At first glance, this week’s section of reading from Joseph LeDoux’s The Synaptic Self provides something undeniably necessary for any study of neuropsychology: an overview of “the most unaccountable of machinery,” the human brain and its various functions, focusing primarily on the eponymous synapses. Such an overview would be beneficial for any students of the brain, whether they were approaching it from our class’s perspective, from the perspective of the straight neurologist or psychologist, or from the perspective of an interested layman; however, LeDoux seems to say, from the chapter’s onset, that exposure to such knowledge would benefit more people than simply those interested in the brain. In his opening set of paragraphs, he discusses certain “beliefs” that people “tend to carry around with them,” such as the folk notion what “we only use 10 percent of our brains” and “part truths” that, when removed from their respective contexts, “are patently false.” “Most of us,” he writes, “are mystified by our brains” – and he spends the chapter addressing this “ignorance” from an evolutionary, chemical, and scientific standpoint.
Given his background in neural science and what he has proposed to endeavor with The Synaptic Self, LeDoux’s choice to write scientifically makes perfect sense and he does so quite efficiently. But, to play Devil’s Advocate for the moment, how much use is there, for the “average” person, in “demythologizing” the brain, which is to say explaining the chemical reactions, the functions of synapses and what stimuli in which regions or areas lead to which sets of openings, closings, and relays? The overall use of studying the brain is obvious: advances in neuroscience have found applications in medicine as well as psychiatry and, ideally, can be applied to help the greater wellness of the “average” people, but it’s all too easy for someone of higher learning to give an abridged version of what a diagnosis means to a patient. Even if the “myths” about the brain that certain people “carry around with them” are not entirely true, if said “myths” have some basis in fact, is it not better than people having nothing at all? In theory, it wouldn’t be difficult for the layperson to simply read The Synaptic Self and debunk all of the neurological fairy stories that s/he had previously held to, but if it’s easier for people to live their lives with a slightly limited or vaguely skewed understanding of everything going on in their minds, are they in the wrong for not wanting to have their notions discredited?
In addition to the logic of these questions, it is necessary to consider the emotional impact of “demythologizing” the brain on people suffering from neurological ailments, which was discussed quite well in this week’s reading from Oliver Sacks, most notably in his section, “The Landscape of His Dreams.” In the footnotes to the main narrative, Sacks mentions two different cases in which artists living with neurological ailments were reluctant to have diagnostic labels pinned to their minds’ lapels: in the first, Sacks describes how painter Girogio De Chirico “was subject to classical migraines and migraine auras of great severity” but, rather than “acknowledge a purely medical or physical cause for his visions” – which he apparently used to drive his painting and integrated into his work – he focused on the strong “spiritual quality” of them, only finally compromising with the term “spiritual fevers.” In the second, Sacks notes how, despite suffering from lifelong debilitating epilepsy, author Fyodor Dostoevsky uses his character, Prince Mishkin, to ask, “What if it is disease? What does it matter that it is an abnormal intensity, if the result… turns out to be the acme of harmony and beauty … of completeness, of proportion?”
The main narrative corresponds well with these notions: although the patient, Franco, a painter of exceptional skill but limited subject matter, finds confusion originating from the “doubling of consciousness” that accompanies the seizures preceding his artistic fits, and although his family members note what seem to be significant disturbances to his general functioning – according to his brother-in-law, “Back in ’61, Franco would talk about anything. …He wasn’t obsessed – he was normal.” and, moreover, the trouble Franco gets from his malady is enough to merit hospitalization, at one point – Franco still rejects the “‘medical’ possibilities” that could explain his obsession and his art, thinking, instead, that “A gift, a destiny, had been vouchsafed to him.”
Sacks, judging from his narrative and footnotes, has a clear understanding of the fact that, for some, “demythologizing” the brain is an ineffective method of assisting them. In one footnote, he even warns against “[going] overboard in medicalizing our predecessors (and contemporaries), reducing their complexity to expressions of neurological or psychiatric disorders, while neglecting all the other factors that determine a life, not least the irreducible uniqueness of the individual.” However, the artistic rejection of “‘medical’ possibilities” seems quite similar to the “myths” that LeDoux’s average people cling to regarding how the brain functions. Is a neurologically afflicted artist’s choice not to be diagnosed, thus, a method of ego-preservation – in that, by rejecting a clinical explanation, the artist keeps alive whatever notions of inspiration s/he holds – or is it, as LeDoux seems to argue regarding laypeople’s “myths,” a willful ignorance that impedes widespread understanding? Do artists have the right to hold their notions and to ignore the scientific aspects of their suffering, or is it necessary to take a reductionist approach, in favor of helping future generations?
You bring up a dilemma which extends far beyond the reaches of Neuroscience: that age-old question of whether ignorance is truly bliss.
ReplyDeleteThere's an interesting Taoist proverb that states "to know too much is to decay" (Chuang Tzu). Of course, those espousing Taoism don't advocate total oblivion, but rather a non-striving form of knowledge usually categorized as "wisdom." [the definition of Wisdom, however, isn't the easiest thing to grasp...and I'm oversimplifying for the sake of saving HTML space]
I'm also intrigued by the forceful imposition of, say, one individual's definition of "health" or "truth" upon another (the former thinking him/herself superior/more intelligent/in the right, the latter percieved as inferior/sick/incapable). Sacks alludwes to this phenomena so tangibly in To See and Not See, with his debate about whether it was indeed benificial to grant Virgil his sight - and whether it was appropriate to expect him to conform.
I look forward to discussing this on Wednesday!
The question here seems to be whether an understanding of the brain is necessary, or whether we are simply better for it. I find that neuroscience provides an enriched context for understanding human behavior, one that is not reductive, but enlarges. For instance: Let’s say you have a friend who’s very impulsive. Let’s say she blurts out inappropriate and hurtful things without any consideration of the effect her words might have on others. You could see this behavior as malice; you could see it as a lack of self-control; you could see it as a kind of stupidity; you could see it as a character flaw--and these labels might hold a grain of truth. But, with knowledge of the brain, you could see that there may be an underlying biological propensity for impulsive behavior, just as some genes seem to be associated with the tendency toward novelty-seeking (something that was touched on in an article in The New York Times that everyone should read, “My Genome, My Self” by Steven Pinker). This isn’t an excuse--you can’t blame the brain--but you can see her behavior in a broader context. You can see that it takes effort and a strong will to control the impulsive behavior. She probably can control it, more or less, but it’s not easy, since the synaptic pathways involved are well-worn. I’ve said this before, but I think brain science, and specifically neuropsychology, can make us a little more sympathetic, a little more tolerant, a little less quick to judge.
ReplyDeleteBut your post is really about what neuropsychology can mean for the patients, and you ask if it’s really of benefit to them. I find that, when you have an illness, any kind of illness, there’s a huge sense of relief that comes with being able to name it, with understanding its workings and its cause, with having an abstract mastery of the problem. And sometimes this abstract mastery can be translated into self-treatment, self-therapy, positive behavior modification, to the breaking of inefficient cognitive habits, etc. And I don’t think, strictly speaking, the science completely negates the more spiritual or mystical or artistic or even just ambivalent views that patients have of their ailments--since knowledge of that kind is fundamentally different, is not based on the scientific method, and is based on unqualified belief. There’s an odd way in which, if one has a chronic health problem, one has to be on intimate terms with it, and, according to Freud, all intimate relationships involve some deep ambivalence, even emotions as seemingly contradictory as love and hate. The illness remains an illness; there’s no use pretending it’s a good thing; but it’s there, and we all have the need to find meaning in our experiences. So you may, mostly unconsciously, find a creative use for it. As Sacks acknowledges, creativity and pathology are frequently in cahoots. That can’t be taken away; once it’s part of your psychic system, it can be repressed, but it can’t disappear entirely forever. The disease is part of you; it will at minimum stay in your memory. Neuroscience may help to bring consciousness to the cognitive and behavioral patterns that have accrued to the illness. It doesn’t undo those patterns--only the patient can undo them--but neuropsychology provides context and promotes consciousness, and there are then more choices for the way ahead.
Does this make any sense?
Kassie's post brings to mind another ancient question (which was also addressed in last week's reading from ch. 2 of The Synaptic Self): Are scientific fact and spiritual/religious belief incompatible? This debate is at least as old as the trial of Socrates in Athens or the Inquisitorial persecution of Galileo, and it is currently active in the national debates over abortion rights (with the pseudo-religious principle that life begins at conception) and evolution (with the conflation of religion and science in Intelligent Design). But most often the question is framed to address the conflict between church doctrine and scientific observation. When two communities try to establish fact based on contrary philosophical understandings of the universe, they are bound to run into areas of incompatibility. But does this incompatibility extend to personal spirituality and mystical understandings of physiological phenomena? I would argue that it can be possible to synthesize seemingly opposed scientific and spiritual/creative understandings of the world. If science can be seen as illuminating rather than reductive, it need not deny a person with a neurological abnormality the power to define his condition on his own terms. The difficulty seems to arise when either the scientific or the spiritual perspective seeks a definitive, simplistic definition of the condition, rather than an individualized, inclusive diagnosis.
ReplyDelete