Mind Hacks

I remember a recently admitted patient, nose-to-nose with his psychiatrist, screaming at her “you don’t know what I’m going through – how the fuck do you know what it’s like little missy?”.

The psychiatrist finished the discussion, saying she’d come back to him later, and after a brief pause to collect herself, moved on to the next patient in the ward round.

It is still an incredibly vivid memory for me, partly because everyone else in the room knew that the psychiatrist had been a patient herself, as she had a lifetime’s worth of experience dealing with her own mental health issues.

Study after study has shown that psychiatrists have higher rates of mental illness than the general population.

Research published in 2001 revealed that 56% of female psychiatrists have a family history of mental illness, and just over 40% have experienced one themselves – almost twice the rate of other doctors. Undoubtedly as a consequence, psychiatrists have double the rate of suicide of the general population.

Psychiatry is certainly a stressful job, but research has also found that there are higher rates of mental disorder in future psychiatrists, suggesting many go into the profession precisely because of their experiences.

Other mental health professionals are much less studied, but from my own experience, I suspect the histories and motivations of mental health nurses, psychologists and social workers and so on are are likely to be similar.

The reason I mention this is because Phil Dawdy has just written a powerful article on responses to a recent murder of a psychologist in New York.

Several people wrote comments to his original notice saying that the murderer was likely on a whole bunch of meds that were making him crazy; and, mental health workers hurt patients all the time, so they get what they deserve.

It is quite apparent that unlike in other areas of medicine, the mental health system has a ‘them and us’ attitude.

Ironically, it is the single area of medicine where ‘them’ are most like to be ‘us’, regardless of whether you’re a patient or a professional.

Link to Phil Dawdy on murder of a New York psychologist and reaction.

Love is the most exalted and sublime of human emotions. It has inspired breathtaking works of art, journeys through continents and even the tragedies of war. Given its powerful hold on humanity it’s surprising that it’s been traditionally neglected by the brain sciences. In spite of this, a new dawn in romance research has begun to bud in recent years, and love has finally blossomed in the lab.

While romantic love has always been an obsession of the psychoanalysts, they were often creating little more than a new poetry of emotion, often beautiful, often bizarre, but rarely explaining more than their own metaphors.

Always a little late to the game, it wasn’t until the end of the 1990s that neuroscience fell head over heals for love. The first to become inspired by this new passion was, as if we needed to ask, an Italian.

Psychiatrist Donatella Marazziti and her colleagues measured levels of a protein that transports the neurotransmitter serotonin in the blood of 20 people who had recently fallen madly in love, 20 people with obsessive compulsive disorder (OCD) and 20 healthy comparison participants.

People with OCD experience intrusive, obsessive thoughts and are often described as having an ‘over-valued idea’ – an almost semi-delusional state where a particular thought becomes the focus of attention.

Marazziti, already an established OCD researcher, knew that serotonin had previously been linked both to obsessional thoughts and to sexual attraction, and wondered whether something similar might be going on in the early stages of romance.

She found that the group of patients with OCD and the recently love-struck were no different in terms of the serotonin transporter protein, suggesting the brain began to function markedly differently as love blossomed.

Although measuring the blood is a fairly crude way of looking at how the brain works, the researchers were struck by the similarities between these two states:

This aspect we believe underlies the obsessive pre-occupation so characteristic of the early stage of love (which, in rare instances, might persist for a lifetime of abstract idealization that leads to poetry and music dedicated to the love object). As far as we are aware, this is the first report of changes in the 5-HT [serotonin] transporter during a physiological state; it would suggest that being in love literally induces a state which is not normal – as indeed suggested by a variety of colloquial expressions used throughout the ages in different countries, all of which refer generally to falling ‘insanely’ in love or to being ‘lovesick’

Since this initial flirtation, love has become a hot topic in the neurosciences, with whole conferences dedicated to it and numerous scientific studies being published every year.

Perhaps unsurprisingly, the traditional connection between love and madness has not been dispelled by these recent studies.

In fact, a 2007 study that looked at new love in adolescents found so many striking similarities between the intensity of teenage romance and hypomania, a symptom of manic-depression, that the authors warned researchers to look out for the love-struck when conducting research with young people, so as not to bias their results.

Link to abstract of study of the serotonin transporter and romantic love.
Link to abstract of study on hypomania and adolescent love.

I’ve just found an interesting page on Wikipedia that discusses the concept of ‘emotional labour‘: where employees are expected to regulate their outward emotional reactions so they are consistent with the company’s goals, regardless of their internal feelings.

A classic ’emotional labour’ worker would be a shop assistant or a waitress, where the employee has to control their emotions and maintain a pleasant demeanour even when customers are being difficult, annoying or even abusive.

This concept was apparently first devised by the sociologist Arlie Hochschild in the book The Managed Heart.

However, a distinction is made between ‘surface acting’, where the display doesn’t need to match internal feelings at all (as when waitressing), and ‘deep acting’ where the employee is expected to genuinely feel the emotions (like in nursing).

Apparently, ‘surface acting’ jobs are associated with stress, feeling inauthentic and depression, while ‘deep acting’ jobs are associated with increased job satisfaction.

How well this is supported by empirical evidence is anyone’s guess, but it’s an interesting concept.

Link to Wikipedia page on ’emotional labour’.

How does the brain generate orgasm? It’s one of the most under-investigated human experiences but two articles, one in the LA Times and another in The Psychologist, discuss some of the key developments of recent years.

The LA Times article is a good description of some of the most interesting neuroscience studies in this developing field, but is a little uncritical in places.

Apparently “About 43% of women and 31% of men in the U.S. between ages 18 and 60 meet criteria for sexual dysfunctions, according to a 1999 report on the sexual behavior of more than 3,000 U.S. adults”.

This report was a research study published in the Journal of the American Medical Association that classified sexual dysfunction as reporting any one of the following during the last 12 months:

(1) lacking desire for sex; (2) arousal difficulties (ie, erection problems in men, lubrication difficulties in women); (3) inability achieving climax or ejaculation; (4) anxiety about sexual performance; (5) climaxing or ejaculating too rapidly; (6) physical pain during intercourse; and (7) not finding sex pleasurable

Almost all of which fall within the normal range of a year’s worth of regular sexual experiences, which probably explains why a third to almost half of people surveyed experienced at least one – but hardly a marker of a serious medical problem in itself.

There’s a much better article on orgasm in this month’s The Psychologist by Barry Komisaruk, Carlos Beyer and Beverly Whipple, authors of a recent book on ‘The Science of Orgasm’.

It looks at the research on the roles of neurotransmitters in orgasm, as well as what the brain scanning literature tells us about brain activity during sexual arousal and release.

Most interestingly, it has a good discussion of non-genital orgasm:

As reviewed in Komisaruk et al. (2006), there are published reports of orgasms elicited by stimulation also of lips, hand, knee and anus occurring during dreaming sleep, of phantom limbs, from electrical or chemical stimulation of the septum, amygdala or thalamus of the brain and of the spinal cord.

Orgasms have also been described by men and women when they suffer epileptic seizures that are triggered by specific activity (e.g. brushing the teeth: Chuang et al., 2004), or that occur spontaneously. While these epileptic orgasms are in some cases described as ‘unwelcome’ (Reading & Will, 1997), others describe them as pleasurable, one woman refusing anti-epileptic medication for that reason (Janszky et al., 2004)

We have measured autonomic and brain activity during orgasms that women have produced by thought alone. During the thought orgasms, the magnitude of the increases in heart rate, blood pressure, pain threshold, pupil diameter, and brain regions are similar to those that we observe during vaginal or cervical self-stimulation-induced orgasms (Whipple et al., 1992). It is not surprising that in those cases of thought-induced orgasms, the specific genital sensory thalamic and cortical, and specific limb-motoric regions, are not activated.

The article notes that a number of different nerve pathways may serve to communicate sensual stimulation to the brain, which may account for why different sites of stimulation can produce orgasm.

Link to LA Times article ‘Science of the orgasm’
Link the The Psychologist article on orgasm.

Full discloser: I’m an unpaid associate editor of The Psychologist.