Between stimulus and response
In conversation with Dr JAMES R. DOTY
Q: Your memoir, Into The Magic Shop, is a wonderful and enlightening read. You picked some great parts of your life to tie together, including learning meditation and visualization as a kid in Lancaster, California, at the Cactus Rabbit Magic Shop, having a near death experience, having a fall from being a multi-millionaire and eventually becoming a brain surgeon against all odds. The finale is your creation of the Center for Compassion and Altruism Research and Education at Stanford eight years ago. I want to hear about being a surgeon but please start with the Center for Compassion and Altruism Research and Education (CCARE). Sometimes people think compassion is internal, vague and hard to describe, and that exploring compassion is a soft science. How are you studying compassion and altruism and what are you finding?”
JD: There’s been a lot of interest in how the brain responds or reacts to meditation and this research has been going on for the last three decades, initially led by Rick Hanson. But what is interesting to me, and remains interesting, is that what is at the core of many of these meditative practices is compassion: compassion for yourself certainly, and compassion for others.
There’s been a lot of interest in how the brain responds or reacts to meditation…
But what is interesting to me, and remains interesting, is that what
is at the core of many of these meditative practices is compassion:
compassion for yourself certainly, and compassion for others.
As I looked at this area, I realized that our survival is related to nurturing and caring for our offspring. And in the human species this involves caring not only for our offspring but for others as well. As a result of this requirement – that our offspring are nurtured for a decade and a half or more after birth, unlike other mammals that just run off into the forest after birth – our offspring require us to essentially teach them, while they mirror our behaviors, so that they will survive. Yet the cost of that to our species – to the parents or the mother – is huge in regards to time, resources and energy. Without that nurturing, caring and bonding, our offspring don’t survive.
As a result, deeply ingrained or hardwired into our brains is a reward system based on us caring for others, primarily our offspring of our own species, but also caring for all beings. What happens is that the areas associated with reward increase their metabolism when we actually care for others. This is a deeply ingrained part of who we are, and what we are, as a species.
As we evolved from the nuclear family in a hostile environment to hunter-gatherer tribes in a hostile environment, in groups of ten to fifty, this requirement that we alleviate suffering or care for and nurture others was even more important. Because if an individual in our tribe or our group was suffering, it meant that potentially they could not do their job. If they did not do their job it could put the whole group at risk. So our ability to read emotional states, micro facial expressions, body language, and even interpret smells, was critically important as we evolved as a species.
Then when we domesticated animals and plants, this led to us having more time. But it’s interesting if you look at how society and religion have functioned; at the core is this absolute requirement for cooperation, caring and nurturing others. In fact it has been shown through a variety of studies that short-term ruthlessness cannot benefit a species. For a species to survive long-term requires cooperation of the individuals in the group. Certainly this is central to the survival of the human species.
In regard to the creation of the Center at Stanford, I was at a point in my life where I started thinking about these things. As a result, from that research and interest, I realized that understanding how the brain responds to these situations, and how compassion affects our physiology, is really critically important. As it turned out, there were a few people exploring this area. I then gathered an informal group of scientists at Stanford and we began some preliminary studies looking at some of these issues.
Then it struck me that it would be wonderful to have the Dalai Lama come to Stanford to speak. What’s interesting is that it struck me one day as I was walking through the campus. That was in 2007 and, prior to that, frankly I had no interest in the Dalai Lama. I was not particularly spiritual and in no way religious, but this image of him coming to Stanford and speaking really hit me; as a result I ended up having a meeting with His Holiness. I spoke with him about the work I had begun at Stanford and subsequently engaged in a conversation about the research we had begun. As you know, His Holiness is very interested in this topic and he also has had an interest in the neuroscience of meditation.
At the end of our conversation, the Dalai Lama began an animated dialogue in Tibetan with his primary translator, Thupten Jinpa, and, at the end of that conversation, not only did he agree to come to Stanford but he also was so impressed with the work that he wanted to make a personal donation. It was the largest donation he had ever given to a non-Tibetan cause at that time. That was incredibly overwhelming and moving, and it set the stage for others to make donations to this work and ultimately to formally create a Center at Stanford, which is part of the School of Medicine and an affiliate of the Neuroscience Institute at Stanford.
Q: It is beautiful how that came about and evolved over time, and I am grateful that you and the Dalai Lama are increasing a sense of compassion and studying it from different angles. I suppose some people might say that humans are born either with compassion or not, or that certain groups of people have it or they don’t. I am guessing that you would say that compassion is something that can be cultivated quite systematically. Is that so?”
JD: I think that is exactly right, and your previous statement is also absolutely correct. Essentially, we are all born with a set of genes that define our attributes. But that being said, many of us don’t utilize those attributes or maximally cultivate them. What I mean, as an example, is that there may be an individual who has significant genetic potential to be a long distance runner, but if he is never put into a situation to run long distances then that will never manifest. Frankly the same is true with compassion and, in fact, happiness. What we know is that all of us are born with a certain genetic potential for those types of behaviors but most of us don’t maximize or potentiate them with intention, because we don’t know how or we don’t appreciate how beneficial they can be.
The other interesting aspect of gene expression is that we also know there are individuals, for example sociopaths, who are born with a disconnection in their brain that limits their ability to understand the emotional states of others. There are individuals who have gene receptors that limit their ability to respond to those transmitters associated with nurturing and caring, like oxytocin. This leads to individuals not responding the same way to a particular situation: a ‘normal’ person would respond empathically whereas this person would not do so, or not at the same level. Genetics do play a part but we also know that we can cultivate or maximize our potential for compassion by certain practices.
Q: Obviously compassion can be viewed and discussed from different angles. One angle is the context of social groups, and the political interaction of groups nationally and internationally. Clearly there is a lot of violence on the planet and a lot of gun violence. I was born in 1963 and I remember in history classes talking about World War II as the last great war, as if war was coming to an end. In my lifetime, the United States has been at war constantly, resulting in a lot of suffering. Also, internally in the country there have been many mass shootings and police killings.
Sometimes I consider compassion as something that flows inherently to where it is not yet. I think of the US as a place where that compassion has flowed from surprising places. I consider how the US bombed Japan with nuclear weapons and after that many compassionate Buddhist teachers and teachings came here from Japan. Later, Thich Nhat Hanh came here from Vietnam while the US was bombing Vietnam. Similarly, it was after China invaded Tibet that the teachings of Tibetan Buddhism spread to the West. My impression is that the Dalai Lama and thousands of Tibetan monks and nuns were quite happy being fairly disconnected from the rest of the world. But they were invaded and their compassion and wisdom exploded outward to where it was needed, including to the US. What do you think about that, and the need for compassion in this world that seems pretty violent now?
JD: Thank you for such an easy question to answer! I think what you say is partly true. Compassion is as important today as it has ever been. I would suggest that there are a couple issues that might give us insight into the situation. We were talking about the evolution of our species and the criticality of nurturing, caring and bonding – compassion – within that context. But there are a couple of other things that impact us that are also part of our evolutionary baggage.
One of those is the amygdala and our fear or flight or fight response. And remember that our DNA has not changed over the last 200,000 years when, on the savannahs of Africa, we in some ways lived an idyllic life in the context of not being burdened by cellphones, jobs or appointments. Our interest was focused on shelter, food, procreation and responding to potential threat.
That threat response, which is part of our autonomic nervous system, our sympathetic nervous system, allowed us to have a release of hormones that entered our blood system and resulted in our heart rate increasing, our blood being diverted from our gastro-intestinal tract to our skeletal muscles so we could run, and our heart being able to pump more blood, whenever we sensed a threat. Our pupils dilated so we could see more clearly and our sphincter tightened. It allowed us to respond to a threat by running and perhaps climbing a tree. If we survived, those affects quickly dissipated to our baseline and we went back to doing what we were doing.
The problem though is that the system has not changed and now we live in a modern environment with technology for which we never evolved. For many people there is constant engagement, perhaps at a low level, but still an engagement, of our sympathetic nervous system. This results in the chronic low-level release of these hormones. Such a situation has very deleterious affects on our physiology, impairing our health and decreasing our longevity. When we are in a constant state of arousal from fear or threat, this has an effect on the occurrence of disease, the duration and severity of disease and ultimately affects our lifespan.
Yet, what we do know is that we can mitigate these effects by certain practices, and switch from engagement with our sympathetic nervous system to this other part of our nervous system called the parasympathetic nervous system, which many call the ‘rest and digest’ system. The parasympathetic system is associated with a sense of calmness and relaxation. Your pupils are not dilated and your sphincter is not tight, your heart rate is at its normal rate, your cardiac function is at its best, your immune system is functioning well and your stress hormones are at their baseline. When you are in this state you are much more open to interaction with others, areas of the brain associated with creativity are functioning at their best and those parts of you that allow you to be productive are also at their best. So we do have some control over being compassionate, but it is this baggage that affects so many people, and which causes many, many problems in society today.
To be continued …
Interviewed by JOHN MALKIN, August 2016
Dr James Doty is the author of Into The Magic Shop: A Neurosurgeon’s Quest to Discover the Mysteries of the Brain and the Secrets of the Heart (Avery, 2016) and is co-founder of the Center for Compassion & Altruism Research & Education (CCARE) at Stanford University in Palo Alto, California, USA.
John Malkin is a journalist and musician living in Santa Cruz, California where he also hosts radio programs on Free Radio Santa Cruz and KZSC.
April 28, 2017
April 28, 2017