The Tolerating Cure

Question: Why don’t some psychologists believe in the effectiveness of ACT?

Steven Hayes: It's an argument about theory and processes, but the processes, and the ones we've been talking about, inform what we think of ourselves and what we should encourage in our children and what we should try to put into the culture. And I think really we've been through a time when we thought we could think our way out of this, and kind of think clearly and that would solve the problem, and detect logical errors and that would solve the problem. We thought of suffering as a problem of sort of dysfunctional cognitions. I think we're coming into a time instead where it has to do with how you stand in relationship to your own world within and in relationship to those around you in the world without. And I believe these are the things that we need to put into our schools, education, into our psychotherapy and into our culture more, finding a way to not be so harsh and judgmental, so objectifying and dehumanizing, constantly focused within and trying to get these difficult thoughts and feelings to go away; or focused without and objectifying and dehumanizing others. So the core of the controversy is, is it more powerful to take an acceptance and mindfulness-based approach compared to a cognitive and emotional change approach when we're dealing with these problems? I think the evidence is more in our favor, especially the process evidence.

And I think if you look at where the culture is going, there's a reason why Eckhart Tolle is on Oprah. There's a reason why The Purpose-Driven Life is a best seller, quite apart from appealing to evangelicals and the Christianity that's in it. It's also -- there's a yearning for meaning, for values and for mindfulness and acceptance, because we've created a modern world where our children are exposed to 10, 20, 30 times the number of words that our great-grandfathers were exposed to. And we're exposed in a single day or two to more horror on our Internet Web pages than our great-grandfathers were exposed to in decades of living. And we have not created modern minds for that modern world. Science and technology has just dumped it on us. And I think people yearn for it. I think you see it in what's popular. And why are people wanting to learn about meditation, and why are they going on mindfulness retreats? And why are they talking about a purpose-driven life? It's because they know more is needed in the modern world.

And that's the core of the controversy. I think it's pretty clear in how things are moving in empirically supported treatments that we're going to be speaking to the culture in a different voice. It's not going to be the loosey-goosey voice of the '60s, but it's going to have some echoes of some of the deeper clinical and spiritual and religious traditions that had wisdom in it. If we're not going to get there through religious means and things of that kind, which greatly has weakened in the West, we're going to have to find a way to put it in the culture in a different way, because we need something right now other than yet another cable shoutcast or yet another Internet Web page showing us the cellulite on the actress's rear end. I mean, the amount of sort of judgment and harshness that's in our culture -- we need something that's prophylactic for that, and I think that's what's inside these new methods.

Can a psychology that aims to change cognition and emotion be effective in such an overwhelming world? A psychologist explains the case for an acceptance-based approached to therapy.

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The surprise reason sleep-deprivation kills lies in the gut

New research establishes an unexpected connection.

Image source: Vaccaro et al, 2020/Harvard Medical School
Surprising Science
  • A study provides further confirmation that a prolonged lack of sleep can result in early mortality.
  • Surprisingly, the direct cause seems to be a buildup of Reactive Oxygen Species in the gut produced by sleeplessness.
  • When the buildup is neutralized, a normal lifespan is restored.

We don't have to tell you what it feels like when you don't get enough sleep. A night or two of that can be miserable; long-term sleeplessness is out-and-out debilitating. Though we know from personal experience that we need sleep — our cognitive, metabolic, cardiovascular, and immune functioning depend on it — a lack of it does more than just make you feel like you want to die. It can actually kill you, according to study of rats published in 1989. But why?

A new study answers that question, and in an unexpected way. It appears that the sleeplessness/death connection has nothing to do with the brain or nervous system as many have assumed — it happens in your gut. Equally amazing, the study's authors were able to reverse the ill effects with antioxidants.

The study, from researchers at Harvard Medical School (HMS), is published in the journal Cell.

An unexpected culprit

The new research examines the mechanisms at play in sleep-deprived fruit flies and in mice — long-term sleep-deprivation experiments with humans are considered ethically iffy.

What the scientists found is that death from sleep deprivation is always preceded by a buildup of Reactive Oxygen Species (ROS) in the gut. These are not, as their name implies, living organisms. ROS are reactive molecules that are part of the immune system's response to invading microbes, and recent research suggests they're paradoxically key players in normal cell signal transduction and cell cycling as well. However, having an excess of ROS leads to oxidative stress, which is linked to "macromolecular damage and is implicated in various disease states such as atherosclerosis, diabetes, cancer, neurodegeneration, and aging." To prevent this, cellular defenses typically maintain a balance between ROS production and removal.

"We took an unbiased approach and searched throughout the body for indicators of damage from sleep deprivation," says senior study author Dragana Rogulja, admitting, "We were surprised to find it was the gut that plays a key role in causing death." The accumulation occurred in both sleep-deprived fruit flies and mice.

"Even more surprising," Rogulja recalls, "we found that premature death could be prevented. Each morning, we would all gather around to look at the flies, with disbelief to be honest. What we saw is that every time we could neutralize ROS in the gut, we could rescue the flies." Fruit flies given any of 11 antioxidant compounds — including melatonin, lipoic acid and NAD — that neutralize ROS buildups remained active and lived a normal length of time in spite of sleep deprivation. (The researchers note that these antioxidants did not extend the lifespans of non-sleep deprived control subjects.)

fly with thought bubble that says "What? I'm awake!"

Image source: Tomasz Klejdysz/Shutterstock/Big Think

The experiments

The study's tests were managed by co-first authors Alexandra Vaccaro and Yosef Kaplan Dor, both research fellows at HMS.

You may wonder how you compel a fruit fly to sleep, or for that matter, how you keep one awake. The researchers ascertained that fruit flies doze off in response to being shaken, and thus were the control subjects induced to snooze in their individual, warmed tubes. Each subject occupied its own 29 °C (84F) tube.

For their sleepless cohort, fruit flies were genetically manipulated to express a heat-sensitive protein in specific neurons. These neurons are known to suppress sleep, and did so — the fruit flies' activity levels, or lack thereof, were tracked using infrared beams.

Starting at Day 10 of sleep deprivation, fruit flies began dying, with all of them dead by Day 20. Control flies lived up to 40 days.

The scientists sought out markers that would indicate cell damage in their sleepless subjects. They saw no difference in brain tissue and elsewhere between the well-rested and sleep-deprived fruit flies, with the exception of one fruit fly.

However, in the guts of sleep-deprived fruit flies was a massive accumulation of ROS, which peaked around Day 10. Says Vaccaro, "We found that sleep-deprived flies were dying at the same pace, every time, and when we looked at markers of cell damage and death, the one tissue that really stood out was the gut." She adds, "I remember when we did the first experiment, you could immediately tell under the microscope that there was a striking difference. That almost never happens in lab research."

The experiments were repeated with mice who were gently kept awake for five days. Again, ROS built up over time in their small and large intestines but nowhere else.

As noted above, the administering of antioxidants alleviated the effect of the ROS buildup. In addition, flies that were modified to overproduce gut antioxidant enzymes were found to be immune to the damaging effects of sleep deprivation.

The research leaves some important questions unanswered. Says Kaplan Dor, "We still don't know why sleep loss causes ROS accumulation in the gut, and why this is lethal." He hypothesizes, "Sleep deprivation could directly affect the gut, but the trigger may also originate in the brain. Similarly, death could be due to damage in the gut or because high levels of ROS have systemic effects, or some combination of these."

The HMS researchers are now investigating the chemical pathways by which sleep-deprivation triggers the ROS buildup, and the means by which the ROS wreak cell havoc.

"We need to understand the biology of how sleep deprivation damages the body so that we can find ways to prevent this harm," says Rogulja.

Referring to the value of this study to humans, she notes,"So many of us are chronically sleep deprived. Even if we know staying up late every night is bad, we still do it. We believe we've identified a central issue that, when eliminated, allows for survival without sleep, at least in fruit flies."

Withdrawal symptoms from antidepressants can last over a year, new study finds

We must rethink the "chemical imbalance" theory of mental health.

Photo Illustration by Joe Raedle/Getty Images
Surprising Science
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Four philosophers who realized they were completely wrong about things

Philosophers like to present their works as if everything before it was wrong. Sometimes, they even say they have ended the need for more philosophy. So, what happens when somebody realizes they were mistaken?

Sartre and Wittgenstein realize they were mistaken. (Getty Images)
Culture & Religion

Sometimes philosophers are wrong and admitting that you could be wrong is a big part of being a real philosopher. While most philosophers make minor adjustments to their arguments to correct for mistakes, others make large shifts in their thinking. Here, we have four philosophers who went back on what they said earlier in often radical ways. 

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Is there a limit to optimism when it comes to climate change?

Or is doubt a self-fulfilling prophecy?

David McNew/Getty Images
Politics & Current Affairs

'We're doomed': a common refrain in casual conversation about climate change.

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