Mind over Matter

Dear Dr Ash,

I’m intrigued about whether there’s any neurological validity to “manifesting” – the idea that believing in an outcome makes it more likely to happen. Someone in my yoga group is convinced she manifested her boyfriend by praying to the universe for someone kind and caring. I’ve read that other people manifest a windfall of money, or their dream job, simply by meditating on it every day, imagining what the dream would feel like in reality. I’m doubtful, but also intrigued. If everyone did this together, would it make the world a happier place? (Or is that just the beginning of another organised religion?) Does it only work for one person manifesting themselves a new car for Christmas, or could we collectively magic, sorry, manifest, a brilliant new prime minister, or a solution to climate change?

Manifester,
Manchester

Dear Manifester,

As I read your letter this morning I am sitting at my desk near a big window, looking out at what appears to be unending grey skies and interminable rain. The English fall can be a beautiful time of colour and slanting sunlit afternoons, but on days like today I find that I can only imagine more grey and more cold and I start to have a sense of panic that maybe I’ve missed the best of the season. Today I thought I’d give your suggestion a try and I tried to commit, really commit, to the belief in a sunny day. I looked at the sky for longer. I despaired. But eventually, after some time and agony, I think that I did see a glimmer of sunlight peeking out under a cloud just near the south-eastern horizon. This improved my mood immeasurably, and I am grateful to you for that.
I think when people talk about “manifesting” they may mean any number of things ranging from the sort of vague hopefulness that I tried, right through to detailed visualisations and the creation of lists and vision boards. In one sense, the neurological explanation for these effects is simple: the brain relies on expectation to shape perception. Indeed, it is extremely difficult for the brain to perceive a thing at all if it is unexpected, a fact that stage magicians rely on when creating their illusions. Expectations about reality create what neuroscientists call “prior probabilities” that help the brain interpret limited sensory information by statistically biasing the sensory signals, a bit like a static-y radio programme that suddenly sounds clearer when you find out what it’s about. I don’t think that my hopeful glances out the window this morning changed the weather, but they certainly changed my experience of it.
A more powerful aspect of manifesting, though, comes when the change in perception causes a change in behaviour. This morning, I might have done more than wish for sunshine. I might have committed to the idea enough that I thought I’d do some work in the garden, or go for a long walk. Then, at the moment that the sun did make a brief appearance, I would already have been outside to enjoy it. In this sense manifesting can’t help but succeed, because it means you are taking the actions needed to make your intentions come to pass, and will continue taking action until they do.
All this sets up a wonderfully positive cycle. You set your intentions on a certain outcome and “invite” that outcome into your life actively, with behaviour changes. If the outcome happens, you feel immense joy. If it doesn’t happen, you simply wait and continue to manifest and hope it will happen. Either way, you are spending most of your time looking for positive changes in the world, rather than obstacles, and this will usually lead to success.
The only downside I see to all this is what in 1975 Harvard psychologist Ellen Langer called the “illusion of control” – the tendency of people to think that their deliberate actions caused effects that were otherwise known to be due to random fluctuation. For example, thinking that crossing your fingers might make a coin more likely to land on heads. Langer pointed out that the illusion of control was particularly strong in gamblers and bankers, who tend to overestimate how much their own skills affect their financial outcomes. My hunch is that, had our recently ex-prime minister been familiar with Langer’s work, we wouldn’t have needed to manifest a new one quite so urgently.

Best wishes,
Dr. Ash

Dear Dr. Ash,

I had covid back in the summer, a nasty flu that kept me in bed for nearly a fortnight. I went back to work as soon as I tested negative but I’ve never recovered the mental sharpness I had before. My job as an administrator in a school requires me to process detailed information about events, students and staff – the day-to-day running of an educational institution. Yet I can’t think straight. I spend hours struggling with spreadsheets, in which names and dates just swim before my eyes. Tasks I’d once have completed in a trice – with a satisfying sense of my own efficiency and a job well done – now take forever. I make silly mistakes and then am sleepless about letting colleagues down. I often reach for reading glasses when I’m already wearing them. Everyone calls this “brain fog” and it does feel like trying to work with a cloud round my head. My GP says that I’m doing fine, that things will get better with time, but I don’t see any progress. Will I feel like this forever? Is there anything I can do?

Foggy,
Farnham

Dear Foggy,

At the beginning of the Covid-19 drama, many doctors watched as the virus apparently changed its form repeatedly. It appeared first in the guise of a mild respiratory infection, just some sniffles and a cough. We rapidly realised it had the potential to become a much more serious, potentially life-threatening infection characterised by breathlessness and high fevers. Early on we debated whether Covid had a neurological component – we now all agree that loss of smell and taste are often part of the disease. More recently cognitive and psychological impairments like brain fog, persistent anxiety, depression and disrupted sleep have been identified as some of Covid’s most troubling incarnations.

What unites these myriad symptoms is inflammation. Normally, when the body deploys its army of immune cells to fight off an infection, the war is limited in intensity and duration. Standard weapons like antibodies and T-cells are precise and effective. But in the case of Covid, for reasons that remain unclear, the army seems to go on fighting an unending and poorly defined conflict with little effective coordination. Think Afghanistan or Vietnam rather than WWII. Civilian casualties are high, manifesting as autoimmune disorders. Without clear, achievable objectives the fight drags on and on, losing its sense of purpose and sapping the resources of the body in an unending war of attrition.

It’s likely that the brain fog that you are suffering from is a part of this ongoing war. The tasks you are struggling with – organisation, planning, short-term memory – are part of the brain’s executive functions, and they depend on the prefrontal cortex. That’s a brain region that is particularly hard-hit when metabolic resources are depleted, and it’s likely to be strongly affected by immune imbalances.

Ending the conflict requires re-establishing a peaceful and balanced world order. There is no set of medications or interventions that will achieve this overnight. The ecology of your brain has changed as a result of your infection, and it will take time to create new, healthy patterns. I suggest that you look into an anti-inflammatory diet as a start, but just as importantly, be extremely tolerant of your brain and your body. Tolstoy wrote that “the two most powerful warriors are patience and time,” and these remain the most powerful tools in the medical arsenal.

Best wishes,
Dr Ash

Dr Ash Ranpura is a neuroscientist and clinical neurologist. He qualified in medicine and general neurology at Yale University and the Yale-New Haven Hospital, and trained in cognitive neuroscience at Queen Square, London