THE EVOLUTIONARYNEUROETHOLOGY OF

PAUL MACLEAN

CONVERGENCES AND FRONTIERS

Edited by Gerald A. Cory, Jr. andRussell Gardner, Jr.

Foreword by Jaak Panksepp

Human Evolution, Behavior. and IntelligenceSeymour W. Itzkoff, Series Editor

Westport, ConnecticutLondon

6THE TRIUNE BRAIN, ESCALATIONDE-ESCALATION STRATEGIES, AND

MOOD D ISORDERS

John S. Price

INT RODUCTION

Paul MacLean described three "central processing assemblies" in the neomam-malian, paleomammalian, and reptilian brains that make decisions aboutresponses to environmental social events relatively independently. In th is chap-ter, I apply this model to explaining the two alternat ive strategies of escalation(fight) and de-escalation (escape or submission). At the neomammalian levelthere is a conscious, .rational decision either to fight or give in. At the paleo-mammalian level which relates to emotions and the limbic system, there isdeployment of either the escalatory emotio ns of anger, exhilaration, and so on,or of the de-escalation emotions offear, depression, shame, etc. I suggest that atthe reptili an level of the forebrain, the escalating strategy consists of elevatedmood and the de-escalatin g strategy consists of depressed mood, which isunfocu sed or self-focused. In some cases the responses of the levels may beincompatible. The implications for mood disorders and their treatment areexamined.

BACKGROUND

The message I got from the work of Paul MacLean entailed the following:the mammalian forebrain has evolved into three "central processing assemblies"for coordi nation of information and decision-making about how to respo nd tochanges in the environment. ' These three assemblies coordinate their actio ns butmake somewhat independent decisions. For ease of communication I talk aboutthe rational brain situated rough ly in the neocort ex (Macl.ea n's neomammalianbrain), an emotional brain in the limbic system (MacLean' s paleomammalianbrain), and an instinctive brain situated in the corpus striatum (Mac Lean's

108 The Evolutionary Neuroe thology ofPaul MacLean

reptilian brain or R-complex). The rational brain uses all the information that wenormally consider conscious, and its decisions have the character ofvoluntariness with fu ll awareness. The emotional brain has restricted access tothe information of consciousness; its decisions have both voluntary and involun-tary components, with only partial awareness of its dec isions; the informationused in emotional bra in decision-making includes elements unavailable to therational brain, as Pascal noted in his famous aphorism "Le coeur a ses raisonsque la raison ne connait pas" (The heart has its reasons which are not known toReason). The instinctive brain has different sources of information that have notbeen much studied yet; its decisions are involuntary with no awareness of anyensuing course of action until that action takes place.

This new conception of the forebrain replaced my previous idea, that ofhomogeneous brain expansion since the time of the common human andrept ilian ances tor some 250 million years ago, and included the general princip lethat higher centres control the lower ones, largely through inhib ition.

The numerous theories of unconscious processes attest to psychiatry'sinevitable concern with brain or mind levels.' When treating pat ients withdepression and anxiety, the clinicia n finds it obvious that higher centres do notcontrol the lower ones. No patient with his rational brain can command hisemotional brain to fee l less depressed or anxious. From the time of Coue andSamuel Smiles to the more recent efforts of psychological healers, peo ple havestood before their mirrors and repeated to themselves such phrases as, "Everyday, in every way, I am gelling beller and better ." But these techn iques do notwork . In fact, they make patients worse, because they arouse expectat ions ofimprove ment that remain unfulfilled, therefore resulting in disappointment and asense of failure. An outstanding feature of psych iatric practice hinges on the factthat the rational brain of homo sapiens, the acme of the evolu tionary process,has no more control over the lower brain centres than does the rider over arunaway horse.

Rational contro l over the lower brains could easily have evolved . The factthat it has not should tell us something-namely, that painful and incapac itat ingprocesses such as depression which emerge so much against our conscious willare, in fact, performing one or more functio ns of adaptive value. It appears thatthe rider does not always know best. There is survival value in having a horsethat sometimes makes the decisions.

WHAT NORMAL BEHAVIOR UNDERLI ES MOOD CHANGE?

In an evoluti onary analysis of psychopathology, we must determine whatkind of behaviour is being affected. A depression may or may not be adaptive,but it likely, at least, exaggerates or distorts some piece of adaptive behaviour.[0 the case of mood disorders, no general agreement exists on what this normaladaptive behaviour might be; except, perhaps, that it involves some form ofsocial behaviour. The extreme incapacity of depression can on ly be maladap tivefor nonsocial events. Generally, we agree that when depression has a cause, it

Escalation, De-escalation, Mood Disorders 109

involves some form of loss or failure. But if, for example, in a group of ourhunter/gatherer ancestors, hunting had gone badly, it would not be adaptive forthe hunters to become so depressed that they were unable to gather effectively.As with foraging deci sions, so with predator avoi dance, there is little place fordepressed mood . Only in the case of dealing with climatic adversity do we get asuggestion that depression might perform some function analogous to hiberna-tion during the winter, and keep us out of harm' s way until spring comes along.But, in spite of the attention devoted recently to seasonal affective disorder(SAD), psychiatry is not a seasonal matter, and there is no suggestion that wemight close our consulting rooms during the summer and take jobs as water-skiinstructors.

Socia l theories of the adaptive value of depression take the form of cries forhelp, changes of social niche, relinquishing of unattainable social goals, andadjustment to loss. At the time I first became engaged with this field, it wasthought that depression served some function in relation to loss, separation orbereavement. This reasoning never convinced me. Although it was c lear that asocial or romantic bond of many years ' duration could not be broken withoutsome grief, it never seemed likely that a depressive episode of several months 'duration could be adaptive following the loss of a good ally or partner.Depression is incapacitating, and if you lose a partner, there is the work of thepartner to do in addition to your own, so that an increase in capacity wou ld bemore advantageous than depression.

SOCIAL COMPETITION

More likely has been tbe possibility that elevation and depress ion of moodserve a function in relation to soci al competition. The reasons for this are asfollows:

Depressed patients feel like failures and losers.'Manic patients feel successful and like winners."The basic strategy set of social competit ion contains the two alternativestrategies of escalation (fight) and de-escalation (flight or submission), \vhichhave similarit ies to elevated and depressed mood, respective ly.'Competing animals can switch rapidly from escalation to de-escalation in theway that a manic-depressive patient can switch from mania to depression.Monkeys who have failed in social competition and thus are low ranking maybehave in a restricted and dysphoric manner similar to that of depressedpatients."

However, there are problems with this line of thinking:

Some high-ranking people are depressed.Some low-ranking people are perfectly happy.

110 The Evolutionary Neuroethology 0/Paul MacLean

Some depressed patients are very powe rful-c-they may be stubborn, demandingand manipulative. Aaron Beck warned, "Beware of locking horns with adepressed patient. oryou may be pushed clean out of the consulting room!"Depressed patients do not act in a submissive way or show deference to morepowerful people.

In our discussions of these matters, we played with ideas of there be ing twodifferent types of submission, voluntary and invo luntary, and that depressionreflected only involuntary submission-so that an alternative to depressioncould be those forms of vo luntary submission that go under the terms ofhum ility, reasonableness, and willingness to compromise. But the water wasmurky, and we could not see the way ahead clearly.

THE TRIUN E MIND/BRAIN

The n came triune brain theory. Although it would be too much to say that allthen was light, it did clarify our ideas great ly. One cou ld say that we passed thewhite light of escalation/de-escalation theory through the prism of triune braintheory and saw the resolut ion of clearly identifiab le parterns of behaviour ateach level of the triune brain (see Table 6.1 next page).

In response to social adversity, or ranking stress as we called it, each level ofthe triune brain seemed to make a decision between escalation and de-escalation.Somet imes the dec isions agreed . Then there was like ly to be a quick resolutionof the conflict thro ugh either defeat, acce ptance of defeat, and reconci liation onthe one hand, or success, acceptance of the other's submission, and reconcil-iation on the other. At other times the decisions did not agree, and then tro ubleensued, leading to psychopatho logy.

We have been concerned at the amount of criticism MacLean has receivedfrom his fellow neuroanatom ists, but we note that these criticisms have beenover deta ils, and have not challenged the esse nt ial concept of three relat ivelyindependent central processing assemblies; in fact, in the ir authoritative mono-graph on the evolution of the venebrate nervous system, Butler and Hodosstate: "Longitudinal transmission of information within the nervous system andthe presence of rostrocaudally localised areas of integration and control arekeystones of the chordate nervous sys tem.' :" p -165

The most efficient way to bring about conflict resolution operates at therational level. One of two competitors should be ab le to say, "The other guy ismore powerful, so I will give in." The lower agonistic strategy sets can be leftalone and this could be called funct ional agonism. But, unfortunately, the humananimal often prefers to not give in. On the way to my present location, I passed aTvshirt with the capt ion, "Never surrender," and this sums up a slogan which hasbeen reiterated over the centuries ever since the Titans were thrown out ofHeaven .

Escalation. De-escalation. Mood Disorders I I I

Table 6.1. T he Socia l Competi tio n Stra tegy Set at Three Levels of theTriune Brain /Mind

Rational!Neocortical

Emotional!limbic

Instinctive!Reptilian

Esca lation

Formation of goalsProclamat ion of goalsOvercoming of oppositionSocia l part icipationSelf-assertionDecision 10 fight on

Joy, raptureEnthusiasmOceanic feelingAngerIndignation

Increase of RH P/SAHPIncrease of resource valueIncrease of "ownership" valueIncrease of energyElevated mood (IDS)

De-escalation

Giving up ofpersonal goalsAdoption ofothers' goalsSubmissionAcceptanceResignationSelf-effacement

BoredomApathyShameGuiltDepressed emotion

Loss of RHP/ SAHPLoss of resource valueLoss of "o wnership value"Loss of energyDepressed mood(ISS)

Another form of functional ago nism works as follows : The rational braindec ides to fight , but the emotional and/or instinct ive bra ins dec ide to de-escalate. These de-escalations affect the thinking of the rational brain , moving itin a more pessimistic direction. To put it techn ically, there is a loss of resource-ho lding potential (RHP), resource value and "o wners hip," so that the individualfee ls less con fide nt of winning, sees the prize as less valuab le, and feels lessentitled to the owne rship of the prize.' Due to th is more pessim istic thinking, therational level switches its strategy from escalation to de-escalation, there isgraceful losing, with the way paved for reconciliation. In this process, the lowerbrain controlled the upper brain . And this seem s to be its funct ion. The uppe rbrain seems designed for escalation, to win at all costs, and not to jeopardise itsfight ing effic iency by any thought of possible damage or defeat. This moni-tor ing of possible defeat has been relegated to, or reta ined by, the lower brain .In some way the lower bra in seems to keep a tally of punishment rece ived, andwhen this gets too great it exerts its authority tell ing the upper brain to de-escalate. The upper brain, which was in any case having a fair ly difficu ltencounter, now has the added handicap of depressive incapacity. So, if it doesnot capitulate grace fully at this stage, the individua l likely gets carr ied out of thearena on a stretcher.

We have identified depression with instinctive de-escalation, and the com-monest cause of prolonged instinctive de-escalation appears to be continuedinappropriate rational escalation, or, to put it another way, blocked rational de-

11 2 The Evolutionary Neuroethology of Paul MacLean

escalation. There are many causes for this, and I will defer discussion of them toa later section.

Prolonged instinctive de-escalation may also stem from inappropriate ernot-ional escalation. An exam ple entails the patents whose child has been killed by adrunken hit-and-run driver. The parents know there is nothing they can do at therational level. but there is often sustained anger that cannot be satisfied orusefull y discharged . The continued "punishment" and hurt accesses the instinc-tive agonistic strategy set and if de-escalation is selected, chronic depressionensues that cannot be resolved because continued emotional escalation persists.

The third clinical variety is emotional de-escala tion assoc iated with rat ionalescalation . This describes, characteristically, wives consulting for marriageguidance' They experience emotional distress, weep, and otherwise de-escalateemotionally. But at the rational level they have esca lated in that they aredetermined to change the ir husbands' behaviour; to make him less spendthrift,or less unfaithfu l, or j ust to pay them more attent ion. Their failure to achieve thischange for the bette r in the husbands took them to marriage guidance. But thehusbands typically sit in the sess ion stony-faced, turned away from theirweeping wive s, apparently unmoved by their distress. They do not want tochange, but they feel confused by their wives' behaviour, escalated at one leveland de-escalated at the other.

In a fourth clinical variety the pat ient de-escalates at all levels , but thesubmission is not being accepted by the important othe r person. Th is occurssometimes from ignorance, sometimes from cruel ty. The fifth and final exampleof dysfunctional ago nism is seen when the instinctive strategy set is too eas ilyaccessed, and de-escalat ion occurs inappropriately to the situation. Thesepatients are oversensitive, too easily moved to tears. Sloman's chapter in thisvolume deals with them extensively.

T REAT MENT

The treatment that arises from our model can be listed in four stages with theinjunction: Try the first stage first, and if that doesn't work, try the second stage,and so on.

l . Find a rational solution. There is nothing wonderful about the operation ofthe lower levels, and their mobili sation of emotional distress and depressedmood sugges t failsafe mechanisms because the higher-level has failed to solvethe problem.

The therapist's task involves:

(a) identifying the contlic t.

(b) estimating the chances of winning, or of leaving the are na, or ofsubmitting the conflict to arbit ration; and if any of these seem possible,helping the patient achieve them.

Escalation, De-escalation, Mood Disorders 113

(c) if the problem is one of blocked voluntary yielding (inappropriaterational-level escalation), devising a means for the patient to give in (orgive up) without loss of face. This best happens before the admini-stration of antidepressant drugs, because the "giving-up" component ofthe depressive cognitions may help. In fact, when this situation arises,this giving-up depressive cognition typically has not been strongenough to achieve the necessary yielding. It needs the depression plusthe therapist to complete the job.

(d) if a third party is causative, dea ling with the problem. Such a thirdparty may be demanding obedience that conflicts with obedience toanother, therefore preventing the pat ient from making a desired submis-sion. This occurs commonly in patients caught between the demands ofa dominant parent and a dominant spouse. They cannot submit to bothat the same time, because the demands are incompatible. Or the thirdparty may not accept the submiss ion, perhaps because he or she fails torecognise what is going on.

(e) if the patient' s instinctive agonistic strategy set is too easily access-ed, perhaps due to "k indl ing" by phys ical or emotional abuse in child-hood, setting in motion appropriate measures. These may range fromlong-term individual psychotherapy to a self-assertion class . (SeeSloman, this volume.)

(I) if the patient has had to give up some unatta inable goal or much-loved incentive, considering the need for "bereavement counselling" ofsome sort. Rosen' discusses this we ll.

2. Refram ing the situation. If the situat ion that gave rise to the depressionseems insoluble, consider how it may seem differen tly to the pat ient. Here therat ional brain tries to control the informational input to the emotion al brain.Since it cannot infl uence the emotional bra in directly, this represents the closestapproximation to infl uencing the decision-making function at the emotionallevel. The best reframing process in the Western wor ld is Chr ist ianity. Reframedpain and suffering take on Christ-like qualit ies: the more one suffe rs, the moreone shares the exper ience of the Sav iour. Gurdjie ff reframed suffer ing to hisdisciples as opportunities to work on the self and so improve the "true self "which, given enough opportunity and enough work, might become immorta l."The class ical reframing, quoted by Watzlawick, II is Tom Sawye r's punishmentof having to pa int a fence. Th is prevented him from go ing fish ing with hisfriend s, so Tom reframed it as a marvellous opportunity to have fun with paint.Th is reframing gained such success that his friends forgot all about fishing andbegged him to let them do the job themselves. For the parent of a ch ild killed bya hit-and-run driver, it may help to see the driver as someone sick rather thanbad, perhaps as someone in the throes of epi lepsy or a heart attack.

114 The Evolutionary Neuroethology of Paul MacLean

3. Substitute group conflict for individual conflict. We have suggested thatthe tendency to depre ssive illness evo lved as pan of the yielding component ofritual agonistic behaviour. Essentially this stems from a dyadic interaction. Thesame considerations do not apply to conflict between groups because groupconflict lacks the primitive ritual quality of dyadic encounters. In other words,when groups lose a conflict, the members may become demoralised, but they donot become depre ssed in the way that individual losers do. Therefore , if thepatient can join other people engaged in the same conflict, the whole operationmay switch from individual agonistic behaviour to an intergroup process. Thepare nts who lost their child to the hit-and-run driver can join other parents andexpress their grief and rage in a group fashion, and hopefull y thereby direct theirenergies into such positive action as campaigning for more severe laws on drunkdriv ing.

4. Last, provide salves and ointment s to the symptoms themselves. Thisshould represent very much a last-ditch action. One hopes that in most cases oneof the preceding three methods would have worked . If not, the symptoms maybe addre ssed directly. I am indebted to Leon Sloman for the vignette of thealpine climber who has a panic attack on the side of a snow-covered mountain.He heard a rumble and feared an avalanche. His breathing acce lerated by anxietycaused him to blow off too much carbon dioxide, his blood became alkaline, andhis muscles went into tetany. In this case, encouraging him to breathe moreslowly results in restoration of the acid -base balance of his blood to normal sohis legs move again and he can walk to safety. Of course, even here, commonsense must be used. The therapist chose the breathing. He would have had lesssuccess ifhe had applied ointment to the tetanic muscles.

In this case, we accept that higher level solutions were not available. Thetherap ist might have done better to prod uce a cell phone and summon up ahel icopter to take the patient off the mountain to safety. Or refram ing thesituation, he could have pointed out that they were not in fact on a real mountainat all- they were actors taking pan in an alpine movie, and the rumbling he hadheard was the movement of a mock Mont Blanc on its castors to take up a newlocation. However, we accept that the deus ex machina of a helicopter is seldomto be summoned, even with a cell phone, and that most climbers who pan ic atthe thought of an avalanche are on real mountains and not taking pan in films.But this direct attack on symptoms represents a last resort, unlike somecognitive behaviour therapists who spend time trying to argue patients out oftheir depressive de lusions.

RESEARCH

Like other evolutionary interpretations, the foregoing represents speculationin the last resort untestable. But definit ive implications for treatment result.These might have been deduced from anoth er theory, but they have not.Treatment either works or it does not; and this can be tested in a controlled trial.The following plan would constitute such a test: (I) recruiting a center already

Escalation. De-escalation. Mood Disorders 115

conducting manualized psychotherapy of depressio n, e.g., interpersonal therapyor IPT;12 (2) inserting into their research desig n addi tional or replacementinterventions based on the evolutionary theory as delineated above. \Ve predictthat the results wou ld show qu icker and greater powc=r.

THE TRIUNE MIND

For centuries, thinkers have expressed intimations that the mind functions ina way dictated by the triune nature of the brain. Plato, in a chap ter entitled "Thethree parts of the soul" describes various fu nctions and asks: "A re we using thesame part of ourselves in all these three experiences, or a different part in each?Do we ga in knowledge with one part, feel anger with another, and with yet athird desire the pleasures of food, sex, and so on? Or is the whole soul at work inevery impulse and in all these forms of behaviour?" 13. p. 132

Eastern philosophy, brought to the West after World War I by Gurdj ieff,' oused the metaphor of the horse and cart to describe the mind. It talked of adriver, a horse and a cart, and of the connec tions between the three elements.The driver represents the rational mind, the horse the emotional mind, and thecart the instincti ve mind. Thi s philosophy aimed to create a fourth element, the"true sel f" representing a "master," who contro lled the driver, and told himwhere to go. Gurdj ieff established a teach ing centre near Paris; its prospectusproclaimed:

a modern man represents three different men in a single individual- the first of whomthinks in complete isolation from the other parts. the second merely feels. and the thirdacts only automatically. according to established or accidental refl exes of his organicfunctions . . . they not only never help each other. but are . on the contrary. automaticallycompe lled to frustrate the plans and intentions of each othe r; moreover, each of them. bydominati ng the other in moments of intensive action, appears to be the master of thesituation, in th is way falsely assuming the responsibili ty o ~ the real "I." 14. p 138

CONCLUSION

In summary, the concept of the tr iune mind has been part of human folkknow ledge for over two millennia . Paul Macl.ean ' s description more recentlyprovided a neuroanatomical basis for this knowledge. offering an enormousboost to the heur istic value of the triune model. In this chapter and elsewhere" Iattempted to demo nstrate some applications to psychiatric practice; and in thefuture I wou ld anticipate that it wi ll have a profound influence on the fields ofindividual and social psychology.

It is, of course, just a theory, that should be com pared with other theoriesdea ling with the same material. Birtchnell, for example, has put forward a twolevel theory 16.17 that may have advantages in certain circumstances; sometimesit is useful to contrast the rational brain with the remainder of the brain . ISHowever, the three-leve l theory has the advantage of dealing with the emotions

116 The Evolutionary Neuroethology ofPaul Maclean

separately. For instance, it clarifies the relation between depressed emotion anddepressed mood (the former focused on an object rap idly responds to changes inthe object's situat ion, in contrast to depressed mood that remains unfocused orse lf-focused, and unresponsive to circumstances present). The present theo rychallenges previous theories of emotion, wh ich, for instance, combine anger anddepressed emotion in the same category of negative emotion in contrast to thepositive emo tions of joy and happ iness. According to triune mind/b rain theory,ange r joins with joy as an esca lating emotion , in contrast to depressed emotionsee n as a co mpo nent of a de-escalating strategy. Empirical research wi ll deci dewhich theory most usefully conceptualizes the data.

NOTES

1. MacLe an PD: The Triune Bra in in Evolution . New York : Plenum Press, 1990.2. Ellenb erger HF: The Discovery oj the Unconscious: The History and Evolut ion of

Dynamic Psychiatry. New York: Basic Books, 1970.3. Beck AT: The development of depre ssion . In D Freedman & H Kaplan (Eds.)

Comprehensive Text book 0/Psychiatry. Philadelphia, PA: Williams and Wilkins, 1974.Pp. 3- 27.

4. Gardner R: The brain and communication are basic for clinical human sc iences .British Journal oj Medical Psychology. 1998,71 : 493- 508.

5. Huntingford F & Turner A: Animal Conflict . London: Chapman & Hall, 1987.6. Price JS: The effect of social stress on the behav iour and physiolo gy of monkeys.

In K Davison & A Keff (Eds.) Co ntemporary Themes in Psychiatry. London: Gaske ll,1989, pp. 459-466.

7. Butler AB & Hodos W: Co mparative Vertebrate Ne uroanatomy. New York : WileyLiss, 1996.

8. Gardner R, Jr. & Price JS: Sociophysiology and depress ion. In: T Joiner & JCCoyne (Eds.) The Interactional Nature 0/ Depression: Advanc es in InterpersonalApproaches, Washington, DC: APA Books, 1999, pp. 247-268.

9. Rosen DH: Transforming Depressio n: Egocide, Symbolic Death, and New Life.NewYork: Putnam, 1993.

10. Ousp ensky PO: In Search 0/ the Miraculous: Fragments 0/ an Unk nownTeaching. London:Routledge & Kegan Paul, 1950 .

11. Watzlawick P, Beavin JH, Jackson DO: The Pragmatics 0/ Hum an Co mm uni-cation: A Stu dy a/ Interactional Patterns, Pathologies and Paradoxes. New York: W.W.Norton , 1950.

12. Weissman NM & Markowitz JC: (1994) Interpersonal psychotherap y: currentsta tus. Archives ofGeneral Psychiatry, 1994; 51: 599-606 .

13. Corn ford FM: The Republic 0/ Plato. Translated with introduction and notes .London : Oxford University Press, 1992.

14. Bennett JG: Gurdjleff Making a New World . I .ondon: Turn stone Rooks , 1976.1 5~ Price JS: The adaptive function of mood change. Brit ish Journal 0/ Medical

Psych ology 1998; 71: 465-477.16. Birtchnell J: The inner brain and the outer brain. The ASCAP Newsletter, 1999,

12 (0 1), 11-17

Escalat ion, De-escalation, Mood Disorders 117

17. Birtchnell J: Relating in Psychotherapy: The Application of a New Theory.Westport CT: Praeger, 1999.

18. Price J: A case of hedonic emotionalllimbic escalat ion. ASCAP Newsle tter 1999;12 (No.5), 1()-12.