The Science March: Can science-based advocacy be both nuanced and effective?

By Jennifer Lee

Jenn Laura Lee is a PhD candidate in neuroscience at New York University. She is also a member of the Scientist Action and Advocacy Network (ScAAN.net), which offers pro bono data science and research to organizations seeking to implement positive social change.

I believe in protests. I attend them, I endorse them, and I think that they make a difference. Raising political consciousness in the scientific community in any form seems like a good thing. The Science March moreover seems like a great opportunity for a community of people sharing common livelihood to advocate for the importance of their work in policy-making, as it relates to nuclear non-proliferation, climate change, vaccination, and so on. 

But while I plan to attend the March for Science in New York, I’m hoping to use this article to examine, articulate, and hopefully mitigate the slight unease that’s been growing in me surrounding some of the language that scientists have been using to describe the march (both critics and proponents alike).

Let’s start by pointing out that protests are effective for a number of reasons— they can apply pressure for lawmakers to advance specific aims (for instance, the passing of a bill). They can also act as a springboard for awareness— a starting point for deeper and more nuanced dialogue. In absence of particularly well-defined specific aims, the Science March might function primarily in service of the latter objective, among others.

Critics like Robert Young have tried to pin their unease on bad optics — they worry about a perceived “loss of objectivity,” or the so-called “politicization of science.” These critics fear we will lose our moral high-ground as calm and objective voices of pure reason in the public eye. We’d also be putting a target on our backs for further budget cuts, the argument goes. 

This stance has received ample backlash. But I’ve been equally struck by cringe-worthy statements made by proponents of the march. Many march leaders are attempting to sanitize themselves of the crazy mess that is American politics by insulating the Science March in a double-walled vacuum of objectivity. “This is a protest, but it’s not a political protest,” Jonathan Berman (a lead organizer of the march) proclaimed to the New York Times. I fail to see how a protest of any kind could be deemed apolitical. (Perhaps he meant “partisan”?)

A march sign at NYU.

Let me express that, unlike Young and Berman, the politicization of science is not the source of my unease. Like many others, I deeply reject the notion that science is apolitical, or that it ever could be. Researchers know this all too well from the ways in which academic hierarchies, granting agencies, and prestigious journals can make or break careers and shape the direction of a field, and from the way that scientific advancements simply cannot be divorced from their social, economic, and ethical repercussions. Best of all, we know this from the way funding is allocated to researchers by private and government institutions with obvious agendas. I’m comfortable in the notion that “doing science” is an inherently social and political endeavour (which aims for and approaches objectivity asymptotically)— and I believe it’s best for scientists to embrace this idea.

Rather, I think my particular flavour of unease stems from a strange hypothetical image I have in my head, in which scientists advocate for nuanced discourse and sober reasoning by blasting platitudes about the importance of “facts” through a megaphone.

“We are trying to reach [Washington] with the message: You should listen to evidence,” Dr. Berman proclaims. While obviously a message I endorse, it is important to remember that evidence is not itself a deciding blow in public discourse, but rather the foundation for more nuanced discourse of its kind. 

Something about the proclamation “Believe me, I’m a scientist!” seems deeply ironic and actually quite antithetical to the scientific process itself. This kind of black-and-white language surrounding fact and fiction, real news and fake news, moreover seems to be part of an alarming trend in which both laymen and politicians alike gesture vaguely towards an anonymous “body of work” to frame their claims as objective truth in public discourse. As scientists who make their living through nuanced thinking, we must do better than this when communicating with the media.

Of course, in Trump’s America, I understand the need for bold, argumentative stance-taking. I support people who will march with banners which will simply proclaim that “Climate Change is Real!” But while I understand the temptation to reference some substantial “body of literature” to support this conclusion, we must be willing and prepared to engage the public on a level much deeper than this. To do otherwise would not just erode the public image of scientists on face— it would be deeply contrary to the scientific process itself.

So for the sake of preserving the spirit of the scientific process, let’s not underestimate the willingness of the general public to engage with real nuance and more complex critical thinking. My suggestion for the march is to not just bring signs with catchy battle cries— bring pamphlets with real content, or at the very least, arm yourself mentally with the specific papers and evidence on which you’ve built your conclusions. Ironically, science advocacy on a shallower level than this might itself be a-scientific.

Image courtesy of Flickr.

Moreover, rather than professing objectivity, insist on and celebrate the inherently social (and subjective) nature of scientific discourse. Science is a social endeavour, and that's not necessarily a bad thing. I can’t say with absolute certainty that climate change is anthropogenic, but I can say with an incredibly high degree of certainty that it probably is, because of the communal nature of the scientific process. I’ve never measured CO2 myself, but I base my conclusion largely on the social and academic institutions we have in place, which are comprised of other people who have recorded a variety of natural phenomena. They’ve printed and disseminated their data through reputable publishing companies, and their conclusions are made available to me through some man-made search algorithm on Google Scholar. It’s in large part because of my prior beliefs on the trustworthiness and reputability of all of the above social institutions that I’ve come to conclude that climate change is very, very likely to be anthropogenic and real, and that we should normatively take policy measures to ameliorate the sad mess that is our environment. 

Of course, I recognize that the nature of protests is to distill nuance down to simple and actionable messages. I understand the hunger for true objectivity in a world of "alternative facts." But the uncomfortable irony is that scientists lose a little piece of their integrity when we advocate for some “objective truth” with a kind of ‘hundred-percent confidence’ which, we all know deep down, we’ve never genuinely experienced in our labs first-hand. 

So my proposal is this: let’s march, shout, protest, and be heard, but let’s also not lose the spirit of certainty, uncertainty, and nuance which makes science scientific. This balancing act is hard to do, as I’ve experienced first-hand. But we must remember that the spirit of nuance which makes our profession at times so infuriating is also so simultaneously sanity-preserving in Trump’s garish world of black-and-white. 

Lastly, let’s not underestimate the capacity of the general public to engage with complex and nuanced evidence, when paired with effective communication. Come prepared with communicable data and let's educate ourselves about the issues that matter, together.

My professor will be marching with a sign that says “Are you with Reason or with the Republicans?,” and another will simply say “PRO-FACTS!” How effective these signs are is a matter of open debate.

I personally had a hard time deciding on which particular science-related social issue to write about on my sign, mostly because everything seems so incredibly urgent. In the end, I think I’ve decided to bring pamphlets with some of my favourite public-friendly figures highlighting neuroscientific evidence in favour of raising the age of criminal responsibility. It highlights thorough but easily digestible research which is proximal to me, and which I think advances an important social cause.

As for a catchy rally cry, I think I’ve decided on a sign that will simply read “MORE NUANCE!” 

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Lee, J. (2017). The Science March: Can science-based advocacy be both nuanced and effective? The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2017/04/the-science-march-can-science-based.html

Would You Want to be a Savant?

By John Banja

John Banja, PhD is a medical ethicist at Emory University’s Center for Ethics, a professor in the Department of Rehabilitation Medicine, and the editor of AJOB Neuroscience.

Darold Treffert (2010), a psychiatrist who has devoted the better part of his career to studying savants, notes that there are at least 3 kinds.

First, those who manifest the “savant syndrome” and display the most astonishing of savant abilities, such as Kim Peek who was the inspiration for Dustin Hoffman’s character, Raymond Babbitt, in the movie Rain Man. Peek, who died from a heart attack in 2009, was remarkable even by savant standards: He memorized more than 12,000 books and was able to read two pages simultaneously, one page with the right eye, the other page with the left. He also had a remarkably hospitable form of dyslexia where he could read words on a page turned sideways or upside down or backwards—such as reflected in a mirror. He could add a column of numbers from a telephone book page and instantly tell you the mean of those numbers, and he could do lightning calendar calculations like telling you which day of the week you were born upon knowing your birth date (Treffert, 2010, pp. 120-129). These were only a few of his talents. 

I might also mention Daniel Tammet who, on March 14th, 2004 on “International Pi Day”—get it?: 3.14—recited from memory Pi to 22,514 decimal places (p. 161). Or George Widener who can tell you what day of the week June 25th will be in the year 47,253 (p. 179). Treffert reports that 50 percent of individuals with the savant syndrome are autistic, while the remainder, like Kim Peek, typically experienced some kind of central nervous system insult prenatally or very shortly after birth. Usually, these individuals have IQs around 60 or 70, such as one savant who could recite Edward Gibbon’s Rise and Fall of the Roman Empire forward and backward but couldn’t explain what any of the sentences meant (p. 2). Kim Peek didn’t walk until the age of 4 and had eye-hand coordination problems all his life. Even as an adult he needed help with simple daily activities like bathing, brushing his teeth and combing his hair. His IQ was measured at 87, but the score was thought too insensitive to his intellectual ability (p. 123).

Kim Peek, image courtesy of

Wikimedia Commons.

A second group Treffert terms the “acquired” savant. These are persons who began life as neurotypicals but then suffered some kind of central nervous system damage like a stroke or dementia (usually affecting the fronto-temporal areas of the brain). Very often, their savant skills take the form of amazing artistic or musical ability where there was none previously. An interesting example is orthopedic surgeon Tony Cicoria, who was struck by lightning in his face, had a near death experience, and survived without any apparent deficits (p. 209). A few weeks after the lightning strike, he began experiencing an insatiable desire to listen to piano music. Although he had some piano lessons as a child, he never pursued any serious training and hadn’t played much for decades. After the lightning strike, he became obsessed with music, re-learned piano playing and now not only plays some of the classical piano repertoire at a near concert level, but he composes and, when not doing surgery, performs professionally. This group of persons acquired their savant-like skills from some kind of CNS disruption, usually occurring during or after adolescence.



The third group is the neurotypical individual with savant-like skills. Many people know about Marilu Henner’s “highly superior autobiographical memory” such that Marilu can recall what she was experiencing at any time of any day over most of her life (CBS, 2010). When she displayed this capacity to the world, it was thought that less than 10 persons existed with similar memory capacity but since then more individuals have been identified (CBS This Morning, 2014). There are also neurotypicals who can begin writing “Calif” with one hand and simultaneously “ornia” with the other; or an individual who can write out similar words simultaneously—one with the left hand, one with the right—but each in a different language (Treffert, 2010, p. 214). Or they can read backwards; or they can instantly alphabetize words in conversation, so that “I like neuroethics” becomes “I eikl ceehinorstu.” (Treffert, 2010, p. 212) My wife’s father could multiply 3-digit numbers in his head, and many neurotypicals with musical savantism can listen to a tune or song only once and then reproduce it with note for note accuracy on piano or guitar. Usually, these persons possessed such talent all their lives with no one suspecting it although Treffert describes certain cases where savant-like skills have suddenly appeared with no evident cause (pp. 204-211).



Given that we are living in the age of the brain, these astonishing cognitive skills—and I have only described a few—make one wonder about the possibility and extent of anyone’s acquiring them. Can anyone not only improve his or her memory or cognitive talents but take them to these kinds of levels? And, very interestingly, would one want to?

Stephen Wiltshire's rendition of the Brooklyn Bridge,

image courtesy of Wikimedia Commons.

I would assume most neurotypicals would think autism, a stroke, a lightning strike, or being born with an encephalocele (like Kim Peek) is too high a price to pay for savant acquisition. But a larger question centers on the value of savant abilities. One of the most salient characteristics of savants is their prodigious memories. Most savants are extraordinary sensory reproducers or duplicators who can represent memories of their sensory experiences with uncanny detail, like Stephen Wiltshire who, after a twenty minute helicopter ride over Manhattan, proceeded to reproduce his memories of the skyline with uncanny accuracy in an 18 foot-long drawing in Brooklyn’s Pratt Institute (CBS, 2009). But the rather uncomfortable, indeed, perhaps unkind point is that the majority of savant skills don’t seem particularly useful. Treffert notes that “savant skills typically occur in an intriguingly narrow range of special abilities” (p. 19) that include calendar calculating like George Widener’s, musical playback ability, artistic re-production like Stephen Wiltshire’s, and mathematical and mechanical skills. What most of these demonstrations lack, however, is a sense of creativity or depth that carries a discipline like mathematics or any of the empirical sciences to the next level of professional conversation and knowledge. Granted, we do have Dr. Temple Grandin’s contributions to the design of animal handling facilities, which are now used in half of the cattle processing facilities in the U.S. (Treffert, 2010, p. 144). But savants like her seem to be distinct exceptions.



Nevertheless, Treffert is at pains in his book Islands of Genius to refute this, at least insofar as he is convinced that savants do make creative contributions, especially in the arts. But professionals like empirical and theoretical scientists, novelists, playwrights, philosophers and sociologists who are regarded as genius-level performers by their peers are virtually never identified as savants (although they may have savant-like skills). Perhaps one reason is that the cognitive accomplishments of savants take the form of immediate demonstration, such as lightning calendar calculating, while scientists and philosophers spend years developing their discoveries and theories. Also, because savant skills are thought to derive from a “liberation” or hyper-development of the brain’s right hemisphere at the cost of left-sided deficits or impairment, persons with the savant syndrome often have poor narrative capacities linked to their compromised verbal abilities.



The fact is, what a philosopher, neuroscientist, or novelist savant would look like is obscure. Lightning calculations done in one’s head don’t play a significant role in these professionals’ creative output, nor does uncanny memory reproduction for highly specific details from one’s sensory experience. Still, the abilities of savants are simply astounding and suggest that our brains are capable of much more than we might assume. Neuroscientist Allan Snyder has been stimulating the brains of neurotypicals with low-frequency repetitive transcranial magnetic stimulation and reporting that many of his neurologically unremarkable participants improve in proofreading, drawing, and numerosity, such as in guessing the number of pixel-like objects on a computer screen (Snyder, 2009). For over a decade, Snyder has been pursuing the idea that all of us have latent savant-like skills that can be elicited by technology or by exercises such as the ones that Betty Edwards (1989) proposed in her book Drawing on the Right Side of the Brain.



I suspect the ultimate value of this research will consist in whether it results in any real improvement of our human culture. Almost certainly, though, neuroscientific investigations of savants will increase our understanding of brain function and, very possibly, enable us to tap into certain cognitive abilities we could not have imagined existed.

References 

CBS. 2010. Marilu Henner’s Super Autobiographical Memory. Found here

CBS. 2009.  Wiltshire’s NYC Matches Up. Found here 

CBS This Morning. 2014. More people have “Highly Superior Autobiographical Memory.” Found here

Edwards B. 1989. Drawing On the Right Side of the Brain. New York, NY: Tarcher/Putnam Press. 

Snyder A. 2009. Explaining and inducing savant skills: privileged access to lower level, less-processed information. Philosophical Transactions of the Royal Society, 364:1399-1405. 

Treffert D. 2010. Islands of Genius. London, UK: Jessica Kingsley Publishers.

Want to cite this post?



Banja, J. (2017). Would You Want to be a Savant? The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2017/04/would-you-want-to-be-savant.html

VR and PTSD: Healing from trauma by confronting fears in virtual reality environments

By Katie Givens Kime

Image courtesy of Flikr

What are the ethical implications of therapeutically re-exposing patients to trauma via virtual reality technologies? Of the 2.7 million American veterans of the Iraq and Afghanistan wars, at least 20% suffer from depression and/or post-traumatic stress disorder (PTSD), and other studies peg that percentage even higher. As a chronic, debilitating mental illness, one PTSD symptom is hyperarousal, in which a person repeatedly re-experiences a trauma in the form of nightmares, panic attacks, and flashbacks.  One of the most long-trusted therapeutic approaches to PTSD is exposure therapy; now, virtual reality technology is increasingly being used to simulate exposure to traumatic events and to environments related to the traumatic event.

Image courtesy of Flikr

Last month’s Neuroethics and Neuroscience in the News event featured the recent research and observations of Barbara O. Rothbaum, who is the Paul A. Janssen Chair in Neuropsychopharmacology at the Emory University School of Medicine and Director of the Emory Veterans Program & Trauma and Anxiety Recovery Program. Rothbaum outlined the way in which exposure therapy (with or without the aid of virtual reality technology) is based on principles of learning and also discussed reliable findings with animals and phobic disorders (Foa & Kozak, 1986). The underlying premise of such therapy is that repeated and prolonged exposure to feared but realistically safe stimuli leads to habituation, and eventually to extinction.

The virtual reality exposure therapy (VRE) combat environments for “Virtual Vietnam” (developed by Georgia Tech and Emory Universities) includes a virtual Huey helicopter, a “fly” over the jungles of Vietnam, a “walk” in clearings near jungles and swamps, and other imaginal immersions in Vietnam-related stimuli. Other examples of VRE environments include “World Trade Center” (Weill Cornell Medical Center/University of Washington), “Terrorist Bus Bombing” (University of Haifa/University of Washington), “Motor Vehicle Accidents” (University of Buffalo), “Virtual Angola” (University of Lusófona de Humanidades e Tecnologias, Lisbon), and “Virtual Iraq” (USC Institute for Creative Technologies).

In some ways, VRE is an enormous innovation, particularly for treatment under a range of conditions not easily controlled or facilitated in the real world. For veterans with extreme anxiety due to in-flight combat events, for example, exposure to flight (including turbulence) is therapeutically valuable. With the help of VRE, recreating that exposure within the context of a 50-minute session in a therapist’s office is immensely more feasible than gaining access to a flight, with an appropriate amount of turbulence. Not only can VRE create dynamic, three-dimensional stimulus environments, it also allows for the recording of behavioral and physiological responses of the patient, which provides clinical assessment options previously unavailable.

While such innovations hold great potential, there are other ways in which VRE is simply an additional tool to aid in traditional exposure therapy, which remains based within the relationship between the clinician and the patient. In her talk, Rothbaum noted that many of the objections and concerns raised about VRE (detailed in an Ethical Issues in Clinical Neuropsychology article by Rothbaum and her colleagues) are similar to concerns raised about exposure therapy in general. Many people (including many clinicians) flinch at the idea of intentionally raising a patient’s anxiety. A primary motivation of any therapist is helping a patient feel better. Thus, exposure therapy can feel counterintuitive because it forces patients to re-experience their trauma and all of the emotions associated with that trauma.

Image courtesy of Flikr

Other ethical concerns about VRE include the potential for VR-related side effects like cyber-sickness (a form of motion sickness commonly reported with virtual reality technology), and other possible symptoms including disturbed locomotion, changes in postural control, perceptual-motor disturbances, fatigue, and generally lowered arousal. Rothbaum named several mitigating practices employed to limit such symptoms, such as limiting session time, keeping the room cool, using equipment with better resolution, and limiting head motion.

Concerns about misuse of VRE equipment by both clinicians and sufferers of PTSD also emerge. What if clinicians lacking training or expertise use VRE with patients? Or, what if clinicians, no matter how well trained, use VRE at the expense of the normal therapist/client relationship? Rothbaum noted the potentially problematic dynamic of how patients wearing head mounted displays cannot see their therapist, and therefore lose any nonverbal communication that would otherwise be absorbed visually. However, in standard imaginal exposure, patients’ eyes are closed, thus also limiting nonverbal communication. In terms of auditory information, the often loud virtual environments, such as Virtual Iraq or even the virtual airplane, can prevent the patient from hearing the therapist. Furthermore, VRE might allow an interpersonally awkward patient to “hide” behind the technology instead of interacting with the therapist.

In response to the potential for clinical misuse of VRE equipment and techniques, Rothbaum pointed out that “bad VRE therapy is just bad therapy.” While the creators of VRE clinical practices and associated equipment cannot prevent misuse, they can take steps to require appropriate training in as much as possible. As for the therapist-patient interpersonal communications, the VRE equipment includes a microphone that allows the therapist to talk directly with the patient and also privileges the therapist’s voice over the sounds of the virtual environment. A sort of “riding shotgun” intimacy is thus often achieved. Rothbaum also noted that the masking “barrier” of the VR headgear can facilitate more verbalization from patients instead of less, and mimics the therapeutic practice of having patients close their eyes when recounting particular events or feelings or sharing about particular emotional states and in standard imaginal exposure.

Image courtesy of Flikr

There are still more concerns of VRE misuse. Might continued access to virtual environments like “Virtual Vietnam” lead to cases of faulty self-diagnosis and self-treatment? When individuals are able to download or purchase VRE assessment and therapeutic tools, what might be the associated risks? A major concern is that of desensitization: by taking the opportunity to repeatedly immerse one’s self in violent and otherwise traumatic events, might VRE tools be encouraging desensitization? Rothbaum noted that 70% of us, statistically, will experience a traumatic event in our lifetime, but only a small percentage of us will develop PTSD. Rothbaum used the example of video games as one of myriad tools and methods engaged by those suffering with PTSD, with wide-ranging results. In the end, Rothbaum’s response to these concerns was, “We’re not trying to make realistically scary things less scary...We’re trying to help people cope better with something scary that happened in their past.”

Looking into the future of how virtual reality technology might change the landscape and potential of mental health care, a recent review of all studies employing VR for mental health conditions found many gaps in meaningful applications of the technology. However, on the basis that “Mental health problems are inseparable from the environment,” the reviewers concluded that the greatest potential for VR lies in its ability to take patient and caregiver to the particular contexts in which the patient struggles to respond appropriately.

Even more broadly, some VR innovators are finding some success in creating VR headsets that operate solely via the brain activity of the user. While using dry electrodes to record brain activity via electroencephalography (EEG) is not new, creating a modality that allows for the execution of virtual tasks just as efficiently as physical input devices (keyboard, touch screen, etc.) would be a new achievement. Such an advance might lead to an entirely different range of options and questions when considering how VR technology best serves the purposes of mental health care.

With VR, we can expect significant leaps forward in broadening access and modalities for those seeking care for their PTSD. 

References 

Foa, E.B., & Kozak, M.J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99, 20-35.

Want to cite this post?

Kime, K.G. (2017). VR and PTSD: Healing from trauma by confronting fears in virtual reality environments. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2017/04/vr-and-ptsd-healing-from-trauma-by.html

Join us for the Emory Graduate Student Neuroethics Symposium on April 28th, 2017

This spring, the Neuroscience Graduate Program and the Neuroethics Program at Emory University are teaming up to present the 2017 Emory Graduate Student Neuroethics Symposium entitled, The Use of Preclinical Biomarkers for Brain Diseases: A Neuroethical Dilemma. This year’s symposium will focus on the neuroethics of preclinical detection, including discussions of the basic and clinical research being performed and the neurotechnologies being developed for the early detection of autism, schizophrenia, and Alzheimer’s disease. 

The symposium will take place on Friday, April 28th from 10am to 4:30pm at Emory University and is free and open to the public. The symposium will be comprised of three sessions: 

Session 1: Autism, with a focus on the ethics of conducting preclinical research.

Session 2: Schizophrenia, with a focus on the ethics of interventions and treatment.

Session 3: Alzheimer’s disease, with a focus on the ethics of delivering a preclinical diagnosis given the risks for stigma. 

Each session will include input from a patient diagnosed with the disease or family member of someone experiencing the disease, a researcher/clinician, and an ethicist. Speakers will include Dr. Cheryl Klaiman, Dr. Donna Chen, Dr. Dena Davis, Dr. Paul Root Wolpe, Dr. Elaine Walker, and Dr. Allan Levey.

Through this symposium, we hope to highlight the challenges that a patient can face after being given a preclinical diagnosis for a mental disorder, and to underscore the ethical challenges that arise when the ability to detect a future disease outreaches our ability to care for the patient.

You can find more information on our website and in the flyer below, and can register for the event here. We hope you will join us!