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“The Wise Mind” Comes Apart

December 29, 2011
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Last week I had to brush the cobwebs off the acronym “DBT”–Dialectical Behavioral Therapy –when our family therapist tapped a Venn diagram called “The Wise Mind” and observed, “It sounds like despite her intelligence, Hope gets stuck sometimes in emotional thinking.”

This is my recreation of “The Wise Mind” diagram:

This secular theory posits that humans make “wise” decisions when they take both logical reasoning (represented by the blue circle) and emotional feelings ( represented by the red circle) into account and arrive at a decision in “the wise mind”–the reasonable middle ground between the two.

The diagram has been sloshing around in my head for a week because that sounds like another way of describing intact executive functioning: logic is supposed to temper or moderate impulse to arrive at a wise decision, not a foolish one. (For a  great example of how executive function fails in kids with FASD, see Dorothy’s recent post, Trying To Play the Wrong Way.)

The first thought that came to mind was: Hope’s circles must be out of balance. Thinking about the contrast between her intellect and her emotional immaturity, I imagined the logical/rational circle bigger than the emotional circle.

I immediately thought, No: that’s Mercy’s diagram. For Hope, the emotional circle is bigger than the logical. So I mentally drew it the opposite way:

But that didn’t work either: it didn’t account for Hope’s variability. Sometimes she makes surprisingly good decisions, but more often she cannot. And when she’s having a hard time, she’s completely stuck in emotional thinking, a mental place where no logic can touch her.

At that point the structural integrity of the Venn diagram failed under the weight of “no logic can touch her.”  The rational and emotional circles came unglued and began floating like bubbles.

And in that moment, the concept worked –even if ceased being Venn.

Hope’s rational thinking and her emotional thinking do not have the routinely overlapping relationship that “The Wise Mind” idea assumes. Her emotional and rational realms are like two soap bubbles independently riding on shifting currents in her mental airspace.

Sometimes they drift close enough to touch.

In those moments, her intellect tempers an emotional impulse; in the span of a few synapses, executive function sparks and she makes a surprisingly good decision.

Then the bubbles drift apart again and she’s unmoored, adrift in emotion and impulse out of reason’s reach.

Hope is okay in that place if no disappointment or frustration intrudes. But think of how we use reason to talk ourselves down out of upset: People don’t win every time; It will be my turn soon; I can ask for help; Try again; These shoes are as good as the other ones…. Sometimes she is cut off from all reason: panicked, scared, fighting. Irrational.

Or, in Dorothy’s example of play, typical kids access rational thinking to determine things like, “I must get a person’s attention before tossing a softball for them to catch.” Typical kids continue to use logic to refine their choices: “What is the best way to get someone’s attention? If I tackle them or take the ball and run, they may be mad and refuse. So I will wait for a good moment to interrupt and I will use words and ask politely to increase my chances of getting a playmate.”

In FASD, it doesn’t seem to matter that affected kids have social rules stored in their rational mind; they live in an emotional bubble and have unpredictable access to their ability to reason. Much of the time, their behavior reflects them acting out of purely emotional reasoning, even when doing so is counter-productive to securing their rational goal.

This is helpful to me. It explains why Hope’s behavior is somewhat linked to her environment and why environment is said to be a key factor in forestalling secondary disabilities in FASD. We might say the environment generates the air currents on which their rational and emotional thinking bubbles float. Some winds are more favorable, propelling the two bubbles closer to each other more of the time. Some are not, keeping them apart.

It also explains why Hope was so integrated on medication. Medication nudged her bubbles back toward more Venn-like alignment where her intellect could better temper emotion and vice versa.

What do you think?

It has me pondering the environments where Hope is functional more of the time: what factors in public places blow her rational and emotional bubbles closer together? What is it about private environments that tend to drive them apart?

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2 Comments leave one →
  1. December 30, 2011 9:13 am

    I never heard of “the wise mind,” but this really makes a lot of sense to me. I see some of the same things in my Little Miss.

    Two thing I have noticed that tend to blow the rational and emotional further apart are unbalanced sensory input and inability to communicate. Among other things, Little Miss has been diagnosed with a speech disorder called MERLD (more here ==> http://beyondthedryervent.blogspot.com/p/what-is-merld.html) When she is unable to communicate, logic fails completely and she is ruled entirely by emotion. It can get UGLY!

    The sensory stuff you probably deal with a lot too. It seems that when their little sensory cups are filled just right, they can make much better decisions. Overfill or underfill and look out!

    Thanks for sharing this theory and your thoughts on how it works for your daughter 🙂

  2. January 1, 2012 9:33 pm

    Karla,

    You’re right about the communication piece. Hope’s ability to communicate slides downhill fast when she begins to lose contact with her rational mind. In fact sometimes that’s my first clue: she regresses to more babyish grammar and speech. I can imagine it is even harder when your daughter struggles to communicate as it is.

    If Joy did not have CP, she’d be diagnosed with something like MERLD, too. But that expressive/receptive combo. so commonly accompanies quadriplegia that they don’t separate out the diagnosis –they just go ahead and do expressive/receptive ST. Although we think her recptive is better than her expressive….But you know how they don’t quantify mommy intuition on reports :). –Carrie

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