The Neurology of Compassion: a conversation with Dr. Jason Crowell

One of my goals with this podcast is to introduce an audience I love to people I love.  I’d love for you to meet Dr. Jason Crowell. 

Dr. Crowell is an actively practicing neurologist and a dear friend.  We talk about neuroplasticity, habit formation, evidence for God in the human brain, and the need for compassion in a fallen world.

Jason is an expert well-worth listening to, and I have learned to love better because of his insights into the Scripture.

Seven Tesla MRI scan of the human brain mentioned during the show can be found here: https://youtube.com/playlist?list=PLlL7CEMX5bxzl1TqkJRK3pMV4Ax6By4bN&si=0OLfC5SHrXI6JydI

"Remember, you are loved, so go, love better!"

New episodes drop on Tuesdays.

Transcript

I’m Scott Beyer and this is the Love Better podcast where we explore the truths and lies about love and more importantly how to turn love into a skill – something we can get better at and hone.

One of my goals with this podcast is to introduce an audience I love to people I love.  I’d love for you to meet Dr. Jason Crowell.  Jason is a husband and father, a dedicated Christian and an actively practicing neurologist.

To know Jason is to love him.  He’s brilliant, but in the sort of way that elevates everyone around him.  He’s kind, articulate, and patient.  He has a heart for people and he is a mender of the wounded.  His family worships with us here at Eastland and Jason, Meagan, and their two lovely children are exceptionally dear to us.

Jason is hardworking, thoughtful, and slow to judge.  He has a heart for following the data, and a heart for his patients.  Dr. Crowell has some beautiful insights into Proverbs 23:7, Romans 7, and the evidence for God we can see in the design of the human brain. I entitled this conversation, ‘The Neurology of Compassion’ and as you listen, I think you will understand why.  

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Scott Beyer: I am here with Jason Crowell. He is one of my absolute favorite people and Jason also happens to be a perfect person to talk to about loving the Lord your God with all your mind, because Jason is a neurologist. So assume I know nothing for a second, Jason. Tell me what a neurologist is.

Jason Crowell: So a neurologist is a physician who specializes in treating, evaluating and treating people with diseases of the nervous system. A lot of the diseases that we treat people for are stroke, seizures and epilepsy, headache, migraine, dementia Parkinson's disease.

 We're not neurosurgeons. That's an often that's a common mistake. So we're neurologists who, prescribe medications and perform tests, but I don't do brain surgery.

Scott Beyer: What is your specialty within

Jason Crowell: Sure. So I'm a movement disorder specialist. Movement disorders is the area within neurology that treats people primarily for Parkinson's disease. There are some other diagnoses that subspecialty.

So people who have tremor that's not due to Parkinson's disease something, a condition called dystonia, Huntington's disease. Within neurology, movement disorders is primarily the subspecialty that deals with disorders of an area of the brain called the basal ganglia. So this is a collection of different neurons deep in the brain that are primarily responsible for modulating and controlling voluntary movement.

Scott Beyer: For you, being just a normal person who has not

Jason Crowell: That's debatable.

Scott Beyer: lots of schooling, Thanks for that. He

Jason Crowell: Scratch that. No, I thought you were about to say, I thought that was a, I thought that was a supposition about me, not you. Scratch that. We'll remove that in, in post hoc. So

Scott Beyer: You have gone to a ridiculous amount of school, and then residency. Like, how long is the residency for a neurologist?

Jason Crowell: neurology residency training is four years. Most, again, most people end up doing some kind of subspecialty training called fellowship training. So I did a two year fellowship training. In, in movement disorders and Parkinson's disease.

Scott Beyer: Okay, so after going to medical school, you said, let's just do another six years on top of that. You don't just do that because what causes you to have, did you always want to be a neurologist or did you just want to be a doctor in general and then move that direction?

Jason Crowell: I, my, my grandfather was a physician in our hometown in North Alabama and he was the small town doctor. There did house calls long past when most people stopped doing that. And so I always, I was always saying when I was a little kid that I wanted to be a doctor like him.

He was an internal medicine syphilis. Specialist. And I wasn't quite sure what I, what specialty I was going to do. When I finished college, I worked for a couple of summers, actually during college and then after college as a technician in the operating room at the hospital in North Alabama, where I'm from.

And I was interested in surgery, but very quickly in medical school realized that would not be good for anybody. So I wasn't quite sure where to go and what I was going to do. And in my first rotation of third. First two years of medical school you're just in a classroom primarily.

And then third and fourth year you do clinical rotations. And my first clinical rotation just happened to be neurology. And I was really interested in it. I was really interested in neuroanatomy and concurrently around that same time, my grandfather had, he had retired, but he, was diagnosed with a form of Parkinson's disease called Dementia with Lewy Bodies.

And so as I was rotating through neurology clinics and learning about neurology, he was being treated for that. And I don't know, I got more and more interested in it. So I realized quickly that was the field I wanted to go into. And so then I did. A couple of years in neurology and very quickly in that realized that, that movement disorder subspecialty was probably the best fit for me.

Scott Beyer: So how much do we know about the brain?

Jason Crowell: We know a lot, I, I told you that I took a little bit of a fence to your podcast a few weeks ago where you claim that the universe was the biggest mystery in the universe. I told you that I respectfully disagreed with that. So I have to say that there's quite a bit that we don't know.

I I, the more you learn, the more you have questions. And so I, I would say that it's still the greatest mystery in my book.

 Is it fair to say, I guess that, that we know a lot more now than we've ever known, but it's, it does feel like the tip of the iceberg kind of. In terms of how much there is to know.

Jason Crowell: Yeah. A lot of the learning that we've. Gained in recent years has had to do with these new imaging modalities. MRI is relatively new. It's not been around. I don't know when MRIs were discovered, but they weren't around 50 years ago and MRI technology that allows us to better see the structure of the central nervous system.

And then increasingly today, these MRIs we have that can help us better understand See what areas of the brain perform which function have really progressed our understanding of how the brain works, but even still there's much more to be understood. We, you and I have talked about the fact that it was always thought that certain brain functions localized to certain areas within the brain.

But now we better understand that it's probably more apt to say that certain brain functions localized to different tracks within the brain. So it's. It's reductive to say that, say, language just localizes to this very specific area. It's probably more correct to say that language localizes to these different areas that are all connected by different tracks within the brain.

And so that, has added a new layer of complexity in understanding neuroanatomy.

Scott Beyer: So there's, it, the connections that we can see with something like an fMRI are increasing the complexity of our of what is going on. It's not as simple as, Hey, this part of the brain does this. And this part of the brain does this. Everything's in some degree, interconnecting

Jason Crowell: That's right. That's right. There's all these connections. And that does present some opportunities for neuromodulation. Suppose someone has had an injury and, In one area of a circuit, then perhaps, down the road, we might have treatments that could work on a different area within that same circuit to try to help people recover from certain symptoms.

I know that's vague, but the fact that these different brain functions are spread across a network rather than a specific area does potentially offer treatment options in the future.

Scott Beyer: So I remember when I was in school, you would do things like IQ tests. And that was a really big deal. I remember being you take an IQ test, and at least my perception at that stage of my life was an IQ test says, this is how smart you are. And that is a static thing. You had the smart kids, you had the dumb kids, you had you had people who had abilities in certain areas and other people who didn't.

And something that I know that you and I have talked a lot about is that it's, it seems like the medical knowledge has changed vastly, at least from my perception, that your brain is a static thing. And you got what you got, you're born with it, and there's no alteration of it, and now we're introduced to this idea of neuroplasticity, where we're saying, no, that's not true at all.

Am I correct in saying that there's a movement in our knowledge to now say the brain is not this static thing that you're born with and it, you get what you get?

Jason Crowell: Yeah, that's right. That's a relatively recent. Understanding that our brains do have the ability to change, and they are not static. They're dynamic, which is pretty remarkable. So you covered the podcast a few weeks ago about the taxi drivers and the evidence that the, their hippocampi can change in response to learning some new set of knowledge.

Yes, I would say that is a change from previous understanding about neuroanatomy.

Scott Beyer: Yeah, for the record, that idea for that podcast came from Jason. He's the one who sent me the article on the taxi drivers. Cause it, it is wild to think people of, varying ages, varying genders, varying backgrounds, and yet they all Saw a huge change in their brain, a measurable change in their brain, just due to what I would call extreme memorization, right?

You're an expert in this area that is a earthly thing, the human brain, it's anatomy, the physiology, and how that interacts. But then you also have your faith as a Christian, and you read the Bible that's been the same even as our medical knowledge has changed, the Bible has been the same word.

 When those two worlds intersect, what does that do for you? How do you see the Bible differently because you're a neurologist or see neurology different because you're a Christian. 

Jason Crowell: I think one of the appreciations I have is, I've spent some period of time in my life trying to understand neuroanatomy and trying to, more pointedly try to help people who have neurological diseases And it's just it's still remarkable to me, the complexity of our brains.

And I don't think that you can overstate just how complex our brains are and how, even as we've alluded to that we've gained all this knowledge, we still quite don't understand how some of these things work. I'd encourage anybody to Google, where does consciousness lie in the brain?

You know that people have been debating that for a long time and yet we still disagree about where the seat of consciousness is and there's all these There's just so much yet to learn about how our brains work and how they recover from injury and how this plasticity that we've discussed works, so I think that's probably one of the first things that comes to mind is I feel like I've tried my best to understand neuro anatomy so that I can help my patients.

And yet, even after all this time, there's still so much that we don't understand. 

Scott Beyer: When you look at the scripture, do you see do you think that there are some scriptures that you probably see a little differently? Other people do just do your, you, the world that you live

Jason Crowell: I think probably so I I frequently think about Proverbs 23 seven. So as he, as a man thinks in his heart, so he is right. When you gave me some of the ideas that we were going to talk about tonight, I was thinking about neuroplasticity and I was thinking about we've talks.

beforehand about different ideas related to addiction and habit formation. And so one of the things that stands out is that, we become the things that we dwell on. So the things that we meditate on, the things that we spend our time thinking about, they influence our behavior. And that's not just in this kind of abstract hand wavy kind of it's not some kind of abstract hand wavy, Sentiment, that's, that's brain neurons synapsing and neural pathways being exercised over and over again.

And that's dopamine being released and that's, that happens on an anatomical level. That's not just something that, that's pie in the sky. That's like a, that's a measurable, observable finding that if we, had the right tools in hand, we could see happening inside someone's brain.

So the strict scriptures like that come to life probably a little bit more.

Scott Beyer: Your point is there's something anatomically happening that when we are dwelling on something, anything for any length of time, can you explain what is happening?

Jason Crowell: So when you say habit, what we're basically talking about is some kind of automated behavior that happens without any conscious effort. And so these are these are things that have been reinforced over and over again, that they can occur without any, focused attention and the way to think about habits is there's really three pieces.

There's a cue. So there's some kind of trigger. There is the behavior and then there's the reward from that behavior. So you've got a trigger, you've got a behavior and you've got the reward that reinforces it. And so there's a couple of different, pieces involved with that from a neurophysiology perspective.

Number one is dopamine. So I think about dopamine on a daily basis is quite involved in folks who have Parkinson's disease. People with Parkinson's don't produce enough dopamine, but dopamine isn't just necessary for motor function. Dopamine uh, in the brain, in different areas of the brain is what makes people feel good.

So it's released when we engage in a new behavior. If the brain perceives that there's a reward present and that could be something that's immediate man, I love these chocolate chip cookies, or that could be something more more diffuse social acceptance or praise or something.

And when that dopamine is released when we get that kind of reward, it reinforces the behavior that led to the rule. And so then it makes that behavior more likely to occur in the future. And the more tightly that you have that dopamine release linked to the reward, the more it gets reinforced. And so that's the main neurotransmitter that's involved here.

And then there's a couple of brain areas involved. So I mentioned earlier that I see people who have disorders of the basal ganglia. So this is, these are certain nerve cells deep in the brain, and they're not just necessary for voluntary movement. They're also, involved with this type of automated behavior and habits.

And so the more that the basal ganglia automates a behavior, the more it becomes a habit and the less it becomes something that's conscious and deliberate. And you've got this feedback loop happening, right? So you've got a cue, you've got a behavior and you've got the reward. And that's going to keep going unless something stands in the way.

You've got dopamine rushing in and reinforcing this feedback loop. And then the way to think about this is there's almost a yin and a yang. So what's the governor for this? This habit that's occurring over and over again. That's really more in the front part of the brain, something called the prefrontal cortex.

So this is the surface of the brain that's in the front part of the brain. The prefrontal cortex has a lot to do with executive function. When I talk to patients and we're talking about cognition. Cognition is comprised of lots of different things. There is Memory, so being able to store and retrieve information.

There is visuospatial function. There is language, so being able to speak and comprehend. There's executive function. So executive function is the activity of the brain that helps us do things in order and sequence and it makes plans and it is involved in judgment and decision making. And so it's this prefrontal cortex that if it's active and it's working like it should be, it can help us regulate these habits.

It can essentially Override these automated behaviors and allow us to choose something else. The problem is that this requires more effort and attention. And so if this prefrontal cortex is not involved and engaged, then the automated, habituated behaviors will win out. 

Scott Beyer: So that's why, like, when I'm doom scrolling on my cell phone, I can. Put it down. But I almost have to like, kick my brain into gear to put it down. Is that, because that's an executive function. The habit the automated function is just keep the thumb moving and keep scrolling.

The executive prefrontal cortex stuff is, Hey, this is not useful to you right now. Put it down. Man,

Jason Crowell: It requires more deliberate action. And and so you, it requires that type of engagement to, to break the automated habit. The third area of the brain that I would say is involved in this as the hippocampus. So again you've mentioned this before, but the hippocampus is the part of the brain that's responsible for memory.

And when we have these automated behaviors happening and dopamine's rushing in and reinforcing this, the hippocampus is what kind of strengthens those connections. And tightens the link between the behavior and the reward and helps remind us that if I do X, then Y will happen. And so those are the three areas I would say that are involved.

Scott Beyer: what I'm thinking about as you're saying all this is it gives me a new perspective on the idea of loving the Lord your God with all your mind. It's okay, not just my executive function, like not just when I'm present, but am I loving him when I'm in my automated function mode? And in order to do that, I've got to build some memories, some kind of core memories that will put me in automated behavior that is good and healthy, not unhealthy.

Jason Crowell: When you start talking about trying to change habits, it, You have to replace it with something, right? We can't create some kind of void in the brain. If X is going to continue happening until you replace it with something else. If X is linked with Y, you're going to keep doing X until something changes.

And so you have to find a way to weaken that neural pathway. And so if there's a cue in a very practical sense, you got to avoid the cue, right? Or if there's a way to de link the behavior from the reward, you have to find a way to do that. There's a lot of, behavioral economic stuff we could talk about trying to introduce friction to make, The cue, the behavior, and the reward less tightly linked, but you have to replace them with something at the end of the day.

And whatever you want the desired behavior to be, you have to find a way to to make that the automated behavior and help that prefrontal cortex override the habituated behavior that would happen otherwise.

Scott Beyer: Because we're going to have automated behaviors, right? That's not something you can ever get to the point where you say, I have no automated features to my life. I just have executive actions that I'm always present.

Jason Crowell: And I'll mention that, what comes to mind is Roman 7, right? Paul talking about it. The things I, I want to do. I don't do the things I want to do and the things I keep doing are the things I don't want to do. This is the prefrontal cortex and the basal ganglia. This is, I'm in automated behavior, cue, behavior, reward.

And that's going to keep happening even though I know that I should be doing something else. I'm stuck in this feedback loop and I can't get out of it.

Scott Beyer: Jason, that is it. That's exactly what that is. Those two those are two parts of the brain kind of, at odds with each other. I've built these habits and I know. Intellectually, at the front of my brain, this isn't good, but I find myself slipping right back into it. And automated behaviors I'm trying to think in, in just general principles, are probably a very good thing.

That's how you can ride a bicycle. That's how you can drive your car. It's probably also why most accidents happen pretty close to your home, because that's when you're most automating driving. And so if something comes out of the ordinary, you're in autopilot. But it's a pretty remarkable thing that we can do things without thinking about it, but it can also hijack

Jason Crowell: That's right. So what it boils down to is what are the types of behaviors? Are they the types of behaviors that you would choose, with all, Impulses and habits set aside, or are they type of behaviors that are the things you would not choose, right? So when you set emotion and habits and all those things aside, are they the type of behaviors you want or not?

Scott Beyer: So in terms of neuroplasticity, that idea that your brain can change. Is that go hand in hand then with the habit formation? I can form these neural pathways. I can make these, but I can also change them and make new ones? Is that a fair way to say

Jason Crowell: that's a fair way to say it. And, neuroplasticity is really it's this is related to habit formation. Neuroplasticity doesn't necessarily have to be related to habits. So neuroplasticity can be. Any type of learning, whether habituated or not, right? So learning, about childhood development.

Our brains are plastic and they're growing and you're creating new neural connections and you're learning language and you're learning how to walk and all those sorts of things. So I would say they're related in a sense but not but not necessarily.

Scott Beyer: Okay, so it just the very fact that I can learn new things at all is neuroplasticity, but it's also I guess I would say that's also why kids are more sponges than adults. There's probably more neuroplasticity at a

Jason Crowell: Yeah. To zoom out for a second, neuroplasticity we talk about the brain having this feature, other organs in the body have the ability to change too, right? So if you, if I asked you to stop wearing shoes tomorrow and for the next month you didn't wear shoes and you walk barefoot and we were to compare the soles of your feet tomorrow and then a month from tomorrow, we would see change in your feet, right?

We would change, see changes in the skin. So it's really not, it's not, We could go through other organs and give similar examples. So it's not altogether different than any other organ. I think the thing that makes it so interesting is, it's really poorly elucidated how this happens in the brain.

So we know a couple of things happen. One is the most basic way that brain cells communicate with one another is via synapses. So a synapse is where two neurons are communicating with one another. They don't actually touch, right? They come close to each other and then they send these little neurotransmitters.

One neuron sends it to another and that's the way that they communicate. And when they send those neurotransmitters, it's like sending this electrical signal. From one to the other and you can almost think of it as like a, we just had the Olympics of a relay happening where the baton's being handed from one neuron to the next.

And so with that idea in mind, one element of neuroplasticity is how strongly or weakly is one brain cell linked to another. So when we send the same signal over and over again, there's an expression for that and that's called long term potentiation and what that basically means is that the strength of the communication between those two neurons increases.

And that's really how learning and memory works, right? As you repeat the same neural pathway over and over again that those two neurons, their synapse becomes so tight that the memory is formed. And then the opposite of that can happen as well, right? So when we don't use pathways, when we don't have this cell talking to that one, there's this, the inverse, this long term depression.

And the expression is that our brain will actually prune those synapses. So it goes through and periodically. Trims away the connections that aren't happening on a regular basis. And it's really about energy conservation, right? So it's like these automated light switches.

When I leave the room and the light turns off, it's saving energy. So if I don't have these two brain cells or this pathway communicating on a regular basis, then the brain's going to trim that away to redistribute its resources elsewhere. So I would say that's one component to this neuroplasticity.

Number two is neurogenesis, and this is what we talked about, that the idea that you can actually form new neurons which, is primarily happens in the hippocampus which is involved with memory. And we know a lot of things that can stimulate that, it's the things that we all talk about. So exercise, diet, sufficient sleep.

avoiding stress, those types of things. And then the third main way that this happens has to do with something called cortical remapping. And we've talked about this, but the different brain functions live in different areas of the brain. I'm oversimplifying because again, it's really more of tracks within the brain rather than a specific area.

But in any case, if there's been injury to one area of The brain does have a way to shuffle around its functions and reassign a different area to take over that area's job. So that's how I would organize it. You've got synaptic functions, so how closely are brain cells talking to one another.

You've got neurogenesis and then you've got this cortical remapping that can happen.

Scott Beyer: So your brain can strengthen existing connections, make some new ones that don't exist and it's dependent on behavior, as well as things like you said, like diet, exercise, sleep, like just, general, we would say probably general well being things that we should all factor in as well.

I want you to imagine for a second that I am your patient, but I am your patient coming to you as a Christian neurologist. And I'm saying, I want to be a better Christian. I want to love God more with all my mind. You understand the mind. What would you prescribe? What would you tell me I should be doing?

That would help my mind to, to mold itself more in service of God.

Jason Crowell: Yeah, in a broad sense. My son's memory verse this week, Colossians 3, 2, set your mind on things above, not on things in the earth. And we've already talked about Proverbs 23, 7. So the things we think about are the things we become. You really have to be intentional about the things that you set your mind on.

And that, that's a conscious effort. That's a prefrontal cortex kind of thing, we live in a physical world where we're not, And so we're constantly bombarded with physical things. We think about food and we think about our sleep and we think about our exercise, but it really requires intention to think about the spiritual that we don't see and that we can't touch.

And so I would say it, it requires some intentionality. And then I would say it also requires some repetition. So you think about Psalm 1 in his law, he meditates day and night. So doing it over and over again. And what you're essentially doing is you're helping to change those habits, right?

So you're changing the things that are instinctual and habitual from focusing and dwelling on the here and the now to focusing on and dwelling. on things that, that are to come.

Scott Beyer: There I think so some of my background was In the science world of biology and in the animal kingdom, that was, I worked in zoos and I did research there and so I was surrounded by people who were scientists and my general view was that Scientists don't believe in God. Though that is true that there definitely are some scientists who don't believe in God, over time I found that is not the case.

That there are plenty of scientists who do believe in God. And I also had the idea that science was was a faith destroyer. That You had either faith or science. I think sometimes people have an idea that once you start looking into the physical world and the way that humans are designed, and and all the science behind it, the more you go into that world, the less interested or less connected to faith you're going to be.

For you, that's not been the case. You're very deeply into the world of medicine and science. You're a very scientifically minded person. Yet you are a very spiritual person. How, what would you say to somebody who, was asking you what the science And what your time as a scientist has done to your

Jason Crowell: Yeah. I don't know how how someone can study anatomy and physiology. And again, I'm biased here. So neuroanatomy and neurophysiology and come away with any conclusion other than it was by a creator. I don't know how anyone draws a conclusion. Otherwise, one of the things that was most fascinating to me is these MRI scanners have become more and more refined in the images that they can produce.

And just in the last couple of years, they were able to produce a, an image of the of the brain on a of an seven Tesla scanners. So MRI scanners are graded based on their strength of the magnet. And the stronger the magnet, the more resolution it provides. And so there's, I'll send it to you after we record this, but there's a, there's an image of a seven Tesla human brain and the detail it provides, you can actually see some of these pathways that, that previously were not able to be seen basically on a lower Tesla scan but it's incredible and it's just breathtaking.

And to think that these things just happen by chance is just preposterous, in my opinion. So I don't see how someone can conclude anything other than intelligent design when you dig to any depth into brain structure and function. 

Scott Beyer: Think that's something more people need to hear because we've been told a different story. Especially at the, ironically, I think we get told this story at the beginnings of learning about science, at the beginnings of learning about, the basics of human anatomy and whatnot that, but.

The truth is whenever I talk to anybody who is an expert they've dived into it deeper and deeper. And the more, you know, the less, you know, and the more impressive it is. 

Jason Crowell: Yeah, that's an interesting point. So I, I, Let's see. I took my first college biology class 17 years ago. 17 years ago. And I haven't heard any discussion since then about, evolution or how, the world was formed. Rather, what I've spent several years studying was the, this incredibly complicated elegantly designed brain and nervous system that we have.

And yeah, I haven't thought about, I haven't entertained ideas about some of these farfetched proposals about how the world began and those sorts of things in a long time. And rather I've spent quite most of my medical career thinking about rather the design, the exquisite design that we all have.

Scott Beyer: It's funny, even one of the examples you gave was of the adaptation of your feet, which is something like all of us can experience that. Yeah. Take somebody's shoes away. And after a week, we're going to see some adaptation in the feet. Calluses, whatever, the skin is going to adapt to the new circumstance.

And we all know that, and yet that's completely a design feature. That is an and it's just a, it's a low level one. It's not even that impressive of one in the big scheme of the things that the human body can do.

One of the things you and I've talked about before that I thought was really poignant when you said was that the more you studied the brain, the more it has made you compassionate for people and their life circumstances. 

Jason Crowell: I think everybody knows someone who has suffered with addiction, whether that's substance abuse or some other form of addiction. And I, as we've discussed, I do think that It is easy to pose simple questions like why don't they just stop? Why does he keep doing that? Why does she keep doing that?

Why do they not understand the consequences of their behavior? And and so the more that we understand about how these habits form and how addictive behaviors happen I do have a better. appreciation and more compassion, as you said, for, there are biological changes that happen that to be clear, does not absolve anyone of their personal responsibility and their personal choices, but that certainly, make it a much more difficult and much more challenging feat to overcome.

And that's not to excuse poor decision making. That's not to excuse poor choices, but but I, it does lend itself to having more compassion for people who, because a certain, Q behavior and reward has happened over and over again for them that they've now put themselves in a position where the deck is stacked against them.

And that doesn't mean that this next time they can't make the right choice, but it does mean that it's supremely difficult for them because of the number of times that they have linked that behavior with that response. And the reason that I think that that it's easy to is because the thing that they're struggling with is probably not the thing I'm struggling with.

I love eating chocolate chip cookies every night and that's a silly example, but we all have different things that tempt us. And so when I see someone who's struggling with X or Y, just because that's not the thing that I struggle with, I have to remember that's the thing that might have beaten them a thousand times in a row.

And so for me to sit here and say that why can't they do it right this time? is not really the full context of the story.

Scott Beyer: I remember being told, just make sure you don't look down on people because they sin differently than you. And I think that there, there's a lot of truth to that. And one of the things that in this modern era that we live in with In some ways, addiction has been monetized, right?

You and I both are familiar with books like Nudge and the idea of, Hey, if you can nudge somebody in a certain direction, you can you can then monetize that. Companies like Google and YouTube and Facebook and a zillion others have done exactly that. And I'm not even blaming them for trying to make money.

I'm just saying that's a reality that we understand that companies have figured out there is an economic benefit to building some of those neural pathways in your head. And so in an era where all of us know what it's like to say I wasn't going to Watched that 15th YouTube video, but I did or I wasn't going to check my text message.

But You know my leg vibrated even though it was phantom because I built the that expectation that it's going to go off and I should probably check it It does make me think that maybe we, more than any other era, should have some compassion for people. Not and like you said, we're not absolving it, right?

This is the tricky thing, is you can have compassion for somebody's painful journey with addiction and poor choices that have led them down that path. You can have compassion and not say that they don't have any personal responsibility. Compassion and personal responsibility are not mutually exclusive.

Jason Crowell: And as you say that, I think one other piece to maybe explain why I've expressed that to you is, within my particular field. So I prescribe people a lot of Parkinson's medications and most of the medications I prescribe work on dopamine receptors in the brain. And it is undeniable and unequivocal that some of the medicines I can prescribe folks can cause impulse control disorder.

And. When that happens, there's no question that it's the medicine that has caused this side effect. It is not that this person has now developed a new deviant behavior that was just under the surface their whole life and has now come to the surface. Because if I stop the medicine, that behavior goes away.

And and then on the flip side of that, some of the diseases that I treat people for, people can have, psychosis and changes in behavior that are a function of the disease. And so I say those things to say that like the idea that these neurotransmitters can dramatically change someone's behavior.

is I see it every day. And so to think that someone who's developed this habit and done it over and over again, I can appreciate that. Yes, they have the choice. Yes, they have the responsibility. But again, they this pathway has been driven into the ground over and over again. So I understand that there's some pathophysiology going on as well.

That's going to make it difficult. If not very hard for them to make that decision. Does that make sense?

Scott Beyer: Yeah, it does. And it's also not fair to compare somebody who's not driven those grooves into the brain, so to speak saying no to a bad behavior. This, you can't compare somebody who's not had that habit over years and years to somebody who does I can say no to that. Yeah, you also don't, you don't have those neural pathways all built up.

You're not hardwired. Literally, at that point, there's a hardwiring issue. And, again, for anybody listening, this is not either of us saying there's no personal responsibility. Part of the beauty of the way God has designed our brain is you can change, but change doesn't always happen fast.

It's not a switch that's flipped. It is a river that is diverted, and those are different things.

 I think the reason that this is challenging is because it's not black and white, right? There is choice, and there is free will, and at the same time there is physiology at play and both of those things can contribute. And that requires nuance and understanding and requires you to pause and really think deeply about what someone's, the challenges that someone's facing and in the context of the decisions they've made in the past.

Scott Beyer: And, to your initial point of compassion, I think that's where compassion lies, right? Compassion lies in the world where we're not sure where personal responsibility and circumstances end. If I knew it's 100 percent personal responsibility and somebody is just choosing 100 percent the wrong choice, then there's really no need for compassion then.

That but it does get muddy. In the same way that context matters, you might have a, a mother who is a fantastic mother and loves her children and You in one moment see her snap at her kids, just say something very terse and maybe not as kind or patient as she ought to be.

If you just took that one moment, you, one, you don't have the context of the greater person that is not who she is all the time. And then two, you don't know the fact that she's running off of three hours sleep. You don't know the fact that the kid's been asking that same question 15 times , or that, she was driving to the grocery store and somebody cut her off and her adrenaline is pumped up because she had been through all those things.

Context matters to behavior. And I guess one of the things that's the takeaway for me from my conversation with you is, there's a context to the brain, right? To, to what's going on there. And is somebody. saying no to something that they don't have any of those habit formations with, or are they trying to say no to something that they have 15 years of cue, habit reward circuits built up.

And that matters. And so there's room for compassion there, not knowing everybody's journey.

Jason Crowell: Yeah, I agree. I think that's well said.

And I would encourage people to as you've discussed when dealing with individuals who might be experiencing some of these habits and things that they're trying to change to, as we've discussed to have compassion and to try to understand the broader context and the history of, what people have have been experiencing.

And I, I Again, I know it's easy for me to wave my hands on a separate note and talk about the complexity of the brain and how that has affected my faith, but I would encourage people to, I don't have an easy resource to refer you to, but there's there's, there are some great images and there, neuroanatomy is, it's because of the internet it has changed how we learn it.

And so there's great ways to explore this and to become better familiarized with it. What's between our ears and how complex that is. So I would encourage people to have some neuroanatomy curiosity and see what they can learn. 

Scott Beyer: I appreciate you. I thank you for taking the time to do this. And for those listening, this guy works a full time job, has a lovely family that he tries to spend time with, and then at nine o'clock at night he got on to do this with me. He is making special time. I appreciate you, and the work that you do for Patients, and I appreciate the work that you do As a Christian. I see you with your family I see in the church, and you do a lot of good my friend And I'm just very thankful for 

Jason Crowell: Thank you. I appreciate that. I appreciate you inviting me on and the good work that you're doing. 

As always, thank you for listening and hopefully we've done something to help make your life a little bit better.  If you have a chance to rate, review or share the podcast it would be a blessing.  By sharing with others or leaving a review on Apple Podcast or Spotify, you help us reach more people. 

Or maybe you have a fun history fact, a feel good news story, or a riveting scientific fact you think could help us love better, I’d love to hear it!  Feel free to email me at scott@biblegrad.com 

And if you are ever in the Louisville, KY area, I’d like to invite you to worship with us at the Eastland congregation.  We meet for worship every Sunday and have Bible classes for all ages Wednesday’s, too.  If you want more information about Eastland, visit us at eastlandchristians.org.  Or if you are looking for more tools to enrich your Bible study, visit my personal Bible site, Biblegrad.com, where you can sign up for daily Bible devotionals called Biblebites and receive them in your email each morning, take online Bible classes, or find videos that will help you study through the Bible throughout the year. 

And until next time, “Remember, you are loved, so go… love better.”