May 1st, 2016

Pruning our lives

It is a warm Friday morning in April and my wife is out to an estate sale. If she sees anything interesting, she will buy it or, if it is something big or expensive, she will call me for a second opinion.

This is our usual arrangement and it has worked well over the years to keep our accumulation of treasures within reasonable limits. These days we are buying less and discarding more or at least that is our intention.

I used to think that this kind of downsizing was an annoying habit of old people too focused on preparing for the end of their lives to enjoy the present moment.

I pushed away gloomy thoughts when my mother sent me home from a holiday visit with a box of my old books, papers, letters, and postcards even as I knew I would smile at the memories they contained. This stuff was mine, after all, not hers. That would come later.

I used to think that getting rid of your stuff was a sure sign that you were getting old and beginning the long slide or short drop into oblivion. That was before I learned that all growth is a matter of pruning the excess from our lives.

Writing in a recent issue of The New Yorker, physician and Pulitzer prize-winning author, Siddhartha Mukherjee, reported on findings concerning the genetic basis of schizophrenia.

Citing the results of a large scale international study first reported in 2009 and updated in 2014 in the journal, Nature, Mukherjee described a strong association between the risk of developing schizophrenia and an abnormality on a section of the human genome that regulates the immune system.

This abnormality seems to be responsible for the production of a protein that the immune system uses to target pathogens and cellular debris for elimination by specialized scavenger cells.

A variant of this protein has been implicated in marking neural synapses for destruction by these same cells in a well-established process of pruning redundant synapses in systems responsible for vision, memory, cognition and learning.

The pruning operation is especially active during the second and third decades of life when schizophrenia is most likely to develop. Moreover, studies have shown that people with schizophrenia have significantly higher levels of the tagging protein than normal controls.

While there are many more questions to be answered, the conclusion of what we have learned thus far seems inescapable. Schizophrenia is a disease of over-pruning. Given that some pruning of overabundant synapses is necessary for focused linear thinking, the protein controlling the brain’s scavenger cells is necessary for normal development.

However, with too much of the same protein and a consequent loss of vital neural connections, the brain reacts to produce the classic symptoms of schizophrenia. It turns out that the body is asking the same question that has been dogging us all along. What do we keep? What do we throw away?

My wife has returned from her estate sale with one item, a book published in Britain after the First World War to raise money for Queen Mary’s hospitals treating wounded soldier and sailors. Containing essays by John Galsworthy and Arthur Conan Doyle, it was good find, a little piece of history well worth keeping.

We can’t keep everything. The basement holds artifacts from three generations of our extended family. Furniture that belonged to our parents jostles for space with our own accretion of outmoded goods and the material record of our adult children’s progress through life.

Bed frames, mattresses, a drum set, a bicycle, books, My Little Ponies, Hot Wheels, skateboarding videos, Candyland, Operation, and Mr. Potato Head all tell the story of family life and chronicle the history of popular culture over the last half century.

The study where I write is crammed with books too numerous to read, too good to throw away. The time has come for some serious pruning and it’s not just stuff that I’ll be discarding.

When I retired nearly a year ago, I began by pruning a 40-hour workweek from my schedule along with a 50-mile daily commute and the responsibilities of a psychologist practicing in a large public sector teaching hospital.

In return, I am discovering a new perspective that allows me to appreciate better the interplay between priming and pruning. While we are always doing both, we pay more or less attention to different aspects of our experience as we move through life.

As I watch young psychologists establish themselves, I know they are engaged in a process analogous to the brain’s priming of essential circuits, strengthening their connections to the world of work that will shape their professional careers.

Friends and colleagues further along in their lives prime and prune with an eye toward maintaining a balance between work and family responsibilities and pleasures. Older friends bring reports of what lies ahead and, by the example of their lives, offer encouragement for the difficult cuts to come.

We come into the world with all the brain cells we will ever need and we grow by discarding the excess. What is essential? What is expendable? The question echoes down the corridor of the years and the answers we give shape the course of our lives.

Alan Bodnar, Ph.D. is a psychologist formerly at the Worcester Recovery Center and Hospital.

By Alan Bodnar Ph.D.

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