Arch of Hysteria

I’ve just bought an excellent book called Invention of Hysteria which is about how the use of photography by the 19th century French neurologist Jean-Martin Charcot helped shape the our concepts of ‘hysteria‘ – a disorder where psychological disturbances manifest themselves as what seem like neurological symptoms.

Such patients would today be diagnosed with ‘conversion disorder’, usually after presenting to a neurology clinic with paralysis, blindness or epilepsy, only for it to be found that there is no damage to any of the areas you might expect or no seizure activity in the brain during a ‘fit’.

Importantly, the patients aren’t ‘faking’, they genuinely experience themselves as paralysed, blind, or otherwise impaired.

What recent research suggests is that there may be a disturbance in higher level brain function which may be suppressing normal actions or sensation.

To use a business analogy, none of the workers are on strike but the management is causing problems so the work can’t be carried out.

Charcot revived interest in this disorder through his weekly, somewhat theatrical, case demonstrations, and, as the book discusses, through some striking and equally theatrical photos and illustrations.

This wonderfully illustrated book examines the history of Charcot’s work at the Salp√™tri√®re, the famous Paris hospital, and how the newly developed technology of photography played a key role in popularising the disorder and shaping our ideas about hysteria.

In the last few decades of the nineteenth century, the Salpêtrière was what it had always been: a kind of feminine inferno, a citta dolorosa confining four thousand incurable or mad women. It was a nightmare in the midst of Paris’s Belle Epoque.

This is where Charcot rediscovered hysteria. I attempt to retrace how he did so, amidst all the various clinical and experimental procedures, through hypnosis and the spectacular presentations of patients having hysterical attacks in the amphitheater where he held his famous Tuesday Lectures. With Charcot we discover the capacity of the hysterical body, which is, in fact, prodigious. It is prodigious; it surpasses the imagination, surpasses “all hopes,” as they say.

Whose imagination? Whose hopes? There’s the rub. What the hysterics of the Salpêtrière could exhibit with their bodies betokens an extraordinary complicity between patients and doctors, a relationship of desires, gazes, and knowledge. This relationship is interrogated here.

What still remains with us is the series of images of the Iconographie photographique de la Salpêtrière. It contains everything: poses, attacks, cries, “attitudes passionnelles,” “crucifixions,” “ecstasy,” and all the postures of delirium. If everything seems to be in these images, it is because photography was in the ideal position to crystallize the link between the fantasy of hysteria and the fantasy of knowledge.

A reciprocity of charm was instituted between physicians, with their insatiable desire for images of Hysteria, and hysterics, who willingly participated and actually raised the stakes through their increasingly theatricalized bodies. In this way, hysteria in the clinic became the spectacle, the invention of hysteria. Indeed, hysteria was covertly identified with something like an art, close to theater or painting.

The book’s website has the first chapter freely available, but sadly none of the photos.

Most of Charcot’s books, containing many of the wonderful illustrations and photos, are listed on Google Books but for some reason I can’t work out, you can’t view the pages.

As they were published in the late 1800s, they should be well out of copyright, so its a bit frustrating we can’t read them.

To give you an idea, however, the illustration on the left is the ‘Grande Hysterie Full Arch’, one of Charcot’s classifications of hysterical epilepsy.

This is one of Charcot’s many illustrations of amazing bodily contortions that was used as inspiration by the famed and somewhat eccentric French sculptor Louise Bourgeois, as you can see in a (possibly NSFW?) article on her work from the Tate magazine.

Link to details of book with sample chapter.

Out of body experiences and grasping the ungraspable

This week’s ABC Radio National’s All in the Mind discusses what happens in the brain during out of body experiences, and why actions can be accurate even when our perceptions are not.

The first interview is with neurologist Olaf Blanke who discusses some of his recent compelling research, including a virtual reality experiment to induce out-of-body touch sensations in healthy participants and one with implanted brain electrodes to trigger full-blown out-of-body experiences in patients undergoing neurosurgery.

The second interview is with psychologist Melvyn Goodale, famous for his work on distinguishing the visual streams in the brain: the dorsal stream and the ventral stream.

Some of the most striking and important results from this work come from patients who have suffered damage to one or the other stream.

In the programme, Goodale talks about brain-injured patient DF, who can correctly and accurately grasp objects she cannot consciously ‘see’. The opposite has been found in other patients, who can accurately see and describe objects they cannot accurately grasp.

This suggests that these two visual pathways, although complimentary, are specialised for different things, one for identifying objects, and the other for working out where they are and how to manipulate them.

The different function of the two pathways can also be demonstrated in healthy people as well.

You may recognise the visual illusion on the left, sometimes called the Titchener or Ebbinghaus illusion. The two circles in the middle are actually the same size, but look different due to their context.

Researchers have created a graspable version of the illusion by putting hoops on a flat surface.

When they’ve measured how people adjust their fingers to pick up the middle circles, they find that we don’t over or underestimate the size. Our fingers are always perfectly adjusted to the actual size.

In other words, it seems that while our perception is fooled by the illusion, our actions aren’t, showing how the specialisation of each visual stream can be seen in everyone.

There’s now a minor cottage industry of research attempting to understand exactly what influences the effect.

UPDATE: “All in the Mind has been honoured with the Grand Award at 2008 New York Radio festivals for best entry across all categories, as well as a Gold World Medal in the Health / Medical category”. – I’m sure it won’t come as a surprise to most Mind Hacks readers but fantastic to have it recognised by the non-initiated!

Link to AITM on out-of-body experiences and other tricks of consciousness.

Trip At The Brain

It’s an age old story. Boy meets girl. Boys loses girl. Boy thinks it might be because he was hypnotised by a crazed scientist who was swinging a brain on a chain. Boy thinks this might explain why the girl was originally a nun but changed into hallucinatory sex vampire.

Yes, it’s the video for mostly nonsensical ‘Trip At The Brain’, produced in 1988 by the skate metal pioneers Suicidal Tendencies.

I suspect it’s what might happen if you were the lead singer of a metal band who hallucinated evil neuroscientists while on a bad trip, or if you were a neuroscientist who hallucinated a metal band while on a bad trip.

Nevertheless, it remains one the finest examples of 20th century neuroscience, heavy metal and hallucinatory sex vampire art.

Link to video of Suicidal Tendencies’ ‘Trip at the Brain’

Average guesses to hit the mark

The Economist has a short but sweet article on a new study that has found that asking the same person to make two guesses and averaging the answer is more accurate than any one guess alone, with more time between guesses improving accuracy.

The study is apparently by psychologists Hal Pashler and Ed Vul and has just been published in Psychological Science, but unfortunately the journal website is down at the moment, but I shall link to the original study when it reappears.

According to The Economist though, here’s the punchline:

The two researchers asked 428 people eight questions drawn from the “CIA World Factbook”: for example, “What percentage of the world’s airports are in the USA?” Half the participants were unexpectedly asked to make a second, different guess immediately after they completed the initial questionnaire. The other half were asked to make a second guess three weeks later.

Dr Vul and Dr Pashler found that in both circumstances the average of the two guesses was better than either guess on its own. They also noticed that the interval between the first and second guesses determined how accurate that average was. Second guesses made immediately improved accuracy by an average of 6.5%; those made after three weeks improved the accuracy by 16%.

Link to Economist article ‘The crowd within’.

Psychotic visitors to the White House

In 1965, The American Journal of Psychiatry published a curious article on delusional people who had visited the White House in Washington DC, wanting to see the President.

The article reviewed the cases of 40 people admitted to the Washington D.C. General Hospital from 1960-1.

It also outlined 10 cases in more detail, this is number 6:

Case 6. A 44-year-old Negro woman “was invited” to see the President many times and prior to her trip wrote that she was finally coming. She hoped the President would stop the “gum chewing” in her head and would stop the police persecution that had caused her ears to flop and her body to go out of shape. She complained of policemen in her ears and riding up and down her nose. The patient was acutely psychotic and her stream of thought disorganized, but she claimed that she had first visited the governor of her home state and the Pentagon before trying to see the President. She refused to discuss previous hospitalization. Diagnosis: schizophrenic reaction, paranoid type.

The paper also contains some interesting speculation: “In 1960, when Mr. Eisenhower was President, only nine patients were admitted, but 32 were hospitalized in 1961, Mr. Kennedy’s inaugural year. This would suggest that some personal characteristic of the President was important.”

The study was actually based on similar research conducted more than 20 years before, on psychotic visitors to government offices in Washington DC.

Link to full text of ‘Psychotic visitors to the White House’.
Link to ‘Psychotic visitors to government offices in the national capital’.

Back from the dead

A scene from a thousand horror movies, retold in the medical literature, with an additional lesson about the correct use of cerebral perfusion and angiography in diagnosing the brain dead patient.

Presumably, learnt shortly after the doctors had stopped screaming.

I love the use of the phrase “the situation became confusing”, just after the dead guy starts moving again.

Unusual movements, “spontaneous” breathing, and unclear cerebral vessels sonography in a brain-dead patient: a case report.

Bohatyrewicz R, Walecka A, Bohatyrewicz A, Zukowski M, Kepiński S, Marzec-Lewenstein E, Sawicki M, Kordowski J.

Transplant Proc. 2007 Nov;39(9):2707-8.

A patient with a brain injury fulfilled all clinical criteria for brainstem death diagnosis. Two standard sets of tests were performed; according to Polish regulations, the patient could be declared brain dead. However, shortly after the completion of the tests and before the final brain death declaration, 6 triggered “assisted” breaths/min were noticed. After careful analysis of the ventilator settings, it was concluded that low trigger sensitivity and airway pressure oscillations during heart contractions were the reasons.

Additionally, a few minutes later, spontaneous jerking movements of lower limbs and clonic movements of neck muscles secondary to painful stimuli were noticed. The situation became confusing; therefore, cerebral Doppler sonography was performed, showing circulatory arrest in both of the internal carotid, middle cerebral, and left vertebral arteries. The basilar artery was not visualized. Forward flow with increased pulsatility was recorded in extracranial and intracranial segments of the right vertebral artery. Cerebral circulatory arrest was still uncertain; therefore, the diagnostic procedures were completed with conventional cerebral angiography, which showed a lack of cerebral blood flow.

Finally, the patient was declared brain dead; kidneys and bones were harvested. Cardiogenic oscillations associated with incorrect low ventilator trigger settings may falsely suggest persistence of breathing efforts in a brain-dead patient. In the case of any unusual events during brain death diagnosis, cerebral perfusion tests should be performed with cerebral angiography as the “gold standard.”

Link to PubMed entry.

Psychobabble worst offenders

PsyBlog has collected the responses to its request for the most annoying psychobabble and you can now vote for your favourite worst offender.

The list reminds me of how many terms, particularly from psychoanalysis, have become part of the language, probably without people realising it.

Being ‘in denial’, being ‘anal’, being ‘defensive’, feeling ‘split’ over a decision, ‘projecting’ your fears, ‘repressing’ a thought, having a big ‘ego’, increasing ‘libido’ and feeling ‘castrated’ were all terms created or popularised by Freud and his followers.

Sadly for jargon haters, today’s psychobabble is tomorrow’s everyday language.

As the late psychologist Julian Jaynes pointed out, the Ancient Greek epic the Iliad makes no reference to a concept of the self or any mental states anywhere in the text.

Much of our everyday language of the mind is a relatively new cultural invention, suggesting that language is just another form of technology.

Hopefully though, some of the more annoying linguistic technologies will fall into disuse fairly soon, although I have to say, I have a fondness for some of the more arcane terms.

‘Enthusiastical’, meaning a form of religiously induced madness, is charmingly Dickensian, and ‘alienist’ – the old word for psychiatrist – has a completely different spin now we tend to think of little green men when we hear the word.

Link to PsyBlog psychobabble vote.

2008-06-27 Spike activity

Quick links from the past week in mind and brain news:

More on experimental philosophy. Scientific America has an excellent piece on the curious new form of conceptual engineering.

The BPS Research Digest looks at new research on ‘non-criminal psychopaths‘.

How to win friends and influence people. Cognitive Daily covers some recent research on popularity at school.

NeuroScene has monthly podcast interviews with mind and brain researchers.

I’m a Blind Climber Who “Sees” With His Tongue. Not only a perfect chat-up line, but also an article for Discover Magazine.

The 1930s Marital Scale is now available as an online test!

The Immanent Frame discusses Pascal Boyer’s cognitive explanation of the evolution of religious thought.

Documentary photographs from institutions for people with learning disabilities from 1960s American, discovered by Neurophilosophy.

If you need an antidote after those somewhat disturbing photos, could I recommend the rocktastic Heavy Load.

How Smart Is the Octopus? asks Carl Zimmer.

The Language Log picks up on some sexual pseudoscience from CNN.

Oxytocin may be a useful treatment for social anxiety, reports The Times.

The Onion radio news reports on a successful case of gay conversion therapy.

NeuroQuantology. Not sure quite what to make of it.

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“>Antipsychotics dangerous and overprescribed in dementia, reports The New York Times.

The mighty Neuroanthropology has a great piece on cybernetic theory and neuroanthropology hot from a recent conference.

The Times has an article on government-by-cognitive-bias book ‘Nudge‘.

Psychologist Deric Bownds reviews the brain’s default network.

The second social scientist from the US military’s Human Terrain System is killed in the ongoing conflicts, reports Wired.

Sharp Brains has an excellent interview with psychologist Arthur Cramer about, well, sharpening the brain!

Hot Spanish psychologist talks about psicología y los hombres como mero instrumento de placer. Not the sort of Spanish lessons I remember, sadly.

Advances in the History of Psychology picks up on an intriguing new book on the history of ignorance.

Pharma industry spent $168 million, yes that was $168 million, lobbying US lawmakers in 2007, up by a third from 2006, notes Furious Seasons.

Developing Intelligence has an excellent piece on untraining the brain and the use of meditation and hypnosis to decouple automatic attentional processes.

PsychCentral hits Time

PsychCentral, one of the original internet psychology sites, has recently been featured by Time magazine as one of the 50 best websites of 2008.

One of my favourite PsychCentral features is Flashback which says what was featured on the site 1, 5 and 10 years ago.

That’s a fantastic pedigree for an internet site and being featured in Time is surely a testament to the hard work psychologist John Grohol has put into keeping it updated with quality news and information.

Time allows you to rate each site, so if you’re a fan like me, drop by and show your appreciation.

Link to PsychCentral on Time’s 50 Best Websites 2008.

A strange rite of nudity

“In a way, young Dr Highsmith had plenty of warning. He should have known all was not well that day he came home and discovered his wife performing a strange rite of nudity.

But Highsmith was too wrapped up in the psychiatric problems of a lovely model named Barbara to be aware what was happening to his marriage. Though sex was his business, he found it difficult to keep it strictly business – especially with Barbara giving him an increasing role in her haywire love life…”

The description of Henry Lewis Nixon’s 1954 pulp novel Confessions of a Psychiatrist, billed as “a titillating treatise on the love therapy racket, told with daring sophistication and unblushing frankness”.

It looks like it was also published as a double bill with another book, which, unfortunately, was not about psychiatrists and their daring sophistication / unblushing frankness.

Sadly, there are few details about the book on the net, so if you’re dying to find out what the “strange rite of nudity was”, you’re going to have to track down a copy for yourself.

Link to a few more details.

The fMRI smackdown cometh

Over the last few months, the soul searching over the shortcomings of fMRI brain scanning has escaped the backrooms of imaging labs and has hit the mainstream.

Numerous articles in hard hitting publications have questioned some common assumptions behind the technology, suggesting a backlash against the bright lights of brain scanning is in full swing.

There are two strands to this debate, and both stem from the fact that the technology and conceptual issues of brain imaging are incredibly complex.

To fully understand what happens during a brain imaging experiment you need to be able to grasp quantum physics at one end, to philosophy of mind at the other, while travelling through a sea of statistics, neurophysiology and psychology. Needless to say, very few, if any scientists can do this on their own.

So the first strand involves how brain imaging experiments are reported in the media. Under the sheer weight of conceptual strain, journalists panic, and do this: “Brain’s adventure centre located”.

It’s a story published this morning on the BBC News website based on an interesting fMRI study looking at brain activity associated with participants choosing a novel option in a simple gambling task. But out of the four words of the headline, only the first is accurate.

And this leads to the second strand of the debate, which, until recently, has been largely conducted away from the media’s gaze, amongst the people doing cognitive science themselves.

It starts with this simple question: what is fMRI measuring?

When we talk about imaging experiments, we usually say it measures ‘brain activity’, but you may be surprised to know that no-one’s really sure what this actually means.

Neuroscientist Nikos Logothetis published an important paper in Nature a couple of weeks ago explaining exactly what we know so far about the link between what brain scans measure and what the brain is actually doing.

It’s very wide-ranging and includes lots of grit-your-teeth hardcore neurophysiology, but is, I think, essential reading if you’re neuroscientifically inclined.

It focuses on BOLD, the signal that reflects the ratio of oxygenated and deoxygenated blood measured by fMRI, and the fact that it can be altered by a huge range of different biological process and neural firing patterns.

One of the main points of the paper is that the brain is not simply an array of tiny localised processors, but it is more like an an ecosystem of communication.

Activity can result from sending more signals, trying to send less, or, from what seems to be particularly important – maintaining a balance of excitation and inhibition.

Furthermore, it seems that a great deal of neural activity is not from neurons that might be directly involved in a task, but from ‘neuromodulation’ – general processes of management and coordination, often linked to attention. This can wax and wane, can spread like ripples and can occur in all sorts of non-linear ways that makes interpretation difficult.

What this means is that brain imaging experiments need to be carefully designed to control for these effects, but this entirely depends on our understanding of the effects themselves.

In other words, our understanding of what brain scanning data tells us evolves over time. A study conducted ten years ago might mean something different now.

An article in Science, published in the same week as Logothetis’ paper, reports on new statistical methods for interpreting imaging data, a different issue again.

The latest edition of The New Atlantis has an article that attempts to come to grips with some of the philosophical aspects of brain imaging experiments, in terms of the conceptual limits in inferring mental states from biological changes.

I have to say, it’s a bit miscued in places, assuming that brain imaging relies on ideas about brain modularity (which it doesn’t) and seemingly confusing it with the notion of pure insertion, and suggesting some rather strange notions about mental causation, but it has many good points and is worth a read.

It’s important that these sorts of issues come to light, because it hopefully heralds a time of increased caution in our interpretation of brain scans – and that goes for scientists, the media and the general public.

This is essential, because this data is starting to be used, literally, in life or death decisions.

The same issue of The New Atlantis has an article on neuroimaging that discusses the ethical dilemmas in applying this imperfect technology to legal decisions concerning capital punishment.

Link to Logothetis on ‘What we can do and what we cannot do with fMRI’.
Link to Science article ‘Growing pains for fMRI’.
Link to New Atlantis on ‘The Limits of Neuro-Talk’.
Link to New Atlantis on Neuroimaging and Capital Punishment.

Works like a charm

The March edition of HR Magazine has an unintentionally hilarious cover article on ‘The Brain at Work’ which informs us that we can ‘squirt’ neurotransmitters into each others’ brains, tell us how we can reboot dendrites and is strangely obsessed with the basal ganglia.

It’s full of fantastic howlers and misplaced metaphors which you’ll have the pleasure of discovering for yourselves, but the stuff about the basal ganglia is just plain odd.

Tired of listening to her employees vent, she told them, “No longer will I listen to a problem unless you submit at least a portion of the solution.”

Weber explains what happened next in neuroscientific terms: “The next day, the basal ganglia were at work continuing to vent about the problems with no solution.” One employee went to the HR professional’s office. He didn’t have a solution, so she sent him away.

“About three days later, workers realized she was serious. So, a different person went into her office with a solution to the problem. The HR professional agreed to and supported the solution put forward with slight revisions to keep it under budget.”

That simple change transformed the employees’ dynamics — and their brains — by turning control over to them. “The conversation in the basal ganglia went from problem-focused to solution-focused,” says Weber. “When people in that department went to sleep at night, they rewired their brains for the new behaviors.”

Let’s just pause there for a moment.

Nope, it doesn’t help.

The curious thing is that the article is generally full of quite sensible advice for managing employees but its just wrapped up in this bizarre alternative universe neurobabble.

Somehow we’ve got to the point where people feel they can’t give good advice without waving poorly-understood neuroscience around like it was a recently enlarged willy.

Link to ‘The Brain at Work’.

The science of theory

Philosopher Eric Schwitzgebel has written an excellent piece on experimental philosophy, the practice of testing out philosophical ideas by using experiments or gathering data.

Now, the more astute of you might be thinking, “isn’t that just science?”, and, you’d be right. Sorta.

Schwitzgebel makes the important point that lots of the things that are taken for granted in the philosophy of mind, like what it is like to have have certain conscious experiences, haven’t actually been examined to see how widely these assumptions or experiences are shared.

Partly, he notes, because psychology is too scared about being called unscientific to start returning to introspection, and partly because philosophers are the ones most concerned about these issues.

In the philosophy of perception, there‚Äôs a long-standing dispute between those who think that our concepts and categories thoroughly permeate and infect even the most basic perceptual experiences and those who hold that people with very different understandings of a scene may still have exactly the same perceptual experience of it…

Such phenomenological claims have two things in common with claims about what’s intuitive that make them ripe for inclusion under the umbrella of “experimental philosophy”: First, it is mainly philosophers who make such claims; and second, there is no substantial tradition outside of philosophy dedicated to the empirical evaluation of the claims.

These facts may be mere historical accident: Back in the days of introspective psychology, psychologists loved to dispute issues of this sort. But fortunately or unfortunately, psychology still has not sufficiently rebounded from the behaviorist revolution that such general phenomenological claims are broadly discussed by mainstream psychologists.

If you consider tradition of phenomenological philosophy, which aims to describe the subjective structure of the mind, it’s striking that it’s been almost entirely based on philosophers’ own intuitions about their mental states, which they then extrapolate to everyone else.

Schwitzgebel also suggests that experimental philosophy could be used for exploring an anthropology of philosophy. In other words, how culture affects our general assumptions about how the mind works.

I have looked at the relationship between culture-specific metaphors and the prevalence of certain views about conscious experience. To highlight some of my own work: Are people (including philosophers) more likely to say that dreams rarely contain colored elements if the film media around them are predominantly black and white? Are people more likely to say that a circular object (such as a coin) viewed obliquely looks elliptical if the dominant media for describing vision are media like paintings and photographs that involve flat, projective distortions?

Of course, there’s a big overlap with psychology here, but the fact is, psychologists just aren’t that interested gathering the data that philosophers would often find most useful, and so they’re setting about gathering it themselves.

The first book on experimental philosophy was recently published, and Schwitzgebel’s article is a fantastic introduction, as well as an eye-opening look at the possibilities of philosophers armed with clipboards.

Link to article ‘The Psychology of Philosophy’.

Gazzaniga on split-brains and bioethics

Michael Gazzaniga, one of the founding fathers of cognitive neuroscience and a pioneer of ‘split brain’ research, is interviewed on this week’s ABC All in the Mind where he talks about the use and abuse of ‘left brain – right brain’ metaphors and how our understanding of free will is impacting on the law.

Gazzaniga was a student of Roger Sperry, who won a Nobel prize for his work on ‘split-brain patients’, people who had the two cortical hemispheres of the brain functional separated by neurosurgery to cut the corpus callosum in an attempt to treat otherwise untreatable epilepsy.

One of the amazing things was that while the people didn’t feel any different, it was easy to demonstrate that the each hemisphere processed things in quite different ways and each was, to a certain extent, independently conscious.

The interview discusses some of this early research, and asks how much of the popular ‘left brain – right brain’ rhetoric that gets thrown around actually stands up to scientific scrutiny. I think you can guess, but it’s good hearing it from the man himself.

Gazzaniga also talks about one of his other interests – neuroethics, and particularly the effect that a neuroscientific understanding of free will is having on our concepts of legal responsibility.

I was interested to read that US judges can now take courses in neuroscience to help them makes sense of the sometimes counter-intuitive findings in cognitive science.

As it happens, Gazzaniga’s new book Human: The Science Behind What Makes Us Unique is published today. If you want a taster an Edge article by Gazzaniga from a few months ago seems to be taken from it.

The AITM Blog also has some bonus audio of Gazzaniga discussing his experience of being on George Bush’s bioethics council when the President was vetoing stem cell cloning.

Link to AITM interview with Michael Gazzaniga.