3 Minutes to a Pain Free Life: Weisberg

Many if not most of us experience chronic pain at least some of the time. But what is chronic pain? What causes it and what can we do to overcome or prevent it? Providing a solution to chronic pain is the purpose of 3 Minutes to a Pain Free Life.

Dr. Joseph Weisberg, P.T., Ph.D., runs a private practice for treating chronic pain -- back pain, headaches, joint stiffness, or arthritis. Contrary to the natural inclination to think that joint pain is from the joint itself, in the vast majority of cases, it is from strain induced in the soft tissue: the ligaments and tendons in the joints.

Acute pain is usually relatively short-lived and the result of trauma, while chronic pain is recurring pain that is the result of the accumulation of the stresses brought on by micro trauma. Dr. Weisberg provides checklists to help you distinguish acute pain from chronic pain. For acute pain you should contact a medical practitioner; don't attempt to resolve acute pain issues on your own.

When you compare chronic pain to more stealthy medical conditions such as coronary artery disease or cancer, you realize that chronic pain has an up-side: it makes you aware that something is wrong. Unfortunately, we generally believe that we need to "baby" the body part that is the source of the pain -- which is advisable for acute pain -- but for chronic pain, that's exactly the wrong approach! Movement is needed to treat chronic pain, but it requires the correct movements to effect healing over time.

Chronic pain is largely the result of bio mechanical dysfunction from tight, stiff or short muscles, weak and imbalanced musculature, lack of lubrication in the joints, misalignment of joints, and/or poor posture. These dysfunctions cause stress on the body mechanics that cause the body to get out of balance, resulting in the continual micro traumas that eventually lead to chronic pain.

Possibly the biggest cause of chronic pain, much to my surprise is the chair! Chapter Two, cleverly titled "The Chair is the Seat of all Evil" explains the history and bio mechanical problems caused by the chair, ergonomic or not! Exposed is the myth that our evolution from quadrupedal to bipedal is the cause of back pain, Dr. Weisberg explains the marvel of the back's S-curve and what an amazing engineering design it is, resisting both gravity and shock that might otherwise damage it. Prolonged sitting has the effect of working counter to the design of our entire musculoskeletal system. [Hint: get up and walk around at least once every hour.] Conversely, moving, standing and squatting are naturally beneficial to the system, relieving tension and lubricating the joints. Although devised several thousand years ago, the chair did not come into common usage until the last 150 years -- not enough time for the evolutionary changes needed for the body to adapt to it. The archaeological evidence is presented that supports this premise!

3 Minutes to a Pain Free Life consists of three parts, each section with a hundred pages of information. The first part is an anatomy lesson in how the body is designed to work, while parts two and three provide exercises along with how, why, and when to perform them. I've been exposed to many exercise programs in the past, but was left without a firm knowledge of why they were important, and without immediate results, tended to stop performing them at some point. Dr. Weisberg's in depth explanations of the importance of this program to your overall well-being provides the science behind the program that helps you to persevere.

The main program consists of six exercises that are performed for 30 seconds each and done at least once a day. The exercises are designed to stretch, lengthen and strengthen the muscles that otherwise get out of alignment and cause the microtraumas that are the source of the pain. Rather than "No pain no gain", the catch phrase is "Work to the pain, not through the pain," allowing the muscles to relax and return to their normal length. Stretching for more than a few seconds is required because the muscles resist this stretching in the same way that they continuously stress to produce the chronic condition. The key to the physiology of overcoming this reaction is that the muscles cannot maintain that tension in a stretched state for more than a few seconds, so the 30 second exercises teach them to relax and return to a normal state.

I have several sources of chronic pain: my knees, back, and right shoulder. I have a bone condition in my right knee (osteochondritis dessicans) which has had open and microsurgery performed over the past forty years. I tore an ACL and MCL ligament (one in each knee) and have osteoarthritis in both knees. These accumulated conditions can made walking difficult, especially on stairs, and prevent me from running anymore. But as it turns out, my knee pain was the result of two factors: the unavoidable mechanical problems in the knees (only correctable through knee replacement) and the chronic soft-tissue micro traumas. I noticed immediate improvements through the 3-minute exercises in a few days and continuous improvements over several months. I am far from pain-free (due to the mechanical problems) but have resumed normal functioning. I'd like to say my tennis game is great now, but let's be reasonable, this is not a miracle program!

I rarely have back episodes anymore, the one exception being long automobile rides in my BMW M3 -- not the most ergonomic experience. The right shoulder pain due to improper weight-lifting in my younger days and exacerbated by my tennis serve has largely subsided -- enough to allow sleeping on that side at night. Overall, I have to enthusiastically endorse The Weisberg Way and the overall improvement in quality of life that it has provided. It's available on Amazon for under $15. If you try the program, please post your experience here to benefit others!

Blink: Gladwell

blink, The Power of Thinking Without Thinking, is about intuition, how it works, and how to refine this capability by an improved understanding of the brain's decision-making process. As a master story-teller, Malcolm Gladwell makes his case through a series of extremely interesting, inter-related examples of successes and failures of this process.

Gladwell refers to our brain's ability to make these impromptu decision as thin slicing, a term from psychologist John Gottman at the University of Washington, who has done extensive research on married couples by studying their facial expressions. Gottman relies on the work of Drs. Tomkins and Ekman, who discovered that our personal interactions are laced with microexpressions that expose our true feelings. They painstakingly codified the basic microexpressions and their combinations while divining their true meaning. Microexpressions are just one portal into thin slicing and helps us to understand our unconscious analytics machinery.

As noted in On Intelligence, one of the principal functions of our brain is to identify patterns in the stream of information fed to it from our primary sensory organs -- sight, sound, taste, touch, and smell -- and our secondary senses -- balance, acceleration, temperature, kinestheics, pain, time, and more! This pattern-matching capability operates in fractions of a second, below the conscious level. We form opinions on matters and often are unable to understand how we arrived at them. blink helps us become better at figuring that out!

Some examples of thin slicing from blink:

• A kouros statue from the 6th century B.C. was sold to the Getty museum in New York for $10M over the objections of several art experts that the statue was a  fake. Fourteen months of investigation and scientific research on the statue preceded the sale, but some time afterward, it was confirmed that the kouros was indeed the result of an elaborate hoax. It just didn't "look right" to the experts -- but why?

• Vic Braden, one of the world's top tennis coaches,  inadvertently realized that he could predict when a professional tennis player was about to double fault in a match, male or female, live or on TV, known or unknown to him! His accuracy was uncanny: typically 19/20 or 20/20 correct predictions. For years he tried to uncover the source of his uncanny ability, but was unable to understand how he did it. It was driving him crazy, literally keeping him up at night! Through the use of high-speed video analysis, he was able to uncover his brain's ability to thin slice the visual input.

• Warren Harding was discovered by Harry Dougherty, a brilliant political analyst, in 1899 and shepherded him to the White House as the 29th President of the United States. By all accounts, Harding was the perfect candidate: tall, handsome, athletic, and confident. Harding died in office and by all acounts, may have been the worst candidate to ever hold that high office. Experts and non-experts alike failed to make the right decision! This was a case of thin slicing gone wrong!

• Paul Van Riper retired from a very successful career as an officer in the Marine Corps. Van Riper was chosen by JFCOM to lead the opposition forces in a war gaming exercise known as the Millennium Challenge. Millennium Challenge was designed to provide the Pentagon with experience in fighting wars in the new millennium -- the unconventional warfare of the future, driven by technology and information, modeling and simulation of every conceivable military, economic, political, societal, cultural, and institutional possibility. Acronyms for new techniques were rampant. Hundreds of military personnel participated in the exercise over several weeks, pitting the new technology against a battle-hardened field commander who relied on instinct and training for the split second decisions needed in combat. In the end, sixteen U.S. ships lay at the bottom of the Persian Gulf; had this been a real war, 20,000 American troops would have died before firing a shot. Van Riper's seasoned decision-making process allowed his intuition or right brain to function unimpeded in the heat of battle while the overly analytical approach adopted by the Pentagon obstructed this process.

Gladwell studied a number of experts of various stripes, all of which were very interesting. One of my favorites sets of experts were Gail Civille and Judy Heylmun -- professional tasters for the food industry. They could not only identify the ingredients in packaged food, but could often identify the particular factory in which it was manufactured! They used a fifteen point scale to identify over ninety attributes of appearance, flavor, and texture. What's commercially interesting, and interesting to the premise of this book, is the Degree of Difference (DOD) ten-point scale that indicates how different one product is from another, even within the same category of food such as potato chips. The significance is that the buying public will not be able to discern the difference between products if their DOD is low; hence buying decisions will be driven by packaging and brand -- don't bother trying to improve the taste! The key to their blink-ability is that they can understand the conscious basis for their impressions, and recognize the difference between those formed by someone of their expertise vs. those of ordinary people -- very important to the advertising industry.

Overall, the book is outstanding, both entertaining and exceptionally informative. You may need to reread it to get the full benefit, focusing on the meaning behind the cryptic chapter titles, which help to uncover several sub-themes that recur through the book. You will be rewarded with a better understanding of how the majority of our opinions are formed and the basis for most of our actions -- decisions we reach in a blink. You will hopefully learn to question those reactions that need further investigation and better understand the importance of honing your experiences to blink better in the future. Advertising executive, political hopeful, or just an average Joe, you need to read blink!

On Intelligence: Hawkins

What is intelligence? How do we know things? What is creativity? What is consciousness? These are ideas that philosophers have pondered for centuries, with earliest records from the Greeks.

I have been fascinated with these topics for many years and have searched unsuccessfully for answers. Philosophy books on the topic were too... well, philosophical... and unsatisfying. Books on brain functioning more than ten years old were very interesting, with most of our knowledge coming from brain dysfunction, where direct knowledge of damage to specific brain areas produced consistently serious problems. Neuroanatomy books were helpful in learning about the parts of the physical brain and the associated high-level notions on the role of specific brain parts.

Recent advances in neurophysiology were more encouraging. There is a tremendous body of knowledge around chemical and electrical signaling mechanisms in the axons, dendrites, and synapses of neuron cells. The known details around these mechanisms begin to peel back the layers of how this all fits together. But the very massive detail and complexity of the mechanisms is a barrier to understanding how and why intelligence results from this amazing system. Having read several books on the biochemistry and neurophysiology encouraged my belief that we could answer the questions on intelligence, knowledge, and creativity, but neuroscientists were still unable to provide those insights.

Jeff Hawkins seems to have shared my interests and similar experience, but has applied his insight and resources to posit a theory which he calls the memory prediction framework. To understand how the brain works, you must begin with how and why it evolved -- the biological value of the brain:

• For millions of years, the animal brain evolved as a mechanism to control behavior in order to increase survivability.
• The brain accepts input from the senses -- vision, hearing, sensory, olfactory -- in order to drive action through the motor systems. Lion -- RUN!
• The brain consists logically of two parts: the primitive brain parts that are shared by reptiles, birds, and mammals, and the neocortex, which is exclusive to mammals. Knowledge and memory in insects seems to be stored and persisted in DNA, while higher level animals store information in the neuronal structures in the brain. The neocortex evolved to provide higher level functions on top of the primitive brain, organized in a multi-level hierarchy.
• Memory allows animals to store experiences perceived from their environment. Learning improves survivability by improving the value of the accumulated memories. Darwinian logic drives this process -- adaptations that improve survivability perpetuate the gene pool.

To understand how this works, some other key ideas are as follows:

• Sensory inputs are at an extremely low-level. Vision consists of about one million nerve fibers of information while hearing has thirty thousand.
• In addition to spatial content, all senses (and everything in the brain) has a time dimension -- quite different from modern computer architectures. Vision, which we perceive as static spatial content, always has a time component; in fact, the eyes move in a process called saccades about three times per second to focus on specific aspects of the visual field. We actually cannot discern objects using our sense of touch without moving our hands or feet on or in the object; i.e., our object recognition through our sense of touch comes through a temporal comparison of sensory inputs. The temporal input is used to constantly modify our working model of our environment.
• Actual cognition occurs at higher levels in the neocortex hierarchy, where concepts are formed. For visual level V1 (which does some pre-processing from the optic nerves), we begin to see lines and edges. At level IT (an intermediate level), we perceive objects such as lions. At higher levels, we develop strategies to deal with our perceptions.
• The main purpose of the brain is to form a model of our environment, mostly to deal with now but in our evolved state, to also plan for the future. Note that at any point in time, our senses are only aware of a small subset of our environment (e.g., the visual field in front of us) and that our memory model of the overall environment (and our history of related situations) allows us to respond to it in a comprehensive manner. If, for example, you are sitting alone at home and hear a certain pattern of footsteps and associated sounds, you realize that your child has arrived at home without actually seeing him or her, and if you have more than one, which one!

We can now begin to talk about the actual functioning of the brain:

• As sensory information moves up the cortical hierarchy, it gets refined into generalized, invariant representations. So we can recognize a song in any key even though the input from the auditory tract is totally different. We can recognize a face from close up, far away, tilted, or from the side, even though the pixel representations are totally different. Invariant representations allow one copy of the Gettysburg Address to be used to recite it orally, write it down by hand, or type it on a computer -- even though the mechanics of reproducing it are totally different.
• As we learn new behaviors and concepts, they get pushed down in the memory hierarchy, allowing higher levels the freedom to cogitate on how we might deal with the object(s) of focus. Note that at birth, we start with a blank slate; i.e., we know nothing. As sensory inputs are received, we store them as raw temporal images until we begin to associate them with our prior experiences and generalize what we perceive.
• The human brain has about 10 billion neurons with somewhere between 1,000 and 10,000 synapses or connections to each one: roughly 100 trillion synapses. Everything we know and do, including our intelligence, knowledge, creativity, and consciousness is contained in these synaptic connections. 

And finally, the Hawkins memory prediction model:

• The many levels of the memory hierarchy communicate up and down and left and right.
• The idea of context is very important. Concurrent neuronal firings determine the context of the situation and how we react, so a loud noise on the 4th of July is normal, but a loud noise in a library would be a cause for concern. 
• The key to understanding the memory prediction model is the prediction part: the current context causes specific levels within the memory hierarchy to pass predictions down the hierarchy in anticipation of what we expect to have happen next. The feeling we get from surprise (like missing the last step when walking up or down a staircase) is when the predictions do not mesh with the subsequent sensory inputs. Predictions are the essence of understanding -- we do not understand something that we simple observe without having an associated knowledge base that automatically forms predictions.
• These predictions are crucial to understanding how we function because the predictions make it possible for us to anticipate what is going to happen so that we can automatically adapt. So in driving down the highway, we ease off the gas pedal as we sense that the driver to our right is about to change lanes unexpectedly.

So how does this relate to intelligence? The memory model is constantly updated based on sensory inputs. In the case of action (say, in sports), it is concurrently sending action commands through the motor cortex to adapt to this changing environment. The memory predictions driven down the memory hierarchy (including the motor cortex) are based on invariant representations of similar past experiences. These invariant representations are what we might also call analogies. Depending on how they are applied, they might also be called biases or prejudices. These predictions run smoothly as long as they measure up to the incoming signals; when they do not, something like an interrupt occurs that focuses attention to address the mis-prediction and learning occurs.

An interesting thing to think about is whether we know anything! What we "know" are neuronal associations, largely in our neocortex. These associations are formed based on relationships to past experiences. When we drill down in our knowledge to a lower level -- peeling back the onion -- our knowledge becomes deeper, but I would question whether there are any absolute truths -- only our current memories related to a topic. An example of this is our initial model of the atom based on electrons circulating around a nucleus and how we are still discovering subatomic particulars such as new mesons that peel back the onion even further. Ask yourself what you actually know about electrons, protons, and neutrons, let alone quarks, leptons, bosons, mesons, or fermions!

Jeff Hawkins is an accomplished computer scientist, and many of his insights come from analogies from his original field. It would appear that many concepts from computer science apply to how the brain functions as well.

• Objects Neurophysiologists have identified a mechanism for objects in the brain. One research study identified the "Bill Clinton" neuron (possibly a series of neurons) in a set of test subjects. Any topic related to Bill Clinton caused the same set of firings in the brain, whether events related to his presidency or Monica Lewinsky. Within a time period in which Bill Clinton is the topic of attention, a series of neuronal firings maintain the context of Bill Clinton.
• Ontologies Although On Intelligence predates the popularity of topics such as RDF, the semantic web, and ontologies, the memory prediction framework seems to map nicely to the concept of an ontology; i.e., a set of objects and concepts (sets of neurons) that are interrelated through synaptic connections. For an ontology, we map subjects to objects using predicates. 
• Attributes Based on experience, objects stored in the brain have relationships to many other objects, including "objects" such as colors, textures, belief systems, etc. otherwise known as attributes. Related synaptic connections that are not currently firing, may fire later when some other aspect of the context increases the action potential of the appropriate synapse(s) to exceed the firing threshold . 
• Algorithms Although there are many differences in brain cell types, there are also great similarities. Essentially, the process that the brain uses to grow and wire neurons is driven by our DNA and is the same process for all brain cells. There are no unique "hearing" cells vs. "vision" cells or language cells vs. motor cells. The fetal brain evolves from a single bud that grows in packages around something called columns. The cells that grow out of a single "column cell" have long-term relationships to each other through synaptic connections in addition to the extended connections they have to other parts of the brain. The mechanism of growth -- how axons can grow long distances (as much as a meter) to connect to other parts of the body is all handled by the same DNA-driven algorithm. 

There is insufficient space in this review to include the many excellent examples from On Intelligence that help to illuminate Hawkins' ideas. For those of you that may have studied neurophysiology, you'll get hints and references to the research that will make you comfortable that this theory is indeed based on the hard science that we currently understand as well as understanding where he takes leaps of faith in developing his theory. I would highly recommend reading the book in order to fully appreciate the magnitude and impact of these ideas.