(14). Letter From An African Psychiatrist

Nuns, Cognitive Reserve and MasterClasses

(14). Letter From An African Psychiatrist.


Master Classes, Life Long Learning and Cognitive Reserve.

All the world is my school and all humanity is my teacher. George Whitman.

The scientific results of the Nuns Study on Dementia were stunning.

From the 1970s an eager pack team of neuroscientists (mainly men) found, investigated and followed thousands of Nuns living in austere, safe monasteries. Their primary focus of interest was memory, especially detection of early memory loss in a Nun and her possible progression to full blown dementia.

The comprehensive research project included regular interviews, mental tests, medical check ups, analysis of writings, work performance, brain scans and blood tests. Plus a brain autopsy after death. Two key insights emerged:

1). After analysing every entry essay of prospective nuns, and matching to mental function many decades later, a very strong correlation was found between the positivity and density of language in the essays and her executive mental function 60 years later. In other words, the (poor) quality of entrance seeking essays between 18 and 21 years can be a predictor of middle age onset of dementia.

2). A specific subcategory of Nuns who reached late eighties years of age, and were still active with meaningful daily routines until death, but had no memory difficulties, had, at post-mortem, all the tell tale brain changes of Alzheimer’s. Yes, even if the brain is pickled with plaques and fibrils, the brain can still function reasonably well. Why?

These findings blew open the contentious discussion of cognitive reserve - that life long learning, regular stress testing the brain (like learning a new language), welcoming effortful challenges, and participating in novel activities, stimulates significant neuronal growth.

Even if there was an unseen pathological process slowly killing other neurons, the bank of new growth, or strengthening of old ones, delayed the outward manifestation of dementia.

I am a great believer in building cognitive reserve to draw on later in life, just as one can withdraw financial savings as a pension, or physical stamina from regular aerobic exercise. (Unfortunately, once symptoms of Alzheimer appear the damage is irreversible. No amount of new learning will change the relentless disease process.)

The key to a healthy balance sheet of cognitive reserve is the attitude and practice of life long learning.

A few of my blessings: I am a life long learner. Curiosity is my motivator. My interest in human behaviour exposed me to the very best knowledge in science, medicine and psychiatry. And about 18,000 patients! Lots of brain stimulation.

My core psychiatric interest now is CBT; (= Cognitive-Behavioural Therapy, by learning and teaching decision-making techniques to optimise thinking and actions - Well practiced techniques can reverse symptomatology in a host of mental diseases, predominantly depression. 

So to get a bit personal:

I read a fortune, from childhood, about 4 - 6 hours a day. And love daily walking predominantly in nature that is an ever changing multi-sensory experience stimulating most parts of my brain. Walking is also a profound way to think and reflect and plan ….. Good brain gym!

Over decades written essays, books, monographs, letters, emails, and what’s app messages that are mentally stimulating in their grammatical construction. And all these products have potential for more creative work. I am pivoting my core hobby (wordsmithing!) to writing for a wide berth of readers. Starting to plan and research a 500 page education thriller - about the use and abuse of medical cognitive enhancement. Stick around a few years for the prequel.

Stimulated by the book - The 100 Year Life (Gratton and Scott), I recently fast forwarded my future possible self deep into the future, and visualised a perfect day.

Besides location and key relationships, I see myself writing 4 hours a day; reading 4 hours a day; 4 hours to consult; and 4 hours to eat, do housework, go shopping, nature walking and gardening. Then 8 hours to bathe, light conversation and good sleep. 

How? It has never been easier to read or write in these days of laptops and the internet. For example:

I purchased and downloaded the Masterclass app early in the Covid Era. Instead of binge watching on Netflix streaming services, I decided to pump up my life long learning skills.

MasterClass is one of many great online resources one can subscribe to. Every class teacher is a master in his or her specific field, and the audiovisual productions are magnificent.

And each Master Class has approximately 20 audiovideo clips, each ranging from 3 minutes to 30 minutes. I can engage with the content 24/6 in the comfort of my home.

So far, I have completed the following classes.

1). Jane Goodall on primatology and conservation.

2). Howard Schultz on Starbucks and building a international public company.

3). Paul Krugman on economic theory, society and geopolitics.

4). Sara Blakey on building a clothing brand and worldwide sales around a manufactured product.

5). Jon Kabat-Zinn on mindfulness theory and practice.

6).  Donna Farhi on the basics of yoga.

7). James Peterson on writing novels.

8). Dan Brown on the A-Z on creating and writing a thriller and educational novel.

9). Alice Waters on the art of home cooking.

10). Daniel Pink on sales and persuasion.

11). Bob Iger on business strategy and leadership.

12). Le Var Burton on the power of story telling.

And I am going to learn from 19 other master writers. Today I begin  learning with Malcom Gladwell.

(BTW there are other great teachers on art, film making, cooking, design, public speaking, sport, reading to children and much more.)

Wonderful entertaining ways to build cognitive reserve, arguably the number one treatment choice in preventing the mental manifestations of dementia.

Simply, find your intellectual sweet-spots, and nourish them. 


(C) Dr Jonathan D Moch


Core Professional Focus

Cognitive-Behavior Therapy/ Techniques“Yes, You Can!”

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Welcome to Letters From An African Psychiatrist by me, Jonathan D Moch. Dr Jonathan D Moch is contrarian psychiatrist and a Mindfulness Based Cognitive Therapist uplifting people by coaching the extraordinary achieve the impossible. Sign up now so you don’t miss the first issue. In the meantime, tell your friends…
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1). The Nun’s Study

2). MasterClass Categories