Posts Tagged ‘Neuroscience’
Posted on March 17, 2010 - by David
Does Flu During Pregnancy Raise Schizophrenia Risk?
The authors of a study recently published in the journal Biological Psychiatry claim that influenza infection during pregnancy may play a role in the development of schizophrenia later in life.
The study subjects were monkeys. 
According to the abstract, twelve pregnant rhesus monkeys were infected with influenza early in the third trimester, and 7 healthy subjects were used as a control group. The brains of the babies were scanned using MRI after one year, and the researchers found that “exposed offspring had significantly smaller cingulate and parietal cortical gray matter and left parietal white matter than nonexposed offspring. Bilaterally, cingulate white matter was greater in exposed offspring than in controls.” (Gellner, Journal Watch Psychiatry) It is this finding that gets translated into a sentence like “The results showed ‘a significant effect’ which mirrored brain changes in schizophrenic humans” which I read in a short news clip on the Dallas-Fort Worth Fox News affiliate website, under the (only slightly misleading) title ‘Scientists Find Link Between Pregnant Women with Flu and Schizophrenia.’
The study’s main author, Sarah Short, chose her words a little more carefully:
“This was a relatively mild flu infection, but it had a significant effect on the brains of the babies,” Short said. “While these results aren’t directly applicable to humans, I do think they reinforce the idea, as recommended by the Centers for Disease Control and Prevention, that pregnant women should get flu shots, before they get sick.”
But obviously, the object of the study wasn’t merely to reinforce the idea that pregnant women should get flu shots. The hypothesis that flu infection during pregnancy might play a role in the development in schizophrenia was first put forth over 20 years ago, in a study involving a Finnish cohort born during the 1957 influenza pandemic. They found that “those exposed to the viral epidemic during their second trimester of fetal development were at elevated risk of being admitted to a psychiatric hospital with a diagnosis of schizophrenia,” but the results of similar studies have varied considerably. To date, only about half of the 25 research papers examining this phenomenon have confirmed these findings. Those who support this hypothesis often cite one of the more recent and “scientific” studies, which looked at maternal blood tests to confirm when and if those diagnosed with schizophrenia were exposed to the flu. The 2004 investigation found that “the risk of schizophrenia was increased 7-fold for influenza exposure during the first trimester.” If this is indeed true, it’s easy to understand why the authors considered it significant, but the finding that “there was no increased risk of schizophrenia with influenza during the second or third trimester,” conflicts with the earlier studies which claimed that risk of schizophrenia was increased with second trimester exposure. Based on the available data, it’s impossible to draw any conclusions about the relationship between schizophrenia and prenatal exposure to the flu, but obviously, as the recent publication of the monkey study demonstrates, researchers are still actively pursuing this track.
A few questions/criticisms about this study from someone with an admittedly (very) limited knowledge of neurology…
Is there a difference between contracting the flu virus in the typical way and forced infection, in terms of effects on the fetus?
If the available data points to first or second trimester exposure as a risk factor, what is the comparative value of this study considering the pregnant monkeys were infected during the third trimester?
What are other health effects for children of mothers who have the flu while pregnant? Has there been any research examining the relationship between prenatal exposure to influenza and any other mental illnesses?
If this really is a significant risk factor, wouldn’t it suggest that in developing countries where the flu vaccine is less readily available, there should be higher rates of schizophrenia?
A summary of the study by Asian News International (available on many websites) says that “rhesus monkey babies born to mothers who had the flu while pregnant had smaller brains and showed other brain changes similar to those observed in human patients with schizophrenia.” To my knowledge, schizophrenics do not have “smaller brains,” and from what I’ve read, nearly every region of the brain and every neurotransmitter has been implicated by one study or another in the etiology or progression of schizophrenia. It seems a bit misleading then to represent the changes observed in the monkey’s brains as “similar to those observed in human patients with schizophrenia.” This may be the fault of the news article and not the study authors, but I feel it’s important to point out that despite all our technology and the proliferation of research into the “biological basis” of schizophrenia, there is no test or scan, no specific brain changes that can be identified and used to diagnose schizophrenia.
Because so many potential genetic and neurological risk factors are being investigated and written about, there can be a false sense that we are approaching an understanding of what causes schizophrenia. But risk and vulnerability are merely that: factors which increase the possibility that a person exposed to the cause of schizophrenia will go on to develop the disease. In the first chapter of a 2007 book called Recovery from Schizophrenia, Norman Sartorius, former President of the World Psychiatric Association and former Director of the World Health Organization’s Division of Mental Health, writes:
“Despite advances in our knowledge about schizophrenia in the past few decades, nothing allows us to surmise that the causes of schizophrenia will soon become known, or that the prevention of the disorder will become possible in the immediate future.” (3)
Sure, I like monkeys, and I understand how biologically similar we are, but if we want to understand schizophrenia, perhaps we should be looking in the realm of what makes us human.
Posted on March 2, 2010 - by David
‘Analytical Rumination’:Depression as an Adaptive Response?
I read an article last week in the New York Times Magazine by Jonah Lehrer called Depression’s Upside, exploring the possibility that depression is an adaptive, evolved response which helps people focus cognitive resources on solving complex problems. The idea comes from a paper by Paul W. Andrews and J. Anderson Thomson, Jr. published in July of 2009 in the Psychological Review, titled The Bright Side of Being Blue: Depression as an Adaptation for Analyzing Complex Problems. Lehrer’s clever lede uses a description of Darwin’s own mental anguish to slide into yet another evolutionary explanation for the workings of the mind. The following paragraph describes the theoretical view from which the work springs:
In the late 1990s, Thomson became interested in evolutionary psychology, which tries to explain the features of the human mind in terms of natural selection. The starting premise of the field is that the brain has a vast evolutionary history, and that this history shapes human nature. We are not a blank slate but a byproduct of imperfect adaptations, stuck with a mind that was designed to meet the needs of Pleistocene hunter-gatherers on the African savanna. While the specifics of evolutionary psychology remain controversial — it’s never easy proving theories about the distant past — its underlying assumption is largely accepted by mainstream scientists. There is no longer much debate over whether evolution sculptured the fleshy machine inside our head. Instead, researchers have moved on to new questions like when and how this sculpturing happened and which of our mental traits are adaptations and which are accidents.
As Lehrer points out earlier in his article, the prevalence of depression poses a problem for those who are “trying to explain the features of the human mind in terms of natural selection.” The only solution for them seems to be to demonstrate that depression actually has evolutionary benefits. Meanwhile a disorder like schizophrenia is rare enough, and a case for its adaptive benefits would be so difficult to make, that I guess it’s easier for them to chalk it up to a kind of glitch in the system.
My first problem is that this point of view fundamentally disregards the symbolic reality of culture. Once again, I’ll quote from Liah Greenfeld’s essay, Nationalism and the Mind, to give background on the view of culture as an emergent phenomenon:
On the most general level, culture is the process of transmission of historical ways of life and forms of human association across generations and distances… In distinction to other animal species, such transmission of ways of life and social organization, in the case of humanity, is not genetic, but symbolic. Humans are the only biological species, the continuation of whose existence is dependent on symbolic transmission.
The products of this cultural process are stored in the environment within which our biological life takes place, but the process itself goes on inside us. In other words, culture exists dynamically, develops, regenerates, transforms only by means of our minds – which makes culture a mental process. Let me reiterate: culture is a symbolic and a mental process. The fact that it is a mental process means that it occurs by means of the mechanisms of the brain. The fact that it is a symbolic process means that its logic cannot be reduced to the logic of the brain mechanisms, that it is an emergent phenomenon and a reality sui generis. In other words: the neural processes by means of which the cultural process occurs serve only as boundary conditions outside of which it cannot occur, but are powerless to shape the nature and direction of the cultural process. In contrast, culture itself consistently directs the brain, by means of which it occurs, forcing brain mechanisms into patterns of organization and operation which (though, obviously, not impossible) are most improbable given all that we may know of the biological functioning of the brain. (15-16)
The idea of culture as an emergent phenomenon leads to a view of the human mind as the individualized process of culture, and this obviously clashes with the argument made by Andrews and Thomson which seeks to explain the human mind as a product of biological evolution. Nevertheless, their argument is based upon an implicit acceptance of the idea that problems in the cultural environment affect the function of the brain.
I think it’s best now to look at the paper itself. On page 6, they describe the theory one claim at a time:
“In summary, we hypothesize that depression is a stress response mechanism: (1) that is triggered by analytically difficult problems that influence important fitness-related goals; (2) that coordinates changes in body systems to promote sustained analysis of the triggering problem, otherwise known as depressive rumination; (3) that helps people generate and evaluate potential solutions to the triggering problem; and (4) that makes tradeoffs with other goals in order to promote analysis of the triggering problem, including reduced accuracy on laboratory tasks. Collectively, we refer to this suite of claims as the analytical rumination (AR) hypothesis.”
By calling depression “a stress response mechanism,” they make it analogous to any animal’s response to a problem (such as the presence of predator) in the physical environment. On page 4, they write that “negative emotions are stress response mechanisms – they are involuntary response to environmental challenges with important fitness consequences, and they evolved to coordinate changes in physiology, immune function, attention and cognition, physical activity and other body systems to meet those challenges.” This view both cuts out the cultural (therefore symbolic) aspect of emotion and fails to acknowledge that “environmental challenges” are cultural challenges – for humans, the most important and challenging terrain that must be navigated is not the physical but the cultural world. When they write that “different environmental stressors trigger different emotions…” the only way to make sense of this is to read “environmental stressors” as “cultural stressors. The “stressor” may be present in the physical environment – a boss, an ex-wife, a place of work – but it is the cultural significance attached to these things which can “trigger different emotions.” I think we can safely assume that the “stress response” of a rabbit exposed to a wolf has never been based on symbolic reality and has probably been consistent over thousands of years. But for humans, both what constitutes a complex problem, and responses to such complex problems, has not been consistent over time and between places.
The authors focus on social dilemmas as the classic example of a complex problem that triggers depression. But you can’t talk about social dilemmas just in terms of evolution, cutting out the symbolic process of culture. Otherwise, each culture and its particularities must represent a separate human evolution. They use sexual infidelity as an example of an evolutionary fitness-related social dilemma, but it doesn’t take an anthropologist or an historian to figure out that such a situation differs widely over time and from culture to culture. It’s like they’re moving between descriptions of humans as just another species of animals and humans as cultural beings without ever acknowledging the difference. On the one hand they write “if his wife gets pregnant…” and then they mention “access to mates.” So are we cultural beings with institutions like marriage or just animals who need mates? They are speculating about the social dilemmas of hunter-gatherer groups and trying to relate this to the depression of modern people who live in a radically different cultural environment, but they don’t seem to see the disconnect.
The core of their theory is the claim that depression can be seen as adaptive rather than a disorder, because the analytical rumination characteristic of depression actually leads people to solutions for their complex problems. I’d like to consider this view in relation to the view of Allan Horwitz and Jerome Wakefield as described in the Loss of Sadness. Horwitz and Wakefield believe that certain symptoms of depression are normal reactions to difficult life events, and can even lead to personal growth of some kind, but they don’t consider these reactions to be true cases of depression. They consider true depression to have no apparent cause or context, or to last longer and have more severe symptoms than “normal sorrow.” Andrews and Thomson, on the other hand, see no qualitative difference between major depression and subclinical depression, claiming that “…depressive symptoms are better characterized on a single continuum of severity, duration, and liability” (7). While there may be good reasons for the continuum view, I believe this allows Andrews and Thomson to make their adaptive response argument for depression on the basis of evidence drawn mostly from subclinical cases and even from subjects in which “depressed affect” was induced by sad music or film clips. I don’t doubt that for some people, rumination may lead to a better understanding of their problems which could in turn lead to resolution or avoidance of future problems, but critics are quick to point out that this is probably not the way it works for severely depressed people. Lehrer quotes Peter Kramer, Brown University professor of psychiatry and human behavior and author of Listening to Prozac, who wrote, “this study says nothing about chronic depression and the sort of self-hating, paralyzing, hopeless, circular rumination it inspires.”
Andrews and Thomson are clearly interested in proposing new methods of treatment for depression, and believe that therapies which facilitate the process of rumination may be effective in dealing with the underlying problems causing depression. They describe a method which involves “having patients write about their strongest thoughts and feelings about their depressive episode in a journal (25). Journal entries were later examined and coded for “avoidance and processing.” The study found that:
“…the peak in processing was also associated with a spike in depressive symptomatology. Thus, the authors viewed the temporary spike in depression as a positive sign of growth and insight during treatment. This suggests that depression may enhance processing that promotes growth and insight into problems and may facilitate the resolution of the episode. “ (26)
I simply don’t see what leads them to conclude that “depression may enhance processing,” except that this view fits with their hypothesis. It would seem more logical to me to conclude that the increase in processing of negative thoughts and emotions caused the “temporary spike in depression.” They also fail to acknowledge the huge difference between depressive rumination in isolation, and carefully facilitated processing which occurs in the context of therapy. “Analytical rumination” may very well be a common feature of depression, but there is no reason this has to be seen as an evolutionary adaptation, and I doubt that it often leads to the resolution of complex problems without some form of outside help that can orient this rumination towards action.
As their paper draws to a close, Andrews and Thomson restate their claims and review the evidence they’ve used to try to demonstrate that “depression evolved by natural selection, probably because it helped people analyze and solve the problems they were ruminating about.” (41) I have to say, I was extremely frustrated by the number of times that “social dilemmas” and “complex problems” were mentioned, without any real examination of what this means for a depressed person today, or any apparent consideration of differences between cultures and over time. Then, I read this little paragraph:
A design analysis does not require depressive rumination to be currently adaptive because modern and evolutionary environments may differ in important ways (Thornhill 1990, 1997). All that is required is that, on average, depressive rumination helped people analyze and solve the problems they were ruminating about in ancestral environments. Still, strong, replicable evidence that depression rumination currently helps people analyze and solve the problems they ruminate about would support the evolutionary argument, and more research is needed here. (41)
Wow. Now they say something about this? So how do these environments differ, and why? They move between their ideas of the evolutionary past and today without blinking an eye, implying continuity and giving the appearance that they are in fact arguing that depressive rumination is “currently adaptive,” and then with only a few pages left to go in the paper they throw this in? So what has the point of all this been?
In looking at ‘now and then,’ so to speak, they suggest that today, compared to the “ancestral environment,” there are more ways to distract oneself from depression and the “complex problems” which trigger it, meaning that we are robbed of the potential benefit of depressive rumination. However, nowhere do they consider the obvious possibility- that the problems that individuals in modern societies face are of a much different nature than those of the “evolutionary past.” In the end, they seem to be saying the same thing Horwitz and Wakefield say, only they take a much more circuitous and frustrating path to arrive at their final statement:
Depression is the primary emotional condition for which people seek help. The current therapeutic emphasis on antidepressant medications taps into the evolved desire to find quick fixes for pain. But learning how to endure and utilize emotional pain may be part of the evolutionary heritage of depression, which may explain venerable philosophical traditions that view emotional pain as the impetus for growth and insight into oneself and the problems of life. (43-44)
I guess by this point, I shouldn’t be surprised when our “venerable philosophical traditions” get reduced to byproducts of evolution, but it still leaves me shaking my head.
Posted on February 2, 2010 - by David
Fish Oil the Latest in Psychiatric Treatment?
This article summarizes the results of a study from the University of Melbourne, which suggests that the omega-3 fatty acids found in fish oil may help prevent psychosis in adolescents and young adults who have been identified as “at-risk.”
The study involved 81 individuals ages 13-25 “who met at least one of the following three criteria: having low-level psychotic symptoms; having transient psychotic symptoms; or having a schizophrenia-like personality disorder or a close relative with schizophrenia, along with a sharp decline in mental function within the past year.”
For 12 weeks, half the group was given fish oil capsules and the other half recieved placebo. Participants were then monitored for next 40 weeks. Only 2 of the 41 people given fish oil developed a psychotic disorder compared to 11 of 40 of the placebo group. The omega-3 group also “also showed significant reductions in their psychotic symptoms and improvements in function.” The researchers hope to replicate the findings in a multicenter trial involving 320 people.
Certainly, the lack of adverse side effects compared to the commonly used anti-psychotic medications would make this treatment a much preferred choice for patients. While these findings are definitely positive, it was a very small and relatively short-term study, so further research is obviously needed to determine the value of fish oil as a treatment or preventitive measure for serious mental illness. Also, this once again highlights how little is understood about what is happening in the brain of the schizophrenic patient. The article mentions some of the potential reasons this novel treatment may be effective:
There are a number of mechanisms through which omega-3s could protect the brain, Amminger said; they are a major component of brain cells. They are also key to the proper function of two brain chemical signaling systems, dopamine and serotonin, which have been implicated in schizophrenia. Fish oil also boosts levels of glutathione, an antioxidant that protects the brain against oxidative stress.
In the quest to understand the cause and progression of this illness, nearly every neurotransmitter and every part of the brain has been implicated in some way or another. While hopefully this study will lead to new ways of dealing with the symptoms of schizophrenia without the devastating side-effects of many commonly prescribed drugs, it seems to be another example of a “scientific” answer which amounts to, “this might work, and if it does, these might be some of the reasons why.”
Posted on January 24, 2010 - by David
Crazy Like Us, Part 3: Schizophrenia in Zanzibar
Chapter 3- The Shifting Mask of Schizophrenia in Zanzibar
In the first two chapters of Ethan Watters’ new book, Crazy Like Us: The Globalization of the American Psyche, we encounter the idea that differences in source of identity and social integration between cultures may account for differences in the expression, (and prevalence), of mental illness. The third chapter suggests that cultural differences may also explain the rather enigmatic finding that those diagnosed with schizophrenia in the “developing” world seem to fare better than their Western counterparts. I found anthropologist Juli McGruder’s case studies particularly interesting, as they raise the possibility that the cause, or at least trigger, for schizophrenia may lie in cultural conditions.
I think it’s worth noting, as Watters points out, that despite the privileged position science has been given in the study of schizophrenia and all the technological advances of the last few decades, we still know very little about the causes of this strange affliction.
More than any other mental illness in the Western world, this one belonged to the “hard scientists” who looked for the causes in bad genes, biochemistry, and the structure of the brain. The advent of brain scans – allowing a researcher to see into the head of live patients – brought with it a seemingly endless series of theories about the root cause of the illness. Abnormalities supposedly key to schizophrenia have been reported in the frontal cortex, the prefrontal cortex, the basal ganglia, the hippocampus, the thalamus, the cerebellum – and pretty much every other corner of the brain as well. No firm consensus had emerged about the location or cause, but there was wide agreement that the exciting advances in understanding the disease were coming from the laboratories of brain researchers.(134)
In the meantime, there are others like Juli McGruder who, (like sociologist Liah Greenfeld), believes that “culture and social setting play a more complicated role in the disease than simply influencing the content of the delusions.” (136) Scholars on the cultural side of the fence point to the results of two international studies by the World Health Organization. The WHO research, which began in the 1960’s and lasted 25 years, suggests that the severity of schizophrenia is not the same worldwide. Watters summarizes the findings:
What they found was that those diagnosed with schizophrenia living in India, Nigeria, and Colombia often experienced a less severe form of the disease (had longer periods of remission and higher levels of social functioning) than those living in the United States, Denmark, or Taiwan. Whereas over 40 percent of schizophrenics in industrialized nations were judged to be “severely impaired,” only 24 percent of patients in the poorer countries ended up similarly disabled. (137)
Liah Greenfeld believes that anomie, which she considers a built-in feature of modern culture, causes problems with identity formation which often lead to mental illness. In Nationalism and the Mind, she describes this phenomenon and its effects on individuals:
Anomie, commonly translated as “normlessness,” refers to a condition of cultural insufficiency, a systemic problem which reflects inconsistency, or lack of coordination, between various institutional structures, as a result of which they are likely to send contradictory messages to individuals within them. On the psychological level anomie produces a sense of disorientation, of uncertainty as to one’s place in society, and therefore as to one’s identity: of what one is expected to do under the circumstances of one sort or another, of the limits to one’s possible achievement… (14)
The chronic, modern state of anomie may not (yet) be a built-in a feature of Zanzibari culture, but when we use the word “developing” to describe a country or culture, we imply that they are developing into something more like us, i.e moving towards modernity. This process of modernization is necessarily anomic:
Anomie, is, in fact, the ultimate cause of cultural change. It both breaks the old cultural routine and encourages the formation of a new one. The general pattern of human history can be imagined as an alteration between relatively brief and rare periods of widespread (though culturally localized) anomie and cultural routine. Widespread anomie, most commonly implying gross inconsistencies between elements of culture impinging on individual identities, specifically inconsistencies within the system of social stratification which defines a person’s position in the social world in general and vis-à-vis particular others, affects large groups of individuals and expresses itself in social turmoil. (14-15)
I wasn’t surprised, then, to see the title ‘Revolution and Madness’ above the section introducing McGruder’s first case study. Watters describes the state of affairs in the country at the time when Hemed began to experience symptoms of schizophrenia:
After years of being a British colony, Zanzibar embarked on the uncertain path to self-governance. There were three political parties, twenty-two trade unions, and sixteen partisan newspapers stirring up anger and resentment on all sides. Hemed’s first experience of derangement, McGruder believes, was sparked by the social upheaval of the time. (142)
Given what was going on in that moment in the history of Zanzibar, the amount of stress felt by Hemed must have been intense. He was a middle-class man from a high-profile Arab minority at a time of growing racial and class distrust. His curly dark hair and facial features made him identifiably Arab. There seemed to be no safe political refuge. Even the political party he belonged to, the Zanzibar Nationalist Party, was internally split between those who considered themselves African and those of Arab heritage. No one knew whom to trust. (143)
We can also see how conflicting cultural messages may have played a role in the experience of Kimwana, Hemed’s daughter who suffered from the same illness.
She was a happy child even though her early years were turbulent times for the island. Her mother and classmates remember her as the brightest student in the class. Particularly skilled with numbers, she graduated from secondary school and took a job with the Ministry of Finance. This was 1983, a time of rapid change for women on the island. To fill in for the many educated men who had fled the political upheaval, women were beginning to enter the professional workforce by the thousands. (144)
While we in the West would see these new opportunities for women aa a change for the better, there still existed traditional guidelines on behavior which seemed to contradict this elevation in social status. It was only a few months after Kimwana started her new job that she began to hear male voices “gossiping that she was a disloyal and disrespectful daughter and sister” (146). Before the cultural changes which led to an influx of women into the workplace, Kimwana’s identity would have been based primarily on her relationship to her family and in behaving according to the prescriptions of the Islamic religion.
Much of the torment of having these male presences in her head related to Islamic rules of female modesty. While the voices were with her, she felt she must respect the codes of conduct as is she were actually in the presence of a man. At such times she could not bathe or undress and she tried not to go to the bathroom. Although she sometimes found it helpful to argue with the voices when they became critical, her sense of decorum made it difficult to do this out loud. (146-147)
In this section of the chapter, Watters highlights McGruder’s amazement at the ability of Amina, the mother and effectively the head of the household, to care for the large family and its two sick members. Her daily activities seem to far surpass western notions of busyness, and she takes the extra load created by mental illness in stride. This is possible, I believe, because she is secure in her identity in a way that neither Hemed nor her daughter Kimwana could be. She was raised to serve her family and God, and that is what she does. McGruder compares the Western, Christian attitude towards adversity to Amina’s stance and sees an importance difference.
In the cosmology of Western Christians, life’s challenges provide opportunities to become stronger and to have a closer relationship with God. The burdens God sends to Christians in the Western world are incitements to self-improvement. The comforts that Amina found in her religious belief, by contrast, were not in an encouragement to overcome or learn from hardships. Rather, simply accepting her burden was a continuous act of penance. (155)
In other words, the challenge of caring for her sick relatives did not provide a reason to change her identity. Her identity was essentially unchanged since childhood, she was merely to continue behaving and believing as she always knew she should. Unfortunately for her daughter, the conflict between the new cultural value of work for women, and the traditional emphasis on family and religion proved too much for her mind to handle.
The chapter also describes the damage often done by family members’ emotional over-involvement in the lives of their schizophrenic loved ones. This cultural tendency, according to Watters, is closely related to the Western emphasis on individual identity and the belief that individuals should be able to control their own destinies. As in the previous two chapters, the resounding message is that the highly individualistic nature of identity in modern societies and the lack of clear, shared cultural beliefs and practices lead to more widespread and more severe forms of mental illness.
Posted on January 22, 2010 - by David
Crazy Like Us, Part 2: PTSD in Sri Lanka
Chapter 2 – The Wave that Brought PTSD to Sri Lanka
In chapter 2 of his new book, Crazy Like Us: The Globalization of the American Psyche, Ethan Watters describes the wave of research and treatment professionals that swept in to Sri Lanka in the wake of the 2004 tsunami, hoping to both heal and study the abundance of psychologically scarred people they expected to see. According to the varying estimates of experts quoted in news articles, anywhere from 15 to 90 percent of the population might be suffering from post traumatic stress disorder.
And did they find this many Sri Lankans suffering from what we call PTSD? The answer seems to be no, but the certainty with which Western professionals entered the supposed psychological disaster zone seems to have made it hard for them to accept what they found. Watters cites the example of a trauma counselor interviewed on BBC radio who was worried by the fact that the children in the village he was working in were more eager to get back to school than to talk about their frightening experiences. His explanation was that they were “clearly in denial.” (77)
Watters is obviously critical of this dogmatic belief that all minds in all cultures are equally susceptible to mental illness. The idea, introduced in the first chapter on anorexia and further developed here, that more traditional cultures do not suffer the way that Westerners do, deserves special attention. By providing meaning and identity through religious beliefs and closely integrated social groups, it seems that traditional cultures avoid the specifically modern forms of mental illness that many in the West assume to be universal. In her research following the tsunami, Dr. Gaithri Fernando, a psychology professor at Cal State University and a native of Sri Lanka, found that in place of the psychological symptoms westerners would expect to see, many who lost loved ones and homes experienced physical symptoms of aches and muscle pains. Without the Western, dualist conception of mind-body split, it seems Sri Lankans felt the pain of loss in their bodies rather than their minds.
As Watters points out in the first chapter, specifically modern forms of mental illness seem to be related to the importance of individual identity and independence in Western societies. Dr. Fernando’s research suggests this difference is key to understanding the conspicuous absence of PTSD.
… Sri Lankans tended to see the negative consequences of an event like the tsunami in terms of the damage it did to social relationships. Those who continued to suffer long after a horrible experience, her research showed, were those who had become isolated from their social network or who were not fulfilling their role in kinship groups. In short, they conceived of the damage done by the tsunami as occurring not inside their mind but outside the self, in the social environment. (91)
If social integration and strong cultural beliefs are key to protecting the individual mind from turmoil, then the lack of these would presumably lead to problems. In looking at where the PTSD diagnosis began, Watters goes back to the Vietnam War and the difficulties of many soldiers upon returning home. “Beliefs that had sustained many of their fathers in World War II were suddenly insufficient and meaningless to these soldiers,” he writes (121). I believe this cultural insufficiency may help to explain why an estimated 300,000 American veterans of the wars in Iraq and Afghanistan are now suffering from PTSD.
In a study published this week in the Journal of Neural Engineering, researchers at the Minneapolis VA Medical Center expressed excitement upon finding that by scanning the brain using magnetoencephalography (MEG), they were able to confirm with 90% accuracy the PTSD diagnoses of 74 American vets. The article that summarizes the findings states that “the ability to objectively diagnose PTSD is the first step towards helping those afflicted with this severe anxiety disorder.” However, all the study did was confirm “objectively” that the “subjective” diagnoses of these soldiers were already fairly accurate. Brain scans do little to explain why veterans today seem to be suffering psychological battle scars at a much higher rate than ever before in U.S history. Could it be the lack of strong cultural belief in what they are doing over there? The ambiguity of the enemy? The possibility that many of these young veterans may have chosen the identity of soldier not merely because of pride and patriotism, but because other paths in life seemed closed to them? The fact that despite the horror of war, the social integration provided during active duty surpasses what they might experience at home? The lesson to be taken out of Watters chapter on PTSD seems to be that the suffering of these veterans cannot be explained by some scientific correspondence between brain malfunction and the horrific events they witnessed and experienced. Is it crazy to think that the inability of American culture to provide a solid identity for soldiers that holds up at home as well as abroad, and the contradictory messages that simultaneously value and vilify the work that they do might be partly to blame for the widespread mental devastation?
A brief article in which Watters highlights some of the main points of this chapter was written in 2007 and is available here.
Posted on December 4, 2009 - by David
Work Begins on Famous Brain
At the University of California, San Diego, Neuroscientists begin work on the brain of HenryMolaison, world’s most famous amnesic. The Brain Observatory’s website has streaming video of the project’s first phase- a 30 hour procedure of sectioning the brain into thousands of hair-thin slices.
Exploring modern culture and its effects on the mind