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SSOCIATED WITH E XCESSIVE PFC A CTIVITY
Overfocused, rigid, and inflexible
Also, see problems of the anterior cingulate gyrus (page 34)
    W AYS TO B ALANCE L OW PFC
Organizational help, coaching  
Intense aerobic exercise (boosts blood flow)  
Goal-setting/planning exercises  
Neurofeedback to boost PFC activity  
Relationship counseling  
Stimulating or exciting activities  
Higher protein diet Developing a deep sense of personal meaning  
Stimulating supplements , to boost dopamine to the brain, such as L-tyrosine or SAMe
Stimulating medications (if appropriate), such as Adderall, Dexedrine, Ritalin, Wellbutrin, Stratterra, or Provigil
WAYS TO BALANCE HIGH PFC
See prescriptions of the anterior cingulate gyrus (page 35)
    Anterior Cingulate Gyrus (ACG)—My Way
or the Highway
    The ACG helps you feel settled, relaxed, and flexible. It runs lengthwise through the deep parts of the frontal lobes and is the brain’s major switching station. I think of it as the brain’s gearshifter, greasing human behavior, and allowing us to be flexible, adaptable, and to change as change is needed. This part of the brain is involved in helping shift attention from thing to thing, moving from idea to idea, and seeing the options in life. The term that best relates to the ACG is cognitive flexibility . Cooperation is also influenced by this part of the brain. When the ACG works in an effective manner, it is easy to shift into cooperative modes of behavior.
    When there is too much activity in the ACG, usually due to lower serotonin levels, people become unable to shift their attention and become rigid, cognitively inflexible, overfocused, anxious, and oppositional. When it works too hard, people have difficulty shifting attention and get stuck in ineffective behavior patterns, where they may be uncooperative or difficult, trapped in their own mindset. When the ACG works too hard, people plan too much, worry too much about the future, and become too serious or obsessed. Difficulties in the ACG can cause a person to constantly expect negative events and feel very unsafe in the world. When the ACG is overactive, people have a tendency to get stuck or locked into negative thoughts or behaviors. They may become obsessive worriers or hold onto hurts or grudges from the past. They may also get stuck on negative behaviors, or develop compulsions such as hand-washing or excessively checking locks. One patient who had ACG problems described the phenomenon to me saying it was “like being on a rat’s exercise wheel, where the thoughts just go over and over and over.” Another patient told me, “It’s like having a Reset button in your head that is always on. Even though I don’t want to have the thought anymore, it just keeps coming back.”
    The clinical problems associated with excessive ACG activity include obsessive compulsive disorder, eating disorders, and addictive disorders. All of these disorders are associated with problems shifting attention. Worrying, holding onto hurts from the past, cognitive inflexibility, automatically saying no, and being rigid, are symptoms of too much activity in the ACG.Increasing serotonin through supplements or medications is often helpful.
    When the ACG is underactive, people have little motivation and get-up-and-go. They shift gears too easily and can be easily distracted and apathetic. Neurosurgeons at the University of California at Irvine School of Medicine described a set of symptoms associated with damage to this part of the brain, from a stroke, tumor, or brain injury. They called the syndrome akinetic mutism, where patients tend to have little physical movement (akinetic) and produce little speech (mutism). They also noted indifference and lower levels of anxiety and worry in patients.
    ACG in Relationships
    When the ACG functions properly, people are able to shift their attention easily. They tend to be flexible and adaptable. They are likely to see options in tough situations. They are