Lower Brain, Higher Brain
"Between stimulus and response, there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom."
On October 24, 1975, Halla Tómasdóttir was seven years old. It was her mother's birthday, and she kept Halla out of school to take her to a rally in their country of Iceland to see several women, including Vigdís Finnbogadóttir, the Artistic Director of the Reykjavík Theatre Company, speak about women's rights. It was more than a protest; it was a strike to demonstrate women's indispensable work and highlight wage disparities and other unfair employment practices. It was estimated that 90% of the women in Iceland participated in this day, known as "Women's Day Off" or in Icelandic: Kvennafridagurinn.
Almost 32 years later, Halla, now a respected businesswoman, founded and became CEO of Audur Capital, a financial firm in Iceland. Halla and her co-founder, Kristin Pétursdóttir, started Audur Capital because they became fed-up with the financial world, which seemed to be led by men, not just in Iceland, but in London, Wall Street, and around the world. They were concerned about the lack of diversity. As she put it in her TEDWomen 2010 talk, they left their successful jobs as investment bankers to start their own company because they "felt a bit overwhelmed with testosterone." But the problem was not in the gender of the financial leaders; it was in their way of thinking.
Halla and Kristin wanted to build a financial company based on higher-brain values dedicated to making a profit and creating positive social and environmental benefits. To do this required a long-term view, rejecting the lower brain focus only on short-term gain. They wanted to avoid the potential consequences of not understanding investment products like the complicated sub-prime mortgage structures of the time. The financial meltdown of 2008 was due primarily to these sub-prime investment products consisting of packages of mortgages that were rated artificially high by ratings organizations incentivized financially to do so. Ultimately, the three largest banks in Iceland went bankrupt, but not Audur Capital.
Even though Audur Capital didn't go bankrupt, this was a challenging time for all of Iceland. Halla noted in her TEDWomen talk that it got so bad, "somebody put our country up for sale on eBay.” But Audur Capital didn’t just survive through the financial crisis; they made it through without taking direct losses to their equity or their clients' funds. The way they did this was by having a set of values that supported taking a long-term view rather than the short-termism they had experienced in the lower-brain-dominated financial industry.
In Iceland, this lower-brain mindset in the banking system began in 2002 when the banks were privatized. Lower-brain values (competition rather than collaboration, short-term focus rather than taking a long-term view, concern only about financial outcomes rather than considering social and environmental outcomes) dominated the financial industry, not just in Iceland, but globally. In Iceland, things changed after 2008; unfortunately, they have not yet changed globally.
There is a neurophysiologic difference between a lower-brain and a higher-brain mindset. The central location for the lower brain thinking is in the amygdala where fear, anger, jealousy, etc. can lead to emotional reactions that result in lower-brain-generated decisions and behaviors (violence, bullying, belittlement of others, etc.).
The higher brain thinking resides in the cerebral cortex, often in the pre-frontal cortex, and, with practice, can override the lower brain reactions and behaviors – I described how this could address racial bias in an earlier blog post here. The higher brain's dominant emotions and resulting actions are vulnerability, empathy, collaboration, and love (compassion/caring for others, rather than romantic love). From a neurophysiologic perspective, I believe the opposite of love isn’t hate, but fear.
It challenges our modern thinking, but violence, competition, and other lower-brain behaviors are not brave. Real courage comes from resisting these harmful responses to fear by demonstrating behaviors that show vulnerability, empathy, collaboration, and love. In reality, these brain interactions are more complex than I’ve described, but we do have a choice in deciding how we think and behave, as explained so well by David Foster Wallace in his commencement speech, titled, “This Is Water.”
I think this higher-brain mindset is desperately needed in healthcare where we are much too focused on short-term productivity and in a chilling irony, with a lower-brain mindset, some institutions are often more concerned about avoiding bad press than taking risks by attempting to address the complex social injustices in healthcare, such as patients dying because they can’t afford insulin, that contribute to the moral injury harming physicians and other front-line healthcare workers. To transform our system from one based on volume (a lower-brain, short-term goal) to a system based on value for the patient (a goal that leads to sustainability) we will need to learn and practice a higher-brain mindset within healthcare.
In 1980, only five years after the Woman’s Day Off, Vigdís Finnbogadóttir, a divorced single mother, was elected President of Iceland. She was the first democratically elected female President in the world. Three male candidates ran against her. One of the male candidates suggested that Vigdis was not qualified to be President because she was only half a woman. Vigdis had previously been diagnosed with breast cancer and had a mastectomy. So, this lower-brain-generated comment was attempting to belittle Vigdis due to her surgically scarred anatomy.
Faced with the verbal attack on her body from a male competitor running for the Presidency of her country, Vigdís Finnbogadóttir did not attack back; she did not even try to defend herself by bragging about feats of strength or other personal achievements to demonstrate she is a whole woman. She simply said, “I’m not going to breastfeed the nation; I’m going to lead it.” And so, she did, for the next 16 years. She led with a higher-brain mindset and compassion for all people of Iceland. She was so popular that she ran unopposed in 1984, won 94.6% of the votes against another woman in 1988, and unopposed in 1992. She decided not to run for re-election in 1996.
In The Gulag Archipelago 1918–1956, Aleksandr Solzhenitsyn wrote, “The line separating good and evil passes not through states, nor between classes, nor between political parties either – but right through every human heart…” Based on the findings in neuroscience the past few decades, I believe the line that imprisons us in a divisive and unsustainable world is the difference between continuing to exhibit lower-brain thinking and behavior, and learning to develop higher-brain thinking. This development of higher-brain thinking will result in behavior that focuses on caring for others, which paradoxically will be the best way to ensure health and well-being for ourselves and those close to us.
To see our healthcare system and our world transform to a sustainable one, promoting value instead of volume, will require us to evolve to a higher-brain mindset. This mindset will allow us to overcome decisions based on fear and selfish lower-brain behavior and instead be led by empathy, vulnerability, collaboration, and love for others. This is where real courage and innovation starts. But what does it look like to go through this evolution in thinking? Books I’ve found that can help evolve our mindset include Humankind, Give and Take, The Altruistic Brain, The Growth Mindset, Collective Genius Article and Book, Subliminal, The Fearless Organization, Daring Greatly, The Gifts of Imperfection, Rising Strong, and Braving the Wilderness.
In this evolving mindsets series, I’ll be writing about examples of lower-brain and higher-brain thinking and behavior including examples of people, including myself, who have gone through this evolution in thinking. In next week’s blog post, I’ll write about a cardiothoracic surgeon who was the CEO of one of the Mayo Clinic hospitals. I’ll describe what it took for him to transform from a lower-brain to higher-brain way of thinking and behavior that led to his successful career as a healthcare leader.