Migration & Pruning in brain cells: Ever heard of it?

Neuropsychology has gained an entirely new perspective with extremely detailed research done through MRI, FMRI and PET scans. However, from the viewpoint of clinical psychology, one question will always remain: ‘Is it in the brain or in the mind?’’

One of the most difficult questions in neuroscience and medicine, isn’t it?

The answer remains equally ambivalent. It is a double-edged sword. It depends on the intensity and type of a disorder with which the person is afflicted. However, one thing is absolutely clear: Just as human beings are ‘’social’’, so is the human brain. 

By the eighth week of conception, the zygote experiences 250,000 neuroblasts (nerve cells per minute). Cells in brain show a particular behaviour. They all perform different functions. Cells that perform similar function, gather together in a place. For example, cells that are to perform verbal functions would gather in a place and relate to that function only.

Cells migrate all the time. Even after birth. However, the process of moving of cells from one place to another is called migration. Visual neurons become visual neurons, not because they are born visual, but because they migrate to a particular part of the brain to perform that activity.

Psychological disorders like schizophrenia, autism, dyslexia and many more are caused mostly because of some defect in migration.

And then comes the time to talk about behaviour. 

These cells, while migrating, and otherwise too, come in contact with genes and when this happens, behaviour (response) activates. Over a period of time, if the neurons are not medicated or trained to change response, that behaviour becomes ingrained and thus, as a result, you get many complaints!!!

‘’He’s got an anger issue, right since his childhood!!!!!’’

‘’She always gets anxious, no matter what the situation is. She has always been like this’’.

Whose gone inside her head would know what took to make her ‘anxious’’ since ‘forever’?

And there, when research so clearly proves that there are lots of substances that inhibit the healthy migration process. Mothers who smoke are shown of have children who suffer ADD. Alcohol also inhibits healthy migration causing FAS (Fetal Alcohol Syndrome).

Let us come to the second part. Pruning.

Before that, let’s make it clear. The world and ‘life’ (each organism) lives and dies in a state of ‘competition’. Charles Darwin’s term ‘Survival of the fittest’ strikes me first as I think about Pruning.

Think of an office where you’ve got nothing but utter competition. Employees who do not perform are thrown out and those who become incapable to perform because of old age, they retire. Same is the case with neurons.

Why does an 83 year old woman face so much of difficulty in seeing? One reason is that the speed with which neurons regenerate in her occipital lobe is very slow. More and more neurons lose their capacity to function; this problem as a result!

Life, movement, regeneration, organization, destruction is more than just a part of nature. It inhabits every cell!

Please let me know if this explanation answers the question:

‘Brain or mind?’ sufficiently

With many clients, I don’t buy into their talk when they use the term ‘’hereditary’’ so loosely. That’s layman talk. Except a very few cases of Huntington’s disease or color blindness or phenylketoneuria, very few disorders are completely governed by one single ‘gene’. It’s so easy to blame ‘genes’.

One epic joke: ‘Sorry darling, I misbehaved. My dad did it this way. It’s in genes!!’

The darling is going to understand the shit behind sophisticated neuropsychology.

Now let’s take the example of diabetes. It is highly genetic, but if the person who is pre-disposed to it takes care not to become over-weight, it can be avoided. Never blame genes fully for anxiety, depression or schizophrenia. It’s always a dual process.

I am not sitting on the fence by speaking on both sides, but I do feel the complexities leave us with no other option.

Eternity.........................: About GAD (Generalized anxiety disorder)

Eternity.........................: About GAD (Generalized anxiety disorder): GAD (Generalized anxiety disorder) is perhaps the most misunderstood clinical condition. It becomes dangerous when used loosely by laymen a...

About GAD (Generalized anxiety disorder)

GAD (Generalized anxiety disorder) is perhaps the most misunderstood clinical condition. It becomes dangerous when used loosely by laymen and professionals without adequate clinical knowledge and training. My purpose of writing this blog is not to write ''about'' GAD but ''for'' it.

Last year, a colleague from the department of Egyptology approached me and said: 

''I have cigarettes. They kick up the system and now I feel I got GAD. You know, I am crazy.''

I felt like clutching my head. I groaned ''Oh God! Not one more, please!!''

First of all, this person was a 100% sure he had GAD.

Secondly, he thought he was an expert and knew what moderated his so-labelled GAD because according to him, feeling anxious about everything defined GAD. Well, GAD isn't that simple.

I asked him, ''Do you know what GAD is?''

He fumbled. He knew he'd been caught on the wrong side but he was quick to reply, ''I think it's just feeling anxious about everything.''

''And what is that everything?'', questioned I.

''I can't clinically define it but this is what I feel''

''It seems you aren't sure what GAD is, are you?''

''No''

''And yet you, so confidently diagnosed yourself''

Most of us think we know ourselves the best, so we can give labels and having a psychological label sounds like a cool new thing on the block. You may know yourself the best, but you don't know the disorder itself. So think a hundred times before self-diagnosing.

Coming back to GAD, I won't defy everything my Egyptologist friend had said. 

GAD does comprise of anxiety, but anxiety's second level, which is called meta-worry is the main driver for GAD. It's not the worry. It's worry about worry. Adrian Wells speaks of these cognitive levels in depth.

Borkovec and Newman (1992) have given another explanation stating that worrying is an attempt to avoid more acute distress. Confrontation with real life situations can be a real ''pain in the arse'' and worrying about them gives a sense of ''solving the problem in head'' (though they are never really solved). But you get the idea how it keeps going.

The third explanation is given by Quebec who says GAD develops with the habit of ''intolerance of uncertainty''. It is not good to remain uncertain. 

Let me speak about my own self to elaborate Quebec's weird but true explanation. 

Autumn 2009. 
I was called in to see our neuropsychology professor, Dr. Tree.
I had read a lot of his work in journals and in books. I respected him and I still do.
However, I did not know why he had called me in his office. I couldn't stand that uncertainty. I was supposed to see him on Monday and the entire Sunday night was spent tossing in bed. Before some light sleep came over to me, I thought I must have failed my Neuropsychology assignment or must have done a project badly. Failing was bad, but was still better than uncertainty.

The next day I enter Dr. Tree's cabin with the conclusion that I must have failed. All I get to know was I had scored the second highest in the entire masters' batch in Neuropsychology Module.


So you see how important it is to be certain all the time?????!!!

That's how brains work!

And mind it, I wasn't diagnosed with GAD because again, we must bear in mind that clinical diagnosis does not depend on 1-2 such events.


GAD presents clinically in a million different ways, but in your case histories, it is very important to understand what events in their lives have precipitated their GAD. There may be many events, but some are crucial. Plus, there is one major philosophy behind GAD and it is:

''Over-estimation of the situation and under-estimation of their own coping resources''

Apart from that, ''Cognitive distortions'' or ''UTH'' (Thinking habits) as described by Burns (2000) must be outlined.With GAD patients, they know they are thinking shit and they don't want to hear it from  their doctor. 

As a psychotherapist, never focus on telling them what's right and what's wrong. Try using Beck's Anxiety Inventory, HADS or GHQ (in general) and GAD-7, which is a specific GAD inventory to know the crucial potholes in their clinical condition and how it impacts their health. 

Never underestimate the ''topics'' about which your GAD clients worry or say, seek internal safety. They might worry about a possible storm and their property getting destroyed, but that cannot be stamped as ''illogical''. If you try to explain the ''truth'' or ''logic'' of the thinking, you'll only involve in an argument. They are not wrong because an unlikely storm is absolutely possible......but why do they worry about it and we don't?

Statistics are alarming.....I don't buy into them, nor would I advise anyone to remember and buy into statistics. They are not perfect and so are researchers (they are more than imperfect)

There is a little more for those who are interested:

There is one more aspect which is good only to rely on when reading; it is Neurobiology of GAD (or any other condition for that matter)
What I present here may not necessarily be the truth, so it is important to be objective.

Just as any clinical condition is bound to cause alterations in chemical, hormonal and neuronal features of the body/ brain, there's one sure universal fact; the brain is affected. You cannot have just a few areas of brain getting affected in isolation.

I would bring into picture Amygdala (the old brain emotional centre), peri-amygdala regions (for the same emotions) as well as Pre-frontal cortex (for cognitive processing).
I might be saying this because I am CBT therapy oriented where cognitions and emotional reaction is the key behind understanding any disorder. 

Biologists and neuropsychology may rely more on Hippocampal regions to understand the impact of ''narrative events'' from case histories.

Most studies are based on activities shown in MRI and PET-scans, but even these and FMRI scans can only speak about the glucose activity going on in these regions at that point of time and since this is extremely fickle, it is hard to put a stamp of 100% objectivity here as well.

The answer to this and many other questions leads us to the topic of GAD treatment which is not the purpose of today's blog. 

I have tried clarifying clinical GAD in a simple manner. I have tried my best to avoid technical terms and jargons and stick to examples from real life events. I just thought this wouldn't make the blog look like an academic lesson.  Your feedback is very important to me.

Thank you very much.


Phoram Trivedi.

First things first: Before CBT or Neuroscience

1. Buy and sell: The knowledge game.

Going to U.K for masters is not a part of sophistication any longer. With India's development and progress in the 21st century, it's a matter of pride that every Indian from financially stable family can afford foreign education if he saves wise and earns smart. I am definitely speaking under the influence of David Cameron's recent visit to India & catching up with students.

However, the point is not this. The point it doing an MSc in Abnormal and Clinical psychology.

As a 16-17 year old passionate kid, I was always keen on studying clinical psychology (Paper 4 as Gujarat University put it) because the processes in the disorders, symptoms, diagnosis looked very appealing. I went to University of Wales, Swansea with the same passion.

ALAS! Only if passion could solve all the problems. Unfortunately, it doesn't.

In clinical psychology, what matters the most is not having diagnostic criteria at the tips of your fingers. I do not remember how many criteria need to be fulfilled in order to be diagnosable for GAD or MDD.

Secondly, it is always necessary to remember that the nature of the disorder has to be explored in depth through research. And rule of thumb, there is nothing right or wrong in research, because no research is perfect. Every research has it's limitations. So, you must learn 'NOT TO BUY INTO' any research, but just read it to be aware. The moment you start relying and buying on already existing researches, you lose focus and critical analysis.

Researchers just try to be objective in their viewpoints, which many, at least in India mistake for lack of knowledge, being diplomatic or sitting on the fence. It is my belief that as students, aiming to launch careers, it is very important to develop critical reasoning as a part of your personality and not just limiting it to academics.


2. Statistics, Mathematics, is that Lucifer, the devil?
Statistics and mathematics is the nemesis for so many students. I won't exclude myself from the category.

As a teenager, I landed up in this completely different world with high class statistical terms like Multiple regression analysis, running an SPSS, Kendall tests, Mann Whitney U-Tests and much more. I cried on the first day, I won't lie about it. However, what I learnt was that conceptual knowledge is more important than results. Indian system needs to learn that.

You are allowed to use calculators, and if you get a wrong answer through calculator, you lose only half a mark. But if your answer is right and you got the wrong procedure, you will be marked down.
You learn a very important lesson.

''Journey is important, not the destination''.

If we all tried to work like this, we'd be literate, quick and educated rather than being literate, quick and uneducated (just informed).

Mathematics and statistics is logic after all........as simple as that. In India, I believed and was really bad at basic school mathematics, but now I don't. The meta concept is that mathematics should be delivered in the right manner. India is the country in which ''0'' was invented, a country that did great stuff in geometry and trigonometry and sadly enough today we are complicating mathematics so much instead of understanding the basics. Is this how you prove that you're into the competition?

(PS: I don't even remember the procedures now, but if I re-acquaint myself, these procedures should come easy).

3. Research and practice are different but same.

''Go and start your practice now'' is the typical advice.

The student becomes happy. I don't have to study any longer......I am the all knowledgeable person in this area because now, I can practice.

Dear Pappas and mummys, your child has started practising, it doesn't mean he/she is an expert. Most of us don't even look back to books once.



This is my view after I finished my Post masters dip degree in CBT Therapy from University of Wales, Newport. I am not a CBT expert. I finished 100 hours of clinical training under supervision and even after all this, there's still improvement.

I almost swore at what I learnt back home about 'Open ended and close ended questions' and 'Settings of a clinical counselling// therapy room''. What the fuck!!! It does not matter.....I never wore any formal clothes to the clinical centre, and still managed to complete a degree accredited by BACP (British Association of Clinical Psychotherapy).

Practice in Clinical psychology is about remaining open to the diagnosis. Giving a label is not enough. A patient comes to me, I talk over and diagnose him with OCD, or GAD. The process through which the vicious cycle of formation is made and how the clinical collaboration works to make this change is the core of practice.

Practice brings you back to research.......How many  clients did you see? How did it work with each one of them? Are there any repetitive patterns you marked in them? A tiring frame of reference to build indeed!

4. At the end, it is application and thinking that matter.

One evening I was feeling quite stressed out and said this to my colleague who's into Marine Science.

He instinctively turned towards me and spoke ''Use psychology here.....''

I did not speak any further. I was shocked as to how loosely terms are perceived.

I may have my own views are are not compatible with a healthy thinking style, but until and unless I don't let them interfere my professional and academic life, how does it matter whether I am obsessive or depressive?

It may matter to some, though.

If you have a critical thinking you should be able to hear crap from others and not arguing back in a loud voice. That is my simple perception, non academic and non clinical.

5. A dream

Based on all the aforementioned crap and some useful stuff I might have written above, I dream of a new education system, at least in my field of clinical science and clinical psychology/ neuropsychology: A system that is not governed by the state, a system that is based on unbiased approaches and a system that makes citizens and responsible professionals out of students.

I do not day dream or fantasize about this, but having this at the back of my mind keeps me grounded and motivated. All I know is that passion and dreams can give you a direction but a proper pathway ensures that you are on the right track.

My dream is to make knowledge primary and information secondary.

My dream is to help promote conceptual thinking and avoid biased thinking.

I want it to be a win-win situation for all.

If I could have your feedback on this, I'd be more than pleased.


Please do not think this blog is written by an expert. It is written by a common student.......a student for lifetime.

The next blog shall be about Neuroscience and CBT.