Recovering schema after brain surgery

My best friend T was diagnosed with epilepsy, a brain disorder characterized by sudden recurring attacks of loss of consciousness or convulsive seizures, when she was 7-years-old. I’ve known T since birth because our mothers were also close friends. She learned how to read by age 3, went on to the mentally gifted program in school and was always very smart. T had her first big seizure at age 7 (the end of Piaget’s second state of development), a few weeks before we were going to perform in a ballet recital. One night, when her mom went to check on her after she fell asleep, she found T in bed shaking and chattering her teeth until a large portion of them fell out. Normally after a seizure patients experience what is called a post-ictal period, where they slowly return to normal awareness. After a month of hospitalization, she had to re-learn how to walk. She also seemed to have a different personality, she became more child-like – using shorter sentences and simpler words, and had difficulty expressing herself in words, but after a few months she slowly returned to her pre-seizure personality. Piaget said that the biggest achievement at this second stage of development is representing the world symbolically, especially through language.

Throughout our teenage years, T took medicine to control her seizures but would still get them if she got over-stimulated because of stress, fun, fireworks, loud music or alcohol, for example. After graduating college and working for a year, T decided to get brain surgery to stop having seizures or taking medicine to control them. If the operation and recovery happened successfully, she would be able to do things such as operate a car or have the option of having children. The doctors had to remove a chunk of her brain above the left temporal lobe, which is close to the “language center”, and warned her that her speech might be disabled as a result of the surgery. She decided to take the chance.

Following the surgery in January of 2005, T went to therapy and had to re-learn how to read. But the surgery didn’t push her back all the way to the first stage of development, because T was still able to recognize letters, people and speech. Having a keen interest in politics, she started by reading short passages in the Metro, a free newspaper that contains short summaries of local, national and international events written at an elementary reading-level. The doctor said it helped her recovery because she was bilingual, and bilingual patients have a more developed language center.

As you can see, I’ve known T all my life and have seen her develop according to Piaget’s stages of development. I’ve also seen her regress after seizures and quickly return to her previous stage.

A year and a half after brain surgery, she is in graduate school and although she is able to comprehend the material, she feels frustrated at times because she is not at the stage of development that she was pre-surgery. She needs to study and read differently and re-read more than she had to in the past. Piaget would say that T is adjusting to her environment post-surgery, and creating new schemata to learn all the new vocabulary one needs to when studying Educational Policy. When I asked her how school was going, she wrote in an email,

“I think the hardest part for me is not what I have to do to remember things now but that I never had to do it before. Its basically having to change the way I learn and get used to it. I'm doing the highlighting and all that but remembering it well enough to be able to discuss it in class is different. Hopefully, I'll get used to it.”

Quitting Smoking

I have been a casual smoker for about a decade now. I say casual because I think for the most part, I was never physically addicted to nicotine. I smoked casually – bumming from friends at bars, from strangers outside restaurants after a heavy meal, and buying “emergency packs” that I kept at home in a drawer and smoked during times of stress, anxiety or anger. But mainly, I smoked when I was around other smokers. This confirms to me Vygotsky’s view of human nature – that no one is a sole learner. I doubt that I would pick leaves from a tobacco plant, dry it, roll it in paper and smoke it if I never saw anyone else do it.

I have quit several times by changing environments and “going cold turkey.” But I always returned, most recently because I was in a relationship with another smoker. A sociohistorical theorist like Vygotsky might say that I learned to smoke through participation and being social with other smokers. But for this journal entry I am not going to talk about how I learned to smoke, but rather how I quit.

In mid-November, I signed up for a six-week, holistic smoking cessation program where I met Sandi, a Reiki healer who helped me look deep within to identify triggers and patterns and help me help myself quit. Sandi did this by encouraging me to journal, practice mindful breathing, exercise and practice Reiki and guided imagery. For the first two weeks, I had to record EVERY cigarette I smoked and journal what I was doing at the time, how I was feeling, and where I was. Once I identified what my triggers were (coffee, stress, social, wanting to take a break), she helped me come up with coping strategies and activities that I enjoy that are not connected to smoking. Vygotsky might say that Sandi was helping me deconstruct my pre-established “signs”, or disassociating stimuli from response, which in this case was smoking. When I wanted to do something with my hands I crocheted and doodled. I ate cookies, carrot sticks and pretzels when I needed an oral fixation. Sandi never told me what activities to substitute smoking with, but rather by meeting hourly every week, we engaged in conversation and she helped me come up with the solutions on my own. She also gave me some rules, such as waiting half an hour after drinking coffee, not smoking in our apartment or porch, avoiding other smokers, or doing activities that I enjoy that don’t involve smoking.

What I love so much about Sandi’s technique is that it can be used for things other than smoking! I would love to try her technique (journaling and self-reflection) with my students who might have problems in school with procrastination or fighting, for example. The only downside I can see is that it is quite time consuming for the teacher. The positives include meaningfulness, self-empowerment, and deep understanding.

Please, no more pumpkin puree!

My friend’s one-year-old son, Joshua, does not like pumpkin puree. This was a problem. When my friend would try to feed him he first moved his head a little and my friend would move Josh’s spoon into his mouth. After doing this for a few weeks Josh started pressing his lips together tightly whenever my friend approached him with a spoonful of the mushy orange stuff. This became a game. My friend would then wedge his lips open with the spoon to get the food into Josh’s mouth. When Josh ate, we felt like we “won.”

I saw her a month later and she informed me that Josh came up with another combative technique against eating the flavorless, (yes I’ve tasted it) but nutritious food. Now when approached with the pumpkin puree, Josh covers his top lip with his bottom lip to protect his overly sophisticated taste buds from the baby food. This technique eliminates the possibility of breaking and entering his mouth through wedging the spoon. My friend later added, “I have no idea where he learned that.” Josh’s slight modifications built from past negative experiences lead him to solve his problem of having to eat undesirable food. This is an example of Dewey’s principle of continuity, which means that every new experience builds on past experiences, and mental models are reinforced, added to or challenged. In Experience & Education, Dewey says,

Different situations succeed one another. But because of the principle of continuity something is carried over from the earlier to the later ones. As an individual passes from one situation to another, his world, his environment, expands or contracts . . . What he has learned in the way of knowledge and skill in one situation becomes an instrument of understanding and dealing effectively with the situations which follow. (Dewey, 1938, p. 44)

In Josh’s case, pressing his lips together was unsuccessful since his mom got the spoon through by wedging his lips open, so his mental model was challenged and adjusted. He adjusted his food-blocking technique by experimenting in different ways and finally was successful. This practical experience is a clear example of “learning by doing.”

This observation reinforces my idea of meaningful learning. Infants are naturally curious, and I have faith that Josh will use his learning experience with other foods in other places and situations.

Living in a Skinner box

In November of this year, I tried breaking up with my boyfriend after a year and a half of verbal, psychological, and eventually physical abuse. One time, as I was trying to pack up my belongings to leave, he grabbed all of my clothes off the closet hangers in a fit of anger and attempted to throw them out the window of the 8th floor apartment that we shared. In addition, he also threatened to throw my schoolbooks out of the window. Worst of all, he threatened to call Penn and get me kicked out. These are all examples of aversive stimuli. I reacted to these aversive stimuli by saying “sorry” and staying in the apartment and in the relationship (even though I later reflected that I did nothing wrong). If you examine abuse through behaviorist lenses, the above makes perfect sense. Behaviorism is the philosophy that all things that people and animals do (actions, thoughts and feelings) are all behaviors. Abusers “teach,” or rather condition, their victims to behave the way they want them to using positive and negative reinforcement.

In my case, my boyfriend would punish my “negative behaviors” - which included wanting to spend time alone with my friends or mother, saying hello to another male, not answering my phone, using up the hot water in the shower, questioning his drinking or drug use - by yelling, grabbing or restraining me, threats, giving me the “evil eye” and kicking me out. Getting worn out from the endless arguing and reasoning, I eventually surrendered and stopped going out. I would stay in the controlled environment of our Skinner box apartment to avoid the aversive stimuli. But as Boeree wrote about Skinner, “the environment doesn’t travel well!” When I would visit my mother on the weekends I returned to my normal [unafraid] behavior or left the controlled environment in a mental way – by reading books. We would have discussions of the books I read and he didn’t have any strong opinions on them usually. However, when I was enamored with Rita Golden Gelman’s book, he veiled his controlling behavior in “romanticism” by saying “please don’t ever do that [travel abroad alone], I would miss you terribly.”

Skinner and Thorndike claim that for behaviorism to work, we must start with someone’s core beliefs. My belief was that human beings are good by nature. Another reason why I believe I put up with the abuse for so long is because I was eager to please and driven by rewards and punishments. My rewards were kindness, love, attention, a soft tone of voice and material things such as ipods, clothes and getting taken out to eat.

Now that the relationship is over, I take away many important learning experiences from it. Just like Skinner learned in his rat experiment, I learned that you grow immune to constant negative reinforcements. When my boyfriend saw that I was no longer affected by aversive stimuli such as yelling, he needed to find stronger negative reinforcements and graduated to physical abuse.

This past week I finally dealt with it by giving him back a taste of his own medicine. I filed a report and put the responsibility of aversive stimuli (threat of jail) in the hands of the police.