August 6, 2012

A Stroke of Insight?

In April, I posted a blog about a medical condition I’m interested in. The condition is sometimes referred to as “athymhormic syndrome” and sometimes as PAP (French: perte d'auto-activation psychique, i.e., loss of subjective autoactivation).
In the following post, you see a sequence of emails between myself and Ron Serrano. Ron is a jhana adept who has studied extensively with Leigh Brasington and consults on meditation research with Dr. Jud Brewer of Yale Medical School.
The exchange raises some interesting and fundamental issues regarding the possibility of a neuronal basis for enlightenment.

On Mon, Jun 4, 2012 at 5:58 PM, Ron Serrano wrote:

…Regarding PAP; is this really a pathological version of arhatship? I read the associated article and this condition sounds more like "indifference" rather than "no self". At first blush, indifference seems like being without hatred and without greed and therefore without ego. On closer inspection, however, indifference is really a separation from the world, where as "no self" is a union. Also, I'm sure you're aware of a great deal of fMRI study which has been done on construction of the self in the brain (including Jud Brewer's work). A number of brain areas, including the posterior cingulate cortex (PCC) and medial prefrontal cortex (mPFC) have been repeatedly highlighted in these studies, but to my knowledge the anterior caudate has never come up. I know that you are well versed in this area, so I am probably missing something here.…

On Wed, Jul 11, 2012 at 5:34 PM, Shinzen Young wrote:

    Hi Ron,
…Okay, I'm willing to admit that referring to Athymhormic Syndrome (aka PAP) as a “pathological version of arhatship” may be a little over the top  : ) .
But here’s why I’m interested in it.
  1. It has some intersection with at least four themes that are central to the Buddhist endeavor.
  2. Its effects in those areas are really dramatic.
  3. Its physical basis can be easily characterized.
The four areas of intersection with Buddhist experience are:
  • Dukkha Reduction. PAP victims report experiencing physical pain with normal poignancy but little suffering. (It would be interesting to know if they have the same relationship to emotional pain.)
  • Lobha-dosa Reduction. PAP victims seem to have little craving or aversion.
  • Samatha. PAP victims apparently experience long periods of time conscious yet without thought.
  • Anatta. Personality does not arise unless booted from the outside.
As you imply, the real question here is what’s the relationship between symptoms of PAP victims and the attainments of Buddhist adepts? There’s some relationship. Even if the relationship is “they’re vastly different,” I think it would be useful to know in a fine-grained way exactly how different and why.
I would divide this question into four sub-questions.
  1. First Person Question - Part One: Do any PAP victims spontaneously experience any of the “good stuff” we associate with advanced meditation?
  2. First Person Question - Part Two: Could PAP victims be trained to find good stuff in their symptoms?
  3. Third Person Question - Part One: Does the neuronal basis of PAP intersect in any way with the neural correlates of meditation states/traits?
  4. Third Person Question - Part Two: Even if the answer to Question #3 is no, it would still be interesting to know if inducing PAP-like states through “reversible lesions” (based on Transcranial Magnetic Stimulation or Transcranial Ultrasonic Neural Modulation, etc.) is in any way useful. Specifically, could it help accelerate a person’s meditation progress? (Metaphor: the mechanical principles underlying the flight of airplanes and those underlying the flight of birds and bees are quite different. Relative to birds and bees, airplanes fly “artificially”, but they still fly!)
I think these questions are worth looking into because:
I think the first step in answering these questions would be “Organoleptic.” I would interview PAP victims to determine if I could smell or taste anything about their conditions that either:
  • is liberation like.   OR
  • could become liberation like through training....
    All the best,

On Thu, Jul 19, 2012 at 11:47 AM, Ron Serrano w

…Regarding the organoleptic interview, you might focus on two aspects: Do PAP victims exhibit either some high level aspect of well being or selflessness (generosity, compassion, etc.)? If so, there could be something of great interest here. Otherwise, it looks more like clinical indifference, which is an altogether different path from enlightenment….

On Thu, Jul 19, 2012 at 12:28 PM, Shinzen Young

    Hi Ron,
…I'm not sure I'll ever have the opportunity to pursue research on athymhormia, but I just wanted to get the idea "out there" just in case someone someday decides to look into it.  So, thanks for permission to post our interactions.  By the way, that goes both ways.  Feel free to use anything I send you in any way you wish….
    All the best,


  1. A similarity between the athymhormic and arahats may be a decrease in default-mode network activity.

    A potential difference is that the athymhormic apparently have lost the ability to initiate DMN-related behaviors (like rumination or daydreaming) without prompting. Perhaps they have entirely lost DMN behaviors altogether -- i.e. they couldn't worry about whether or not their neighbors are judging them even WITH an external cue.

    Arahats seem quite capable of engaging the DMN when needed, even though they disengage it when unneeded (unlike most non-meditators).

    In the samatha department, I wonder if the consciousness-without-thoughts of the athymhormic is similar to the executive-function-driven dissociative states of jhana.

    In both shamatha practice and athymhormia, the lack of thoughts would probably correlate to decreased DMN activity as discussed above. But my first guess is that the causes are different; in shamatha the DMN is actively inhibited by prefrontal executive areas, whereas in athymhormia the DMN is silent due to lack of excitatory input from lower-level systems in the basal ganglia.

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  3. Am in the Yale group work w/Jud Brewer and Ron Serrano and agree with Ron's comments. i could strongly caution looking on TMS and its capability to cause "reversible lesions" as a route to awakening with our current knowledge.

    Even w/much excellent work @ Yale and other places on key centers like the PCC and mPFC wrt long term meditation, these are complex centers with many functions and we are only deactivating one small region of them a few % to get significant meditation effects. Causing "reversible lesions" there w/current knowledge is highly likely to be catastrophic.

    As someone who has very few self-referential thoughts, which does track to decreased DMN activity and much Zen practice, there are much safer and well-proven ways to do this.

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