Terrifying Electric Shock Treatment

Frankenstein op saved me from suicide!!!

That's the front page headline on today's News of The World, a popular British Sunday tabloid which would probably be the worst newspaper in most other countries, but which by British standards is only slightly below average.

TV actress Bev Callard tells how she suffered an episode of severe clinical depression, and was given ECT or as the News put it "terrifying electric shock treatment" which "plunged her into a scene of horror beyond anything TV scriptwriters could have imagined." Although it's never made clear what the horror was: according to Callard her twelve sessions of shock therapy was the only thing which worked to help lift her out of her suicidal state and, as the headline says, it may even have saved her life.

She was worried about the possible side effects, including memory problems, and describes experiencing difficulty learning her lines initially, but she says, she always managed to do so successfully.

The print version includes some sensible comments from a doctor who points out that ECT is effective as a last resort in cases of depression that don't respond to drugs alone. He also comments that "Bev is so brave to talk about this".

She is, but she shouldn't have to be: talking about depression shouldn't be a matter of being brave, any more than talking about any other illness. The reason it takes courage is that unlike with other diseases, admitting to suffering from a mental illness is liable to land you on the front page of the papers.

Social Learning in Antisocial Animals

In an unusual study with potentially revolutionary implications, Austrian biologists Wilkinson et al show evidence of Social learning in a non-social reptile.

Social learning means learning to do something by observing others doing it, rather than by doing it yourself. Many sociable animal species, including mammals, birds and even insects, have shown the ability to learn by observing others doing things. It's often seen as a distinct form of cognition, separate to "normal" learning, which evolved to facilitate group living. It's one of the things that everyone's favorite brain cells, mirror neurons, have been invoked to explain.

But if observational learning is a specifically social adaptation, then non-social animals would be predicted to lack this ability. One distinctly unfriendly species is the South American red-footed tortoise (Geochelone carbonaria). In the wild, they hatch from their eggs alone, and get no parental care; they live most of their lives without interacting with others.

Wilkinson et al found that red-footed tortoises can, nevertheless, learn by observation. They took four tortoises and got them to watch another "demonstrator" tortoise completing a difficult task: walking around an obstacle to get to some food (it's hard if you're a tortoise).

The observing animals all learned to do the task. In most cases, they walked around the obstacle to the right, which is what the demonstrators did, but sometimes they went left, showing that they were not simply copying the movements of the demonstrators. The wood chips on the floor of the floor of the cage were mixed up after each trial, to rule out the possibility that the tortoises were just following the smell of the demonstrator. None of four control tortoises, who got no demonstrations, managed to figure it out on their own.

The authors conclude that

The dominant hypothesis in this field claims that social learning evolved as a result of social living and therefore predicts that the tortoises would have difficulty with this task. They did not. The findings suggest that, in this case, social learning may be the result of a general ability to learn. Although the brain mechanisms that underlie the tortoises’ ability to learn socially remain unclear, it seems most likely that it is the product of a general learning mechanism that allows the tortoises to learn, through associative processes, to use the behaviour of another animal just as they would learn to use any cue in the environment.

This is a nice experiment, and the result is important: the idea that social learning is somehow evolutionarily and neurally "special" underlies a lot of modern social neuroscience. However, I'm not convinced that these tortoises can be accurately described as "non-social". Even the most anti-social species have to socialize in order to mate: no animal is an island. According to Wikipedia the red-footed tortoise has some quite elaborate (and hilarious) mating behaviours...

male to male combat is important in inducing breeding in redfoots. Male to male combat begins with a round of head bobbing from each male involved, and then proceeds to a wresting match where the males attempt to turn one another over. The succeeding male (usually the largest male) then attempts to mate with the females. The ritualistic head movements displayed by male red-foots are thought to be a method of species recognition. Other tortoise species have different challenging head movements....The unique body shape of the male redfooted tortoise facilitates the mating process by allowing him to maintain his balance during copulation while the female walks around, seemingly attempting to dislodge the male by walking under low-hanging vegetation.

Wilkinson, A., Kuenstner, K., Mueller, J., & Huber, L. (2010). Social learning in a non-social reptile (Geochelone carbonaria) Biology Letters DOI: 10.1098/rsbl.2010.0092

Why Do We Dream?

A few months ago, I asked Why Do We Sleep?

That post was about sleep researcher Jerry Siegel, who argues that sleep evolved as a state of "adaptive inactivity". According to this idea, animals sleep because otherwise we'd always be active, and constant activity is a waste of energy. Sleeping for a proportion of the time conserves calories, and also keeps us safe from nocturnal predators etc.

Siegel's theory in what we might call minimalist. That's in contrast to other hypotheses which claim that sleep serves some kind of vital restorative biological function, or that it's important for memory formation, or whatever. It's a hotly debated topic.

But Siegel wasn't the first sleep minimalist. J. Allan Hobson and Robert McCarley created a storm in 1977 with The Brain As A Dream State Generator; I read somewhere that it provoked more letters to the Editor in the American Journal of Psychiatry than any other paper in that journal.

Hobson and McCarley's article was so controversial because they argued that dreams are essentially side-effects of brain activation. This was a direct attack on the Freudian view that we dream as a result of our subconscious desires, and that dreams have hidden meanings. Freudian psychoanalysis was incredibly influential in American psychiatry in the 1970s.

Freud believed that dreams exist to fulfil our fantasies, often though not always sexual ones. We dream about what we'd like to do - except we don't dream about it directly, because we find much of our desires shameful, so our minds disguise the wishes behind layers of metaphor etc. "Steep inclines, ladders and stairs, and going up or down them, are symbolic representations of the sexual act..." Interpreting the symbolism of dreams can therefore shed light on the depths of the mind.

Hobson and McCarley argued that during REM sleep, our brains are active in a similar way to when we are awake; many of the systems responsible for alertness are switched on, unlike during deep, dreamless, non-REM sleep. But of course during REM there is no sensory input (our eyes are closed), and also, we are paralysed: an inhibitory pathway blocks the spinal cord, preventing us from moving, except for our eyes - hence why it's Rapid Eye Movement sleep.

Dreams are simply a result of the "awake-like" forebrain - the "higher" perceptual, cognitive and emotional areas - trying to make sense of the input that it's receiving as a result of waves of activation arising from the brainstem. A dream is the forebrain's "best guess" at making a meaningful story out of the assortment of sensations (mostly visual) and concepts activated by these periodic waves. There's no attempt to disguise the shameful parts; the bizarreness of dreams simply reflects the fact that the input is pretty much random.

Hobson and McCarley proposed a complex physiological model in which the activation is driven by the giant cells of the pontine tegmentum. These cells fire in bursts according to a genetically hard-wired rhythm of excitation and inhibition.

The details of this model are rather less important than the fact that it reduces dreaming to a neurological side effect. This doesn't mean that the REM state has no function; maybe it does, but whatever it is, the subjective experience of dreams serves no purpose.

A lot has changed since 1977, but Hobson seems to have stuck by the basic tenets of this theory. A good recent review came out in Nature Neuroscience last year, REM sleep and dreaming. In this paper Hobson proposes that the function of REM sleep is to act as a kind of training system for the developing brain.

The internally-generated signals that arise from the brainstem (now called PGO waves) during REM help the forebrain to learn how to process information. This explains why we spend more time in REM early in life; newborns have much more REM than adults; in the womb, we are in REM almost all the time. However, these are not dreams per se because children don't start reporting experiencing dreams until about the age of 5.

Protoconscious REM sleep could therefore provide a virtual world model, complete with an emergent imaginary agent (the protoself) that moves (via fixed action patterns) through a fictive space (the internally engendered environment) and experiences strong emotion as it does so.

This is a fascinating hypothesis, although very difficult to test, and it begs the question of how useful "training" based on random, meaningless input is.

While Hobson's theory is minimalist in that it reduces dreams, at any rate in adulthood, to the status of a by-product, it doesn't leave them uninteresting. Freudian dream re-interpretation is probably ruled out ("That train represents your penis and that cat was your mother", etc.), but if dreams are our brains processing random noise, then they still provide an insight into how our brains process information. Dreams are our brains working away on their own, with the real world temporarily removed.

Of course most dreams are not going to give up life-changing insights. A few months back I had a dream which was essentially a scene-for-scene replay of the horror movie Cloverfield. It was a good dream, scarier than the movie itself, because I didn't know it was a movie. But I think all it tells me is that I was paying attention when I watched Cloverfield.

On the other hand, I have had several dreams that have made me realize important things about myself and my situation at the time. By paying attention to your dreams, you can work out how you really think, and feel, about things, what your preconceptions and preoccupations are. Sometimes.

Hobson JA, & McCarley RW (1977). The brain as a dream state generator: an activation-synthesis hypothesis of the dream process. The American journal of psychiatry, 134 (12), 1335-48 PMID: 21570

Hobson, J. (2009). REM sleep and dreaming: towards a theory of protoconsciousness Nature Reviews Neuroscience, 10 (11), 803-813 DOI: 10.1038/nrn2716

Attitudes to Mental Illness

Ever wondered what the British public think about mental illness?

Well, the British government has, and the results of the 2010 Attitudes to Mental Illness Survey are out. I'm never sure how much faith to put in such data because what people are willing to say they think, and what they really feel, are not the same.

So while it's encouraging that only 20% of people say they agree with the statement that "Anyone with a history of mental illness should be excluded from taking public office", it would be naive to think that the other 80% would really be equally likely to vote for someone with a psychiatric history when push came to shove. We've moved on since McGovern, but maybe not all that much.

Worse, a lot of the questions are dubious. One asks whether you agree that "Mental hospitals are an outdated means of treating people with mental illness", the 'right' answer, that gets counted as a nice positive attitude, being to agree. I disagree, not least because inpatient treatment for depression helped my grandfather hugely when he was a young man. If that means I have a bad attitude to the mentally ill, so be it. I don't think it does.

*

Another item asks "What proportion of people in the UK do you think might have a mental health problem at some point in their lives?" The approved answer, as Neuroskeptic readers may have guessed, was 1 in 4. But only 16% of the British public picked that option from the multiple-choice quiz. Most thought it was much lower:

How silly of them...or maybe not. There has in fact never been a study of the lifetime prevalence of mental illness in Britain. Studies in other English-speaking countries, such as the US and New Zealand, have repeatedly shown lifetime prevalence rates of 50%, or higher, for mental illness according to DSM-IV criteria. But these figures and these criteria have been credibly accused of overstating the proportion of people with a genuine psychiatric illness, maybe greatly so. There's a lot to say on both sides of this debate, but the point is that the question is open. Expecting the public to know the answer, when the experts don't, is rather unfair.

However, interestingly enough, this very survey asked whether respondents had ever suffered mental illness themselves. How many had? There's a 4 in it, but it's not 1 in 4, it's 4%.

I strongly suspect this is an underestimate. Some people are ill and don't know it or don't admit it. People with mental illness might be less likely to participate in the study. There'll be people will get ill at some point in their lives after they fill in the survey. And the format of the question was a bit odd (see page 64 and see what you make of it). But still, this is another point of data for the great prevalence debate.

The proportion of people with mental illness ultimately depends on how you define "mental illness". I don't think anyone has an entirely satisfactory definition, so any attempt to pin down the lifetime prevalence is problematic until we sort that out, but if I had to put it a number on it, it would be about 1 in 10 in Western countries.

I'm no expert on this topic so take this with a big pinch of salt. Still, I'd find it very hard to accept a figure much lower than this, from personal experience if nothing else. I'd be open to the idea that the true figure is much higher, but this would mean that tens of millions of British people are going around getting mentally ill and never receiving treatment, and it would take some very strong evidence to convince me of that.

On Faithless Preachers

Everyone's favorite atheist neuro-philosopher Daniel Dennett and colleague Linda LaScola present a paper on Preachers who are not Believers - Christian clergy who stopped believing in God, in some cases many years ago, but remain in their jobs.

It's well worth a read; it's free to access, and very well written. Dennett and LaScola interviewed five (anonymous) preachers, from a variety of American Protestant denominations. All have been atheists, or something very close to it, for some time. And all are, as you'd expect, "in the closet" about their lack of belief, although some have admitted it to selected colleagues and confidants.

Two things struck me about the five men's stories. First, they're all reasonably content with their situation. Partially this must reflect the selection criteria: this was designed as a study of faithless preachers, not ex-preachers. But it's also a testament to the fact that people can accommodate themselves to fulfill even the most contradictory of roles.

Most of these men would find it very difficult to quit, because their whole career, salary, friends, and in a couple of cases marriage, are bound up in the church. But most have come see their position as morally acceptable because they see Christianity as a force for good, even if the doctrines are wrong:

My first few years of doing this were wracked with, ‘God, should I be doing this? Is this ---? Am I being ---? Am I posing? Am I being less than authentic; less than honest?’ … And, I really wrestled with it and to some degree still. But not nearly as much. I will be the first to admit that I see Christianity as a means to an end, not as an end unto itself. And the end is very basically, a kind of liberal, democratic values.

Another says

I will say one strong aspect of any religion, I’d guess, that I’ve been in is the community life. You have great friends who are close; you can depend on them. When there’s hard times, financially, emotionally, whatever, you’ve got a support group.

The second thing that interested me was the idea that the faithless priest situation is a lot less unusual than you'd think. A recurring theme in the stories of these five is that their doubts started in seminary, when they were first introduced to archaeology and Biblical criticism, the historical and linguistic study of the Bible.

Now, it's quite difficult to study these things and remain a believer in the idea that the Bible is anything like the inerrant word of God. But most American churches, and not just the very liberal ones, require their clergy to take Masters level courses in them at seminary.

Rank and file church members don't have to do this and most don't, leaving them more free to hold stronger or literalist views. So the clergy are, paradoxically, often the ones with the most liberal i.e. least traditional interpretation of the things they preach:

A gulf opened up between what one says from the pulpit and what one has been taught in seminary. This gulf is well-known in religious circles.... Every Christian minister, not just those in our little study, has to confront this awkwardness, and no doubt there are many more ways of responding to it than our small sample illustrates. How widespread is this phenomenon? When we asked one of the other pastors we talked with initially if he thought clergy with his views were rare in the church, he responded “Oh, you can’t go through seminary and come out believing in God!” Surely an overstatement, but a telling one.

As someone who hasn't sat down in a church for a decade I don't really know how true this is. Maybe Dennett, LaScola and these five men are exaggerating the size of the "gulf" - but it sounds plausible. If so it suggests that these atheists are just the extreme end of a spectrum of more or less doubtful clergy.