Thomas Lewis - A General Theory of Love

Table of Contents

A General Theory of Love

THOMAS LEWIS, M.D., is an assistant clinical professor of psychiatry at the University of California, San Francisco, School of Medicine, and a former associate director of the Affective Disorders Program there. Dr. Lewis currently divides his time between writing, private practice, and teaching at the UCSF medical school. He lives in Sausalito, California.

FARI AMINI, M.D., is a professor of psychiatry at the UCSF School of Medicine. Born and raised in Iran, he graduated from medical school at UCSF and has served on the faculty there for thirty-three years. He has also been on the faculty at the San Francisco Psychoanalytic Institute since 1971, and served as its president in 1981. Dr. Amini is married, has six children, and lives in Ross, California.

RICHARD LANNON, M.D., is an associate clinical professor of psychiatry at the UCSF School of Medicine. In 1980, Dr. Lannon founded the Affective Disorders Program at UCSF, a pioneering effort to integrate psychological concepts with the emerging biology of the brain. Dr. Lannon is married and the father of two; he lives in Greenbrae, California.

Drs. Lewis, Amini, and Lannon have been working together since 1991. Each comes from a different generation of psychiatrists: Dr. Amini from one in which psychoanalysis reigned unchallenged, Dr. Lannon from the era that first saw the use of psychoactive medication in treating emotional illness, and Dr. Lewis from the recent generation of psychiatrists who trained during the collision of psychodynamics with neuroscience. Dissatisfied with the standard accounts of the mind, they combined their energies to construct alternative paradigms. Their collaboration has generated academic papers and numerous presentations for psychiatric professionals. Perhaps most important, their partnership has spawned the most precious outcomes of collaboration: creativity, pleasure, and friendship.

Once you have flown, you will walk the Earth with your eyes turned skyward; for there you have been, there you long to return.

LEONARDO DA VINCI

PREFACE

What is love, and why are some people unable to find it? What is loneliness, and why does it hurt? What are relationships, and how and why do they work the way they do?

Answering these questions, laying bare the hearts deepest secrets, is this books aim. Since the dawn of our species, human beings in every time and place have contended with an unruly emotional core that behaves in unpredicted and confusing ways. Science has been unable to help them. The Western worlds first physician, Hippocrates, proposed in 450 B.C. that emotions emanate from the brain. He was rightbut for the next twenty-five hundred years, medicine could offer nothing further about the details of emotional life. Matters of the heart were matters only for the arts literature, song, poetry, painting, sculpture, dance. Until now.

The past decade has seen an explosion of scientific discoveries about the brain, the leading edge of a revolution that promises to change the way we think about ourselves, our relationships, our children, and our society. Science can at last turn its penetrating gaze on humanitys oldest questions. Its revelations stand poised to shatter more than a few modern assumptions about the inner workings of love.

Traditional versions of the mind hold that Passion is a troublesome remnant from humanitys savage past, and the intellectual subjugation of emotion is civilizations triumph. Logical but dubious derivations follow: emotional maturity is synonymous with emotional restraint. Schools can teach children missing emotional skills just as they impart the facts of geometry or history. To feel better, outthink your stubborn and recalcitrant heart. So says convention.

In this book, we demonstrate that where intellect and emotion clash, the heart often has the greater wisdom. In a pleasing turnabout, scienceReasons right handis proving this so.The brains ancient emotional architecture is not a bothersome animal encumbrance. Instead, it is nothing less than the key to our lives. We live immersed in unseen forces and silent messages that shape our destinies. As individuals and as a culture, our chance for happiness depends on our ability to decipher a hidden world that revolves invisibly, improbably, inexorablyaround love.

From birth to death, love is not just the focus of human experience but also the life force of the mind, determining our moods, stabilizing our bodily rhythms, and changing the structure of our brains. The bodys physiology ensures that relationships determine and fix our identities. Love makes us who we are, and who we can become. In these pages, we explain how and why this is so.

During the long centuries when science slumbered, humanity relied on the arts to chronicle the hearts mysterious ways. That accumulated wisdom is not to be disdained. This book, while traveling deep into the realm of science, keeps close at hand the humanism that renders such a journey meaningful. The thoughts of researchers and empiricists join those of poets, philosophers, and kings. Their respective starting points may be disparate in space, time, and temperament, but the voices in this volume rise and converge toward a common goal.

Every book, if it is anything at all, is an argument: an articulate arrow of words, fledged and notched and newly anointed with sharpened stone, speeding through paragraphs to its shimmering target. This bookas it elucidates the shaping power of parental devotion, the biological reality of romance, the healing force of communal connectionargues for love. Turn the page, and the arrow is loosed. The heart it seeks is your own.

One

THE HEARTS CASTLE

SCIENCE JOINS THE SEARCH FOR LOVE

Two girls discover the secret of life in a sudden line of poetry. I who dont know the secret wrote the line. They told me (through a third person) they had found it but not what it was not even what line it was. No doubt by now, more than a week later, they have forgotten the secret, the line, the name of the poem. I love them for finding what I cant find, and for loving me for the line I wrote, and for forgetting it so that a thousand times, till death finds them, they may discover it again, in other lines in other happenings. And for wanting to know it, for assuming there is such a secret, yes, for that, most of all.

Denise Levertov, The Secret

Some might think it strange that a book on the psychobiology of love opens with a poem, but the adventure itself demands it. Poetry transpires at the juncture between feeling and understandingand so does the bulk of emotional life. More than three hundred years ago, the French mathematician Blaise Pascal wrote, The heart has its reasons whereof Reason knows nothing. Pascal was correct, although he could not have known why. Centuries later, we know that the neural systems responsible for emotion and intellect are separate, creating the chasm between them in human minds and lives. The same rift makes the mysteries of love difficult for people to penetrate, despite an earnest desire to do so. Because of the brains design, emotional life defeats Reason much as a poem does. Both retreat from the approach of explication like a mirage on a summers day.

Although the nature of love is not easy to define, it has an intrinsic order, an architecture that can be detected, excavated, and explored. Emotional experience, in all its resplendent complexity, cannot emerge ex vacuo: it must originate in dynamic neural systems humming with physiologic machinations as specific and patterned as they are intricate. Because it is part of the physical universe, love has to be lawful. Like the rest of the world, it is governed and described by principles we can discover but cannot change. If we only knew where and how to look, we should be able to find emotional laws whose actions a person could no more resist than he could the force of gravity if he fell off a cliff.