of the thalamus adhere to a number of structures, most of them distinct, and are connected to many parts of the hindbrain, midbrain and forebrain, including most importantly the hippocampus and the reticular formation. Regulation of alert consciousness and rhythmic responses are activated here. The pineal gland is close by and, as the name suggests, the hypothalamus, with its pituitary connection, lies below.
We share with all other vertebrates and especially with mammals the knowledge of where we are in space, the ability to move and respond physically to the environment and our perceived needs and responses to challenge for these goals. We cannot say that this knowledge and set of complex abilities is coordinated in the thalamus alone but we need a shorthand for what might otherwise be called the proprioceptive mind. Proprioceptive receptors are found in peripheral tissues. The thalamus clearly has a multiplicity of integrative functions, and seems to connect with structures of the limbic system as well as all the senses except olfaction. I propose it therefore as nothing more than as a shorthand69 for the capacity of all vertebrates to know where they are and to move and respond appropriately to their circumstances. The horse rubs its back along the bark of the tree because it is so minded. We do not learn to scratch an itch.
Proprioception is an integral part of the musculature and skeleton; indeed moving and being are indissoluble partners. To be is to move but we cannot do so without air. The backstop for the proprioceptive mind lies in the brainstem and the respiratory centres and in their connection with other stabilisers of pH, notably the kidney. The other ancient structure and one absolutely vital for stabilisation and survival is the vestibular apparatus in the inner ear with its central and peripheral connections.
Advanced human age is usually characterised by a slowing of processing speed which reduces capacities on a number of fronts. While cognitive function may happily be preserved, musculoskeletal capacity is usually reduced. Exercise not only reduces the loss of muscle bulk and function, it will aid and extend communicability in other systems, notably the cognitive. It follows that increasing all inputs to the thalamic mind will give power to the hypothalamus and assist in preserving its centrality to life.
The thalamic mind holds an immediate archive: the history of our physicality. But it is a valve: the direction is up from the body which is the part of us that inhabits the present. Everything above the thalamic mind is in a state of constant and continuous processing of signals that have already arrived. In this sense, we can never entirely inhabit the present. The “present–ist” seeks to inhibit hypothalamic processing of material coming from the thalamus, to censor censorship, to be overwhelmed by the thalamic, to seek the surge, itself a source of desire.
If we are to understand human health, and to help with finding it in our patients, we must surely connect the so–to–speak “thalamic” with the hypothalamic mind.
The hypothalamic mind
Here again, I am engaging in shorthand speak: the hypothalamus is the connecting hub between the brain's sense of the whole body and the endocrine system which relays back to the body by way of the pituitary gland. The four major pituitary axes are stimulated by four hypothalamic pacemakers, getting their pulse from (and to) the optic and pineal systems. The two hormones of the posterior pituitary act somewhat as overriders, especially as oxytocic receptors are found also in the brainstem and spinal cord and those for ADH are found in the SCN.70 The anterior nuclei of the thalami receive information from here and so are linked to the central timekeeper. The final mediation between parasympathetic and sympathetic outputs most likely occurs here. In any patient, the relation between the cholinergic networks and aminergic drives is one of the most crucial clinical interpretations for us to make.
In terms of computational size, the conscious mind is so much smaller than the proprioceptive mind (but so dominant to the sense of self).71 Although the sources to and from the proprioceptive mind and the hypothalamus are so widely distributed, they are brought to a culmination here to integrate the output response. As a matrix it seems almost to have a mind of its own. Humans are probably unique in their capacity to inhibit their physical behaviour and to delay and time the stimulus to their movements. While we may be as reflexly open as any other creature, these controlling mechanisms make the centrality we accord our “Minds” seem justified. The hypothalamic mind gives us access to the history of our mentality and sociality, with our pre–social emotionality in the annexe of our limbic system, masked to varying degrees. The intemperate crying of a baby recalls our pre–social emotionality.
Mindedness
Just as the reticular system may not easily be defined with strict anatomic or functional borders, so the distinction between so–called autonomic functions and so–called willed actions is impossible to make. Purposeful autonomy and self–willed action interdigitate in an endless fractal frontier always in one or the other and always in both.
The regulation of the chemical architecture of the brain and its peripheral satellites is of great interest to herbalists as so many medicinal plants operate on neural modulators and endocrine stimuli that mediate mindedness in so profound a manner.
Mindedness illuminates the narrow window between determinism and indeterminism. Even classical physical theory is not as determinist as it at first appears nor quantum mechanics so indeterminist. You might think biological structures would escape the question altogether except that the nature/nurture dichotomy still rumbles on in some quarters. The understanding of the genetic basis for variance has led to an erroneous impression that DNA determines our lives. It is of course the basic parameter but cannot determine anything on its own as the epigenetic sphere is influenced by so many ecological factors such as the womb itself and the behaviour of those who interact with the mother. Cellular mindedness is defined by being biased and depends for its energy on that bias but every choice in every moment of circadian biological time is free to pull against that bias. At the scale of a human life, once a choice is made and a path taken, other paths are excluded. Although we may always rush across a field and through a hedge to the nearby path we had recently forsaken, as time goes on the possibility for this manoeuvre diminishes as does the probability of its success. The “fresh start” is always from a different place to where the divergences took place. Time does not wait for our decisions to be made.
Consciousness
If consciousness (creeping in with a small c) is a hallucination of an unknowable reality, for a social being, this must represent a shared hallucination. It is almost certainly a field event: there will be gradients of collaboration and levels of inclusion and exclusion. Circadian rhythms may well have contributed to this sharing: cooperation with or competition against can only be viably maintained when participants do things at the same time, or agree to divide tasks over time.
As for inclusion and exclusion, socialisation places great burdens on the will and determination of the individual terrain but, by way of compensation, provides the reward of coherence and reciprocity that a probable majority of people find acceptable for most of the time, subject to gender and age, and which must be qualified by developmental staging. These may be no more than statistical truths and conceal the fundamental contradictions and tensions of human existence. The life's work of sociologists, criminologists and psychiatrists would be needed for more detailed expansions and qualifications to these simplistic remarks. In the section that follows, I shall try to connect what may seem disparate ideas into a unified structure and so build a platform on which to place therapeutic strategies.
Poise as stabiliser of the trajectory
Even though consciousness assumes the mantle of identity and may be apt to forget that the Life on which it depends must be assured of a constant supply of energy, “thalamic and hypothalamic” mindedness will provide the reminder and so guard against hubris. The hypothalamic connections to pacemakers in the liver and kidney will enable these organs to recalibrate so as to cope with needs as they arise. When critical thresholds are approached, the conscious self is given warning by peripheral and central signals, especially from the liver as the body's “glucostat”. The signal is a stable message that warns of impending instability.
On many if not most occasions, the immediate