex. Sur-


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Brain Motivation and Emotion

prisingly disconnection from or destruction of rele-vant thalamic structures does not produce such aneffect.

It may well be that effective corticocortical con-nections are what make human linguistic and othercultural processes possible. Nevertheless, it is worthconsidering that the se processes rely on th e relation-ship between th e cerebral cortex and the basal gan-glia. Exploratio ns of th e role of th e basal gaglia (e.g.,by electrical stimulation) in language have yet to beundertaken.

Karl H Pribram

Brain Mo tivation and EmotionTo understand the relation between brain systemsand feelings and their expression, it is necessary todistinguish emotion from motivation. Emotions areto a large extent processes occurring within theorganism, while motivations extend the relationshipof the organism to its environment th rough intendedor expressed action. Synonynls for emotion are flecrand feeling When emorions are expressed, theyreflect the internal process by facial and other non-verbal designations or by the prosodics of language.Such expressions are used by organisms as signals toguide social intercourse.

By contrast, moti\~ ations initiate planne d,intended action. Aggression (agonistic behavior)provides an example of the difference between emo-tion and n~otivation.Emotional aggression resultsfrom frustration. It is characterized by an outburstof poorly organized behavior, directed at whateverhap pen s to be in th e vicinity. Motivated aggression iscarried ou t with cons umm ate skill, as when a lionessstalks and succeeds in bringing down her prey. Simi-larly, en~ oti on al ove is passionate; when expres sed,i t reflects an internal state of the lover. Motivatedlove is directed toward the well-being of the lovedone. Romantic, passionate love resulted, during theperiod of the Crusades, in incarcerating the lovedperson in n tower and forcing her to wear a chastitybelt Toda y, passionate involvenient often leads tofrustration, anger, and occasional violence againstthe loved one. Better not to be the recipient of this

sort of extreme passionate love; rather, passionshould be leavened with motivated caring andcommitment.

T he diencephalon of the brain contains two recip-rocally acting regions. O ne centers on th e ventrome-dial nucleus of th e hypothalamus; the o ther is knownas the far lateral hypothalamic region. Electricalstimulation of the region of the ventromedialnucleus produces a series of responses graded as afunction of the amount of current in the stimulus.Mild stimulation produces alerting and the cessationof ongoing activity, including that of eating anddrinking. The region has thus become known ascritical to the orien ting reaction a nd as a satiety cen-ter. More intense stimulation will produce signs ofirritation and , in the extreme , "sham" rage, an exam -ple of aggression directed at whatever is close athand.

T he far lateral region of the hypotha lamu s is madeup of fiber tracts and contains few nerve cells. Someof these tracts co nnect the amygdala with the ventro-medial hypothalamic region. T h e amygdala is a basalganglion, which has been shown to modulate ventro-medially initiated orienting , satiety, and-aggression.

By far the majority of fibers coursin g through thislateral diencephalic region are tracts that connectthe substantia nigra with the corpus striatum andglobus pallidus. These connections mediate thedopaminergic activity of the basal ganglia in\rolvedin the control of posture and other attitudinalaspects regulating behavior. Here lie the neural sub-strates of motivation, the substrates of motivatedaggression, love, and com mitm ent. Unfortunately, aso now the details of the manner in which thesemotivational processes operate are not as carefullyworked out as those that modulate emotions by theactivity of the amygdala.

One of the clearest ways to understand theprocesses mediated by brain systems is to investi-gate, whenever possible, the sensory input to the sys-tem. With respect to the processes regi~late d y theamvgdala, the modalities of pain and temperaturehave been f o l d o be critical. In the spinal cord, thenerve fibers carrying pain and temperature sensationtravel together in the ventral spinothalamic tract.However, only about one-third of these fibers


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Brentano, Franz Clemens 1838-1917)

find their way directly to the thalamus. Th e re ~n zin -der of the pain and temperature input reachesthe region of the amygdala and surrounding cor-tex hy way of the periaqueductal gray matter of themesencephalon.

Pain comes in two distinct modes: 1) a sharp sen-sation localized in time and place, and 2) an achingsensation lhat seems to wax an d wan e and is dilficultto locate. Th e fi le rs mediating the sh arp sensationfind their way to the parietal cortex via the dorsalthalamus; intractable aching is relieved by orbito-f rontal loboto~ny,which disrupts its uncinate con-nections to the amygdala.

Temperature discrimination has a similar dualrelationship. O nly very fine tempe rature d iscrimina-tions have been shown to be disrupted by parietallobe resections. For the most part, disruption oftemperature sensibility occurs when the amygdalasystem is stimulate d electrically or is excised.

From this analysis of the difference between sen-sory input to the parietal convexity and that of theamygdala system and its connections, a distinctionbetween an epicritic and a protopathic aspect ofsomatic sensation can b e draw n. Epicritic sensationsshow local sign; they can b e precisely located in timeand space. Protopa thic (the term is related to theGreek pathos, from which pathological, as begettingcompassion, is derived) sensations provide hedonictone. Th e hedon ic tone of pain is aching discomfort;that of tempe rature is comfort. Com fort reflects no r-mally operating metabolism, which is anchored, inwarm-blooded animals, by basal temperature.

Th e results of lob oto n~ y ndicate that mod ulationof the paidtemperature process involves higher-orde r regulation of the amygdala system. In add itionto the orbital part of the frontal lobe, its dorsal part,through connections with the cingulate gyrus andthus the hippocampal system, has been shown toplay an important role in mediating between emo-tional and motivational processes. Motivations areregulated via connections with the striatum. Media-tion takes effort and prevents the hedonic processfrom becoming hung up in passion or in blindcommitment.

In summary, by distinguishing emotions frommotivations and both from epicritic processes, brain

systems regulating the hedonic foun datio t~s f expe -rience and behav ior have been identified.Kurl l-I. Pribratlz

Brentano, Franz Clemens 1838-191 7)Brentano's work encompasses several areas in phi-losophy and psychology; he defines psychology asthe science of the soul. Th e act of perceiving, notthe content of what is perceived, is the subject mat-ter of Brentano's psychological system.Be~ljar rirr Wo bn an

Breuer, Josef 1842-1 925)An Austrian physician and physiologist whose workwas a precursor to Fr e- ~d ia n sychoanalysis, B reuerdeveloped the ca thartic treatment m etho d, based onsuggestion and hypnosis. Ureuer and SigmundFreu d believed that hysterics suffer mainly fromreminiscences. A psychological traum a may lead toa discharge of energy, whereas hysteria blocks dis-charge. The accumulation of' the blocked mentalenergy, which causes hysterical symptoms, mustbe unblocked and discharged. Hypnosis enablesunblocking, and a release called carhrrrsis restoresmental health. Breuer treated a young woman withserious hysterical sylnptoms by encouraging her totalk freely in an autohyp notic state. Freu d com paredthe cathartic method to an incision and drainage ofan abscess; the open pathway permitted the dis-charge of accumu lated energy and a cure.Be~jatlzitzB. Wolnzan

Brigham, Amariah I 798-1 849)Brigham was one of the thirteen founders of theAmerican Psychiatric Association. In 1842, he orga-nized and became head of the new State LunaticAsylum in Utica, New York, where h e put into prac-tice mild and mora l (psychological an d milieu)therapy. Brigham was an advoca te of phrenology.Johtz C. Burnharn

brain and language t-198

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