A Social Account of Suffering

50,000 cultured brain cells sit in a petri dish. Through a combination of electronic sensors, software engineering and robotic sculpture, the physiology of the cells interacts with the psychology of some patrons of an art gallery [1]. From this transaction, judgments arise - the audience might report feelings of being watched, of play, or simply of remotely observing an oblivious 'seizure machine.' One particular type of audience member, the Animal Ethicist, might even wonder if we should be worried that the culture of brain cells (as a former animal) might be in pain.

Brain cells, electrodes, and tiny Peter Singer (image from here). 

While in most cases it is fairly straightforward to determine that a human is in pain, when one starts to asks if non-humans (or even humans with severe communication problems, such as locked-in patients) are in pain, it is common to turn to neuroscience for help. The idea is that while mental states (such as pain and suffering) can only be deduced from behavior if the behaviors are 'wired up correctly,' mental states are always (or non-contingently, to borrow the language of Dr. Martha Farah [2]) related to brain states. Thus, the tools of neuroscience can give us direct access to the amount of pain an organism is experiencing, bypassing a body that might hide this information from us (which could happen because of injury, or because the body was never equipped with a human face). We are obligated to perform this scientific investigation, as we have an obligation to prevent pain and suffering.

Pain is something the brain does.  Nociception sends information about tissue damage (1) through the spinal cord, where such information can be modulated (2).  However, pain doesn't really become that nasty, unpleasant experience until it weasels its way into your limbic system (4).  Image retrieved from here.  

At this point, we are working with the following assumption:



1) “Neural systems are the substrate of private, internal 'mental' events (such as “suffering”), which can be a source of moral value”



Amusingly enough, this assumption can lead us to a mathematical formulation of suffering. The logic is as follows: the human brain, as well as perhaps other brains, has the capacity for suffering. We can be somewhat precise about this, and say that this capacity is defined as the 'natural' ability to orchestrate behaviors that have been identified as correlates of suffering (such as freezing, favoring limbs, calling for help, and 'pained' facial expressions), in response to stimuli that are 'naturally' associated with suffering (extended bouts of pain, either physical of social). The circuitry within the brain that provides this capacity, while not yet fully understood, should in principle be a physical, deterministic system. As part of a physical, deterministic system, this circuitry should be describable as a set of mathematical relationships. Furthermore, as we earlier decided that mental states are only contingently related to brain states, it is this mathematical relationship (which the 'suffering-behaviors' merely point to) that is the essence of suffering [3].

Is pain merely a mathematical construct?  Image from here. 

The implications of this are delightfully absurd: if suffering is a mathematical relationship, then any system that implements that relationship (a rat, a culture of brain cells, or a deviously engineered toaster) should qualify as being able to suffer, and under some ethical systems (here I am alluding to those of the animal ethicists Peter Singer and Richard Ryder) thus enter into the realm of morally relevant beings. That is, it becomes a moral obligation to prevent these entities from suffering, no matter how silly or alien their “suffering” might appear, simply due to the physical laws that govern part of their behavior.



Before we get too carried away (and start passing laws against posting such equations in public), let us carefully revisit that assumption number 1. This statement can be problematized from a variety of perspectives (it's Cartesian, for God's sake!), but lets stick to a neuroscientific perspective. First, we've supposed the existence of private, internal events (“qualia”) that can't be directly measured, and have to be accounted for in addition to the (public) neural events that we can measure. Secondly, we must also deal with the fact that we've given these mysterious, ghostly events control over value, effectively tying one mystery to another. Compare the above assumption then, to the one below:



2) “Neural systems are the substrate of public, embedded 'social' events (such as “suffering”), which can be a source of moral value”



This small change in wording has solved the two problems outlined with assumption 1. First, we no longer have to contend with an awkward metaphysics that describes two kinds of events (internal, unmeasurable “mental” events and our normal, measurable “physical” events)- instead, all events are now public and capable of being measured (which, as scientists, causes us a sigh of relief). Secondly, we no longer have value popping out of nowhere. Instead, suffering has moral value as it is a social event: a social, 'embedded' subject is needed to judge that suffering to has occurred, and while doing so judges this suffering to be 'bad.'

This can be seen as emphasizing (after Dr. Grant Gillett[4] and Dr. Daniel Goldberg[5]) the social components of subjectivity (specifically, handing the definitions of subjective experiences to the social realm), while denying that subjectivity exists outside of the social realm (after Dr. Daniel Dennett[6]).

Is "do cockroaches feel pain?" a question for neuroscientists studying cockroaches, or for social scientists studying humans?  Animated version here!

One disadvantage of this perspective is that it limits what we can expect to learn about pain if neuroscience focuses exclusively on "pain-pathways," while ignoring empathy.  This social perspective on suffering suggests that multiple entities (or at least multiple systems in the same entity) must be interacting before we can talk about suffering, or subjective states at all[7].  Instead, whatever abstractions or circuits that we come across within a single brain must be considered as the building blocks of subjectivity and morality, and not equivalent to such.  This implies an obligation to use value-neutral descriptions of neural states and circuits, or risk confusing “the substrate for the reality,” in the words of Dr. Gillett[4].  Thus, we can't look at a culture of rat neurons sitting in a dish and evaluate their subjective state by using the techniques of neuroscience- the question is one for the audience.



Lastly, one advantage of this conception of suffering:  by not rejecting the social component of suffering, we are forced to accept suffering as being a thick, value-laden concept that escapes reduction to a sterile set of equations, or carnal set of 'brain states.'  Suffering instead is seen as a function of not just the individual, but also the ever-changing culture the individual exists within.

---

[1] Zeller-Townson, RT. (2012). Why use Brain Cells in Art? The Neuroethics Blog. Retrieved on April 29, 2013, from http://www.theneuroethicsblog.com/2012/09/why-use-brain-cells-in-art.html

[2] Farah, Martha J. "Neuroethics and the problem of other minds: implications of neuroscience for the moral status of brain-damaged patients and nonhuman animals." Neuroethics 1.1 (2008): 9-18.

[3] Unless you hold that the fact that these equations are being expressed through neurons, rather than other physical systems, is morally salient- but that is another blog post.  I'm adopting a functionalist stance in this post.

[4] Gillett, Grant R. "The subjective brain, identity, and neuroethics." The American Journal of Bioethics 9.9 (2009): 5-13.

[5] I'd like to thank Dr. Daniel Goldberg for pointing out these particular accounts of pain (via twitter, of all places!) Goldberg, Daniel. "Subjectivity, consciousness, and pain: The importance of thinking phenomenologically." The American Journal of Bioethics 9.9 (2009): 14-16.

[6] Dennett, Daniel C. Consciousness explained. ePenguin, 1993.

[7]This isn't to say that someone can't suffer (or experience other, more pleasant qualia) in isolation.  I am merely suggesting that the judgment that this subject makes, "I am suffering," is as much a function of the subject's brain state, as it is the social environment that shaped the subject's operational definition of 'suffering.'  However, I am saying that if no one applies the label "suffering" to a state (say, the struggles of a virion as it battles your immune system), ever, then it hasn't suffered.





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Zeller-Townson, R. (2013). A Social Account of Suffering. The Neuroethics Blog. Retrieved on
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Appreciating Neurodiversity: Learning from Synesthesia

By Guest Contributor Katherine Bryant

PhD Candidate, Neuroscience

Emory University



Who are synesthetes?

[Describing the experiences of subject MMo] Eights are yellow, for example, a square feels like mashed potatoes, and the name Steve is somehow like poached eggs. (Cytowic p. 26)

“…I [asked the vendor] what kind of ice cream she had.  ‘Fruit ice cream,’ she said.  But she answered in such a tone that a whole pile of coals, of black cinders, came bursting out of her mouth, and I couldn’t bring myself to buy any ice cream after she’d answered that way…” (Record of patient “S”, Luria p. 82)

Colored alphabet,

via Wikipedia Commons

The unexpected sensory pairings described above are the experiences of a minority of people, perhaps 4% of the population (Simner et al., 2006), known as synesthetes. Synesthesia is a perceptual phenomenon in which unusual linkages occur between sensory modalities – sounds may evoke colors, tastes may evoke shapes, or numbers may evoke spatial patterns – in all, over 40 unique pairings have been documented.  Synesthesia creates problems – it defies normal categories of clinical pathology, and yet is clearly different from what we might call “normal” or neurotypical perception. But examining the phenomenon can help us gain a greater understanding of how synesthetes perceive the world, how others perceive them, and in what ways neuroscience can help us better understand unusual neurological phenotypes – what we might call neurodiversity.



A brief history of synesthesia



The earliest known documentation of synesthesia comes from an Austrian physician who provided a self-description of his own “colored ideas” (Sachs 1812, Jewanski et al., 2009).  Sir Francis Galton provided some of the first descriptions of individuals who conceive of numbers in specific, idiosyncratic spatial forms (Galton 1880, 1881). Not long after, physician and poet Victor Ségalen reported an even wider variety of linkages, drawn from multiple first-person accounts: The poet Arthur Rimbaud experiences the letter A as black; a math prodigy describes Monday as light chestnut brown; a Jesuit priest describes his sound to color synesthesia as an “ocular harpsichord” (Ségalen 1902).

Cytowic RE and Eagleman DM,

Wednesday is Indigo Blue:

Discovering the Brain of

Synesthesia

The unusual nature of these reports combined with inherent difficulty of verifying personal accounts has frequently lead researchers to conclude that synesthetes are either confabulating, schizophrenic, or using hallucinogens (Day 2002). As a result, many synesthestes feel their personal sensoria render them abnormal, alien - different from “normals” or non-synesthetes. Some who learned to suppress reports of their sensory experiences later borrow language from gay rights movement – “closet synesthetes” will “come out” to family and friends (Day 2002). Modern neuroscientific and psychological methodologies have established the synesthesia as empirically measurable and therefore valid discrete neurological “condition”. Medicalizing synesthesia in this way can both validate synesthetes’ experiences, but also raises some ethical problems.  Scientific researchers and clinicians are often ill-equipped to comment on diversity, but when neuroscientists and neurologists make scientific claims about “normal” and “non-normal” brains, they do, perhaps unintentionally, make identity claims about the owners of those brains. Referring to synesthesia as a “neurological condition” may marginalize and de-legitimize synesthetic experience in the eyes of some, even as it validates it as a “real” experience.  Next, we’ll the research of clinicians who have examined the cognitive impacts of synesthetic experience, without pathologizing the condition, in an attempt to understand the variation between synesthetes and neurotypicals.



Synesthesia and the mechanisms of metaphor



Metaphors like “sharp cheese” and “bitter cold” are understood by most English speakers, despite the seemingly arbitrary nature of the cross-modal pairings. The appreciation of metaphor by synesthetes and non-synesthetes alike suggests a tie between synesthesia and metaphor (Ramachandran and Hubbard, 2001a).  Other arbitrary pairings are appreciated by synesthetes and non-synesthetes alike - in one experiment, a soft curved shape and a sharp jagged shape are presented, and subjects are asked to guess which shape is named Kiki, and which Bouba.  Most pick Bouba for the curved shape, and Kiki for the jagged shape (Ramachandran and Hubbard 2001b; Köhler 1947). The cortical substrate responsible for the phenomenon is the angular gyrus (Ramachandran and Hubbard 2005), an area already implicated some number-spatial forms of synesthesia from a clinical case – a synesthete who lost his synesthetic number forms after a bullet tore through the same brain region (Spalding and Zangwill 1950).



Psychologist A. R. Luria’s patient S was a synesthete with multiple forms of intense synesthethias; so intense, they were impossible for him to ignore. Interestingly, he had great difficulty with metaphor. When asked to explain the expression “to weigh one’s words”, S responds:

“When I hear the word weigh, I see a large scale […] where they put bread on one side and a weight on the other.  The arrow shifts to one side, then stops in the middle… But what do you have here – to weigh one’s words!” [Luria p. 119]

But is S representative of all synesthetes?  Scores of talented synesthetic artists, writers, and musicians suggest otherwise (examples include Kandinsky, Nabokov, Itzhak Perlman, and Stevie Wonder).  The fact that synesthesia appears to play an important role in the art produced contradicts the notion of a trade-off – perhaps synesthetic perceptions support facility with metaphor, and other forms of artistic expression.

Kandinsky's Reiter, via Wikipedia Commons

The question remains - why do the arbitrary associations of metaphor appeal to so many? If linkages are arbitrary, shouldn’t they be idiosyncratic, as well? Surprisingly, recent work suggests that arbitrary cross-modal pairings in synesthetes may not be as arbitrary as we thought – among synesthetes who experience letter-color pairings, Baron-Cohen and colleagues (1993) discovered subtle, non-random patterns – U is often yellow to light brown, I and O are often white, and X is often black. Even among synesthetes, where idiosyncrasy is the rule – commonalities emerge.



Learning from Neurodiversity and the role of the neuroscientist



If non-synesthetes also appreciate and employ metaphor, is it possible that there are other features of experience that synesthetes and non-synesthetes share? Do these neurophenotypes overlap – and how?

JM: “…the name Paul is such an ugly color, its [sic] gray and ugly. I told her ‘anything but Paul’. And she couldn’t understand why and I said ‘it is such an ugly color, that name Paul.’ […] The name probably isn’t that bad, but in my mind it’s very awful. And that influences how I feel about people”. [Cytowic, p. 45]

Although synesthetic experiences blur the usually rigid boundaries of perceptual modalities and conceptual categories in ways that seem arbitrary, synesthesia offer a new framework for understanding how non-synesthete, or “normal” perceptual and conceptual processing are constituted.  I propose that although different from normal perception, synesthetic perceptions may be the manifestation of an extreme end of a continuum of human variation, in which implicit cross-sensory linkages “break through” into explicit perception. The ability of synesthetic artists of different kinds to reach broad audiences despite the idiosyncratic and rather arbitrary nature of their associations may belie some common, unconscious, less arbitrary associations that may resonate with neurotypicals. A final anecdote from a synesthete watching a figure skating routine seems to suggest that synesthetes, in their “abnormality”, see that which the non-synesthete cannot see but somehow also knows (emphasis mine):

“A young woman […] skated to a piece of music that was green and full of squares.  Her costume was totally black; her routine started out with curving motions.  It became uncomfortable to me to watch such a mismatch, so I just looked at my hands in my lap.  She placed last in her category at the end of the evening’s judging.” [Record of subject MLL; Cytowic p. 38]

Neuroscientists have an ethical obligation to take heed of these synesthete self-reports - not only do they underscore the rich neurodiversity that exists among us, but they also may lead to new, exciting areas for research. If, as I have suggested, cross-sensory pairings exist in all of us, studying the neural substrates that support synesthesia will illuminate common mechanisms of perception in synesthetes and non-synesthetes alike. Neuroscientists should remember that the boundaries between normal and abnormal are not always bright lines – and in the case of synesthesia, understanding synesthetes and neurotypicals as existing on a continuum of human neurodiversity can help us gain new insight into how perception operates in all of us.



References



Baron-Cohen S, Harrison J, Goldstein LH, Wyke M. 1993. Coloured speech perception: Is synaesthesia what happens when modularity breaks down? Perception 22: 419-426.



Cytowic RE. 2002. Synesthesia: A Union of the Senses. MIT Press. 394 pp.



Day S. 2005. Some demographic and socio-cultural aspects of synesthesia. In Robertson LC, Sagiv N, eds. Synesthesia: Perspectives from Cognitive Neuroscience. New York: Oxford University Press, Inc. 266 pp.



Galton Sir F. 1881. Visualized numerals. Journal of the Anthropological Institute of Great Britain and Ireland 10: 85-102.



Galton Sir F. 1880.Visualised Numerals. Nature. 252-256.



Jewanski J; Day SA, Ward J. 2009. A colorful albino: The first documented case of synaesthesia, by Georg

Tobias Ludwig Sachs in 1812. Journal of the History of the Neurosciences 18: 293-303.



Köhler W. 1947.Gestalt Psychology (2nd ed.). New York: Liveright.



Luria AR. 1968. The Mind of the Mnemonist: A Little Book About a Vast Memory. Cambridge, Mass: Harvard University Press.



Nabokov V. ed. 1999. Speak, Memory.  New York: Everyman’s Library. 344 pp.



Ramachandran VS, Hubbard A. 2001a. Psychological investigations into the neural basis of synesthesia. Proceedings of the Royal Society of London, B 268: 979-983.



Ramachandran VS, Hubbard A. 2001b. The Emergence of the Human Mind: Some Clues from Synesthesia. In Robertson LC, Sagiv N, eds. Synesthesia: Perspectives from Cognitive Neuroscience. New York: Oxford University Press, Inc. 266 pp.



Sachs GTL. 1812. Historiae naturalis duorum leucaetiopum. Auctoris ipsius et sororis eius. Erlangen [Online].



Ségalen, V. 1902. Les Synesthésies et l'Ecole Symboliste. Montpellier.



Simner J, Mulvenna C, Sagiv N, Tsakanikos E, Witherby SA, Fraser C, Scott K, Ward J. 2006.

Synaesthesia: The prevalence of atypical cross-modal experiences. Perception 35:1024-1033.



Spalding JMK, Zangwill O. 1950. Disturbance of number-form in a case of brain injury. Journal of Neurology, Neurosurgery, and Psychiatry 12: 24-29.



Want to cite this post?



Bryant, K. (2013). Appreciating Neurodiversity. The Neuroethics Blog. Retrieved on

, from http://www.theneuroethicsblog.com/2013/04/appreciating-neurodiversity-learning.html

Neuroconservationism: A Neural Pathway to Preservation

Wallace J. Nichols, a marine biologist and environmentalist, has proposed an idea that may galvanize conservation movements based on neuroscientific evidence that suggests our brains deeply crave the ocean. In fact, he launched what he calls a mind-ocean initiative named BLUEMiND, with the hopes of merging the fields of cognitive science and oceanography. The group will be holding its third conference this May to facilitate discussions regarding the burgeoning field of neuroconservationism, with a major focus on exploring the biological basis of our emotional connection with the ocean and the environment.

Your brain on ocean

A Responsibility Problem

According to many scientists, the verdict is in: climate change is real and human-caused. [1] Fortunately, debates regarding the science of global warming have somewhat subsided and discussions regarding solutions have emerged. Needless to say, the world will continue to heat up and the oceans will continue to rise absent large-scale changes. [1] It has become increasingly obvious that global warming not only poses an imminent threat to the stability of our climate, but that it also represents a moral problem for our society. Policymakers and environmentalists have failed to effectively communicate the urgency of global warming in a manner that elicits action.

Unfortunately, there are barriers that discourage individuals from taking responsibility for human-induced climate change. Regardless, a strategy is desperately needed to motivate citizens to conserve. The nature of climate change makes it difficult for policymakers to encourage people to alter their lifestyles, because these changes may come with a hefty high price tag. Often, the short-term costs of acting in a more environmentally friendly way (i.e. buying environmentally friendly light bulbs, installing a solar panel on your roof, etc.) require taking on a rather large financial burden. [2] Therefore, policymakers may need to tap into the part of the brain that compels individuals to make different choices despite costs. Nichols seems to think he has found a way to use the brain’s fascination with water and the ocean to inspire action.  More specifically, he proposes that the brain’s innate connection with the ocean could be used in tandem with neuromarketing research to potentially halt the coming ecological crisis.



Addicted to the Ocean?

Nichols has championed conservationism by proposing the idea that our brains find the ocean soothing in a uniquely spiritual way. This claim has incredible implications for how policymakers and environmentalist choose to motivate people for the purpose of conserving the Earth’s precious resources. Specifically, Nichols hopes to combine the tenets of neuromarketing and neuroscience to develop a new neuro-related field: neuroconservatism. The union of all these ideas forms quite an interesting theory. In Nichols own words, “We can use science to explore and understand the profound and ancient emotional and sensual connections that lead to deeper relationships with the ocean."



Many believe Nichols may be on the verge of discovering something significant. For instance, he suggests there are persuasive ways that our society can incorporate the ocean’s uniquely beautiful characteristics into our narrative regarding environmental conservationism. He notes that there is something distinctive about the ocean: it has the capacity to soothe our anxieties and to calm our minds. Why not utilize these images and sounds to appeal to that isolated part of the brain for the purpose of spurring environmentalism? Many are hopeful that we can capitalize on these findings to do just that; specifically, others have mentioned that Nichols’ idea has great potential to motivate people to care about other environmental issues in a way that does not rely on complicated statistical models or confusing climate data. [3]



Specifically, Nichols proposes that brain scans of people 'hooked on ocean' could provide invaluable insight into the brain’s connection to the environment. He indicates that advertisers could use this information to influence consumers to conserve. Preliminary research has been done on neuromarketing strategies and consumer purchasing trends, but uncertainty remains. Many researchers question this techniques’ ability to read buyers’ minds for the sake of changing behavior. For instance, several neuromarketing firms like Neurosense and EmSense have popped up in the past decade with the hopes of integrating advertising principles and brain imaging results. However, despite the growth of the field, there does not seem to be strong evidence for a “buy button” in the brain. Furthermore, there is little evidence to support the claim that catering to the brain’s pleasure centers results in behavioral changes. At most, advertisers can appeal to consumers in a way that makes certain brands look more alluring, but this does not actually mean that consumers will go out and buy a product. These conclusions do not bode well for the future of neuroconservationism. How could information about the brain’s perception of the ocean encourage consumers to install a solar panel on their roof when doing so is associated with a huge financial cost? The answer is not clear. Additionally, Nichols' blog does not indicate precisely what he thinks should be done if research were to emerge that indicated images of the ocean could stimulate action. Rather, he presents an intriguing yet slightly vague premise that could be promising but has not been substantially researched up to this point.



Say neuroscience research and neuromarketing techniques could be used to subconsciously motivate individuals to conserve. Could advertising firms spur an environmental movement? Maybe conservation groups such as Greenpeace or the Sierra Club could conduct studies to determine what images of the oceans could do to incite preservation. The results of these studies could influence how environmentalists frame advertising campaigns, commercials, or fundraising initiatives that promote conservation.  Nonetheless, doing so raises a whole other set of ethical questions. If the technology were to able to point researchers to a place in the brain that triggered a humans to buy, should marketers be allowed to take advantage of such expertise? Some believe using neuromarketing would be an unethical way to coerce humans. In fact, bioethicists suggest that using brain imaging to promote certain products is an example of market distortion that should be avoided, because it does not protect the consumer.  Others tend to believe that the onus is on the buyer to reject appeals to purchase certain products. 

A Picture by Jim Patterson: Water on My Mind

Ultimately, it is unknown to what extent our brain’s potential craving for the ocean can alter our society’s exploitative habits. Nichols insinuates that the manipulation of the mind may be necessary given the current ecological circumstances. Specifically, he asserts that we desperately need to connect what we know about the neurological basis for emotional to craft a strategy that lures the subconscious mind into thinking it has an obligation to preserve natural resources. For example, Coca-Cola has recently decided that they will use neuromarketing techniques to evaluate emotional reactions to their famous soda brand in the next year. Nichols could follow suit and begin using similar technology to measure emotional reactions to advertisements that incorporate aesthetically pleasing images of the ocean.

Does this strategy have the capacity to transform the way environmentalists and policymakers approach the biodiversity crisis? Should we appeal to our emotional connection with water and the ocean? More importantly, should we continue to fund projects that allow neuroscientists to do more research in this direction? Perhaps, a brief look into moral psychological research sheds an alternative perspective.

Can Emotion Motivate Action?

Thankfully, neuroscientists offer insight into some of the decision-making areas of the brain that suggest there are ways in which we can change our framing of climate change to hasten action. In particular, a study done by Joshua D. Greene and colleagues delineates between decisions made from a deontological standpoint versus a consequentialist context. Using fMRI technology, he performed an experiment that measured reaction times in certain moral situations. The dilemmas presented to the participants were variations of the classic footbridge and switch problems. [4] In both scenarios, one person dies in order to save five riding on a trolley. However, in the footbridge setup, the participants are asked whether or not it is morally acceptable to save the people on the trolley by pushing someone onto the tracks. In the switch problem, the participants are asked to judge whether or not it is okay to save the people on the trolley by pushing a switch that will result in the indirect death of someone down the tracks. The study yielded fascinating results: people that were evaluating switch-like problems had greater brain activation in the dorsolateral prefrontal cortex and the inferior parietal lobe. On the contrary, people that judged the footbridge-like scenarios had greater brain activation in emotional areas of the brain such as the amygdala. Additionally, those who thought the footbridge scenario represented a morally sound decision had to overcome emotional impulses. Furthermore, Greene performed a later study that concluded that slower reaction times demonstrated the greater cognitive processing necessary for making a utilitarian decision in contrast to the quick, emotional processing of a deontological decision. [5]

The Trolley Dilemma

How do these findings relate to say about Nichols’ work, which emphasizes emotion? Greene’s findings suggest that framing remains an incredibly important component of raising climate change to the level of a moral problem in the minds of individuals. Given the complexity of climate change, policymakers should stray away from utilizing emotional appeals to raise consciousness about an issue that is not emotionally prominent. Similarly, Marco Grasso suggests that injecting our pleas to reduce emissions with emotionally charged representations do little to activate our fear-oriented parts of the brain. [6] Rather, we should employ a utilitarian decision-making calculus to persuade others to engage in action to prevent climate change.



I believe findings lead us to a more provocative question: how could neuroscientists use our knowledge of the brain circuits involved in moral decision-making to encourage people to act in a more ethical manner? Emerging research seems to suggest that there is a possibility that we could morally enhance people to alter the way in which a person thinks or judges a particular situation. John R. Shook discusses the possibility of marketing a drug that could transform the way humans make moral decisions. He delves in the different scenarios in which a certain drug could be appropriate; for example, a drug could be used for “elevating devotion to a social cause” or “intensifying prejudices against despised ethnic minorities.” [7] Nonetheless, it does not appear out of the realm of possibility that climate change and environmental problems could fit into the former category. Theoretically, if a drug were to be developed that could effectively alter the moral parts of the brain in a way that would change the way in which humans think about the environment, the drug could also help save the planet. Clearly, the prospect of moral enhancement raises other pressing questions. For example, who would get the drug, and how will the drug be designed? Nonetheless, the potential ramifications of its development could be tremendous.



What Now?

The possibility of moral enhancement and ocean-based neuromarketing seems to offer innovative mechanisms to spur environmental conservation. However, neither strategy will be able to solely combat the large environmental problems that will ensue during the 21st century. Nonetheless, we should not be resigned to passivity in the face of major challenges. Rather, neuroscience should continue to look into how we can apply images of the ocean to combat environmental problems into a marketing context to spur conservationism with the hopes of potentially altering consumer behavior. Even if researchers cannot develop a perfect tool to elicit conservationism, environmentalists, policymakers, and academics should still encourage discussions around these pressing problems. Hopefully, the third BLUEMIND conference will inspire further conversations regarding the burgeoning field of neuroconservationism.



If you want to learn more, visit this website on May 30th, 2013 to watch a live stream of the conference.

BLUEMiND Conference

References

[1] Prothero, Donald R., “How We Know Global Warming is Real and Human Caused.” The Skeptic Magazine 17 (2012): 14-24.

[2] Shome, Debika and Marx, Sabine. “The Psychology of Climate Change Communication.” Center for Research on Environmental Decisions (2009). New York.

[3] Andrews, Candice. “Is Neuro-conservation the New Hope for Environmental Messages?” Gaiam Life (2012). Retrieved from http://blog.gaiam.com/blog/is-neuro-conservation-the-new-hope-for-environmental-messages/.

[4] Greene, Joshua D., et al. “An fMRI Investigation of Emotional Engagement in Moral Judgment.” Science 14 (2001): 2105-2108.

[5] Greene, Joshua D., et al. “Cognition Load Selectively Interferes with Utilitarian Moral Judgment.” Cognition 107.3 (2008): 1144-1154.

[6] Grasso, Marco. “Climate Ethics: With a Little Help from Moral Cognitive Neuroscience.” Environmental Politics (2012): 1-17.

[7] Shook, John R., “Neuroethics and the Possible Types of Moral Enhancement.” AJOB Neuroscience 3 (2012): 3-14.





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Marshall, J. (2013). Neuroconservationism: A Neural Pathway to Preservation. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2013/04/neuroconservationism-neural-pathway-to.html

Being Careful About How We Use Evidence for the "Reality" of Social Pain

Images courtesy of the

Social and Affective Neuroscience Laboratory

at UCLA.

Neuroscience is changing the way we view the brain. It is also changing the way we view ourselves. Discoveries announced in journal web pages one day find themselves as fuel for debate on newspaper op-ed pages the next. Some of these discoveries have practical implications and point toward promising new medical therapies. Others suggest new - and often troubling - approaches for dealing with social or legal problems. Many simply shed new light on long-standing questions about human nature.

Like it or not, the evidence that supports these discoveries turns out to be quite persuasive. Wearing the mantle of science, decorated with images that hint at the workings of the human mind, it commands a special, and perhaps not entirely deserved, authority. This evidence is also subject to being appropriated for purposes beyond that supported by conclusions of the research which gave rise to it. Consequently, we must be careful when we enlist neuroscience evidence in the service of even the best of causes, lest we unwittingly find ourselves endorsing the kind of erroneous thinking that we should be trying to correct.



I will offer two examples - one here and another in a blog post to follow - of what I consider to be incorrect applications of neuroscience evidence to well-intentioned efforts to change public attitudes. I will also point out the fallacies that I believe are at play.





Shared underpinnings of physical and social pain

My first example originates with a recent installment of the Emory University Neuroethics journal club that met to discuss the paper The pain of social disconnection: examining the shared neural underpinnings of physical and social pain by Naomi Eisenberger, director of the Social and Affective Neuroscience Laboratory at UCLA. (Here social pain refers to the distress we feel as a result of rejection, the loss of loved one or the unwanted end of an important personal relationship.) Eisenberger reviews evidence in support of the hypothesis that there is significant overlap between the brain structures associated with physical pain and those associated with social pain. Citing a variety of experimental results, she makes a compelling case that specific brain structures, namely the dorsal anterior cingulate cortex and the anterior insula, are implicated in the processing of both physical and pain. Other evidence, unrelated to neural imaging, supports this relationship.



The "reality" of social pain

Some participants in the journal club discussion expressed doubt that this discovery would change how social pain is regarded by the public at large. Others, though, saw it as a demonstration of the “reality” of social pain and welcomed the evidence as a way to alter public attitudes in a constructive way, holding out the hope that, with this evidence in hand, social pain would be taken more seriously. On the surface this appears to be to be a useful application of a neuroscience discovery. But complications are revealed with closer examination.



While I agree wholeheartedly with the need to change public attitudes about social pain in order that it be treated more effectively, I disagree with the idea of applying the evidence cited in the paper to support the claim that social pain has somehow been elevated to the status of “real” pain. My concerns are of two types. The first originates in the limitations imposed by the philosophy of science. The second has to do with how I believe that this application buys into a false dichotomy, one that contradicts the conclusions reached by the author of the paper herself.



Concern from the philosophy of science

With regard to the philosophy of science, I first note that so-called scientific truths do not arise out of necessity. Hypotheses rise or fall on experimental outcomes. Here the hypothesis that physical pain and social pain utilize common brain structures might well have been disproved by experiment. The studies undertaken might have revealed no overlap between social and physical pain. Would this outcome have weakened the resolve of advocates for social pain being taken more seriously? I don't think so.



To compound matters, scientific truths are always provisional. It may indeed turn out that the results of future experiments - or the detection of some flaws in ones that have been conducted - may lead to different, even contradictory, conclusions about the relationship between physical and social pain. (He who lives by the scan, dies by the scan.) Would we then abandon new efforts to have social pain regarded on a par with physical pain? I would hope not.



Although I appreciate the importance of understanding the neurological overlap between social pain and physical pain for a variety of reasons, in my opinion the reality of social pain rests entirely on the reality of our experience of it and not on the existence - or lack - of specific neurological correlates of any kind. I don't believe we should shy away from taking this position.



Concern having to do with an unsupported conclusion

This brings me to my second concern, and that is that, by insisting that the evidence cited in the paper supports the claim that social pain is as “real” as physical pain, we miss the important point made by Eisenberger herself in her conclusion.

… [T]he findings reviewed here highlight the counterintuitive nature of pain. We typically reify physical pain as “real” pain and often dismiss social pain as “psychological,” but the connection between the two kinds of pain suggests that each of these lay theories is only half right. Physical pain is a deeply psychological phenomenon that can be altered by expectations, mood and attention. Likewise, social pain is a deeply biological phenomenon that has been built into our brains and bodies over millions of years of mammalian evolution because of the crucial part it plays in our survival. A better understanding of the commonalities between these two types of painful experience may provide greater insight into the underlying nature of each.

The ecumenical and symmetrical consideration of physical and psychological pain here is noteworthy. This passage itself stands as a small manifesto against the false dichotomy usually associated with physical and psychological pain. By buying into this persistent distinction, even in the service of getting social pain to be taken more seriously, we may be helping to perpetuate a misunderstanding.



The challenge of unification 

The triumph of neuroscience may well be its contribution to our developing a unified understanding of the physical and the psychological. It will be a challenge to educate a public accustomed to seeing a clear cut delineation between these two modes of explanation. More the reason we should be careful about how we make our arguments using neuroscience evidence.





Want to cite this post?



Merlin, M. (2013). Being Careful About How We Use Evidence for the "Realiy" of Social Pain. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2013/04/being-careful-about-how-we-use-evidence.html

Misophonia: Personality Quirk, Symptom, or Neurological Disorder?

When I first learned about misophonia, it was described as a severe annoyance by certain specific sounds, most commonly bodily sounds such as chewing, breathing and slurping, or repetitive sounds such as ceiling fans, beeping, etc.  A quick Wikipedia search described it as, “a form of decreased sound tolerance… believed to be a neurological disorder characterized by negative experiences resulting only from specific sounds, whether loud or soft.”



Immediately, I had a number of questions: if misophonia is just a hatred of certain sounds that leads to annoyance or anger, how is this classified as a neurological disorder?  Wouldn’t everyone have this disorder to some degree?  Everyone has their pet peeves as far as sound goes; I cannot stand the sound of people chewing, and while it is sometimes very irritating, I would by no means say that I have a neurological disorder.



The Wikipedia entry stated, “Intense anxiety and avoidant behavior may develop, which can lead to decreased socialization. Some people may feel the compulsion to mimic what they hear.”  If everyone has sounds that they hate, but some people get uncontrollably angry or anxious when they hear their hated sounds, then isn’t this disorder a behavioral issue?  I initially had two hypotheses about misophonia: 1) someone who cannot control their behavior in response to certain sounds probably has trouble controlling their behavior in response to other stimuli as well, and therefore misophonia is the side-effect of another neurological or psychiatric disease, not its own one.  And 2) misophonia is one of those “disorders” that just seems like a scheme to sell more drugs to hypochondriacs.  But this was Wikipedia, so I first looked to the DSM-IV to learn more about misophonia.



Misophonia is not classified in the DSM-IV, so even in the small pool of research available on the subject, there seems to be little agreement on what misophonia actually is and what causes it.  Some papers lump misophonia into the same category as tinnitus (hearing ringing sounds that are not there, usually due to cochlear damage or hearing loss) and hyperacusis (sensitivity to sound).  In a study of tinnitus patients, Sztuka et al [7] found that 10% of the patients they studied had misophonia.  However, other studies found that while hyperacusis, tinnitus, and misophonia are related, misophonia is not caused by auditory damage. Jastreboff and Jastreboff [3, 4], found that when a trigger sound is played to people with misophonia, it results in a larger activation of the limbic and autonomous nervous system, but not a larger activation of the auditory system.  The limbic system plays a part in other behavioral disorders such as OCD, so this suggests that misophonia could have an anatomical origin that may cause people with misophonia to react to sound differently.  Now that I had learned of an actual neurological difference in people with misophonia, I felt that my initial reaction - that misophonia is a ridiculous attempt to label something normal as a disorder - was false.  However, there is still evidence to support the position that misophonia is a symptom of a larger behavioral disorder, so I wondering about the legitimacy of misophonia as a stand-alone behavioral disorder.

A map of the misophonia activation pathway, from Tinnitus Retraining Therapy: Implementing the Neurophysiological Model [4]

Another study published in January of this year studied 42 patients with misophonia. [5]  The triggers for these patients were all human-generated noises; chewing, breathing, hand sounds, etc.  Some patients also reported visual triggers, simply referred to as “repetitive visual movements.”  This study conducted several personality tests and found that of their 42 patients, 35 had a comorbid disorder including mood disorders, panic disorders, ADHD, OCD, and OCPD, among others.  22 out of 42 patients were found to have Obsessive-Compulsive Personality Disorder (OCPD), a disorder characterized by “a chronic non-adaptive pattern of extreme perfectionism, preoccupation with neatness and detail, and a requirement or need for control or power over one’s environment.”  Since OCPD is estimated to occur in 7.88% the population [1], the extremely high comorbidity of misophonia and OCPD found in this study cannot be ignored.  Interestingly, in the discussion of this paper, Schröder et al. call to distinguish misophonia its own neurological disorder, explaining how misophonia is not a symptom of another disorder, but its own disorder [5].  They assert that misophonia, while similar to social phobia, is not a social phobia because patients do not feel anxiety, only anger and disgust.  Other studies [3, 4, 6]  found that misophonia patients do feel anxiety or fear as well as anger.  This paper also says that misophonia cannot be caused by OCD, because while they are both marked by obsession and avoidance, misophonia patients do not perform compulsions.  However, Hadjipavlou et al. found that misophonia patients will often mimic compulsively annoying sounds as a way to reduce the stress caused by them.



But to me it still remains unclear whether misophonia is a separate, distinct disorder.  Since misophonia is reported in people with auditory disorders as well as people with behavioral and mood disorders, it seems as though misophonia is a symptom, not its own disorder.  However, this begs the question, “How do we define a disorder?”  Many disorders are co-morbid with each other, yet we still classify them separately and we especially have difficulty with psychiatric disorders. These topics have also been discussed on this blog here, here, and here.



Right now, it seems that there are not many good treatment options for people suffering from misophonia.  Certain therapies including Cognitive Behavioral Therapy, and Tinnitus Retraining Therapy are options- while these options may improve symptoms, they are not a cure for the disorder.  In fact, in this blog submission, the patient’s therapist had not even heard of misophonia.  At this point it seems that whether it actually is its own disorder or caused by something else is less relevant than the problem that those suffering from the disorder are not getting the treatment they need.   However, it seems that providing misophonia with its own distinct identity might be part of the solution for helping these patients.  Hopefully the call to recognize misophonia as a disorder will spark interest in the subject, which will increase research on the neurological mechanisms of misophonia and innovation in treatment, so that patients will eventually be able to receive the treatment they need.



References

[1] Grant, Bridget F., et al., "Prevalence, Correlates, and Disability of Personality Disorders in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions." The Journal of Clinical Psychology 65 (2004): 948-58. Print.



[2] Hadjipavlou, G., S. Baer, A. Lau, and A. Howard. "Selective Sound Intolerance And Emotional Distress: What Every Clinician Should Hear." Psychosomatic Medicine70.6 (2008): 739-40. Print.



[3] Jastreboff, Margaret M. "Chapter 2: Decreased Sound Tolerance." Tinnitus: Theory and Management. By Pawel J. Jastreboff. Hamilton, Ont.: BC Decker, 2004. 8-15. Print.



[4] Jastreboff, Pawel J., and Jonathan J.P. Hazell. Figure 2.14. N.d. Tinnitus Retraining Therapy: Implementing the Neurophysiological Model. N.p.: Cambridge UP, 2004. 49. Print.



[5] Schröder, Arjan, Nienke Vulink, and Damiaan Denys. "Misophonia: Diagnostic Criteria for a New Psychiatric Disorder." PLoS One 8.1 (2013): n. pag. 23 Jan. 2013. Web.



[6] Schwartz, Paula, Jason Leyendecker, and Megan Conlon. "Hyperacusis and Misophonia The Lesser-Known Siblings of Tinnitus." Minnesota Medicine (2011): 42-43. Print.



[7] Sztuka, Aleksandra, Lucyna Pospiech, Wojciech Gawron, and Krzysztof Dudek. "DPOAE in Estimation of the Function of the Cochlea in Tinnitus Patients with Normal Hearing."Auris Nasus Larynx (2009): n. pag. Print.





About the author 

Emily Young is a third-year undergraduate Biology major at Georgia Tech.  She has participated in research at the Center for Advanced Brain Imaging at Georgia Tech, BRAIN, the United States Army Criminal Investigations Laboratory, and currently works in Dr. Maney’s lab at Emory University.  Emily is also the Vice President of marketing of GTNeuro, the neuroscience club at Georgia Tech.

Want to cite this post?

Young, E. (2013). Misophonia: Personality Quirk, Symptom, or Neurological Disorder? The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2013/04/misophonia-personality-quirk-symptom-or.html