Friday, November 02, 2007

Right Front Insula

I am about to read Sandra Blakeslee's book, The Body has a Mind of its Own for the second time.

Chapter 10, entitled "Heart of the Mandala", discusses a part of the brain I am particularly interested in because of my work as a manual therapist, the insular cortex. It registers all "incoming" from the body including interoception from organs. You could say it monitors 'business as usual' and remains alert to any fluctuations. It reads the body surface as well. It is both threat detector and interpreter. It is very important in my work to realize this region exists, that it is reading one's interventions continually, and to not trigger it the wrong way.

This region is found in other mammals, but in a rudimentary form. In primates it is much more developed, and humans alone have a level of integration nonexistent in any other animal:

From p. 186:

After reading off the internal state of the body from both the left and right insulas, the human brain - and only the human brain - performs yet another level of integration. The information from both your insulas is routed to the right frontal insula, the same region Critchley found corresponding in size and metabolic vigor to a person's empathic talent.

Your right front insula "lights up" when you feel all the quintessential human emotions - love, hate, lust, disgust, gratitude, resentment, self-confidence, embarrassment, trust, distrust, empathy, contempt, approval, disdain, pride, humiliation, truthfulness, deceit, atonement, guilt.

One's touch, one's handling conveys all manner of conscious and non-conscious intent - the best one can do is intend to be as helpful as possible.

One of the hardest challenges is describing something that has no words, something ineffable. Many years ago while writing a pamphlet describing to potential patients what to expect during a visit, I struggled to describe that elusive interface of manual treatment, that completely subjective zone where hands touch person and physical boundaries disappear for awhile. I wanted to reassure potential patients that I knew how to be helpful without being overwhelming. Finally I came up with a sentence describing my hands. I used the words "slow, light, kind, intelligent and effective". Looking back, I'm quite sure now that the feeling those terms encompass came up from my right frontal insula via the left cortical hemisphere and out through my typing fingers. In fact I'd lay odds that if an fMRI were done on me while writing, it would show that zone never shuts down - it's both my biggest impetus and harshest editor, for better or worse.

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