By Allen Frances*

When the third edition of psychiatry’s manual of mental illness, the DSM-III, was published 30 years ago, there was great optimism it would soon be the willing victim of its own success, achieving a kind of planned obsolescence. Surely, the combining of a reasonably reliable system of descriptive diagnosis with the revolutionary new tools of neuroscience would quickly yield a deep and broad understanding of psychopathology. And just as surely this would translate into standardized biological tests that would replace the cookbook listing of subjective symptoms and subjectively evaluated behaviors that comprised the DSM-III criteria sets.

Blood tests cannot yet reveal mental illness. Courtesy of Bobjgalindo via Wikimedia Commons

Sadly, progress has been much slower than anyone expected, with many exciting findings turning out to be no more than dead ends. The vast research funding has indeed provided a basic science revolution, but so far its discoveries have had no impact whatever on clinical diagnosis. Even the most promising candidates—biological tests for the accurate diagnosis of dementia—are several years away. And, for the rest of psychiatry, there is no immediate prospect that our rich basic science knowledge base and powerful investigative tools will contribute to clinical practice any time soon.

We have learned a great deal in the past 30 years, but perhaps the most important lesson is that the brain is ineluctably complex and reveals its secrets only slowly and in very small packages. There has been no low hanging fruit. The expectation that there would be simple gene or neurotransmitter or circuitry explanations for schizophrenia or bipolar or obsessive-compulsive disorder has turned out to be naïve and illusory. The problem of teasing out heterogeneous clinical presentations in psychiatry is compounded by the fact that they also have heterogeneous underlying mechanisms. There will not be one pathway to schizophrenia; there may be dozens, perhaps hundreds. Biological tests that appear to be associated with schizophrenia are never useful for making the diagnosis because they always show more variability within the category than between categories. And seemingly intriguing findings usually don’t replicate.

That progress in psychiatric diagnosis is slow should perhaps occasion no surprise. In every branch of medicine, the translational step between basic to clinical science has been difficult. For example, the discovery of genetic correlates for breast cancer has been much more of a slog than originally anticipated, with each advance explaining only a very small portion of the variance. And psychiatry faces the most awesome of translational leaps: the brain is ever so much more complicated than any other body organ, wired with complex redundancies that will defy simple and sweeping explanations of how it generates symptoms and behaviors. For the foreseeable future, except for dementia, we must reconcile ourselves to the staying power of purely clinical diagnosis in psychiatry.

Fortunately, despite all its obvious limitations, the DSM system does the necessary everyday job of fostering clinical communication and providing the foundation for treatment planning and clinical research. Granted that psychiatric diagnosis and treatment are purely empirical rather than based on understanding of mechanism, but this is also true of almost all available medical treatments. The good news is that descriptive diagnosis, when done well, usually leads to psychiatric treatment that is effective and efficient.

Courtesy of Alaina Abplanalp Photography via Flickr.

But we must also not minimize the grave practical problems and limitations associated with not having biological tests to identify psychiatric disorders. Most troubling is the fact that the overwhelming majority of prescriptions for psychotropic medicines are written by primary care physicians who often have little training in psychiatry; little time to perform an adequate diagnostic evaluation; a tendency to depend on tests rather than talking to patients; and too great a susceptibility to quick trigger diagnosis and poorly chosen pill solutions (fostered by aggressive and misleading drug company marketing). The lack of precise and easily available biological tests in psychiatry permits much loose diagnosing and cowboy prescribing.

And beyond this, a diagnostic system without objective tests is vulnerable to arbitrary changes that can do more harm than good. The furor over the draft of the upcoming edition of psychiatry’s diagnostic bible, the DSM-5, is caused by its radical expansion of the boundaries of psychiatry that will increase by tens of millions the number of people presumed to be suffering from mental disorders. This would be done based on fallible committee decisions, unsupported by solid scientific understanding. Seemingly small and weakly supported changes in the definition of mental disorders can have huge real world impacts, often with extremely harmful unintended consequences.

The safest and most realistic course is to recognize and respect the limitations of descriptive diagnosis. DSM-5 got off on the wrong track because it held the completely unrealizable ambition to provide a paradigm shift. Striving to do the undoable, the framers of the DSM-5 have encouraged recklessly innovative proposals well before their scientific foundation has been prepared.

In clinical psychiatry, as in the rest of medicine, modesty is the best policy and “Do no harm” is the most important injunction. Descriptive psychiatry can serve us well if we don’t stretch it beyond its realistic limits.

*Allen Frances, an emeritus professor of psychiatry at Duke University, chaired the task force for the DSM-IV.

Yesterday: I reflected on why mixed depression/anxiety could be real, despite concerns that everyone might have it.

Depression and anxiety are like a pair of warring siblings. Both are disruptive and trying. They don’t want each other’s company, but are stuck together by virtue of the same parentage. Depression, after all, is often a product of rumination, the grating mental do-overs of ugly past events, usually with no solution in sight. Anxiety is the brainchild of too much forecasting of doom. Both seem to emerge from the sort of person who is stuck so securely in his mental time machine that he has no idea the roses are even there. Forget about stopping to smell them.

Courtesy of Luiz Fernando/Sonia Maria via Flickr.

Psychologists tend to link the depressed and the anxious by personality. Both groups share the trait of “negative emotionality,” the propensity to harbor bad feelings such as anger and anxiety. (In contrast to those with depression, though, those with textbook anxiety spike their dourness with a dollop of wellbeing, energy, closeness to others, and the like.) And of course, the two temperaments feed each other. If your future is so terrible, what’s not to be depressed about? Conversely, if you rake over the past enough, you’ll undoubtedly unearth a goof that is sure to destroy your prospects. For all these reasons, not to mention shared genetic risk factors, lots of people who are depressed are also anxious—and vice versa.

Yet these practically conjoined twins of psychological distress have long been separated in psychiatrists’ diagnostic bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM), currently in its fourth incarnation. A depressed person is someone who feels overwhelmingly sad and worthless, the DSM says, and who can no longer enjoy activities they used to like. They may also have thoughts of death or suicide. Generalized anxiety disorder (GAD)—to pick one of the many certified forms of fretting—involves excessive, and at least somewhat debilitating, anxiety and worry about more than one part of your life that you experience on most days for six months or more.

But what about all those ruminators who can’t help forecasting future doom—and yet don’t qualify as officially depressed or pathologically anxious? Currently, as of the DSM-IV, these folks remain in a kind of diagnostic limbo. Their pending label, “mixed anxiety-depressive disorder” is in the book’s appendix, a place for proposed ailments in need of further study. Accumulating data suggest that these people are numerous. In the United Kingdom, national surveys suggest that 8.8 percent of the population would qualify for mixed anxiety and depression as defined by the World Health Organization’s compendium of diseases—the International Statistical Classification of Diseases and Related Health Problems (ICD-10). By comparison, fewer people—only 7.7 percent—satisfied diagnostic criteria for major depression, GAD or a combination.

Many of the 8.8 percent are more than moderately miserable. Studies show that the impact of this cocktail of sadness and worry on quality of life is similar to that for anxiety disorders: 12 percent of sufferers, for example, have reported suicide attempts and the disorder accounted for 20 percent of all disability days in the United Kingdom. So these folks do seem to need help.

Woody Allen escapes a "gorilla," in the 1969 movie "Take the Money and Run." Courtesy of John McNab via Flickr.

As a result of such findings, the framers of the DSM-5 originally proposed to move “mixed anxiety/depression” (with its slightly altered name) up to an official diagnosis, meaning insurance would reimburse you for treatment (which, drug-wise, is likely to be Prozac and its ilk). The proposed criteria for the new disorder included having three or four of the symptoms of major depression along with anxious distress. The latter required having two or more of the following issues: feeling nervous & anxious, inability to control worrying, having difficulty relaxing, being so restless it is hard to keep still, and fearing that something awful might happen. These problems must have plagued you for at least two weeks and must have caused “marked distress or significant impairment.” “Mood and anxiety disorders blur together,” says Scott Lilienfeld, a psychologist at Emory University. “This was an admission that they can’t be separated in any clean, neat way.”

And in this respect, the mixed disorder makes a great deal of sense. And yet as of last Thursday, the DSM-5’s framers seemed to take it all back. They reversed their initial push to promote this ailment to the body of the diagnostic bible. The criteria for mixed anxiety/depression were a bit vague and elastic, critics contended. The naysayers fretted that scads of mild chronic worriers—the Woody Allens of the world—would fall into it, their hypochondria ironically legitimized. The proliferation of false positives is a problem with the new DSM in general, some argue. “They are going to be diagnosing almost everybody,” Lilienfeld quips. Taking back the proposed mixed anxiety/depression diagnosis was one attempt to cut back on the number of newly mentally ill.

Of course, these critics could have been among the masses eligible for the proposed-now-nixed label, worriers that they are. But let’s give them some credit. Maybe they think they’re fine. And maybe they are.

Yesterday: Edward Shorter, a historian of psychiatry at the University of Toronto, argued that the principal diagnoses of the DSM—depression, schizophrenia and bipolar disorder—are artifacts and should essentially be discarded.

Tomorrow: Allen Frances, the chief framer of the DSM-IV, tells us why we lack biological tests for mental illness and how that deficiency hurts diagnosis.

Part 3 in a series

One might liken the latest draft of psychiatry’s new diagnostic manual, the DSM-5, to a bowl of spaghetti. Hanging over the side are the marginal diagnoses of psychiatry, such as attention deficit hyperactivity disorder and autism, important for certain subpopulations but not central to the discipline.

At the center of the spaghetti bowl are the diagnoses at the heart of psychiatry: major depression, schizophrenia, bipolar disorder.

Courtesy of Shot_by_Cam via Wikimedia Commons.

There has been enormous commentary in the media and in professional journals about proposed changes in the strands hanging over the side, such as lumping different forms of autism together in an autism spectrum diagnosis. (For more on these changes, see “Psychiatry’s ‘Bible’ Gets an Overhaul,” by Ferris Jabr, Scientific American Mind, May/June 2012.) Indeed, the number of dangling strands has increased so greatly that some observers, such as Allen Frances, the editor of the current manual, the DSM-IV, have very correctly commented on the increasing medicalization of areas of life previously considered normal: the draft DSM-5 does seem to be expanding the scope of what is considered a psychiatric disorder.

But that is not the main problem.

Few observers have called attention to difficulties at the center of the spaghetti bowl. The main difficulty is that the principal diagnoses of psychiatry are artifacts. Let’s consider them one by one.

Major depression

Major depression was created in 1980 by DSM-III editor Robert Spitzer as an effort to bridge disagreements between psychoanalysts, when they ruled the roost in the American Psychiatric Association, and the rest of the profession, which was becoming increasingly oriented towards biology. As a political construct, major depression included the two forms of depressive illness that previously had been considered as different from each other as measles and tuberculosis: melancholic illness and nonmelancholia. Melancholia, a grave form of depression involving slowed thought and movement, a complete joylessness in life and lack of hope for the future, had always been considered a separate illness. By 1980 the term melancholia had gone out of style and had been replaced by endogenous depression.

Courtesy of Hendrike via Wikimedia Commons.

The other form of depressive illness that psychiatry had always recognized as separate was an ill-defined aggregation of symptoms of mood, anxiety, fatigue, somatic complaints – and a tendency to obsess about it all – that had been called on occasion neurasthenia, neurotic depression, reactive depression and other terms indicating real illness but not melancholic disease.

So the first artifact the DSM series created was lumping these two forms of depressive illness together. In fact, they are so disparate that the depression term itself should be abandoned. It is now shopworn with use and has approximately the same scientific value as other discarded psychiatric diagnoses such as hysteria and madness.

In 1996 Gordon Parker, professor of psychiatry at the University of New South Wales, proposed melancholia and nonmelancholia as the main mood diagnoses, and his proposals have gained much traction, though not, alas among the disease designers of DSM-5.

Schizophrenia

The second artifact at the heart of DSM is schizophrenia. A term coined in 1908 by Zurich psychiatry professor Eugen Bleuler, schizophrenia is nothing more than a synonym for chronic psychosis. (The Massachusetts General Hospital’s psychiatric Manual, for example, has replaced the once-obligatory chapter on schizophrenia with one on “Psychotic Patients.”) There is no natural disease entity called schizophrenia: it has no typical, or pathognomonic, symptom, no predictable response to treatment, no reliable prognosis. Chronic psychosis is really a common final pathway for several disparate forms of psychotic illness that should not be lumped together.

Courtesy of mRio via Flickr.

One such form, baptized hebephrenia in 1871 by German psychiatrist Ewald Hecker, is really core schizophrenia, meaning chronic psychosis that begins in adolescence with social withdrawal, proceeds to a psychotic break, and then involves restitution to a relatively low level of function (but neither does it lead to a vegetative existence on the terrible “back wards”). Hebephrenics can hold undemanding jobs as porters or laborers; they can marry. Their illness trajectories may, or may not, include later episodes of psychosis. But they never return to their prepsychotic levels of functioning.  This enfeeblement is very different from other forms of chronic psychosis, and lumping them all together commits the same error as lumping together melancholia and nonmelancholia.

Bipolar disorder

The third fatal flaw at the center of the bowl of spaghetti is bipolar disorder, a diagnosis that assumes that the depression of unipolar disorder (otherwise known as major depression) is different from bipolar depression. But they’re really the same. The response of bipolar and unipolar depression to electroconvulsive therapy, for example, is identical. In fact, it makes little sense to classify depressions by polarity. There may be a difference, in the sense that bipolar depression is often melancholic, and major depression is highly diverse, but there are no natural disease entities called “bipolar depression” and “unipolar depression.” And the entire concept of bipolar disorder has been a gift to the pharmaceutical industry, which has been able to re-position anticonvulsant drugs to counter the terrible bipolar menace. Being considered “bipolar” has not, however, been a gift to patients with mood disorders, who end up being diagnosed and treated inappropriately.

Does it really matter which diagnoses get into this wretched manual, stuffed as it is with artifacts of every manner?

Yes, it does. It matters, for example, to drug discovery and development. There has been almost no progress in psychopharmacology for the last thirty years: among drugs for “depression,” none has been shown superior to the first of the tricyclic antidepressant medications, imipramine, that reached the American market as Tofranil in 1959. Among antipsychotics (with the possible exception of clozapine, an effective but dangerous agent), none is superior to the first antipsychotic ever launched, chlorpromazine, marketed as Thorazine in the United States in 1955.

Why this lack of progress? You can’t develop drugs for diseases that don’t exist. And in U. S. psychiatry today the principal diagnoses are comparable to a handful of smoke. Will DSM-5 fix this? Don’t count on it.

*Edward Shorter is an historian of psychiatry at the University of Toronto

Tomorrow: I reflect on why mixed depression/anxiety could be real, despite concerns that almost everyone might have it.

Yesterday: Ferris Jabr explained why science has so far played only a bit part in the creation of the new DSM.

Further Reading

Melancholia: A Disorder of Movement and Mood. Gordon Parker and Dusan Hadzi-Pavlovic, Cambridge University Press, 1996.

Before Prozac: The Troubled History of Mood Disorders in Psychiatry. Edward Shorter, Oxford University Press, 2009.

Opening Pandora’s Box: The 19 Worst Suggestions for DSM-5. Allen Frances Psychiatric Times, Feb. 11, 2010.

Endocrine Psychiatry: Solving the Riddle of Melancholia. Edward Shorter and Max Fink, Oxford University Press, 2010.

The Failure of the Schizophrenia Concept and the Argument for Its Replacement By Hebephrenia: applying the medical model for disease recognition (Editorial). Michael Alan Taylor et al. Acta psychiatrica scandinavica 122, pages 173–183, 2010.

Part 2 of a series

In the offices of psychiatrists and psychologists across the country you can find a rather hefty tome called the Diagnostic and Statistical Manual for Mental Disorders (DSM).

The current edition of the DSM, the DSM-IV, is something like a field guide to mental disorders: the book pairs each illness with a checklist of symptoms, just as a naturalist’s guide describes the distinctive physical features of different birds. These lists of symptoms, known as diagnostic criteria, help psychiatrists choose a disorder that most closely matches what they observe in their patients. Every few decades, the American Psychiatric Association (APA) revises the diagnostic criteria and publishes a brand new version of the DSM. The idea is to make the criteria more accurate, drawing on what psychologists and psychiatrists have learned about mental illness since the manual’s last update.

The fat volume on top is still skinny on the science. Courtesy of Ferris Jabr.

In May 2013, the APA plans to publish the fifth and newest edition of the DSM, which it has been preparing for more than 11 years. On its DSM-5 Development website, the APA states that the motivation for the ongoing revisions was an agreement to “expand the scientific basis for psychiatric diagnosis and classification.” The website further states that “over the past two decades, there has been a wealth of new information in neurology, genetics and the behavioral sciences that dramatically expands our understanding of mental illness.”

In other words, the APA intended to make the DSM-5 the most scientific edition of its reference guide yet, which would be a real boon for a book that has been routinely lambasted as fiction borne out of convenience, rather than a solid clinical text grounded in research. Now, only one year away from the planned publication of the DSM-5, most psychiatrists have accepted that the APA’s initial optimism about informing revisions with cutting edge science is well intentioned, but premature. Most of the proposed revisions to current DSM criteria—many of which are genuine improvements—are based not on insights from genetics and neuroscience, but rather on clinical experience, prevalence studies and plain old common sense. Indeed, many of these changes could have been made years ago. (For more on these changes, see “Psychiatry’s ‘Bible’ Gets an Overhaul,” by Ferris Jabr, Scientific American Mind, May/June 2012.)

Cutting and Collapsing Categories

Consider, for example, that the DSM-IV organizes schizophrenia into six types, all of which the APA proposes eliminating from the DSM-5. Why? Because these archaic subcategories were never grounded in empirical research in the first place; they were just what sounded good to the DSM authors of yore. In truth, these ostensible types of schizophrenia probably do not exist. Similarly, the APA is nixing three of the 10 current personality disorders, essentially acknowledging that these were never legitimate illnesses in the first place. So many people fit the criteria for more than one personality disorder simultaneously that 10 varieties become superfluous.

Likewise, the DSM-5 collapses four of the five current pervasive developmental disorders—including autistic disorder and Asperger’s—into a single category called autism spectrum disorders, because there is so much overlap in their respective criteria. None of these revisions are founded on recent revelations from genetics and neuroimaging research. Study after study has failed to discover a set of genes or unusual brain structures that reliably identifies major mental disorders. Rather, these are changes that many psychiatrists have been advocating for the past two decades based on their everyday clinical experience, studies of illness prevalence and the sense that some of the current criteria do not make sense. Despite awareness of these flaws, the APA did not get around to updating the DSM until now, the first substantial revision in 30 years.

One exception to the APA’s disappointed ambitions to base the ongoing revisions on neuroscience are the proposed changes to addictions. Scientists understand quite a bit about how the addicted brain differs from a typical brain. The APA has proposed adding gambling disorder to the DSM-5, in part because reward circuits in the brains of gambling addicts light up in the same way as those in alcoholics and drug addicts. Still, some researchers worry that the DSM will end up sanctioning addictions to everything—gambling, sex, the Internet—shifting focus to what people are addicted to from why addictions form in the first place.

Flaws in the Process

Easing the pain of mental illness requires labeling it. Courtesy of breahn via Flickr.

All the proposed revisions to the DSM-5 emerge from the task force: 27 scientists affiliated with the APA who sort through all the relevant research literature. In the past, many psychiatrists have criticized the APA for not creating an independent review committee to examine this literature—a group of scientists who are not obligated to appease the APA.

In January of this year, David Elkins, president of the Society for Humanistic Psychology, authored an open letter to the APA calling for such independent review: “As you know, it is common practice for scientists and scholars to submit their work to others for independent review…Will you submit the controversial proposals in DSM-5 to an independent group of scientists and scholars with no ties to the DSM-5 Task Force or the American Psychiatric Association for an independent, external review?” [Emphasis theirs]

In a letter of its own, the APA responded: “There is, in fact, no outside organization that has the capacity to replicate the range of expertise that DSM-5 has assembled over the past decade to review diagnostic criteria.”

Recently, the APA has mentioned here and there that it has in fact created such a “scientific review committee,” separate from the task force, but you will not find any satisfactory description of it or its responsibilities on the DSM-5 Development website. Darrel Regier, vice-chair of the Task Force, explained that the committee includes about six scientists selected by the board of trustees, because “there is no way you can have truly independent review,” and declined to say more. Allen Frances, chair of the DSM-IV Task Force and the most outspoken critic of the DSM-5, says that the APA only created this group at the last minute in response to criticisms. “The scientific review committee is not even transparent,” Frances says. “They report confidentially to APA.”

Frances and other critics have pointed to a related flaw in the ongoing revisions. Every time the APA revises the DSM, it conducts “field trials” of new diagnostic criteria. These are dry runs of the proposed revisions in clinical settings that test their reliability—that is, whether two different psychiatrists using the new criteria reach the same conclusion about a given patient.

Since 2010, the APA has been conducting field trials for the proposed DSM-5 diagnostic criteria. (For more on the results of the field trials, click here.) Critics contend—and Regier confirms—that the trials fail to explicitly compare the criteria suggested for the DSM-5 to that in the DSM-IV, except in the case of post-traumatic stress disorder. That is like a taste test in which the judges decide that a new diet soda is better than its non-diet predecessor because everyone approved of the flavor, even though the judges never bothered to directly compare the diet and regular versions. Although in past revisions the APA has done such a comparison, Regier says that this time doing so would double the size of the survey, making it too costly and time-consuming to conduct. “You just don’t do science that way,” Frances says.

*Ferris Jabr is an Associate Editor at Scientific American

Tomorrow: Edward Shorter, a historian of psychiatry at the University of Toronto, argues that the principal diagnoses of the DSM—depression, schizophrenia and bipolar disorder—are artifacts and should essentially be discarded.

With each iteration of this diagnostic bible, our definition of mental illness changes. Courtesy of Ferris Jabr.

A select clique of psychiatrists has been at work for years on the latest version of the official manual of mental illness, the Diagnostic and Statistical Manual of Mental Disorders (DSM). In 2000, they came out with a revised fourth edition of this compendium of psychiatric problems, the DSM-IV. Now, they are toiling away on DSM-5 (dispensing, for one, with those pesky Roman numerals). In the May/June issue of Scientific American Mind, Scientific American’s Ferris Jabr documents some of the biggest proposed changes in this edition-in-progress, slated for publication in 2013 (see “Psychiatry’s ‘Bible’ Gets an Overhaul”). Already, the DSM’s framers have backtracked on some of their original proposals, but most of the elements behind this significant reworking of the DSM remain in effect.

Many, if not most, of these features remain highly controversial. So in conjunction with the publication of the feature article in Mind, Ferris and I have written and commissioned a series of four blogs discussing some of the most hotly debated features of this new DSM. The first, penned by Ferris, will appear tomorrow, followed by one blog each day published here, on Streams of Consciousness, for the remainder of the week. Here’s a quick rundown of what to expect.

• Tuesday: Ferris Jabr explains why science has so far played only a bit part in the creation of the new DSM.
• Wednesday: Edward Shorter, a historian of psychiatry at the University of Toronto, argues that the principal diagnoses of the DSM—depression, schizophrenia and bipolar disorder—are artifacts and should essentially be discarded.
• Thursday: I reflect on why mixed depression/anxiety could be real, despite concerns that everyone might have it.
• Friday: Allen Frances, the chief framer of the DSM-IV, tells us why we lack biological tests for mental illness and how that deficiency hurts diagnosis.

The process of defining mental disorders is a serious undertaking. People with true psychiatric problems need help, often urgently. But this DSM business also makes me think about thinking and feeling in new ways and to wonder how we draw the line between normal and abnormal mental functioning. So, over the course of this week, let’s contemplate what it means to be sane. And hey, if you figure it out, let the committees—and me—know.

Belonging to a group is good for your health. Courtesy of joncandy via Flickr.

One advantage of belonging to a cohesive society in which people help each other is that the group is often better equipped than a set of individuals to deal with threats from the outside. People intuitively realize there is strength in numbers, and take comfort in the company of others, especially in times of anxiety or need. Or, as Patrick Henry famously said, “United we stand, divided we fall.” (Ironically, Henry collapsed and fell into the arms of bystanders shortly after uttering the phrase.)

It’s all good and well that we can unite against an external foe, but what is perhaps more interesting is a result put forth by a slew of recent studies: people who are a part of a group are also far better equipped to conquer an internal foe—the threat of bad health.

To appreciate the impact of social connection on the state of your body, one need only consider what happens when it is abruptly cut off. Many languages have expressions such as “hurt feelings” that compare the pain of such social rejection to the pain of physical injury. We now know that those are more than just metaphors: there are two components to physical pain, an unpleasant emotional feeling, and a feeling of sensory distress, associated with different structures in the brain. Social pain is also associated with a particular brain structure, the anterior cingulate cortex—the same structure involved in the emotional component of physical pain. This connection between physical and social pain reflects the tie between social connection and the physiological processes of the body. (For more on this connection, see “The Pain of Exclusion,” by Kipling D. Williams, Scientific American Mind, January/February 2011.)

Both social and physical pain register in a brain region called the anterior cingulate cortex (yellow). Via Mysid Brodmann and was_a_bee/Wikimedia Commons. http://commons.wikimedia.org/wiki/File:Gray727_anterior_cingulate_cortex.png

In one of the recent studies on the health benefits of social relationships, published earlier this year, researchers provided evidence that social ties and increased contact with family and friends are associated with a lower risk of death in young women with breast cancer. Another presented a similar conclusion with respect to surviving heart surgery. What’s more, a 2010 meta-analysis of 148 other studies showed that social connection doesn’t just help us survive health problems: the lack of it causes them.

In a study whose results are typical of the 148 reviewed, researchers surveyed 4775 adults in Alameda County, near San Francisco. The subjects completed a survey asking about social ties such as marriage, contacts with extended family and friends, and group affiliation. Each individual’s answers were translated into a number on a “social network index,” with a high number meaning the person had many regular and close social contacts, and a low number representing relative social isolation. The researchers then tracked the health of their subjects over the next nine years.

Since the participants had varying backgrounds, the scientists employed mathematical techniques to isolate the effects of social connectivity from risk factors such as smoking and also from socioeconomic status and reported levels of life satisfaction. They found a striking result. Over the nine-year period, those who placed low on the social network index were twice as likely to die as individuals who had placed high on the index but had otherwise similar risk factors.

In the course of researching this issue for my new book, Subliminal: How Your Unconscious Mind Rules Your Behavior (Pantheon), just released today, I took a look at a web directory of support groups in Los Angeles. I found groups focused on abusive behavior, acne, adderall addiction, addiction, ADHD, adoption, agoraphobia, alcoholism, albinism, Alzheimer’s disease, ambien use, anemia, anger management, anorexia, anxiety, arthritis, Asperger’s syndrome, asthma, ativan addiction and autism—and that’s just the A’s. This abundance of support groups is a reflection of the human desire to associate with others, especially in time of need. The research shows that it’s a beneficial instinct.

Connecting with friends can lessen stress. Courtesy of Scarleth White via Flickr.

Of course, we’re not all alike. We all know people who need people—and those who appear to need them much less. Does social contact matter more to some people than to others? Genetics suggests it does. Recent research hints that the biochemical carrier of the benefits of social support is the neuropeptide oxytocin. It is well known that oxytocin plays an essential role in the regulation of social behavior and attachment, and has throughout mammalian evolution. When administered to volunteers, for example, oxytocin reduces stress responses and increases prosocial behavior. Your genes enter the picture because studies suggest that the gene for the oxytocin receptors in the brain comes in a “more social” and “less social” form. People having the latter form of the gene tend to be less empathetic and demonstrate more negative affect. A paper published last December indicates that the more social form of this gene, called OXTR, is required for a person to benefit from social support. For individuals with this version of the gene, social connection lowered stress levels, but enlisting a friend’s counsel did not calm those who lacked this form of the gene.

Until genetic testing becomes commonplace, most of us will just have to go with our instincts regarding the importance of having a social network. And until then, hermits will remain bad bets for life insurance underwriters.

*Leonard Mlodinow teaches at Caltech and is the best-selling author of Subliminal: How Your Unconscious Mind Rules Your Behavior (Pantheon, 2012). For an excerpt from the book, see  “Why Light Touching Can Double Your Chances of Getting a Date.”

Don't blame her. Images of youthful knockouts are not the root of body image problems. Courtesy of liber via Flickr.

Knowing Ourselves. How we see ourselves—physically, that is–can play a significant role in our lives. Our body image likely undergirds much of our social and athletic confidence, and partly through those factors, our mood. Females, more than males, often struggle with their body image at some point in their lives, probably because they are judged by their appearance more than males are. For most, the trouble amounts to little more than a vexing, but temporary delusion such as, “I look fat in this dress.” But for the unfortunate few, a negative, and hugely distorted, body image produces persistent trouble, resulting in a disorder such as anorexia. Either way, getting at the root of such feelings of physical inadequacy is of no minor significance.

I have always thought that body image issues stemmed from what we see. We look in the mirror and compare ourselves to the beautiful woman we saw on TV, in the magazine, walking down the street—or wherever—and we are sorely disappointed. But in this issue of the magazine, I learned that body image isn’t all, or even mostly, determined by that visual comparison (see “Inside the Wrong Body,” by Carrie Arnold). It is, instead, hugely influenced by how we feel inside. That is, a little known sense called interoception, awareness of the internal state of one’s body, anchors our impression of what we look like.

Interoception enables us to read our own emotions and to know when we are hungry, thirsty, hot, cold or in pain. People vary on how well this sense works for them. Those who suffer from eating disorders and serious body image issues usually have major deficits in interoception. Research shows that such people are more susceptible to media images of thin women and more easily swayed by others’ opinions. If your interoception is good, then you are relatively immune to such influences and less likely to think you are fat when you are really thin—or vice versa. Want to know how well your internal sense operates? Read the article for a do-it-yourself test.

Subliminal songs? Ozzy Osbourne was accused of imbedding backmasked secret tracks in his music that influenced children. Courtesy of Focka via Flickr.

Subliminal Silliness. When I was a kid, my pals told me that commercials contained hidden subliminal messages designed to suck us into buying things we don’t really want. I also remember hearing that records from reportedly nefarious rock musicians, when played backwards, issued spoken messages that could provoke people to behave badly, again working through the unconscious mind. It all sounded very fishy to me, and I never lost sleep over it—suspicious as I am of most claims and not the sort who responds to suggestions to engage in bad behavior anyway. Still, it wasn’t voodoo, but psychology, and despite the fact that both of my parents were research psychologists, I don’t remember ever learning whether these assertions had any validity.

As an article in this issue tells us, these particular examples of subliminal influence are mythical (see “The Subtle Power of Hidden Messages,” by Wolfgang Stroebe). It is possible to flash words or phrases onto a screen too briefly to be consciously processed, and audio engineers can record utterances backward onto a track, a technique known as backmasking. But no visual or aural messages transmitted beneath our awareness can change our preferences or make us do things we otherwise would be loathe to attempt or pursue.

That said, under certain circumstances, subliminal messages can subtly sway us. But we have to be ready for them. That is, if we are already thinking or feeling something that relates to the message, that phrase or sentence can serve as a reminder of something we like, making us more likely to choose that item over something else. In other cases, we might subconsciously associate a stimulus—such as the type of background music in a store—with high- or low-brow taste, and this can influence the amount of money we spend. But such cues don’t make us do anything radically different from what we intend or want to do.

The effect of such subliminal signals seems to me to be a lot like other happenstance influences on our behavior. I work in an open office so lots of people walk by my desk. I rarely pay attention to them, but I do sometimes vaguely register their presence. Most of the time, the passerby has no affect on my behavior. But occasionally, I notice someone who reminds me of a task that I have forgotten to do. Maybe I am working with that person, or he or she is part of a meeting in which whatever I was supposed to accomplish would be discussed. In such cases, I might stop what I am doing and turn to the forgotten task. But since that degree of influence doesn’t seem too sinister to me, I am going to continue to find concerns more worthy of sleep loss.

Communal benefits. Religion can bolster well-being, in part because going to church provides a sense of community. Courtesy of tbower via Flickr.

Can Atheists Be Happy? Being religious confers big benefits. Time and again, studies have shown that people who have a religious faith are more likely to be healthy and happy than those who lack one. Religious people may even live longer. Go to church and you could outlive your atheist friends by a good seven years, as we report in this issue (see “Healthy Skepticism,” by Sandra Upson). Yet doctors don’t counsel patients to take up Christianity, say, as a way of beating back mental or physical distress. Even if such advice were socially acceptable, it wouldn’t work. Most people can’t just go out and find religion if the idea hadn’t resonated with them before. But finding out the secret ingredients behind religion’s powerful effects might reveal something that could be prescribed.

One clue: religion makes the biggest difference for well-being in places where life is hard, suggesting the belief system, or the camaraderie that accompanies it, provides support when times are tough. But if you are affluent, and things are going well, you may be perfectly happy without this psychological safety net, studies show. Being religious also seems to be most beneficial if you live among mostly religious people, indicating it is way of fitting in socially. In countries where few people believe, the psychological benefits of faith disappear.

So if you are nonbeliever, surround yourself with like-minded people, and work on achieving your goals in other parts of your life (see “The Secrets of Self Improvement,” by Marina Krakovsky, Scientific American Mind, March/April 2012). Having close friends and other forms of psychological support can also boost your well-being. Your social and professional successes will then help you weather life’s ups and downs just as religion does. If you live in the U.S., these accomplishments might even help you withstand the most unrelenting downside of being nonreligious: the feeling of not fitting in.

A scene from People V. The State of Illusion. Courtesy of Samuel Goldwyn Films.

People V. The State of Illusion, a new docudrama from Samuel Goldwyn Films, is a mixture of fiction and brain science that, despite these awkward bedfellows, was compelling enough to keep me up late on a Friday night. Although most of the well-worn findings parroted by the movie’s parade of experts were not new to me, the filmmakers helped me see them in a new light. The result was at the very least thought provoking and might, in fact, inspire some people to change their outlook on the world for the better.

The movie tells the story of a single father, Aaron Roberts, who destroys his life in an instant, in an accident portrayed as a culmination of stress and sadness. Roberts was driving while intoxicated and ran a red light, leading to a crash that claimed the life of the other driver. He ends up in prison and his daughter becomes a ward of the state. The prison walls become a metaphor for the confining boundaries we build in our minds and from which, the movie suggests, we must all try to escape if we want to be happier and reach our full potential. As Roberts gradually transforms his outlook inside the prison cell on the movie set, the experts tell the rest of us how to do this in a more metaphorical sense.

J.B. Tuttle as the imprisoned father in People V. The State of Illusion. Courtesy of Samuel Goldwyn Films.

The film, which was written and produced by a former attorney Austin Vickers, invokes a good deal of science to back up the simple, uplifting argument that we all have the power to change our lives by changing our own minds. The message is not unlike that of many life coaches, but the arguments are more subtle and interesting than the platitudes I usually hear. Here are some lessons the film extracts from the science along with a few untethered snippets of advice for becoming a happier person:

• We perceive a tiny fraction of the information impinging on our senses. The brain employs a filter: neural processes focus our attention on the data that seem necessary and important to us at that moment. The sheer amount of data that exists, however, underscores the theoretical possibility of choice. If we are paying attention to something that makes us unhappy, then, we could, in theory, choose to focus on something that would make us feel good instead. The film doesn’t initially tell us exactly how to train our attention differently or even what we are supposed to be looking for, but the idea of being able to live in a different perceptual universe from the one we currently inhabit is kind of cool.
  

  Stress relief? Courtesy of Mindfulness via Flickr.

• Many of us have incredibly busy lives that often feel stressful. The stress, the film suggests, has the effect of making our world seem smaller, of making our mental walls close in. The suggestion is reasonable, although I’ve never heard it put quite this way. Stress hormones are known to suppress the function of our brain’s chief executive, the prefrontal cortex. This area, on the brain’s surface just behind the forehead, governs numerous decision-making, thought-juggling tasks. Stress inhibits those processes. As a result, children who grow up in stressful homes have trouble in school. It somehow never occurred to me, though, that my own stress could shut down my thinking capacity, or that, more generally, the epidemic of adult busyness (or worse) might be having that same impact on an entire culture. The film indicates, moreover, that if we don’t slow down and figure out how to limit the stress in our lives, our brains could be dangerously compromised. When you can’t think clearly, you could end up like the film’s protagonist: a victim of impulses that lead to dangerous behaviors such as drinking and driving. I am not sure the slope is usually that slippery, but the advice to slow down and take it easy for these reasons did resonate with me.
  

  Feelings guide our gaze. Courtesy of scinern via Flickr.

• No matter how mellow our lives or how well our brain’s CEO is operating, the film reminds us that emotion is what really guides our behavior. Our fears, loves, ambitions direct our attention even down to manipulating the eye muscles that govern our gaze. People often feel that their feelings are immobile, that they are stuck with them and so simply need to cope with them or somehow, work around them. But in truth, like everything else in the brain, the emotional system is flexible. We can train ourselves to feel differently about things. Strangely enough, one way to accomplish this about-switch is through practice, or so the movie’s experts tell us. People who practice suffering every day do the same thing as people who practice their golf swing: they get better at it. Conversely, if you practice optimism, you may well get better at that. Programs for children such as Goldie Hawn’s MindUP, an initiative spreading through schools around the world, help instill such emotional habits and patterns at an early age.
  

  iPhone lock screen reminds you to be mindful. Courtesy of ssoosay via Flickr.

• Another way to influence your emotional reactions is to retell your life story. Think about the story you are in, how you cast the narrative of your existence. Ask yourself, the film advises, “What might be a different perception of the same facts that would change my life for the better?” Assemble the pieces of your life that are dark, broken or dirty into an attractive mosaic or cast them off to the side as unworthy of inclusion. Psychotherapists frequently help their clients recast upsetting events in a new way. The technique can be very helpful, although perhaps difficult to accomplish on your own.
• Sometimes we need turn off that internal storyteller. Lighten up. Relax. Be in the moment. Research suggests that practicing mindfulness, a state in which we focus fully on the present moment without elaboration or judgment, can lower stress and increase happiness. Or as one talking head put it, “We are all in a deep slumber.” So let’s wake up.
• Once we open our eyes, we should also be willing to take risks. To achieve success, people need to say yes to the unknown, and embrace the discomfort of unsafe territory.
• Another piece of related wisdom the movie tosses out: Be gentle with yourself. Take the time to pat yourself on the back. Be kind to others as well. Love, we learn, is the act of me allowing you to be you.

Austin Vickers in People V. The State of Illusion. Courtesy of Samuel Goldwyn Films.

For more about People V. The State of Illusion, which opened March 16 in Seattle and today in Denver, click here. Future release dates are:

Portland: March 30

San Francisco: April 13

San Diego: April 20

Los Angeles: April 27

Chicago: May 4

Dallas: May 11

Miami: May 18

New York City: June 1

Snowy Owl, by Anita (Grade 7), Watercolor. All photos courtesy of Tyson Schoeber.

VANCOUVER. You could call his classroom a rescue mission. Each September, Tyson Schoeber takes under his wing 15 fourth through seventh graders that normal classrooms have left behind, defeated and too often, deflated. Ten-year-olds arrive unable to decode more than a few words without help. One eight-year-old who loved geography had trouble finding any book on the topic that he could read on his own. Another boy, a fifth grader, had a six-year-old sister who could already read far better than he could.

Schoeber’s program, called THRIVE, at Nootka Elementary School helps to bring a select group of kids, many of them dyslexic, back from the brink of academic stagnation. It boosts their reading and writing skills using individualized programs, multisensory learning techniques, lots of repetition—and most importantly, encouragement.

Hundreds of private schools exist for kids with learning disabilities. For a hefty tuition, they offer small class sizes and specialized instruction. Many of their graduates do quite well. They go on to college and successful careers, Schoeber says. “Yet why should that opportunity only be available to kids with means?” he asks.

Train Station, by Carson (Grade 7), Pencil and Pencil Crayon.

In Schoeber’s rare public-school classroom, every child works independently on his or her own learning plan, with intermittent help from Schoeber and a part-time special education assistant. The kids focus on setting goals, their own personal progress and learning how to learn. “We are trying to create an environment in which [kids] feel ownership for what they are working on,” Schoeber says, “so that they don’t need someone standing over them all the time.” This approach builds self-efficacy, a belief in your own competence and ability to solve problems. Kids with a learning disability tend to lack this belief, and they often harbor little hope for what they might become as adults, Schoeber says.

Creatures, by Tristan (Grade 5), Graphic Arts.

That cloudy forecast too often becomes self-fulfilling. Although 5 to 10 percent of schoolchildren have learning disabilities, learning-disabled individuals represent up to 55 percent of incarcerated youth. A report by Heather Fels of the University of California San Francisco School of Medicine suggests that about half of the adult prison population has some form of learning disability (although studies have revealed rates between 8 and 77 percent). In addition, Fels states that 35 percent of learning disabled students drop out of high school, twice the rate of students without these issues, and 31 percent of adolescents with learning disabilities are arrested three to five years after graduating. (These statistics do not mean that most children with learning disabilities turn to crime. They indicate such kids are at increased risk.)

These are kids who often start out as sweet, social and attractive. They seem like normal children—until you ask them to do schoolwork. “If you talk to a learning disabled kid, you may not know anything’s wrong,” Schoeber says. “These are bright, capable kids.” But exposed to repeated failure in school, they tend lose their sense of self worth and give up. In later life, it’s no wonder they lack opportunities.

3-D Ball, by Mancy (Grade 7), Pencil Sketch.

One way to stop the cycle of discouragement and defeat is to celebrate the special gifts these children can often claim. “Many people with dyslexia have incredible talents that get swallowed up in schools,” says Schoeber. In many cases, their aptitudes are spatial, says Adele Diamond, a developmental neuroscientist at the University of British Columbia. Although many students don’t learn well when they have to listen or read, they easily manipulate objects and perform tasks in three-dimensions. Such abilities are quite useful in many contexts, Diamond points out. “The ones who learn spatially, let them shine using these skills,” she suggests.

Owl at Night, by Lyla (Grade 4), Graphic Arts.

Some of the children express their superior sense of space through art. One sixth-grade girl who was at least three years behind in reading and writing rendered beautiful paintings of nature that her family framed and gave out as gifts. This blog showcases the artwork of many of those young people, including that of Carson, a charismatic 12-year-old who keeps a sketchbook in his desk. Anita, now an 8th grader, who made the painting above also created a fantastic animated film called Owly. THRIVE students have been participating in a student film-making competition for the past four years. I will feature their award-winning documentaries in an upcoming post.

Pomegranates, by Eli (Grade 6), Watercolor.

At the same time, Schoeber is on a mission to teach his charges to read and write with some degree of proficiency. In the general population, some kids start reading incidentally. One of Schoeber’s own sons taught himself to read when he was three. But most kids do not learn that way, Schoeber explains, instead requiring some type of direct instruction. And for 3 to 5 percent, ordinary reading lessons are not enough. These are the kids who participate in THRIVE.

Greek Urn, by Alexis (Grade 7), Papier-mâché.

The program emphasizes metacognitive strategies, or ways to think about thinking and learning, to help the students understand that there is a process to skills such as writing. To this end, Schoeber repeats, models, explains and illustrates the steps of the writing and reading process frequently throughout the day. He also enhances verbal learning through touch. For example, students use their fingers to trace letters on custom-made colorful drill cards while sounding them out. And, of course, on every skill these kids must master, they get lots of practice. Schoeber’s class operates on a shoestring: $430 per year, not including his or his assistant’s salaries or the donated Macintosh computers that line its walls.

Owl at Sunset, by Dezarae (Grade 7), Watercolor.

Despite its miniscule funding, THRIVE boasts some wonderful success stories. One youth who was “virtually illiterate” at the start of grade 4, is now on the honor roll in high school, performing at the 90^th percentile or better in all subjects. Getting there required tremendous effort: she reports studying from 4pm until midnight six days a week. “Learning and achieving the way she’d like is hard work for her kind of brain,” Schoeber says. She is one of the top achievers emerging from THRIVE, but many other THRIVE students are finding their way as well. “Most of our kids have gone on and done okay,” reports Schoeber, who has taught the program for 15 years. Many of them graduate from high school; some go on to college.

Cartoon Owl, by Joy (Grade 7), Graphic Arts.

Schoeber’s website outlines the methods used in THRIVE and provides all the materials created for the program for free to anyone who wants them. This intense, loquacious man is painfully aware that his ever-patient prodding and coaching can only make a small—if important—dent in the wider problem. The distribution of his tools through the Internet is a way to spread the pedagogy. “I want to try to help others, too,” Schoeber says. “It’s my commitment to social justice.”

Awesome Man, by Carson, Graphic Arts.

Courtesy of Dennis Wong via Flickr.

Smelling the past. I don’t give much thought to odors, unless I have to purge one from the kitchen or car. So I had never considered the possibility that my ability to smell affects how I think and what I remember. But it turns out that that scents have a strong connection with memories of our personal past. As a story in the March issue of Mind notes, a whiff of an odor brings the mind farther back in time than do other sensory cues. Odors also have a unique power to summon emotional memories. Problems sensing odors often accompany cognitive deficits, and in part because of such ties, researchers hypothesize that some kind of smell training could stave off cognitive decline (see “Smells Like Old Times,” by Maria Konnikova).

Courtesy of mrsraggle via Flickr.

I feel your pain–or joy. One of my more embarrassing recurring experiences is realizing that I am still talking to someone who clearly is not listening or wants to be doing something else. The person doesn’t generally say she is bored with my banter or anxious to get on with her life, but I can tell she is. I have always assumed that I received this implicit signal from reading my companion’s expression. It turns out, though, that the face doesn’t always adequately convey such sentiments. When we read emotions in others—an ability critical for good social skills—we usually rely on multiple sensory cues, including tone of voice, body posture and even smell (see “I Know How You Feel,” by Janina Seubert and Christina Regenbogen). And there are special regions of the brain dedicated to combining these components to figure out what someone is feeling. (For a tour of those regions, watch our video “Social Cues in the Brain.”)

An easy button, sold by Staples. Courtesy of Civilian Scrabble via Flickr.

That was easy. We all target certain aspects of our lives for improvement. Maybe we want to keep a cleaner house, save more money, lose weight or be kinder to others. Whatever your ambitions, an article in this issue offers tips for achieving them (see “The Secrets of Self-Improvement,” by Marina Krakovsky). One of my favorites is: take baby steps. People get discouraged when something seems too hard, but will work or try harder when a job seems easier or can be made to seem that way. My son’s room is very often a bit messy. He doesn’t like the job of cleaning it up, so instead of saying, “clean your room,” which sounds daunting to him, I say “pick up 10 things.” And then periodically, I ask the 10-year-old, “have you done your 10 things?” That job seems doable to him, so he’ll do it. His room does not suddenly resemble a showroom, but it stays livable—without me having to clean it. Similarly, I’ve seen my daughter refuse to do a pretty basic homework assignment because she has arbitarily decided it is too hard. On the other hand, she’ll tackle something arguably complex right away if she considers it easy. One strategy to making a task or assignment seem simpler is to break it into parts and make finishing just one part, or maybe two, the goal.

Thinking “easy” really does have a lot of power, no matter how you accomplish that psychological feat. Last year my daughter scored four goals in a soccer game. I asked her how that happened. “Well, mommy, at first I was scared,” she explained, referring to the start of the game. “But then I realized, ‘this is easy!’ “ Staples may be accomplishing more than promoting its own slogan with those buttons it is selling.

Make flower cupcakes--the easy way. Courtesy of Wendy Piersall via Flickr.

Action plans. If you really want to change, you not only need a realistic doable (“easy”) goal, you also need a plan for how you are going to make it happen—what psychologists call an “implementation intention.” If you are going to save a certain amount of money each month, where will you cut back? Will you make your lunch every day instead of buying it? If so, what will you put in it and when will you purchase those items? The other day, a doctor gave me a multipart eye-care regimen. No one aspect of it was hard, but I still had to figure out how to work it into my busy life. So I asked him a lot of questions about logistics and timing. He seemed surprised and said, “Wow time is really important to you.” “Yes, it is,” I told him. “But I also know that without a plan, this isn’t going to happen.” Doctors might be able to improve compliance with treatment regimens if they discuss such details with patients—dull and picky as they seem—even when the patients don’t ask.

Speed dating offers choice--perhaps more than we need. Courtesy of Steve Bowbrick via Flickr.

Dating: the tyranny of choice. Having more choices does not always bring greater wellbeing—and can lead to less happiness (see “The Tyranny of Choice,” by Barry Schwartz, Scientific American Mind, April 2004). I am often overwhelmed when faced with more than a couple of types of toothpaste, so I cannot imagine enjoying the task of picking a date from a serial lineup. But people who engage in speed dating willingly take this on.

An article in the March/April Mind suggests that although this rapid-fire interview approach may seem like an efficient way to sift potential partners, having lots of choices does not necessarily lead to better dates (see “Science of Speed Dating Helps Singles Find Love,” by Sander van der Linden). For one thing, more options makes us narrow our criteria to avoid cognitive overload: we rely mostly on basic features—age and looks, for example. But making a judgment based on age or height is like trying to predict how food will taste by reading its nutrition label. Knowing that a guy is 5 foot 5 or 6 foot 3 reveals nothing about how he looks at you or how much he makes you laugh. Apparently a frantic two-minute chat just isn’t enough to give you a sense of what really matters.

Don't try this at home. For the vast majority of us, multitasking may be hazardous to our health. Courtesy of Wootang01 via Flickr.

Multitasking magicians. I love articles on multitasking, because they give me more ammunition for the mantra I repeat to anyone who seems not to know: you can’t multitask; true multitasking is a myth and it’s generally not a smart way to live. If either job is mentally more demanding than chopping carrots, you aren’t multitasking, you are switching back and forth between them. The result is inefficient at best, because the switching takes time. If neither task is time-sensitive, your work will just take more time to complete. But if one of them is, say, driving a car, which requires total concentration at key moments, then talking on the phone during those instants can kill you. And, folks, it’s not about the headset. We are not talking about your hands here, but your brain. Your mental resources are tapped out. Indeed, as a new article in Mind tells us, the crash risk from such behavior is greater than that from being legally drunk (see “Top Multitaskers Help Explain How the Brain Juggles Thoughts,” by David L. Strayer and Jason M. Watson). You can’t get better with practice either. Practice only makes you overconfident, reinforcing your bad behavior. (And, of course, the more you do it, the more chances you have to get hurt.)

These facts may resonate with me because I am so obviously bad at multitasking, and unlike many of you, I dislike it. Juggling jobs makes me anxious. But I have noticed that some people seem a lot calmer, at least, when besieged by multiple duties. I never paid this impression much heed, convinced as I was of the myth of multitasking. But I learned something from the psychologists who penned the article in this issue: a tiny fraction of you—about 2 to 3 percent—can multitask. In experiments, such people can do two tasks at once as well as just one. This ability may even have a genetic basis. Who knew? But for the other 98 percent, I am still perfecting my lecture. (For more information on the science of multitasking, see “The Limits of Multitasking,” by Klaus Manhart, Scientific American Mind, December 2004.)

Stopping a bully could save a child from psychosis. Courtesy of Joe Shlabotnik via Flickr.

Staving off psychosis. My uncle Glenn suffered from schizophrenia, so I paid careful attention to a book excerpt in the issue concerning ways to help kids with the disorder (see “A Mind in Danger,” by Victoria Costello). Glenn had always been a little odd, his brothers told me (see “Seeing Schizophrenia Before It’s Too Late” on Streams of Consciousness), so I was not shocked to learn some of those oddities are now thought to forecast possible psychosis. These include antisocial tendencies, flatter emotions and perhaps also some physical quirks. More surprising to me was that the disorder might be partly preventable if you know what to look for.

I had always thought schizophrenia was pretty much genetically determined. But, in fact, the environment contributes to the disease. No, we are not back to the days of blaming parents. But parents and other adults can help protect vulnerable children. Bullying by peers and smoking pot are now thought to help push such kids into a danger zone, so both are issues that take on heightened concern for a child who shows signs of mental trouble. Both are, of course, stoppable if not easily so. By contrast, making home a happy and stable a place can help lead a child at the edge onto safer mental terrain. In short, parents aren’t to blame if a child develops a serious mental illness, but parenting does matter. Parents do have some control, even if not as much as they would like. And for some kids, the stakes are higher than they are for others. (For more on schizophrenia, also see my earlier post, “Crux of Schizophrenia’s Emotional and Social Deficits May Be Cognitive.”)

For more lessons about the mind from the latest issue of Mind, stay tuned for my next post.

Although individuals vary in how much of this motivational firepower they possess, the amount is not fixed. You can boost your psychological capital—and the key is changing your habits. Simply deciding to improve your outlook won’t work. Instead, people need to cultivate a positive mindset through rituals and goals, say University of Nebraska management scholars Fred Luthans and Peter Harms. Here’s how:

Courtesy of redcargurl via Flickr.

1. Write a gratitude letter. Consider the people and things you are most grateful for—and write them down. If you wish, you can write a letter to a person who means a lot to you. The recipient is likely to be touched. But if addressing an individual is uncomfortable or inappropriate, pen a note to yourself about all the things that are going well or that you feel fortunate to have. Set aside a time each day to do this. For instance, write one journal entry each night just before bed listing the good things that happened to you and what you are grateful for. Too much of the time, we focus on our fears and problems, because those relate to situations we need to avoid or solve to survive. But if you stop to count your blessings, you will realize how lucky you are.

Courtesy of insouciance via Flickr.

2. Seek out the good things in life. Make an effort to find situations that make you feel happy and proud. Spend time with those who love and support you. If you know people who make you feel miserable, don’t interact with them. “Although criticism can be a good thing,” Harms says, “unrelenting criticism rarely is.”

3. Don’t forget to relax. Exercise or meditate on a daily basis, even if you only have a short time to do so. Fifteen minutes per day to clear your head and relax has been shown to be associated with both happiness and physical wellbeing. Getting enough sleep helps as well, Luthans says.

4. Put problems in perspective. Think about the true scope of your troubles. “Not everything’s the end of the world,” Harms reminds me. In fact, he adds, most of us worry about relatively minor hassles and concerns on a daily basis. You worries will seem less significant if you compare them to those of people in the throes of divorce, who have lost their jobs or who have been diagnosed with a serious illness. Harms gets his perspective from soldiers he sees regularly for one of his projects. “These are people who are putting their lives on hold to go to a place where people are trying to kill them,” he reports.

5. Set achievable goals. Make sure your aims are meaningful to you so that you gain satisfaction from completing them. Make them challenging, but also realistic and specific enough that you can act on them. If you are too ambitious, you will set yourself up for failure. Then keep a record of your progress so that you can look back and see how far you have come. Seeing that improvement is possible will motivate you to keep moving forward.

Rubber bands on your arm can remind you to be nice to others. Courtesy of fekaylius via Flickr.

6. Do nice things for others. One way to get in the habit of doing nice things for others, suggests Luthans, is to put three rubber bands around one of your wrists and transfer one band to the other wrist each time you do something kind for another person. The bands can serve as reminders to finish your three tasks before the day ends.

7. Spend money on experiences, not objects. Better yet, spend money on other people. Individuals who are given cash and told to spend it on others report higher levels of wellbeing than those who spend it on themselves, Luthans says.

Courtesy of wovox via Flickr.

Whether you succeed at work may depend on many factors—intelligence, empathy, self-control, talent and persistence, to name a few. But one determinant may outweigh many of these: how you perceive those around you. New research suggests that your own ability to get things done—not to mention your success in non-work relationships—is highly correlated with how you see others. Are your coworkers capable and kind, or are they, dare I say, incompetent jerks?

It turns out that such opinions are tied to a key component of achievement called psychological capital, a mixture of efficacy (self-confidence), resilience (you believe you can bounce back from setbacks), hope (you believe you can achieve your goals) and optimism (you expect good things to happen in the future). As a concept, psychological capital reflects our capacity to overcome obstacles and push ourselves to pursue our ambitions. Not surprisingly, scoring high on this measure is linked to markers of success: being promoted, winning awards, popularity with peers, stability of marriage and even longevity.

Confidence (efficacy). Courtesy of michael.melewski via Flickr.

Given the power of this trait, psychologists—and employers—want to measure it. After all, a prospective employee with a lot of psychological capital is likely to do well on the job and thus, be a smart hire. Individuals might like to know how much of it they have. (I am curious about my own stockpile.) It is difficult to intuit, even if you think you know yourself fairly well, because you have little sense of how you compare with others. “People are often unaware of what is normal,” says Peter Harms, a psychologist and management scholar at University of Nebraska-Lincoln. If you are Oscar the Grouch, you assume that mindset is typical. If you are a Polly-Anna, you suppose your sunny outlook is the norm.

Yet to get at this trait, you can’t ask people the obvious questions, because people know how to answer them. Even if they want to be honest—and they may not if they are applying for a job—people fool themselves all the time. “If I ask you about you, you’ll probably say something nice about yourself. Even in an experiment, people will try to make themselves look good,” says Harms. “You need to take the focus off the person.” So Harms and University of Nebraska management scholar Fred Luthans decided to subtly probe the concept by asking people how they view others.

Courtesy of *USB* via Flickr.

Rather than using real people, some of whom may actually be jerks, they asked subjects to conjure up imaginary people, on whom they could impose their own schema and mindsets. The result is a world they have completely made up. “It’s all a projection,” Harms explains, a kind of ethereal Rorschach test. And it seems to work.

In the test, people create stories in their head about their imaginary someone in response to a positive, negative and neutral prompt. These are: the person has a new job (positive); the person makes a mistake at work (negative); the person talks to their supervisor (neutral). Then the participants answer questions, on a 7-point scale, about the made-up character. Is he feeling confident and self-assured in his ability? Does she believe she can bounce back from setbacks? Does he believe he can accomplish his goal? Does she expect good things to happen in the future? The answers, which target the four components of psychological capital, range from -3, which means the opposite is true of the character, to +3, which indicates the statement is very true of this made-up individual.

Optimism. Courtesy of seeveeaar via Flickr.

Harms and Luthans compared the answers, which they collected from 278 adults who worked in a variety of professions, to measures of job satisfaction, “citizenship” deeds such as helping coworkers, ability to complete tasks, and tendency to engage in deviant work behaviors like cheating on time sheets. They found that a high positive score on this new implicit test was significantly correlated with high grades on job satisfaction, citizenship and task performance as well as a lower mark on counterproductive work behaviors. In fact, the imaginary-person test worked better than the traditional self-report measure of psychological capital. “We end up being better able to predict workplace performance with these projected measures,” Harms says.

Resilience. Courtesy of AirAn via Flickr.

Take a manager who believes others are intrinsically motivated. She will give her employees the autonomy and freedom they need to flourish. By contrast, one who micromanages because he believes his charges are incompetent and lazy will end up with a demoralized team. “It becomes a self-fulfilling prophecy,” Harms says.

The test should work well for job interviews, too. It is not cumbersome to administer and applicants don’t know how to fake their answers. “With an imaginary person, people don’t know whether they are supposed to be positive, so they respond honestly,” says Harms.

Courtesy of USACE-Sacramento District via Flickr.

In addition to predicting on-the-job performance, implicit positive perceptions of others are associated with greater satisfaction with groups to which we belong, less cynicism and greater popularity among your peers. Such perceptions and worldviews are also likely to impact health and marriage. If you associate the gym with drudgery, you are unlikely to exercise. If you don’t trust your spouse or you don’t believe in happy endings, you may be less keen on your relationship.

In general, knowing how positively you see people and situations could be used for self-improvement. A counselor could inform you that the way you see the world is not healthy and provide exercises to improve your outlook. So keep in mind that you may, in fact, be the author of your own misery. Ask yourself, Harms suggests, “Maybe not everyone else is a jerk. Maybe it’s me?”

Up next week: How do you improve your outlook—and boost your psychological capital?

Status can be pricey. Courtesy of vivek_nallur via Flickr.

Sellers have long charged a premium for objects that confer some kind of social status, even if they offer few, if any, functional benefits over cheaper products. Designer sunglasses, $200,000 Swiss watches, and many high-end cars often seem to fall into this category. If a marketer can make a mundane item seem like a status symbol—maybe by wrapping it in a fancy package or associating it with wealth, success or beauty—they can charge more for it.

Although this practice may seem like a way to trick consumers out of their hard-earned cash, studies show that people do reap real psychological benefits from the purchase of high status items. Still, some people may gain more than others do, and studies also suggest that buying fancy stuff for yourself is unlikely to be the best way to boost your happiness or self-esteem.

The striatum (green) is the brain's reward center. It becomes active in response to both social rewards and money. Courtesy of Andreas Maye-Lindenbert, M.D., Ph.D., NIMH Clinical Brain Disorders Branch via Wikimedia Commons.

In 2008, two research teams demonstrated that people process social values in the brain’s reward center: the striatum, which also responds to monetary gains. That these two values share a cerebral home suggests we may weigh our reputation in cash terms. Whether we like it or not, attaching a monetary value to social status makes good scientific sense.

Much of what revs up this reward center—food and recreational drugs, for example—is associated with a temporary rush of pleasure or good feeling, rather than long-lasting satisfaction. But when we literally pay for that good feeling, by buying a high-status car or watch, say, the effect may last long enough to unleash profitable behaviors. In a study published last year, researchers at National Sun Yat-Sen University in Taiwan found that the mere use of brand name products seemed to make people feel they deserved higher salaries, in one case, and in the other, would be more attractive to a potential date, reports Roger Dooley in his Neuromarketing blog. Thus, even if the boost of good feeling—and self-worth—is short-lived, it might spawn actions that yield lasting benefits.

Other data suggest that owning fancy things might have more direct psychological benefits. In a study published in 2010, psychologist Ed Deiner at the University of Illinois and his colleagues found that standard of living, as measured by household income and ownership of luxury goods, predicted a person’s overall satisfaction with life—although it did not seem to enhance positive emotions. (See “The Many Faces of Happiness,” by Suzann Pileggi Pawelski, Scientific American Mind, September/October 2011.) That rush of pleasure you get from the purchase probably does fade, but a type of self-esteem effect seems to last.

Luxury can boost self-esteem, at least a little. Courtesy of Meagan Fisher via Flickr.

Still there may be some drawbacks to trying to boost your self-confidence by opening up your wallet. People who feel that they are lacking in status, power or influence are willing to pay the biggest premium for social status. The result can be discrimination—that is, disadvantaged groups end up paying more, starting a vicious cycle that brings these groups further down the social ladder (see “When You Try to Buy Status, It Can Backfire”). Still, people in these studies paid the higher prices only after being reminded of their low ranking, suggesting that trying not to shop when feeling insecure could buffer folks from this effect.

Additionally, this work seems to imply that not everyone accrues equal benefits from buying name brands. People who generally feel fine about their place in society may not get the same rush from luxury, and thus may own fewer expensive or ostentatious items than others of similar means. The asking price for status may simply be too high for some.

The best way to boost self-esteem is to think about others, leading to lasting friendships. Courtesy of Gideon from Paris, France via Wikimedia Commons.

Yet even if you are someone who really relishes fancy wares, buying stuff for yourself is not the most effective way to increase your feelings of self-worth. A far bigger benefit can come from giving to others.  The effort you make to support another person often spawns a strong friendship, which has lasting gains for self-esteem, reported psychologist Jennifer Crocker, now at The Ohio State University, last year at the convention of the Association for Psychological Science (see “Give and You Shall Receive—A Boost to Your Self-Esteem”). And in a study that came out a few years ago, scientists determined that people got the biggest boost in happiness from money when they gave it to someone else (see “Money Can Buy Happiness”).

Ad on a London Bus. Courtesy of Annie Wade via Flickr.

People have long tried tricks to aid their memories. One of the most useful of these so-called mnemonic devices, I’ve found, involves associating names with word pictures or with other people you know well. I was just at a party, for example, and met a man who shared a last name with someone I’ve known for a while. I am sure I would have forgotten his name had I not associated it with that other person. But two days later, I remembered the connection and drew his name from the memory bank.

Perhaps my favorite mnemonic was one my daughter brought home in kindergarten. She came home one day singing the Happy Days theme song. To my delight, this song had been her teacher’s choice for helping the kids remember the days of the week. Other mnemonics involve fitting familiar words to unfamiliar acronyms. The fictitious name “Roy G Biv” helps people remember the order of the colors in a rainbow: ROYGBIV. (Or you can just think, “Rake over your grass because it’s verdant,” but that seems a little convoluted.)

As much time and attention as has been paid to helping people remember stuff, however, I’ve never seen a list of tactics for helping people forget. Forgetting is essential to our ability to think, to remember what is important to us, and to remain calm and happy. I wrote about the power of forgetting in the January/February 2012 Scientific American Mind (see “Trying to Forget”). In reporting that story, I collected ideas for ways to wipe things you don’t need or want from your brain.

Courtesy of lett-/\= via Flickr.

I am not sure what to call these forgetting tactics. The word “mnemonic” comes from mnemonikos, which means “of memory” in ancient Greek, and evokes Mnemosyne (“remembrance”), goddess of memory in Greek mythology. To my knowledge, the Greeks did not create a god of forgetting, and none of the English words related to the phenomenon have the right ring to them. So I’ll borrow from the French verb, oublier, “to forget,” and call my tips on forgetting “oublionics” for want of a term with fewer syllables. Whatever you want to call them, here are tips for forgetting your troubles along with the random clutter piling up in your brain.

The prefrontal cortex of the human brain includes two major sections. Via Wikimedia Commons.

1.     Shove the thought away. When you are reminded of something you don’t want to think about, just refuse to go there. Let your mind go blank rather than allowing it to make the connection. Sound ridiculously simple? Research shows that many, if not most, of us can will ourselves to forget in this way. The engine of such suppression is your prefrontal cortex—the same region of the brain that puts brakes on inappropriate actions. But just as some people are better at blocking bad behavior than others, some are more proficient at memory suppression than others. If you turn out to have loose reins on your brain, you might need to practice (see #2) or to use one of the other tricks.

2.     Push it back again—and again. If you want to boost your chances of forgetting something for good, shove it out of consciousness on a daily basis. In a month, it might be gone, if modern psychology experiments are any guide. (Freud argued that such repressed memories would come back to haunt us, but the jury is still out on this idea.) Over a longer period, practicing this mental block might hone your skill. People who have had to frequently block a traumatic memory—loss of a parent, say, or their house burning down—to prevent it from overwhelming them score higher on tests of memory suppression than do people who have been lucky enough to have avoided significant suffering. One explanation for this result is that practicing suppression over the years makes you better at it.

Courtesy of Calsidyrose via Flickr.

3.     Think of something else. Rather than just willing an upsetting memory into the dustbin, replace it with a nicer idea. So if seeing a Hawaiian lei reminds you of your ex drunk at a party, try to link the lei with images of a sandy beach instead. People who struggle to block memories—a group that usually includes people who tend toward rumination or who suffer from depression—have more success forgetting unwanted recollections if they find good substitutes for what they want to put out of their minds.

4.     Prepare for shutdown. Thinking about the need to block associations ahead of time can boost your ability to do just that. Even a second of advance warning can give your brain added inhibitory power, research suggests. So if you have to see someone who you think might bring back a difficult period in your life, tell yourself before the date that you’ll be halting these thoughts before they reach consciousness. The mental barricades you erect will be sturdier with a little advance notice.

5.     Just do it. When you sense a reminder of something bad coming on, do something to distract you. Anything. Pick up the phone. Walk around the block. Stomp your foot. Say hello to a passerby. In one study, scientists found that pressing an enter key at the moment of recall triggered forgetting.

Courtesy of Sterlic via Flickr.

6.     Study. If your mind is awash in clutter, one of the best ways to clear it out is to reinforce what you do want to keep. When you study particular information, to learn it better, you automatically forget closely related material. This phenomenon, called retrieval-induced forgetting, efficiently tidies your mental closet.

7.     See it another way. Sometimes we are upset because we are interpreting a particular situation in the worst possible light. If you can find way to see the same experience more positively, you may be inadvertently inducing forgetting. That is, by reinforcing the positive you are automatically toning down the negative in your mind.

Courtesy of willfc via Flickr.

8. Walk through a doorway. Remarkably, this simple act closes the door on what happened just before. See “Why Walking through a Doorway Makes You Forget.”

More to Explore
» Memory in the Brain [Interactive]
» Trying to Forget

A doctor examines C.T. scans from a patient before performing deep brain stimulation surgery to alleviate tremors. Courtesy of Swedish Neuroscience Institute.

Peter West makes his living working with explosives, but for a long time he did his job despite a terrifying handicap: tremors. His hands would twitch and shake, his head would bob, his speech would become garbled. Sometimes he could barely pour milk from a pitcher—the milk slopping over the side of the glass. “At that time, I was mixing high explosives,” West says. “I knew it was a matter of time before I dropped one.”

Luckily the most significant thing West, 54, dropped was his golf ball. In 2003, while on the links, a doctor in West’s party noticed he was having trouble balancing the ball on the T. One thing led to another, and West was diagnosed with essential tremor, a neurological disorder characterized by shaking of the hands and other body parts. The main treatment option was drugs that would make him sleepy—a hazardous side effect in his line of work.

A stimulator and leads used for deep brain stimulation surgery. Courtesy of Medtronic.

West, however, hooked up with doctors at Rhode Island Hospital who performed deep brain stimulation. In 2004, they opened West’s skull and implanted an electrode in his thalamus, a structure in the center of the brain just above the brainstem. They ran a wire to another device, inserted under the skin of his collarbone, that generated pulses of electrical current. The treatment reduced West’s tremors to manageable levels, and allowed him to continue his work.

The underlying theory of deep brain stimulation, pioneered in the late 1980s, is that the pulses disrupt the aberrant neuronal impulses that are thought to cause tremors. “We seek out these abnormal neurons and tell them to stop,” says Andres Lozano, who chairs the neurosurgery department at the University of Toronto. [For more on DBS, see Sparking Recovery with Brain Pacemakers, by Morten L Kringelbach and Tipu Z. Aziz, Scientific American Mind, December 2008/January 2009.]

Drawings from a patient with a essential tremor show improvement after deep brain stimulation surgery at Swedish Neuroscience Institute. Courtesy of the Institute.

Recently deep brain stimulation has become a mainstream treatment for Parkinson’s disease, a degenerative neurological condition that also leads to uncontrollable shaking, which often leaves patients disabled. Most of the 90,000 people worldwide who have had deep brain stimulation procedure suffer from Parkinson’s. About five percent of the procedures are performed on patients who, like West, suffer from essential tremor, estimates Lozano.

The FDA has approved the procedure for both essential tremor and Parkinson’s, and it’s practiced at a number of academic centers, including the University of Toronto and the Swedish Neuroscience Institute in Seattle. Surgeons at Swedish treat about 40 patients with tremor every year. Lozano says his team operates on about 10 with essential tremor as well as more than 100 with Parkinson’s. As surgeons develop more experience with the operation, however, they are starting to apply it to psychiatric conditions, such as depression and obsessive-compulsive disorder.

On Friday, December 16 at 9am Pacific Time, 12pm Eastern, Scientific American streamed video of an operation performed an hour earlier in the day on an essential tremor patient, courtesy of Swedish Neuroscience Institute in Seattle (watch it now in the viewer below).

(Please excuse the ad that may run for 30 seconds before the video begins. We do not control the content of any ads. If you have trouble viewing the video, try refreshing the page or checking your Internet connection.)

Soup With A Spoon

Follow up studies have shown that 90 percent of essential tremor patients see improvement after surgery. Typically, the benefit is significant: a 90 percent reduction in hand tremor, as measured on a severity scale of 1 to 4. Quality of life improves as well. Patients become newly able to perform ordinary tasks such as drinking water without spilling, dressing themselves and brushing their teeth.

To calm essential tremor using deep brain stimulation, surgeons implant electrodes into the brain's thalamus. Courtesy of Swedish Neuroscience Institute.

Along with the benefits, however, come significant risks. To find that thalamus, surgeons have to dig deep inside the brain. The chance of bleeding or stroke is about 1 percent, Lozano says. In 5 to 8 percent of patients, complications from a broken electrode or an infection ensue. In about 20 percent of cases, Lozano adds, the electrical stimulation can cause speech and balance difficulties, tingling, pain and occasionally mood changes. Because of such risks, Lozano won’t operate unless a person is disabled and medications don’t work for them. In some cases, he’ll accept a patient whose tremor interferes with her career even if it is not otherwise debilitating—he’s operated on several surgeons, for instance.

West falls in that category. For him, the disease was troublesome but not life threatening. For as long as he can remember, his hands have twitched and shook. At age five or six, his arms would be resting on a table only to suddenly jump several inches to a new location. He struggled with sports as a teenager. When he’d throw a ball, a twitch or tremor would send it off in the wrong direction. Since his dad and his sisters also had tremors, West thought it was a normal condition.

After his diagnosis, West’s tremors continued to worsen. On average, tremor gets more severe at a rate of 1.5 to 5 percent per year, according to Elan Louis, a neurologist at Columbia University who has studied the disorder. Doctors offered to prescribe medications to diminish the shaking. Anti-seizure and high-blood pressure drugs are the first-line treatments for essential tremor, although these drugs only work for about half of patients. West didn’t give them a chance, however, because of what he did for a living. “Which is better? Making explosives with tremor or sleepy?” he asks. He spoke to me from a quarry, where he was on a project to break up bedrock for use under roads. So he lived with the tremors, until he found out about the brain surgery.

A patient performs a drawing test for tremor during deep brain stimulation surgery. Courtesy of Swedish Neuroscience Institute.

West recalls the operation vividly (he was awake during the procedure). At one point the surgeon wanted to test the electrode placement—both for its effects on the tremor and on other brain systems such as vision. He asked West to look over at the door to the operating room and to tell him if the top of its frame was straight—parallel to the floor. “It wasn’t,” West recalls. “It was V-shaped.” A few adjustments to the electrode straightened out that door.

West has had some side effects from the surgery. He thinks he gets more irritable and agitated than he used to–at least on some days. He has decided to live with that problem, because his tremor is virtually gone. Some tasks, such as painting a baseboard or holding a glass with one hand, are still difficult. But he can pour milk now, eat soup with a spoon and manipulate chopsticks. He enjoys working with explosives, which he feared he would have to give up if his tremors hadn’t calmed down.

Last Saturday, December 10, he was building a train for his granddaughter. The project required soldering, hooking up electrical wires using a soldering gun, a task that once took him more than two hours to accomplish. But this time, he said, “it was no problem.”

Postscript: For more on deep brain stimulation for essential tremor as well as other types of surgery for the condition, please see tomorrow’s webcast on this page. Peter West is happy to talk to other people with essential tremor considering getting the operation. He can be reached at pwwest@maine.rr.com.

Artist James Gurney's painting of this deli in Poughkeepsie, New York, closely resembles the real thing. Courtesy of James Gurney.

A few years ago, James Gurney, a celebrated artist and author, stood before his easel to paint a deli in Poughkeepsie. Surveying the scene before him, he was immediately overwhelmed with literally millions of details. People strolled by. Insects fluttered overhead. Signs poked out from the store and up from the street. Every tree had about 200,000 leaves. “How am I going get all this down onto a 9 by 12 panel in a matter of hours?” he wondered, despite having confronted this conundrum countless times before.

The task was a visual one: translate the three dimensional scene that your eyes and your brain compile into a flat picture that makes you—and other viewers—re-experience something similar. Your eyes play tricks on you. Your brain plays tricks on you. As an artist, Gurney knew, you have to trick them back—or what you produce won’t look anything like what you thought you saw.

Although all good visual artists need to understand perception, Gurney has taken the study more seriously than most. He writes a blog, Gurney Journey, that includes numerous posts on vision and how it works. (He has also illustrated articles for Scientific American. For a video showing his process for painting realistic dinosaur scenes, see Illustrating ‘Dinosaur Death Trap.’) “Painting is a record of one person’s subjective visual experience of the world,” Gurney told me. Artists, he explained, want to convey that experience. But doing so often means, in a very real sense, not trusting their own eyes.

When Pink Is Bluish Gray

One of the ways our eyes can’t be trusted concerns color. Our visual systems manipulate tones and hues in nonobvious ways. In what scientists call color constancy, we perceive an object’s hue as constant no matter if it is brightly lit, cast in shadow, curved or illuminated by colored light. So a school bus looks yellow even in shadow or dented in a way that locally changes its shade. In the case of a sunlit man in black holding a white paper cast in shadow, we see his suit as black and the paper as white no matter how objectively bright or dark these objects are. Beneath our awareness, we adjust for the lighting.

Squares 1 and 2 are the same gray. The suggested shadow makes our eyes see 1 as black and 2 as white, but the artist adjusted for that effect. Courtesy of James Gurney.

But such subconscious adjustments may lead an artist astray, if he or she is unaware of them. In the case of the man with the paper, a beginner is likely to paint as his conscious brain sees, so that the coat is rendered in very dark tones and the paper quite white. An artist who knows about color constancy, however, will know that “white in shadow can very often be darker than black in sunlight,” Gurney says. To see this for yourself, look at the checkerboard. The squares marked 1 and 2 are actually the same tone. Our eyes adjust for the shadow such that we see the square that we think is illuminated (1) as much darker than the one that seems to be in shadow (2). As this illusion demonstrates, this adjustment is almost impossible to override. “Colors don’t exist as an objective reality,” Gurney says. “Color is something that happens in the brain.”

The blue square in the red picture is the same color as the red square in the green picture. Courtesy of James Gurney.

Painters need to be aware of this subjectivity, he says, because it makes a difference in how they paint. Here’s another striking example. Let’s say an artist wants to paint a pale-skinned figure standing outside at dusk or in a flame-lit interior. Looking at the figure, his skin would appear pinkish, because we know Caucasian skin to be pink. But cast in a bluish light, it isn’t pink at all, Gurney says. It is bluish gray. As a result, a painter must mix grays and blues in that environment to make the skin appear pink. To see how dramatically our eyes adjust for a color cast in a picture, see the colored cubes above. Although the square denoted in the red picture looks blue or (or to some, green or “cyan”) and the one in the green picture, red, Gurney rendered both using exactly the same color mixture. Here, a skilled artist uses an identical mix of paints in the two contexts to produce what appear to be two very different colors. You need to know how color context affects perception, says Gurney, “to get the color you want in a subjective color environment.”

The Benefits of Blur

Our eyes and brain also continually give us a false sense of focus. When we look out at a scene, we are constructing a sharp image of just a small part of it—the spot at or near the center of our gaze. The cells that detect light here, called cones, are responsible for all high-resolution vision. By contrast, objects on the periphery appear fuzzy because the light-detectors there, called rods, are not tuned to visual details. Nevertheless, as our gaze naturally shifts, our brains combine the various points of focus to construct a detailed mental picture of a large swath of visual territory.

Using this mental picture as a guide, novice artists tend to draw or paint an entire canvas in high definition. But because not everything is in focus when we actually see, softening the edges in the background of a painting actually makes it seem more real, says Gurney. It gives the image greater depth. That sense of reality and immediacy is Gurney’s goal. “I want to better understand how my eyes and brain work so that I can create a record of my observations,” he says.

An eye-tracking heatmap depicts the areas of a painting at which most people looked. Courtesy of James Gurney.

In deciding what to paint with precision, Gurney also takes into account what people like to look at. Gurney has always wondered where viewers spent the most time looking in his pictures. He brought several of his paintings to Greg Edwards, who is the founder of Eyetools, an eye tracking company in San Francisco. Edwards tracked the eye movements of 15 viewers as they looked at Gurney’s art to discover which parts their eyes landed on most. Above, one of Gurney’s paintings is accompanied by the same painting overlaid with an eye-tracking heatmap. The red color denotes the areas where almost 100 percent of people gazed, followed by decreasing percentages in the orange and yellow. The blue and darker colors mark where hardly anyone looked. The results jibe with the notion that people are drawn to faces—and to human figures, in general. Knowing what captures people’s interest helps tell Gurney what to spend the most time rendering in fine detail. Such eye-tracking work justifies the extraordinary attention some artists pay to painting faces. Some famous artists such as the American portrait painter John Singer Sargent reportedly repainted visages repeatedly to fix, say, the lighting, expression, or direction of gaze.

Underlying the rationale for eye tracking is the notion that attention is central to seeing. You don’t see what you don’t focus on, perceptually and conceptually. When Gurney sat down to paint that deli, he could not paint everything in front of him. He had to choose what to paint with precision and what to simplify, to reflect what he felt best represented the scene and what stood out to him. But despite seeing too much, he also saw too little: after an hour and a half of absorbing the sights, he suddenly noticed some telephone wires. It was if they had just suddenly appeared in the scene. “But I didn’t paint them in,” he recalls. “The scene was busy enough, and it was time for lunch.”

Courtesy of Poi Photography via Flickr.

People are particular about their things. Property—who owns it or did what with it—is the subject of many a legal battle. It’s odd to me how attached people get to objects and how emotional they become when someone messes with their stuff. Yet we take notions about sharing and rules such as “don’t take what is not yours” very seriously—so much so that grownups get upset when kids seem to flout them. So it might help to realize that an understanding of ownership has its own developmental trajectory, one that psychologists are just beginning to work out.

Obviously, a baby doesn’t care who owns the rattle she is shaking—or the dress she is wearing. But babies don’t express any opinions at all, really, and it’s obvious when they chew on your book, that they mean no disrespect. By age two, suddenly, that baby christens everything in the room “Mine!” But although she seems to have an idea of things belonging to her, she cannot fathom the possibility of an object belonging to someone else. So by default, she decides everything is hers. She isn’t selfish; in her mind, there can be no other possibility. At the age of three, she may no longer be the owner of all that she sees. But she is hardly wise in the ways of stuff. If she had a hand in making something, it is unequivocally hers, no matter that the material used to construct the masterpiece was not. Adults take a more nuanced view. (See “Passion for Possessions: Mine!” By Bruce Hood, Scientific American Mind, September/October 2011.)

Although we may find a toddler’s ideas of property rights markedly primitive, some research suggests that kids don’t act like adults with regard to objects before about age 10. When evaluating scenarios about other people, younger children tested in a study did not see any ethical difference between destroying something you own (which is okay) and ruining an item that belongs to someone else (wrong). (I have also noticed a change around age 10 in a child’s regard for small toys given out at arcades and birthday parties. My eight year-old still covets these items; the ten-year-old can’t be bothered. What this difference says about the maturation of ownership concepts in the brain, I can’t be sure. )

Courtesy of cathyse97 via Flickr.

A new study published this month suggests, however, that kids start to adopt certain adult notions of ownership long before age 10. The findings show that a magical mental leap with regard to objects seems to occur at the astoundingly early age of three. Unlike two year olds, three-year-olds realize on some level that what is okay to do with an object can depend on who owns it, if the kids observe the action (rather than just hearing about it). In the journal Cognition, psychologist Michael Tomasello at the Max-Plank-Institute for Evolutionary Anthropology in Leipzig, Germany and his colleagues showed 30 three-year-olds and 30 two-year-olds a scenario in which a puppet took away, and then disposed of, a hat. In some cases, the hat belonged to the toddler. In others, the hat belonged to the puppet. And in the third scenario, the hat belonged to a third party.

The puppet took possession of the various hats and happily tossed them in the trash, right in front of the kid. The researchers then watched how each child reacted. Tossing your own hat in the trash is acceptable. We might think it’s a waste of a perfectly good hat, but it’s allowed. Tossing someone else’s hat in the trash, however, is not okay, according to ownership rules. The researchers expected a toddler to get upset when the puppet took and disposed of his or her own hat. What interested them was: Would he or she protest when the puppet threw away another’s hat?

The two-year-olds didn’t. They did not stand up for the property rights of the other person, although they did protest fairly often when the hat was their own. The authors think the two-year-olds did not understand the rule, but perhaps they did and just didn’t care enough to intervene. The three-year-olds, by contrast, did object when the puppet either took—or threatened to throw away—the other person’s hat. They said things such as “You can’t do that. It’s hers.” They complained far more in this scenario than when the puppet did the same to the puppet’s own hat. The study shows that kids begin to have a sense of right and wrong in relation to ownership at an earlier age than people had imagined. In particular, it demonstrates that three-year-olds know that it is okay, morally anyway, to throw away your own stuff (even if it is wasteful), but not to throw away someone else’s. “At three years of age but not younger, children start to appreciate other people’s ownership of objects,” says psychologist Bruce Hood of the University of Bristol in England.

The work is a small piece in the emerging puzzle of how children’s concept of property develops. Kids might first learn that possession can take on different forms, the authors suggest. So they might discover early on, for instance, that being given something is different from borrowing it. Children might also get some idea about what true ownership implies—for example, that you have more say in what to do with something if it is officially yours. Later, kids may grapple with complexities. Although researchers are not sure which specific concepts kids get first, three-year-olds are already showing some understanding that property rules are made by the larger social group and that these social norms are important. They will even enforce these larger group rules whenever individuals break them.

Courtesy of 21TonGiant via Flickr.

The social perspective gives me a better sense of what these kids are learning about property. Some researchers say our feelings about objects stem from the fact that we consider things to be extensions of ourselves. But I find it easier to get my mind around this idea if there’s a social context. To me, people are so much more important than things. When social rules guide our relationships toward objects and what we are allowed to do with them, then breaking the rules puts holes in the social contract—and the act becomes personal. When someone gives something to me, if that person is special, the object becomes special. So to me it makes sense if the development of the property parts of our brains is tied to the social parts. It may take a while to learn the social code, but perhaps it is that code that gives objects their emotional significance. And maybe my 10-year-old dismisses the plastic sunglasses and rubber balls in goodie bags because by now he knows that those gifts have become so obligatory that they carry scant social meaning. Or maybe he just remembers that he has not found them particularly useful.

Courtesy of Digital Shotgun via Flickr.

Earlier this year, Senator Tom Coburn published a report called “Under the Microscope,” in which he criticized the funding of any research he couldn’t immediately understand as important. Of particularly dubious value, in Coburn’s opinion, are the behavioral and social sciences—including my own field, psychology. Following his report, Coburn proposed eliminating the National Science Foundation’s funding for these “human” sciences, writing: “…do any of these social studies represent obvious national priorities that deserve a cut of the same pie as astronomy, biology, chemistry, earth science, physics and oceanography?” Mo Brooks, the chair of a congressional panel considering such cuts, echoed this opinion. Brooks explicitly claimed that the human sciences have yet to prove their worth.

Given that people’s thoughts and choices, by definition, play the single most powerful role in shaping our society, why does studying the human mind seem like such a dispensable endeavor? One reason may be that people often feel as though they understand their minds already, and that the study of people and cultures can’t tell them anything new. Topics such as social networks, emotion, memory, and race relations sound less scientific than the study of cellular structure, protein folding, or electromagnetic force. These latter topics seem as though they will uncover insights inaccessible to our intuitions, whereas the human sciences might not. This couldn’t be further from the truth: examinations of the human mind often dredge up huge surprises.  In fact, a broad message emerging from the last 50 years of psychological research is that forces outside of our awareness drive many of our most critical mental operations—our moral judgments, preferences and the like. Acknowledging these forces and putting them to work has the potential to change—and even save—lives. Here are four ways the human sciences can help us on a broad scale, and reasons we cannot live without the rigorous investigation of our own minds.

Youth voting campaigns often encourage young people to step out from the crowd--and vote. But a better approach would be to cast voting as something everybody is doing. Courtesy of youthdecidegriffith via Flickr.

1. Insights from psychology can reform social programs: Oftentimes, social programs are based on misguided notions about the psychological sources of healthy behavior.  Consider conformity, which has gotten a bad rap for over a century. The party line is that conformists are weak, and that their combined lack of backbone leads to everything from witch-hunts to financial bubbles to teenage smoking. Groups such as D.A.R.E. (Drug Abuse Resistance Education), the long-running lesson program led by police officers, emphasizes that resisting peer pressure is critical to living drug- and violence-free lives. Youth voting campaigns have also appropriated this intuition, and encourage their audiences to buck the sorry trends set by their peers. These strategies frame healthy behavior as an individualistic step away from the crowd—and they rarely work. Instead, research by social psychologist Robert Cialdini (an emeritus professor at Arizona State University), Yale University political scientist Alan Gerber and others shows that a more efficient strategy is to frame positive behaviors such as voting and responsible use of energy as something that others are doing, and harness the power of conformity to encourage such behaviors. This insight suggests critical changes to several large-scale programs. D.A.R.E., for example, receives huge amounts of government funding, and—more importantly—has reached tens of millions of children in the U.S. alone, despite no evidence that it does any good, and some evidence that it does some harm. Simple changes inspired by the human sciences could vastly improve the efficacy of such programs.

Praising kids for effort motivates them to learn; other sorts of praise may be harmful, however. Courtesy of woodleywonderworks via Flickr.

2. Behavioral research can improve education. Motivating children is among educators’ most important jobs. Our culture approaches this job through the intuition that behavior is best motivated through reinforcement. We pay people for work, give children prizes for high test scores, and honor charitable donors on the assumption that these external validations will make people try harder and enjoy their work more. Although most of us wouldn’t want to stop being paid, my colleagues Mark Lepper and Carol Dweck at Stanford describe ways in which particular forms of praise can backfire. Lepper showed that praise in the form of rewards can “overjustify” otherwise enjoyable activities: if I like math and you pay me for doing it, I will eventually conclude (perhaps implicitly) that I am only doing it for external rewards, and as a result will enjoy it less. Dweck showed that certain forms of praise induce a problematic “fixed mindset:” the idea that intelligence is fixed at birth rather than something that can be developed. If you tell me that I am good at math, I may start to believe that aptitude at math is a stable trait, and that my innate ability means that math will always come easily to me. When I face new challenges—say, moving from arithmetic to algebra–I might read my initial difficulties as a threatening sign about my innate abilities. Instead of piquing my interests, more difficult work may cause me to decide that I am no longer a “math person,” and give up on the subject. Dweck has developed simple methods for encouraging people to adopt healthier ways of thinking, for example by praising children for effort, rather than skill or ability. (For more on Dweck’s tips and science see, “The Secret to Raising Smart Kids,” by Carol S. Dweck, Scientific American Mind, December 2007/January 2008.) These methods produce clear benefits in children’s’ long term motivation to learn, but they must be understood to be effectively put to use.

3. Research can vastly improve the lives of people suffering from illness. Mental illness exerts an enormous public health burden, in addition to deeply damaging the lives of patients and their families, yet most psychiatric disorders remain partially or poorly understood. The last few decades have produced enormous research-based changes in the way we understand these disorders. In many cases, we have shifted our focus away from engrained notions about separate psychiatric illnesses as non-overlapping, and towards the commonalities between them. For example, although depression, self-injury, schizophrenia, and obsessive compulsive disorder seem vastly different at the surface, they may not be the diagnostic islands we once imagined them to be. Instead, research indicates that they share key transdiagnostic phenomena (a kind of clinical “active ingredient”), such as difficulties in regulating emotional responses. Psychologists are increasingly focusing on the cognitive and neural bases of these phenomena, and on novel treatments aimed not only at the symptoms characterizing a particular illness, but also on the hidden cognitive ingredients that underlie these symptoms. This approach opens the door to potentially transformative forms of individualized medicine: treatments that are based on a profile of each patient’s cognitive quirks, as opposed to relatively rigid (and often stigmatized) diagnostic labels.

People think that money makes them happier than it actually does. Hint for happiness: Share the wealth. Courtesy of jollyUK via Flickr.

4. Evidence can guide us towards better lives. Most of us do not suffer from a psychiatric disorder. Yet empirical research can help us, too, by telling us how to maximize our well-being. A growing cadre of researchers in the human sciences has cataloged the effects that all sorts of behaviors have on our happiness. Some of their results may be patently un-shocking (if interesting): people are happier when they exercise, when their minds are focused on the present as opposed to wandering, and when they spend money on other people as opposed to themselves. What is surprising is how bad people’s intuitions about happiness seem to be. We systematically fail to correctly predict what will make us happy: for example, believing that wealth predicts psychological well-being more than it actually does, and that spending money on ourselves will make us happier than sharing it. In many cases, these flawed intuitions can drive weeks, months, or even years of striving towards goals that, in the end, provide disappointing returns. By rigorously studying happiness, researchers can provide new and powerful evidence that can guide individuals towards more fulfilling pursuits. On a larger scale, such data can enter community, and even national, conversations about how to improve psychological well-being as opposed to just material wealth, on a large scale.

One of the most exciting aspects of human sciences research is that its results are often of immediate use to laypeople—teachers, parents, policy makers, spouses—requiring no fancy equipment to implement. What is required: understanding the data. People do not need to believe in propulsion physics for NASA to launch shuttles; people do not need to understand drug action mechanisms for their medicine to be effective. But in the human sciences, ordinary people—and especially policy makers—need to internalize lessons learned from our fields to implement them. So my colleagues and I are in the unique position of needing to explain what we’ve done not only for the purposes of getting future work funded, but also so our work can be as useful as possible. To improve health and society, the spoils of psychology and its sister fields must reach a wide audience and overturn the misguided notion—embodied by people like Tom Coburn—that the human sciences have nothing useful to say. Here’s hoping this helped.

*Jamil Zaki is a postdoctoral fellow at Harvard University’s Center for Brain Science. Beginning in July 2012, he will be a professor of psychology at Stanford University.

Filmmaker Kate Schermerhorn cuts the cake with her second husband. The couple started filming "After Happily Ever After" together on their honeymoon. Courtesy of Claudia Lanzoni.

In the U.S., 90 percent of us get married—and usually without a whole lot of thought. We may do it for love, which is fine, but arguably a dubious reason to tie the knot. You can love someone perfectly well without marrying him, after all. We get married because, that’s what people do. For women in particular, getting officially attached to a man is what society expects; if you buck that tradition, some people will wonder about you…if just a little.

And so it is unseemly to question marriage. When people become engaged, you are supposed to be happy for the couple—not to second-guess their decision. Reconsider marriage as an institution? That is unlikely to make you very popular either. And even though half of marriages in this country end in divorce, people too rarely take a hard look at the practice to determine what makes a marriage flourish—or fizzle.

Yet these unfashionable topics are just what Kate Schermerhorn broaches in a delightfully quirky new documentary called “After Happily Every After” to be released on DVD and Video-On-Demand on November 1. A critical examination of marriage is long overdue, because as one of the film’s speakers points out, a success rate of 50 percent would not be considered acceptable in any business context, so why do we think it’s okay for marriage?

Donald and Nancy Featherstone have dressed alike every day for more than 30 years. Courtesy of Kate Schermerhorn.

As if to underscore that point, Schermerhorn’s second marriage did not outlast the making of the film. Her own story of love, and love lost, neatly and entertainingly frames the experts and couples from whom she seeks advice and perspective. Here are seven slivers of wisdom I gleaned from this insightful look at matrimony.

1. Sixty-nine percent of problems in marriages are perpetual; only 31 percent are solvable. So select someone who makes you miserable in ways you can live with.

2. Fill a saltshaker with all ways you can say “yes.” Pour in “Good point.” Add “I never thought of it that way” and “Oh, if that’s important to you, let’s do that.” Sprinkle those statements on your sweetheart throughout the day. That is apparently what the “masters” of relationships do.

3. Define a soul mate as something you make out of a relationship, not as the person who is perfect for you from the start.

4. Don’t be selfish. Look out for the other person’s needs first, because if you’ve done it right, that person is doing the same for you—so you are taken care of.

Schermerhorn and her second husband work together on the film. Courtesy of Steve Anderson.

5. Keep expectations reasonable. Most of the time, marriage is not going to be “bliss.” “You can’t wish for more,” one member of a long-married couple advised. Pass on this perspective. Instead of pretending your relationship is perfect, tell your kids that marriage is difficult, so they come to it later with realistic hopes. (Some kids don’t seem to need you to tell them this, however. When I tried to give my 10-year-old son this piece of crucial information, he feigned shock—having thought until that moment, he said, that marriage was “a dream come true,” sarcasm oozing. I don’t know what his response reflects more, though: his insight or the transparency of his parents’ squabbles.)

6. Ask yourself: Are you the marrying type? Not everyone is. If you want secrecy, don’t want to say “no” to other sexual opportunities, and are not willing to take responsibility for your partner’s problems or meet his or her needs, then marriage is not for you. (Bear in mind that monogamy is rare in nature and does not come naturally to humans. People have to work at it. Some people may just not want to.)

7. Don’t go into the arrangement unprepared. Read books on marriage to boost your chances of making yours succeed.

Phyllis Lyon and Del Martin were the first same-sex couple ever to marry in California. They had been together for 50 years at the time of their union. Courtesy of Kate Schermerhorn.

Rather than working so hard for the sake of marriage—we could, of course, make marriage work better for us. Experts in the film forecast a future in which matrimony in its current form would relinquish its monopoly over people’s sexual, parenting and economic arrangements. In a future iteration, “`til death do us part” would no longer be part of the deal. Instead, couples might sign a more realistic 15-or 20-year contract during which they would agree to create and sustain a family. Or something else a little less binding than hanging out until someone dies.

Alternatively, child rearing could occur outside of marriage. If you find someone you think would make a good father (or mother) you could decide to raise a kid together. Period. Divorced parents raise kids in separate households. Why can’t that happen with two parents who planned it that way? Obviously, there are economic advantages—and likely advantages for the children—of having two parents in the same house. But that ideal may often be unattainable, at least in the long run. In the end, not aiming for perfection might truly take the pressure off couples and families, too. That way, marriage might bounce back as an institution so that those who choose to pursue it are more likely to meet with success.

Courtesy of h.koppdelaney via Flickr.

Desire. When you have it, nobody questions it. When it is absent, it can be tricky to talk about. After all, the subject is delicate, and what is the point? You probably have little clue what is going on anyway. Luckily, scientists are looking out for you—because it is not even close to being just you. An astounding 40 percent of American women between the ages of 20 and 70 have problems with low sexual desire. Men have issues, too, but the numbers are shaky, because, as difficult as this is for women to talk about, men won’t touch the subject. (Even in a doctor’s office, their willingness to address an absence of sexual wants begins and ends with the mechanical issue.)

Plenty of folks have considered the usual suspects in the sapping of sexual desire. A recent study of young women shows the most common factor in females is stress and fatigue, followed by poor self-image and then sexual difficulties such as the inability to reach orgasm. But a lack of desire can stem from conceptual problems involving the way you view sexual experiences, says Syracuse University neuroscientist Stephanie Ortigue. “Desire is more than an emotion,” says Ortigue. “It involves brain areas involved in thinking intellectual things. That is why it’s so personal, so subjective, and so common.”

And although endocrine, genetic and psychological factors can all contribute to desire, or the lack of it, Ortigue’s perspective comes largely from looking at brain circuits.

Several years ago, Ortigue’s team and two others sketched a network in the brain that is always activated when we experience sexual desire. The three research teams independently landed on the same brain regions. These included areas governing emotion, motivation, body image—and, notably, memories associated with life experiences. Memories can affect desire in subtle, subconscious ways. For example, if a person has a feature or personality that reminds you of something positive in your past, a subconscious association between that person and pleasant reveries may trigger desire, Ortigue says. In this way, desire emerges from a collaboration of emotional, motivational and intellectual parts of the brain, she says.

Courtesy of Peter Pearson via Flickr.

Ortigue and her team recently took a look at these brain regions in 13 women between 26 and 47 who qualified as having hypoactive sexual desire disorder. These women either had no feelings of sexual interest or those feelings had plummeted to a low level of late; many had no sexual thoughts or fantasies. They lacked any impulse to even try to become aroused. And they said the absence of these feelings and thoughts distressed them.

The researchers asked these women—as well as 15 women with no lack of desire–to look at both pictures of male models and nonerotic photos while their brains were being scanned. As expected, the women who lacked desire showed abnormally low activity in the brain network previously linked with that feeling. More surprising, however, was that these same women also showed more activity in prefrontal brain regions involved in inhibition of action, attention to and judgment of the self, and interpreting the actions of other people. That is, that proverbial headache probably has its roots in this decision-making, self-control, theory-of-mind part of the brain.

The increased activity there suggests that people with depleted desire have two problems. One is that they are spending time trying to interpret the intentions of the other person—and probably coming to incorrect conclusions, says Ortigue. The second is that, they are monitoring or evaluating their own responses to erotic stimuli. They are not “living in the moment,” Ortigue says. Such analysis can interfere with the erotic experience, perhaps in the same way that explaining a joke can sap it of its humor.

The work dovetails with decades old studies by William H. Masters and Virginia E. Johnson, who coined a behavior called “spectatoring” they found common among people with sexual disorders. In spectatoring individuals become spectators of themselves during intimate encounters, viewing themselves from above and judging the situation.

“People really suffer from this,” says Ortigue, referring to hypoactive sexual desire. And knowing that the cause is less chemical in nature than psychological and intellectual may offer hope. Instead of fiddling with hormones, says Ortigue, teach people to stop judging themselves and others so much.

Postscript: Stephanie Ortigue is at the forefront of a field called social neuroscience, which blends chemistry, neuroscience and social psychology to improve our understanding of human relationships and develop treatments for social disorders such as autism. The second annual meeting of The Society for Social Neuroscience takes place November 10 and 11, 2011 in Washington, DC.

Goldie Hawn in 1989 at 61st Academy Awards. Photo by Alan Light via Wikimedia Commons.

ASPEN. When I arrived at the Aspen Meadows Resort for the Second Annual Aspen Brain Forum last Thursday evening, Goldie Hawn was getting out of a vehicle near the entrance. I knew she was about to give the keynote address, but I was startled to practically run into the actress. A grandmother now, Hawn looked fabulous in over-the-knee black leather boots and a chunky silver belt strung around a black miniskirt. It wasn’t so much her looks, though, that made her instantly recognizable. Her trademark laugh and general effervescence mark her like a strobe light, quite visible even in the bright Colorado sun. I watched her stop to enthusiastically greet—hug, kiss—various other conference attendees, who seemed equally eager to chat her up, whether to advance their work or sidle up to celebrity, I couldn’t say.

Hawn spoke without notes, claiming to be a born communicator, a claim she backed up by her performance. As she talked, it occurred to me that vivaciousness and beauty did not alone propel her to stardom. Unlike most people who wing it, Hawn strung together rhythmic sentences that made sense. If the neuroscience community was going to be delivered an advocate, they could have done a lot worse.

She answered the obvious question first: Why is Goldie Hawn speaking at a brain conference? I already partly knew the answer. Just as any 7-year-old can now do, I had looked it up on the web. Six years ago Hawn established a nonprofit group called The Hawn Foundation “to promote children’s academic success in school and in life through social and emotional learning.” It is based on the notion that kids’ intellects do not exist in isolation from their emotions, their connections to others or the rest of their bodies. The MindUp program, the Foundation’s signature educational initiative, is designed to address these oft-neglected components of learning. It was a perfect fit for the forum, which this year addressed “The Cognitive Neuroscience of Learning: Implications for Education.” But more on that in a bit.

Hawn’s version was more personal. Decades ago (in 1972 she said), when she became famous, she felt newly anxious and something hard to imagine happened: she lost her signature smile. The change was foreign to Hawn—and not welcome. “When I was 11 years old, I decided that what I wanted to be in life was happy,” she said. “I thought, `All I want to do is hold onto this joy, this tickle I had when I was little.’” Having lost that tickle Hawn went spelunking, in her own psyche. She saw psychologists and began meditating, embarking on a nine-year psychological journey. Such an adventure might make lesser folks crazy or depressed in itself, but Hawn became surprisingly analytical about it. It led, she said, to her first understanding of the brain, “what it can do, how it can change.” She was particularly interested in neuroscience and spirituality, fancying questions such as “What is that God part of the brain?”

Hawn moved to rainy Vancouver, because her son, Wyatt, wanted to play hockey. While watching the rain outside her meditation room sometime in 2002, Hawn’s quest turned outward—in particular, to children. “I was a happy child,” she recalled. “I signed all my 4^th grade papers, “Love, Goldie.” But in the wake of 9/11, she perceived U.S. children as being profoundly unhappy. “And I thought why can’t we do something that gets kids to understand their potential? Why don’t we teach our kids about the brain?”

The brain. Via Wikimedia Commons.

Hawn was no brain expert, but she reasoned that teaching kids about the brain might make them more aware of their own thoughts and emotions. It might help them to develop the ability to think about thinking, or metacognition. That awareness would then give them better control over their own mind—directing their attention more appropriately or calming themselves down—in ways that could improve learning. Hawn seems to give kids lots of credit. I doubt most grownups would be similarly confident that kids could ably control their minds if shown how. Hawn saw this mission as urgent, though. She particularly wanted to prevent stress from shutting down executive function, the self-control of thought, action and emotion that is essential for learning.

So Hawn asked a team of educators, neurologists, psychologists and social scientists to develop a new curriculum built, in part, around lessons about how the brain works. Nowadays teachers in about 65 U.S. schools, nearly 150 in Canada, seven in the UK and one in Venezuela are using MindUp. Some of its young students now weave brain anatomy into casual conversation. One six-year-old girl, Hawn says, explained that it was her aunt’s amygdala that saved her life when the aunt pulled her out of the way of an oncoming car. Another kid reportedly said, “Oh, that lights up my prefrontal cortex, I know how to do this.”

Not all scientists think explicit knowledge of brain anatomy is necessary for prepping kids for study. But it is kind of cool. And why not? “I don’t think kids need to know about the amygdala,” says Adele Diamond, a developmental cognitive neuroscientist at the University of British Columbia. “But kids enjoy learning about the brain. I don’t think it hurts.”

Another component of MindUp, also apparently aimed at metacognition, is meditation. For three minutes, students concentrate on their breathing. The activity not only promotes calm but also sharpens attention. “It is very hard to stay focused on something for three minutes,” Diamond says. “This is training the mind.”

Courtesy of woodleywonderworks via Flickr.

An equally important objective of MindUp is social and emotional development. Kids are taught, for example, that random acts of kindness matter. They know about mirror neurons, Hawn says, and they learn that you become happy when you give to someone else, a lesson in line with the teachings of the Dalai Lama. Similarly, in “gratitude journals,” children regularly jot down what they are grateful for. I think this is also designed to make them feel good (Hawn invoked dopamine, the brain chemical for reward, in her talk), and to build better relationships. My kids are told to do this at Thanksgiving, and every November I have the passing thought that we really should be counting our blessings more often.

Preliminary data suggest the program works. Kim Schonert-Riechl, an applied developmental psychologist at the University of British Columbia and her colleagues tested the effectiveness of MindUp in 75 schools in her area. So far, the program seems to have had “incredibly positive effects,” says Diamond, who helped parse the data. It not only boosted kids’ self-reported feelings of happiness, liking of school, and sense of belonging, but also moderated kids’ cortisol levels, suggesting it lowered stress in the classroom. Perhaps most strikingly, it improved children’s executive function.

Scientists I spoke to about MindUp were enthusiastic about its potential to benefit children, particularly those at risk of being unhappy and failing in school. A lot of it did make scientific sense. After all, meditation exercises of the type used in MindUp can help adults better orient their attention, according to work presented by psychologist Amishi P. Jha of the University of Miami. And stress can shut down the ability to think—so reducing it should do the opposite. Some studies exist on the effects of gratitude as well: expressing your appreciation for a romantic partner, for example, seems to solidify those important bonds. (See “The Happy Couple: Secrets to a Long Marriage,” By Suzann Pileggi, Scientific American Mind, January/February 2010.) MindUp is reportedly gaining the support of teachers as well. “Teachers love it,” Diamond claims. “That’s why it’s spreading.”

MindUp is far from the only educational program designed to nurture kids’ executive function through novel means or to focus on social and emotional needs. Among the experimental are Tools of the Mind and the Responsive Classroom. Sandra Brettler, a fourth-grade teacher from Seattle (who also holds a Ph.D. in neuroscience), wrote to me about the impressive results seen with the latter approach. “So much of our struggle in education today does not take into account the whole student or our need for positive contributors to our society,” she wrote. “It’s a gift to be able to say that my students get daily practice in becoming cooperative, assertive, responsible, and empathetic community members and that through this lens, they become competent and advanced academic thinkers.”

But Hawn’s program is unique, if for no other reason, because she’s behind it. I couldn’t help admiring this scientific novice for doggedly following up on the instincts she had a decade ago, far-fetched as they might seem, and molding them into something undeniably real and data-driven. Hawn’s determination obviously cuts across disparate fields. “We are going to change education as we know it,” Hawn said.

The World Trade Center, 1995. Courtesy of Aaron Logan via Wikimedia Commons.

A decade ago, we lived in an apartment tower in Jersey City overlooking the Hudson River. We had a panoramic view of Manhattan—and of planes flying in and out of the nearby airports. After several years there, I got used to rolling my eyes as my husband pontificated on the make, or approach, of various pieces of equipment as they roared by our large windows.

On 9/11, as we sat down to breakfast, my husband suddenly said: “Wow, that plane is flying awfully low.” That got my attention, wondering if he could really have spotted something amiss. But he soon left for work, only to return a few minutes later. A crowd had greeted his arrival at the train station. The clustered commuters, he determined, were all looking at the aftermath of the first plane strike. As the drama unfolded, we took our five-month-old out of daycare and drove to my in-laws, who resided much farther away from the action.

Like nearly everyone else who lived through that day, I feel I remember it clearly, even though data shows that people’s recollections of 9/11 have, in fact, significantly degraded with time (see How Accurate Are Memories of 9/11?). Recent research published in Psychological Science suggests that some of that distortion is social. My conversations with others about the event—the retelling of my own experience, for example—have etched particular parts of 9/11 in my mind at the expense of other facts and memories.

This latest work is an elaboration of a revelation about human memory psychologists made the mid-1990s. Back then scientists discovered a phenomenon they called retrieval induced forgetting in which a person’s attempt to recall one piece of information causes him or her to forget closely related memories. This type of forgetting explains why repeatedly taking a better route to a friend’s house makes the old route fade in your mind, but has no impact on your memory for, say, how to get to your office.

Smoke rises from what remains of the World Trade Center shortly after the second tower collapsed. Courtesy of Wally Gobetz via Wikimedia Commons.

That earlier work applied largely to people’s independent efforts to practice, read or recite material. Yet much of what we do during the day involves interacting with others. So a few years ago, psychologist William Hirst and his colleagues at New School for Social Research in New York City decided to study forgetting in a social context. In their first experiments, they found that one person’s selective recounting of a written story caused both that person and a listener to forget related, unstated information from the story (which they both read) more than unrelated material. Then Hirst, along with Alin Coman, now at the University of Pittsburgh, and David Manier at City University of New York, tested the idea in a more lifelike setting by investigating the effect of conversation on 9/11 memories.

The team asked 22 people who lived in the New York City area on September 11, 2001, to fill out a questionnaire about what they remembered about that day. Then pairs of participants (who did not know each other) discussed their personal recollections of the attack. If either conversant left out specific relevant details from the questionnaire, Hirst, Coman and Manier found, both of them had trouble remembering the omitted items later on. Memories that were closely related to the ones mentioned in the conversation became the most difficult for both the speaker and the listener to access. For instance, if one person shared that she woke up at 8 a.m. that day, but neither she nor her conversation partner then mentioned the time at which they heard about the attack, they each had trouble recalling that detail later. Over multiple conversations, Hirst speculates, that neglected information could become forgotten.

And as people repeatedly talk to each other about shared experiences such as 9/11, as I have, they may trigger a kind of collective forgetting that shapes joint memories. “What people forget in common is also a function of what they remember in common,” Coman says. “If a group of people forget the same things, that will increase the amount of shared information in their memories.” Such morphing of memory through conversation helps forge a collective identity in society by creating a common view of the past, Hirst believes. Other communication practices such as those propagated through the media are also likely to influence both individual and collective memory.

Our conversations with others alter our memories. Courtesy of Alectrevelyan006 via Wikimedia Commons.

I now wonder how listening to other people’s 9/11 stories might have shaped my own. And even though I now know my remembrances of that day are probably warped, I am sticking to my story, because it is truly the only one I have. I don’t mind the fact that my brain does not accurately record all the events of the past as a digital camera might. The notion that my life, including all the people who have enriched it, has distorted my recollection of events is even sort of appealing. I favor the metaphor of my mind as a tapestry stitched together by arguably useless chitchat. In fact, knowing that I enlist others to remake my memories of parties, adventures, romantic breakups, car accidents—and major disasters, doesn’t bother me at all.

Ingfei Chen contributed to this blog.

Wealthy people can afford independence. As a result, they pay less attention to social cues than poorer folks do. Via Wikimedia Commons.

Money can bring you happiness, studies show, but not as much as you might think. The richer you get, the happier you get, but the returns diminish after you reach a certain standard of living. (See Do We Need $75,000 a Year to Be Happy?) One of the reasons for this finding might be that as you move up in social ranking (socioeconomic status) you lose some of your dependency on others. Richer people don’t have to call friends for help. They can pay for it. A recent study shows, however, that there are big benefits from the increased social interaction that comes with being “lower class” in America.

Social psychologist Michael W. Kraus at the University of California, San Francisco, and his colleagues have found that people who have less education (a proxy for riches and occupational prestige) or who come from self-described “lower class” families are better at reading the emotions of others than higher status people are. The people in the lower social status group scored higher on a test that involved identifying emotions in photographs of human faces. They more accurately judged the emotions of a partner during a hypothetical job interview. They were also better at inferring feelings from images of just the eyes. (Test your skill here.) In an earlier study, Kraus also showed that lower-class individuals exhibit more social engagement through gestures such as nodding the head and laughing.

The currency of status, not empathy. Via Wikimedia Commons.

By extension, richer and more educated people are not very good at recognizing other people’s emotions. They lack empathy. (This may explain the fact that rich people are not very generous and so, typically, do not make large charitable donations; see Can Money Buy Happiness?) The social disconnect that seems to accompany riches seems sort of sad, and it made me appreciate the ways in which my family’s lack of them might be making me happy.

We are not poor, but I have made certain choices for financial reasons that richer people would not. For one thing, we have only one car, which is, admittedly, a challenge for a family living in the suburbs with two kids. But I like challenges—and I really do not want to spend time and money on a second vehicle, even though I notice that almost none of my friends have deprived themselves of one. The one-car problem usually starts out as my logic puzzle for the week—how to get everybody where they need to go on Saturday, given two drivers but a single vehicle. When even my husband can’t solve the conundrum, I start texting and emailing other dads and moms about carpooling.

This coordination takes quite a bit of effort, and no, I don’t always like asking other people for help. But once I have made it happen, I realize how wonderful it is. Not only does everybody get to do what they wanted, or signed up, to do, but they end up with playdates at my house, or the friend’s. Sometimes the grown-ups hang out for dinner or a beer. I hear hilarious exchanges between my kids and their friends in the back seat. And always, my kids get to come and go to the party, or the practice, or the robot club meeting, with a pal.

There are other ways in which less money can beget social payoff. We use an after-school program for our kids rather than a sitter, mostly because sitters, while more convenient, are more expensive. Of course, these programs force my kids to interact with others. But in addition, the fact that they are not infinitely flexible means that sometimes, I need to ask friends or family to fetch my little cherubs. The other day, that earned us a visit from my incomparably generous mother-in-law. Other times, I call on my friends—and it usually cheers me up to see them, and to be reminded that I have them.

Bonding with others is the fast track to happiness, experts say. Via Wikimedia Commons.

It never occurred to me that my frugality could boost my social life. And although I know that not having a fleet of fancy cars does nothing for my image, it actually makes my life richer, not poorer, in ways that I had not anticipated.

Too much attention to social cues and context can breed conflict, of course, and may contribute to the fact that lower-class individuals are more likely to get stuck in negative moods and suffer from mood disorders. (Many other factors could be involved here as well, not least of which might be financial stress.) But despite the potential drawbacks, connecting with neighbors, friends, family and colleagues is something that humans, rich or poor, should be doing more, not less. Forming close social bonds, experts say, may be the wisest investment in well-being that a person can make.

Via Wikimedia Commons

Maybe because this porn watching is perturbing male minds, engendering sexist, even misogynist attitudes toward women? Maybe its use portends a rise in violence against us, the weaker sex?

A new report (The Sunny Side of Smut) in the current issue of Scientific American Mind by Melinda Wenner says nah, let the guys (and gals) have their porn. Sure, porn gives a lot of us bad vibes. At best, it is in bad taste and worse, flatly immoral. But engaging in a tasteless, sleazy diversion is different from doing something dangerous. In fact, it’s very difficult to find backing for the argument that porn is harmful. And there is at least as much data to support the contention that porn might be doing its fans—and even the rest of society—a bit of good. (Hear me chat about this on the radio.)

First of all, the guys who watch mainstream porn seem to be just normal guys—not total creeps—which, given that porn watching seems pretty darn common, does not surprise me. But to give the research its due: in a 2007 survey of 650 young men, scientists found that users of mainstream, nonviolent pornography were neither more nor less sexually satisfied than nonusers. Both groups felt the same degree of intimacy in their relationships and had similar sexual experiences.

The men with a penchant for violent or fetishist porn did have a few quirks: they masturbated more frequently, had more sexual partners in their lives, and were not as close to their partners as the average, non-porn-watching male (whoever that is). But, of course, people do vary in these characteristics in ways that are not necessarily pathological or bad. Other studies Mind columnists described in a previous article (Sex in Bits and Bytes) have shown that men who view a lot of violent porn are more likely to display sexually belligerent behaviors such as holding a woman down against her will. But think about it. Guys who like to view violence tend to be more violent. Not sure what the porn had to do with it.

My take: a lot of things happen to males during their development to shape their brains one way or the other, to be nice guys or jerks. By the time they start watching porn, their habits are more likely to reflect who they are than to shape their personalities in any significant way.

Via Wikimedia Commons

But Wenner’s story goes beyond saying porn is safe. It suggests that it might actually be beneficial. I am not sure I buy this, but some coincidences worth mentioning back up this view. First, as access to Internet pornography grew in this country, rates of rapes and sexual assault went in the opposite direction. Those stats are at their lowest levels since the 1960s. And something similar happened in Japan, China and Denmark.  Along those lines, the U.S. states in which rapes rose by 53 percent had the least Internet access between 1980 and 2000—and so the least access to Internet porn. States with the most access saw a 27 percent drop in reported rapes. These opposing trends don’t prove anything. It could be that they are unrelated to each other or that a third factor underlies both. But it makes you wonder.

If porn somehow reduces rape, why would that be? Wenner suggests that pornography may be a safe outlet for deviance. Exposure to it correlates with lower levels of sexual repression, experts say. And people seeking treatment in clinics for sex offenders commonly say that it helps them keep their abnormal sexuality in their minds. Otherwise, maybe these folks, and others, might have been contributing to those rape stats. I don’t really know, but that’s the idea.

Relationship-wise, watching porn could have drawbacks. Guys, if you overindulge and advertise it, you are unlikely to score points with your wife or girlfriend. In a study of female partners of heavy porn users, 42 percent said it made them feel insecure; 39 percent said it had a negative impact on their relationship and 32 percent said it negatively affected their lovemaking.

On the other hand, maybe more of us gals should see what it’s like. Peeking at porn is probably not going to make us violent toward our partners, after all. Maybe we’d get it (and be one with the guys). Maybe we’d be grossed out. Maybe both. In any event, it might spark ideas. And those can be good for a relationship.