Tag Archives: neuroscience

Rethinking the Placebo Effect: How Our Minds Actually Affect Our Bodies

 

“In 2013, Neil deGrasse Tyson hosted a mind-bending debate on the nature of “nothing” – an inquiry that has occupied thinkers since the dawn of recorded thought and permeates everything from Hamlet’s iconic question to the boldest frontiers of quantum physics. That’s precisely what New Scientist editor-in-chief Jeremy Webb explores with a kaleidoscopic lens in Nothing: Surprising Insights Everywhere from Zero to Oblivion(public library) – a terrific collection of essays and articles exploring everything from vacuum to the birth and death of the universe to how the concept of zero gained wide acceptance in the 17th century after being shunned as a dangerous innovation for 400 years. As Webb elegantly puts it, “nothing becomes a lens through which we can explore the universe around us and even what it is to be human. It reveals past attitudes and present thinking.”

Among the most intensely interesting pieces in the collection is one by science journalist Jo Marchant, who penned the fascinating story of the world’s oldest analog computer. Titled “Heal Thyself,” the piece explores how the way we think about medical treatments shapes their very real, very physical effects on our bodies – an almost Gandhi-like proposition, except rooted in science rather than philosophy. Specifically, Marchant brings to light a striking new dimension of the placebo effect that runs counter to how the phenomenon has been conventionally explained. She writes:

It has always been assumed that the placebo effect only works if people are conned into believing that they are getting an actual active drug. But now it seems this may not be true. Belief in the placebo effect itself – rather than a particular drug – might be enough to encourage our bodies to heal.

She cites a recent study at the Harvard Medical School, in which people with irritable bowel syndrome were given a placebo and informed that the pills were “made of an inert substance, like sugar pills, that have been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes.” As Marchant notes, this is absolutely true, in a meta kind of way. What the researchers found was startling in its implications for medicine, philosophy, and spirituality – despite being aware they were taking placebos, the participants rated their symptoms as “moderately improved” on average. In other words, they knew what they were taking wasn’t a drug – it was a medical “nothing” – but the very consciousness of taking something made them experience fewer symptoms.

Illustration by Marianne Dubuc from The Lion and the Bird

This dovetails into recent research confirming what Helen Keller fervently believed by putting some serious science behind the value of optimism. Marchant sums up the findings:

Realism can be bad for your health. Optimists recover better from medical procedures such as coronary bypass surgery, have healthier immune systems and live longer, both in general and when suffering from conditions such as cancer, heart disease and kidney failure.

It is well accepted that negative thoughts and anxiety can make us ill. Stress – the belief that we are at risk – triggers physiological pathways such as the “fight-or-flight” response, mediated by the sympathetic nervous system. These have evolved to protect us from danger, but if switched on long-term they increase the risk of conditions such as diabetes and dementia.

What researchers are now realizing is that positive beliefs don’t just work by quelling stress. They have a positive effect too – feeling safe and secure, or believing things will turn out fine, seems to help the body maintain and repair itself… Optimism seems to reduce stress-induced inflammation and levels of stress hormones such as cortisol. It may also reduce susceptibility to disease by dampening sympathetic nervous system activity and stimulating the parasympathetic nervous system. The latter governs what’s called the “rest-and-digest” response – the opposite of fight-or-flight.

Just as helpful as taking a rosy view of the future is having a rosy view of yourself. High “self-enhancers” – people who see themselves in a more positive light than others see them – have lower cardiovascular responses to stress and recover faster, as well as lower baseline cortisol levels.

Marchant notes that it’s as beneficial to amplify the world’s perceived positivity as it is to amplify our own – something known as our “self-enhancement bias,” a type of self-delusion that helps keep us sane. But the same applies to our attitudes toward others as well – they too can impact our physical health. She cites University of Chicago psychologist John Cacioppo, who has dedicated his career to studying how social isolation affects individuals. Though solitude might be essential for great writing, being alone a special form of art, and single living the defining modality of our time, loneliness is a different thing altogether – a thing Cacioppo found to be toxic:

Being lonely increases the risk of everything from heart attacks to dementia, depression and death, whereas people who are satisfied with their social lives sleep better, age more slowly and respond better to vaccines. The effect is so strong that curing loneliness is as good for your health as giving up smoking.

Illustration by Marianne Dubuc from The Lion and the Bird

Marchant quotes another researcher, Charles Raison at Atlanta’s Emory University, who studies mind–body interactions:

It’s probably the single most powerful behavioral finding in the world… People who have rich social lives and warm, open relationships don’t get sick and they live longer.

Marchant points to specific research by Cacioppo, who found that “in lonely people, genes involved in cortisol signaling and the inflammatory response were up-regulated, and that immune cells important in fighting bacteria were more active, too.” Marchant explains the findings and the essential caveat to them:

[Cacioppo] suggests that our bodies may have evolved so that in situations of perceived social isolation, they trigger branches of the immune system involved in wound healing and bacterial infection. An isolated person would be at greater risk of physical trauma, whereas being in a group might favor the immune responses necessary for fighting viruses, which spread easily between people in close contact.

Crucially, these differences relate most strongly to how lonely people think they are, rather than to the actual size of their social network. That also makes sense from an evolutionary point of view, says Cacioppo, because being among hostile strangers can be just as dangerous as being alone. So ending loneliness is not about spending more time with people. Cacioppo thinks it is all about our attitude to others: lonely people become overly sensitive to social threats and come to see others as potentially dangerous. In a review of previous studies … he found that tackling this attitude reduced loneliness more effectively than giving people more opportunities for interaction, or teaching social skills.

Illustration by André François for Little Boy Brown, a lovely vintage ode to childhood and loneliness

Paradoxically, science suggests that one of the most important interventions to offer benefits that counter the ill effects of loneliness has to do with solitude – or, more precisely, regimented solitude in the form of meditation. Marchant notes that trials on the effects of meditation have been small – something I find troublesomely emblematic of the short-sightedness with which we approach mental health as we continue to prioritize the physical in both our clinical subsidies and our everyday lives (how many people have a workout routine compared to those with a meditation practice?); even within the study of mental health, the vast majority of medical research focuses on the effects of a physical substance – a drug of some sort – on the mind, with very little effort directed at understanding the effects of the mind on the physical body.

Still, the modest body of research on meditation is heartening. Marchant writes:

There is some evidence that meditation boosts the immune response in vaccine recipients and people with cancer, protects against a relapse in major depression, soothes skin conditions and even slows the progression of HIV. Meditation might even slow the aging process. Telomeres, the protective caps on the ends of chromosomes, get shorter every time a cell divides and so play a role in aging. Clifford Saron of the Center for Mind and Brain at the University of California, Davis, and colleagues showed in 2011 that levels of an enzyme that builds up telomeres were higher in people who attended a three-month meditation retreat than in a control group.

As with social interaction, meditation probably works largely by influencing stress response pathways. People who meditate have lower cortisol levels, and one study showed they have changes in their amygdala, a brain area involved in fear and the response to threat.

If you’re intimidated by the time investment, take heart – fMRI studies show that as little as 11 hours of total training, or an hour every other day for three weeks, can produce structural changes in the brain. If you’re considering dipping your toes in the practice, I wholeheartedly recommend meditation teacher Tara Brach, who has changed my life.

But perhaps the most striking finding in exploring how our beliefs affect our bodies has to do with finding your purpose and, more than that, finding meaning in life. The most prominent studies in the field have defined purpose rather narrowly, as religious belief, but even so, the findings offer an undeniably intriguing signpost to further exploration. Marchant synthesizes the research, its criticism, and its broader implications:

In a study of 50 people with advanced lung cancer, those judged by their doctors to have high “spiritual faith” responded better to chemotherapy and survived longer. More than 40 percent were still alive after three years, compared with less than 10 percent of those judged to have little faith. Are your hackles rising? You’re not alone. Of all the research into the healing potential of thoughts and beliefs, studies into the effects of religion are the most controversial.

Critics of these studies … point out that many of them don’t adequately tease out other factors. For instance, religious people often have lower-risk lifestyles and churchgoers tend to enjoy strong social support, and seriously ill people are less likely to attend church.

[…]

Others think that what really matters is having a sense of purpose in life, whatever it might be. Having an idea of why you are here and what is important increases our sense of control over events, rendering them less stressful. In Saron’s three-month meditation study, the increase in levels of the enzyme that repairs telomeres correlated with an increased sense of control and an increased sense of purpose in life. In fact, Saron argues, this psychological shift may have been more important than the meditation itself. He points out that the participants were already keen meditators, so the study gave them the chance to spend three months doing something important to them. Spending more time doing what you love, whether it’s gardening or voluntary work, might have a similar effect on health. The big news from the study, Saron says, is “the profound impact of having the opportunity to live your life in a way that you find meaningful.”

Philosopher Daniel Dennett was right all along in asserting that the secret of happiness is to “find something more important than you are and dedicate your life to it.”

Each of the essays in Nothing: Surprising Insights Everywhere from Zero to Oblivion is nothing short of fascinating. Complement them with theoretical physicist Lawrence Krauss on the science of “something” and “nothing.”

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June 30, 2014 · 6:51 pm

What the Brain Can Tell Us About Art

By ERIC R. KANDEL

Published: April 12, 2013

“THIS month, President Obama unveiled a breathtakingly ambitious initiative to map the human brain, the ultimate goal of which is to understand the workings of the human mind in biological terms.

Jonathon Rosen

Many of the insights that have brought us to this point arose from the merger over the past 50 years of cognitive psychology, the science of mind, and neuroscience, the science of the brain. The discipline that has emerged now seeks to understand the human mind as a set of functions carried out by the brain.

This new approach to the science of mind not only promises to offer a deeper understanding of what makes us who we are, but also opens dialogues with other areas of study — conversations that may help make science part of our common cultural experience.

Consider what we can learn about the mind by examining how we view figurative art. In a recently published book, I tried to explore this question by focusing on portraiture, because we are now beginning to understand how our brains respond to the facial expressions and bodily postures of others.

The portraiture that flourished in Vienna at the turn of the 20th century is a good place to start. Not only does this modernist school hold a prominent place in the history of art, it consists of just three major artists — Gustav KlimtOskar Kokoschka and Egon Schiele — which makes it easier to study in depth.

As a group, these artists sought to depict the unconscious, instinctual strivings of the people in their portraits, but each painter developed a distinctive way of using facial expressions and hand and body gestures to communicate those mental processes.

Their efforts to get at the truth beneath the appearance of an individual both paralleled and were influenced by similar efforts at the time in the fields of biology and psychoanalysis. Thus the portraits of the modernists in the period known as “Vienna 1900” offer a great example of how artistic, psychological and scientific insights can enrich one another.

The idea that truth lies beneath the surface derives from Carl von Rokitansky, a gifted pathologist who was dean of the Vienna School of Medicine in the middle of the 19th century. Baron von Rokitansky compared what his clinician colleague Josef Skoda heard and saw at the bedsides of his patients with autopsy findings after their deaths. This systematic correlation of clinical and pathological findings taught them that only by going deep below the skin could they understand the nature of illness.

This same notion — that truth is hidden below the surface — was soon steeped in the thinking of Sigmund Freud, who trained at the Vienna School of Medicine in the Rokitansky era and who used psychoanalysis to delve beneath the conscious minds of his patients and reveal their inner feelings. That, too, is what the Austrian modernist painters did in their portraits.

Klimt’s drawings display a nuanced intuition of female sexuality and convey his understanding of sexuality’s link with aggression, picking up on things that even Freud missed. Kokoschka and Schiele grasped the idea that insight into another begins with understanding of oneself. In honest self-portraits with his lover Alma Mahler, Kokoschka captured himself as hopelessly anxious, certain that he would be rejected — which he was. Schiele, the youngest of the group, revealed his vulnerability more deeply, rendering himself, often nude and exposed, as subject to the existential crises of modern life.

Such real-world collisions of artistic, medical and biological modes of thought raise the question: How can art and science be brought together?

Alois Riegl, of the Vienna School of Art History in 1900, was the first to truly address this question. He understood that art is incomplete without the perceptual and emotional involvement of the viewer. Not only does the viewer collaborate with the artist in transforming a two-dimensional likeness on a canvas into a three-dimensional depiction of the world, the viewer interprets what he or she sees on the canvas in personal terms, thereby adding meaning to the picture. Riegl called this phenomenon the “beholder’s involvement” or the “beholder’s share.”

Art history was now aligned with psychology. Ernst Kris and Ernst Gombrich, two of Riegl’s disciples, argued that a work of art is inherently ambiguous and therefore that each person who sees it has a different interpretation. In essence, the beholder recapitulates in his or her own brain the artist’s creative steps.

This insight implied that the brain is a creativity machine, which obtains incomplete information from the outside world and completes it. We can see this with illusions and ambiguous figures that trick our brain into thinking that we see things that are not there. In this sense, a task of figurative painting is to convince the beholder that an illusion is true.

Some of this creative process is determined by the way the structure of our brain develops, which is why we all see the world in pretty much the same way. However, our brains also have differences that are determined in part by our individual experiences.

In addition to our built-in visual processes, each of us brings to a work of art our acquired memories: we remember other works of art that we have seen. We remember scenes and people that have meaning to us and relate the work of art to those memories. In order to see what is painted on a canvas, we have to know beforehand what we might see in a painting. These insights into perception served as a bridge between the visual perception of art and the biology of the brain.

So how does our brain respond to portraiture? As we look at a portrait, our brain calls on several interacting systems to analyze contours, form a representation of the face and of the body, analyze the body’s motion, experience emotion, and perhaps, empathy. Along with these instantaneous responses, we form a theory of the subject’s state of mind.

The brain’s representation of faces is especially important to the beholder’s response to portraiture. Our brain devotes more space to reading the details of faces than to any other object. We react strongly to the expressionist works of these Viennese artists, in part, because our brain contains specialized cells that respond powerfully to the exaggerated facial features these painters portrayed.

Moreover, the sense of stimulation we often experience when we look at a portrait is thought to be due in part to the activity of “mirror neurons.” Signaling by these cells in the motor areas of the brain can make us perceive the actions of others as if they were our own.

All of which goes to show that the real “eye” of the beholder is the brain itself.

Eric R. Kandel, a professor of brain science at Columbia University, a senior investigator at the Howard Hughes Medical Institute and a recipient of the 2000 Nobel Prize in Physiology or Medicine, is the author of “The Age of Insight: The Quest to Understand the Unconscious in Art, Mind and Brain, From Vienna 1900 to the Present.””

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April 15, 2013 · 2:41 pm