Friday, November 28, 2014

Buy Nothing Day 2014

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“Today, humanity faces a stark choice: save the planet and ditch capitalism, or save capitalism and ditch the planet.”
– Fawzi Ibrahim


Until we challenge the entrenched values of capitalism – that the economy must always keep growing, that consumer wants must always be satisfied, that immediate gratification is imperative – we’re not going able to fix the gigantic psycho-financial-eco crisis of our times.

That challenge is a deeply personal one: in a world where every inch of the capitalist system is bullying you into submission, can you resist? When advertisers hound you day and night, can you escape? This Black Friday, a massive, absurd, and destructive consumerist machine will coordinate against you for one simple reason - to convince you to max out your credit card to buy shit you don’t need so that a broken system stays afloat. So when they say "BUY!", will you say NOTHING!”?

Buy Nothing Day is legendary for instigating this type of personal transformation … as you suddenly remember what real living is all about … you sense an upsurge of radical empowerment and feel a strange magic creeping back into your life.

Join millions of us in over 60 countries on November 28/29 and see what it feels like. Then, after Buy Nothing Day, take the next step … for generations, Christmas has been hijacked by commercial forces … this year, let’s take it back.

And why not get playful while you’re at it!? … Put up posters, organize a credit card cut up, pull off a Whirl–mart, or a Christmas Zombie walk through your local mall.
 https://www.adbusters.org/sites/all/themes/adbusters5/assets/img/6/buy_nothing_day_2014_2.jpg

Monday, November 24, 2014

Link Dump - Brain, Neuroscience, and Mental Health

Here are a few links that have been hanging around in my browser for the last few days (or weeks). Hope you find them interesting - follow the title links to read the whole article.

How to Study the Brain


6112-Marcus
Stuart Bradford 
for The Chronicle Review


And that is a good thing. On virtually any account, neuroscience needs more data—a lot more data—than it has.

To begin with, we desperately need a parts list for the brain. The varied multitude of cells in the human brain have names like "pyramidal cells," "basket cells," and "chandelier cells," based on their physical structures. But we don’t know exactly how many cell types there are—some, like Cajal-Retzius cells (which play a role in brain development) are quite rare. And we know neither what all these different cell types do nor why there are so many. Until we have a fuller understanding of the parts list, we can hardly expect to understand how the brain as a whole functions.



A double exposure of weakly electric fish with recordings of brain activity. Credit Béatrice de Géa for The New York Times

Research on the brain is surging. The United States and the European Union have launched new programs to better understand the brain. Scientists are mapping parts of mouse, fly and human brains at different levels of magnification. Technology for recording brain activity has been improving at a revolutionary pace.

The National Institutes of Health, which already spends $4.5 billion a year on brain research, consulted the top neuroscientists in the country to frame its role in an initiative announced by President Obama last year to concentrate on developing a fundamental understanding of the brain.
Scientists have puzzled out profoundly important insights about how the brain works, like the way the mammalian brain navigates and remembers places, work that won the 2014 Nobel Prize in Physiology or Medicine for a British-American and two Norwegians.

Yet the growing body of data — maps, atlases and so-called connectomes that show linkages between cells and regions of the brain — represents a paradox of progress, with the advances also highlighting great gaps in understanding.

Wednesday, November 19, 2014

Kristin Neff: Overcoming Objections to Self-Compassion

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This is short, but important. From the Greater Good Science Center.

Published on Oct 16, 2014

The world's leading researcher of self-compassion and founder of the Mindful Self-Compassion program considers--and rebuts--some of the main objections to treating yourself with kindness.

Monday, November 17, 2014

Trauma and Psychosis: A Review and Framework for Psychoanalytic Understanding

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I have long felt that psychosis is more adequately understood when it is seen as the most extreme form of dissociation - a need so intense that it is not the body, or emotions, or memories that are dissociated, it is reality itself.

Although it is reality that is dissociated (through delusions, hallucinations, paranoia, and cognitive distortions), it is fundamentally the emotions that are most important in making sense of the psychotic features and in bringing the client back. I have no doubt that meds are important for some, but not everyone benefits from the psychological numbing effects of the atypical antipsychotics.

What my clients have taught me is that the key to recover is to reclaim the body, and with it the emotions that are so painful the person needed to create a different reality, where the client is often a different person, with different origins, and who is much more important in some ways than they ever were in their "normal" life.

This is a free article (until the end of December) from the International Forum of Psychoanalysis in which Lawrence Kirshner offers a psychoanalytic take on psychosis and its roots in trauma (follow the links to read online or download).

Full Citation:
Kirshner, L.A. (2013, Jun 4). Trauma and psychosis: A review and framework for psychoanalytic
understanding. International Forum of Psychoanalysis, DOI: 10.1080/0803706X.2013.778422


Lewis A. Kirshner

Tuesday, November 11, 2014

All Good Things . . .

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I have been doing this blog for nearly ten years, pretty much two or more posts every day. I have loved the reading and sharing that goes into a blog, as well as the opportunity to preach my beliefs about whatever I was interested in on a given day. But, for a variety of reasons, it's time to do something else.

I'm not shutting down the blog, but any posting will be occasional or a more in-depth exploration of some topic of interest.

I have made this decision for The Masculine Heart as well (which has been a daily effort for more than six years).

THANK YOU to all of you who read this blog and especially to those of you who have engaged in conversation here.

The One Thing that Could Save the World: Why We Need Empathy Now More than Ever

I completely disagree with Paul Bloom (psychologist at Yale) that empathy is a poor moral guide. Bloom sets empathy against rationality, which is a false dichotomy.
George Lakoff: “Empathy is at the heart of real rationality, because it goes to the heart of our values, which are the basis of our sense of justice. Empathy is the reason we have the principles of freedom and fairness, which are necessary components of justice.”
In the article below,

The one thing that could save the world: Why we need empathy now more than ever

Critics say that empathy clouds our judgment and distracts us from true morality. Here's what they're missing.




The one thing that could save the world: Why we need empathy now more than ever 
Gregory Peck and Brock Peters in "To Kill a Mockingbird" 
Empathy is trending. President Obama wants to tackle America’s “empathy deficit,” medical students routinely receive empathy training, and everyone from business gurus to the Dalai Lama have become its champions. The latest neuroscience research shows that 98 percent of us have the capacity to empathize wired into our brains and, like riding a bike, it’s a skill we can learn and develop. No wonder Google searches for the E word have more than doubled  in the past decade. The art of imaginatively stepping into another person’s shoes and seeing the world from their perspective is, it would seem, a most valuable and valued twenty-first century asset.

Not so, says Yale psychologist Paul Bloom, leading the counter-charge against empathy’s popularity surge. It is, he claims, a poor moral guide, lacking the power to inspire us to act on, say, child poverty or humanitarian disasters. “Our public decisions will be fairer and more moral once we put empathy aside,” says Bloom, insisting we should instead, “draw on a reasoned, even counter-empathetic, analysis of moral obligation.” But in doing so, Bloom creates a false – and dangerous – dichotomy between empathy and reason, and misses the long lesson from history: that time and again, empathy has played a crucial role in creating a democratic culture that respects human rights. So where have the critics gone wrong?

The anti-empathy brigade launch their attack with the claim that having too much empathy can lead to what Bloom calls “empathetic distress” or burnout. Yes, identifying closely with someone else’s pain and mirroring their emotions – known as affective empathy – can seem overwhelming. But according to altruism expert Daniel Batson  at the University of Kansas, there is no scientific evidence that those with high levels of affective empathy are less able to respond to other people’s needs: they are not paralyzed by their sensitivity – indeed many may be motivated by it. Moreover, people who need to keep a cool head when the emotional heat is rising – be they doctors, firefighters or social workers – know to draw, instead, on their capacity for cognitive empathy, an ability Bloom too easily sidelines. And there’s a crucial distinction between the two.

If affective empathy is our mirror for reflecting others’ emotions, cognitive empathy is, by contrast, a pair of shoes that invites us to imagine the world from their viewpoint. So the smart doctor aims not to feel her patient’s anxiety, but to understand it, so that she can respond appropriately. Every good parent teaches cognitive empathy to their kids: ‘Imagine how you’d feel if someone did that to you,’ we tell them as a first step in their moral education. Trying to understand others’ perspectives is an essential part of our emotional intelligence toolkit, and it matters all the more if their lives and needs differ from our own. As George Bernard Shaw quipped, ‘Do not do unto others as you would have them do unto you – they might have different tastes.’ Our cognitive empathy enables us to discover those different tastes.

A second charge against empathy is that it fails at a distance: we empathize more easily with people in our backyards, say the critics, so help our neighbors while ignoring earthquake victims overseas. This is muddled thinking. Proximity is clearly no guarantee of care: we can stroll past a homeless person on our street just as we can be stopped in our tracks by a news story about a woman in Japan left homeless by an earthquake. The real question is how to give people a human face, whether they are near or far, so we get beyond abstract statistics and stereotypes and can make an emotional connection with their lived reality. Without empathy, we could never explain the massive rise in humanitarian giving by individuals to developing countries since the end of World War II.

The strongest critique in the empathy wars is the risk of empathic bias: the concern that we are partial towards our in-group – people of a similar socioeconomic or cultural background to our own. Think of the judge who gives a more lenient sentence to a white-collar criminal whose educational background resembles his own. Empathic bias is real and it matters – but it means that we need to deepen, not discard, our empathy, by escaping the boundaries of our peer group. That’s just what the Eton-educated writer George Orwell did when, in the late 1920s, he swapped his natty suit for tramping clothes and lived amongst hobos and beggars on the streets of East London, an empathic immersion described in “Down and Out in Paris and London” that exploded his prejudices about the homeless. We might all learn from his example and get talking to the strangers on our doorsteps, whether it’s your new Afghani neighbor or the heavily tattooed woman who delivers your mail each day.

Our empathy is powerful but it is clearly not perfect. So should the critiques of Bloom and others convince us to cast our innate empathic abilities aside and rely, instead, on reason as our moral compass? This would be a monumental mistake, proving us blind to the lessons of history. Reason divorced from empathy was a specialty of the Nazis, who used reason to argue that Jews were subhuman and then codified it in the Nuremberg Laws. What made the Holocaust possible was the Nazis’ racial ideology that achieved one of the most successful erosions of societal empathy in political history.

There are positive lessons from history too. A growing wave of scholars, from the cultural historian Lynn Hunt to the arch-rational psychologist Steven Pinker, argue that democratic rights have been won when societies have extended their empathy to previously neglected social groups. Look no further than the 18th century humanitarian revolution, which generated the first campaigns to tackle child poverty, the anti-slavery movement and associations to improve working conditions. In “The Better Angels of Our Nature,” Pinker points out it was rooted in ‘the rise of empathy and the regard for human life’, underpinned by the ‘reading revolution’ as literature opened up imaginations to previously hidden lives. When the public became sensitized to the suffering of marginalized groups, it spurred legislative reform. And this story has been repeated in struggles throughout democratic history, from women’s suffrage to gay rights and disability rights.

If there is one lesson that history teaches us, it is this: empathy cracks open the door of our moral concern, and laws and rights wedge that door open. Reason – embodied in laws and rights – and empathy are not, as the critics contend, polar opposites. They are in fact a democratic double act: like knife and fork, ball and socket, Fred and Ginger, they work best when they work together. As the cognitive linguist George Lakoff puts it, “Empathy is at the heart of real rationality, because it goes to the heart of our values, which are the basis of our sense of justice. Empathy is the reason we have the principles of freedom and fairness, which are necessary components of justice.”

Cast empathy aside to lean on reason alone and we would become emotionally tone deaf and politically indifferent. That is not who we want to be and – more importantly – it is not who we are.

Roman Krznaric’s new book is Empathy: Why It Matters, and How to Get It (Perigee/Penguin, on sale Nov. 4). He is a faculty member of The School of Life in London and founder of the world’s first digital Empathy Library. Follow him on Twitter at @romankrznaric.

TED Talk Playlist: All Kinds of Minds (9 Talks)

This is a cool collection of TED Talks entitled, "All kinds of minds." These nine talks "shatter" common beliefs and stereotypes about mental illness, or more accurately, neurodiversity.


These powerful stories shatter preconceived notions about mental illness, and pose the provocative question: What can the world learn from different kinds of minds? 

Playlist (9 talks)


14:52 -
Elyn Saks A tale of mental illness -- from the inside
"Is it okay if I totally trash your office?" It's a question Elyn Saks once asked her doctor, and it wasn't a joke. A legal scholar, in 2007 Saks came forward with her own story of schizophrenia, controlled by drugs and therapy but ever-present. In this powerful talk, she asks us to see people with mental illness clearly, honestly and compassionately.



19:43 -
Temple Grandin The world needs all kinds of minds
Temple Grandin, diagnosed with autism as a child, talks about how her mind works — sharing her ability to "think in pictures," which helps her solve problems that neurotypical brains might miss. She makes the case that the world needs people on the autism spectrum: visual thinkers, pattern thinkers, verbal thinkers, and all kinds of smart geeky kids.



14:17 -
Eleanor Longden The voices in my head
To all appearances, Eleanor Longden was just like every other student, heading to college full of promise and without a care in the world. That was until the voices in her head started talking. Initially innocuous, these internal narrators became increasingly antagonistic and dictatorial, turning her life into a living nightmare. Diagnosed with schizophrenia, hospitalized, drugged, Longden was discarded by a system that didn't know how to help her. Longden tells the moving tale of her years-long journey back to mental health, and makes the case that it was through learning to listen to her voices that she was able to survive.



8:44 -
Ruby Wax What's so funny about mental illness?
Diseases of the body garner sympathy, says comedian Ruby Wax — except those of the brain. Why is that? With dazzling energy and humor, Wax, diagnosed a decade ago with clinical depression, urges us to put an end to the stigma of mental illness.



22:18 -
Sherwin Nuland How electroshock therapy changed me
Surgeon and author Sherwin Nuland discusses the development of electroshock therapy as a cure for severe, life-threatening depression — including his own. It’s a moving and heartfelt talk about relief, redemption and second chances.



5:51 -
Joshua Walters On being just crazy enough
At TED's Full Spectrum Auditions, comedian Joshua Walters, who's bipolar, walks the line between mental illness and mental "skillness." In this funny, thought-provoking talk, he asks: What's the right balance between medicating craziness away and riding the manic edge of creativity and drive?



18:01 -
Jon Ronson Strange answers to the psychopath test
Is there a definitive line that divides crazy from sane? With a hair-raising delivery, Jon Ronson, author of The Psychopath Test, illuminates the gray areas between the two. (With live-mixed sound by Julian Treasure and animation by Evan Grant.)



18:48 -
Oliver Sacks What hallucination reveals about our minds
Neurologist and author Oliver Sacks brings our attention to Charles Bonnet syndrome — when visually impaired people experience lucid hallucinations. He describes the experiences of his patients in heartwarming detail and walks us through the biology of this under-reported phenomenon.



9:26 -
Robert Gupta Music is medicine, music is sanity
Robert Gupta, violinist with the LA Philharmonic, talks about a violin lesson he once gave to a brilliant, schizophrenic musician — and what he learned. Called back onstage later, Gupta plays his own transcription of the prelude from Bach's Cello Suite No. 1.

Monday, November 10, 2014

When Does “Altering Brain Function” Become “Mind Control”?

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From Frontiers in System Neuroscience, this article looks at the resurgent interest in functional neurosurgery for "psychiatric illness." The preferred approach is deep brain stimulation (DBS) technology, "because it allows clinicians to directly alter the functions of targeted brain regions, in a reversible manner, with the intent of correcting diseases of the mind, such as depression, addiction, anorexia nervosa, dementia, and obsessive compulsive disorder." However, the question must be asked: At what point does altering brain function become a form of mind control?

Full Citation: 
Koivuniemi A and Otto K. (2014, Oct 14). When “altering brain function” becomes “mind control”. Frontiers in System Neuroscience; 8:202. doi: 10.3389/fnsys.2014.00202

When “altering brain function” becomes “mind control”


Andrew Koivuniemi [1] and Kevin Otto [2,3]
1. Indiana University School of Medicine, Indianapolis, IN, USA
2. Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA
3. J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
Functional neurosurgery has seen a resurgence of interest in surgical treatments for psychiatric illness. Deep brain stimulation (DBS) technology is the preferred tool in the current wave of clinical experiments because it allows clinicians to directly alter the functions of targeted brain regions, in a reversible manner, with the intent of correcting diseases of the mind, such as depression, addiction, anorexia nervosa, dementia, and obsessive compulsive disorder. These promising treatments raise a critical philosophical and humanitarian question. “Under what conditions does ‘altering brain function’ qualify as ‘mind control’?” In order to answer this question one needs a definition of mind control. To this end, we reviewed the relevant philosophical, ethical, and neurosurgical literature in order to create a set of criteria for what constitutes mind control in the context of DBS. We also outline clinical implications of these criteria. Finally, we demonstrate the relevance of the proposed criteria by focusing especially on serendipitous treatments involving DBS, i.e., cases in which an unintended therapeutic benefit occurred. These cases highlight the importance of gaining the consent of the subject for the new therapy in order to avoid committing an act of mind control.


Introduction


The use of deep brain stimulation (DBS) technology for the treatment of psychiatric disorders is one of the most promising and rapidly evolving areas of neurosurgical research (Abelson et al., 2005; Mayberg et al., 2005; Lozano and Lipsman, 2013). Nonetheless, in treating diseases of the mind by directly altering the brain’s functioning, neurosurgeons, neurologists, psychiatrists, and neuro-engineers run the risk of having this effort interpreted as “mind control”. The purpose of this paper is to address that specific concern in the context of DBS as it is currently practiced and studied by providing a definition of “mind control” that applies to DBS. That is, it is not intended to account for the neurosurgeons staffing the wards of philosophical thought experiments, whose powers to monitor and manipulate the brain and their patients’ actions know no limits (Frankfurt, 1969). Therefore, this paper seeks to cover adult patients who have given informed consent for the treatment of their psychiatric or neurologic illness.

By narrowing the scope of the article, we hope to maximize its relevance while minimizing distracting (though philosophically interesting) cases. It is important to point out that the conditions under discussion (adults, undergoing treatment, who are capable of informed consent—including patients in states such as locked-in syndrome) describe nearly all individuals currently receiving DBS with the exception of those treated for persistent vegetative state who lack the capacity to do anything, including the ability to provide consent (Yamamoto et al., 2010).

While the phrase “mind control” appears in the contemporary literature discussing advances in DBS, it is often brought up dismissively (Fins et al., 2009) or to catch the reader’s attention (Horgan, 2004) but never with an accompanying formal definition. This is surprising, especially given a sophisticated and robust ethics literature on DBS and psychiatry that deals with related topics such as autonomy and informed consent (Bell et al., 2009; Clausen, 2010), authenticity (Kraemer, 2013), enhancement (Earp et al., 2014), and paternalism (Sjöstrand and Juth, 2014) as well as unintended side effects of stimulation which alter personality (Synofzik and Schlaepfer, 2008) and the way in which DBS can influence patients’ perceptions of their identity (Lipsman et al., 2009). Common features in this literature are an agreement that autonomy is one of the key features that must be preserved in the ethical practice of DBS and that this can been accomplished in psychiatric patients through the practice of informed consent (Dunn et al., 2011).

Beyond the contemporary neuro-ethics literature, mind control has been the subject of numerous books and articles. One of the most thorough accounts of mind control in the context of electrical stimulation of the human mind appears in Elliot Valenstein’s aptly titled Brain Control (Valenstein, 1973). While Valenstein never supplies a formal definition of mind control, his primary argument focuses on discrediting the notion that a subject’s thoughts, choices or actions could be manipulated through electrical stimulation of the brain by giving a detailed account of its known capabilities and limitations. Other discussions of mind control tend to have focused on psychopharmacologic methods or behavioral methods of altering brain function, such as those employed in the Central Intelligence Agency’s MKULTRA program (Senate, 1977).

Possibly the richest source of accounts of mind control is not in the formal academic literature but in the online accounts of individuals who claim to have witnessed acts of mind control or who claim to be the target of mind control. In 2006 Bell et al. provided a formal textual analysis of 10 characteristic examples. Though the authors make it clear that they take these narratives as signs of a delusional disorder and their analysis focused primarily on the social network of the reports, they managed to highlight several themes which the accounts shared. These shared features help to establish an intuitive basis for what people believe qualifies as mind control. The accounts often focused on: (1) an authoritarian organization, such as “the police,” “the Dutch government,” or “freemasonic intelligence agencies;” (2) employing some tool to augment brain function, such as a “frequency weapon,” “brain implant” or “network of transmitters,” in order to; (3) alter the subject’s thoughts or actions; (4) without the subjects consent.

In proposing our criteria for mind control we retained and formalized all of the common themes of the internet accounts with the exception of the authoritarian organization. The authoritarian element was dropped because the authors saw no reason to exclude individuals acting alone from being capable of committing an act of mind control. This is especially true in the context of DBS where typically only one person or a few people are responsible for the management of the treatment. Therefore, we are proposing the phrase “mind control” be used to describe instances when researchers or clinicians using DBS intentionally alter patients’ behavior without consent and define those instances using the criteria below.

After stating our formal criteria, we explain why the criteria are limited to the subject’s behavior and neutral with regards to the subject’s mental events during the act of mind control. Then we provide test cases, which we argue intuitively do and do not qualify as mind control and are correctly included and excluded by the proposed criteria respectively. Next, we apply the criteria to a non-obvious case of mind control. Finally, we conclude with a discussion of mind control in the context of serendipitous therapy, i.e., cases where an individual sees a therapeutic effect for a psychiatric illness for which he or she did not give consent to have treated, such as in a patient treated with DBS for anxiety who saw a remission of his alcoholism. We argue that in such cases one should gain the individual’s explicit consent for the treatment of the serendipitously improved co-morbid illness or else one would qualify as committing an act of mind control.


Criteria of Mind Control


Alteration of the brain’s functioning through direct stimulation (either activation or suppression of action potentials) within the subject’s brain qualifies as mind control when it meets all of the following three criteria:
Result Criterion: Direct alteration of the brain’s function must result in a behavioral change in the subject.

Consent Criterion: The behavioral change does not need to be against the expressed will of the patient. The change must simply have taken place without the subject’s consent.

Intent Criterion: The behavioral change must have been the goal or the purpose of the person or the group controlling the DBS. It cannot be an accident or an unintended consequence, including side effects, of the stimulation.
In summary, mind control must alter the patient’s behavior in an observable way without the subject’s consent and must be enacted for that purpose.


Limiting Mind to Behavior


The above criteria rest on an assumption that the ultimate purpose of “mind control” is to modify the behavior of an individual, and the word “mind” is used in a folk psychology manner to describe the intuitive mechanism of the control (Dennett, 1982). It is important to spell out the definition of “mind control” in the context of behavior because that is the relevant way DBS is currently employed. This is because neurosurgeons and neurologists cannot make perfectly reliable a priori guesses about what effect a given instance of DBS will have on a given patient. They must therefore rely entirely on their observations of the patients’ behaviors, which include their patients’ reports.

To understand this point, consider that neurosurgeons have a great deal of information about what parts of the brain are associated with certain faculties, such as the formation and comprehension of speech, sensation of touch over the body, execution of intended movement, and sight. Further, they know that the destruction of these regions will leave the patient with a deficit so protecting them during surgery is one of the surgeon’s highest priorities. However, the surgeons cannot predict exactly where these regions are located in specific patients based on previous studies alone (Penfield and Perot, 1963; Kim et al., 2009). Therefore, some neurosurgical cases are performed with the patient awake so that he or she can report the sensations he or she experiences when the neurosurgeon applies electric current to the brain region of interest. Based on the patient’s reports, the surgeon will individualize his approach in order to resect the pathological tissue while sparing the functionally important, so called eloquent, cortex. If the procedure were performed without the patient’s behavioral feedback there would be a very high probability that an important cortical region would be damaged leaving the patient with a neurological deficit (Penfield and Boldrey, 1937).

The same type of procedure is also essential to the practice of DBS. For example patients must be closely observed intra-operatively for behavioral signs, such as a reflexive smile, in order for the surgical team to determine the effect of stimulation (Okun et al., 2004; Haq et al., 2011). Once the electrode and stimulator are implanted, specially trained neurologists adjust the stimulation parameters and closely observe the effect on the patient’s symptoms (Volkmann et al., 2006). Finally, patients must be closely followed during treatment for signs of cognitive decline (Parsons et al., 2006), mood disorders (Bejjani et al., 1999; Kulisevsky et al., 2002), or other, sometimes serendipitous, behavioral changes (Kuhn et al., 2007). In summary, the use of DBS relies entirely on the patient’s behavior as the sole feedback mechanism for targeting the electrode as well for modifying the stimulation parameters in order to achieve the desired effect. Because the person or persons controlling the DBS rely on observation of behavior, any instance of mind control using DBS would necessarily rely entirely on the subject’s behavior. Therefore, a practical definition of mind control can be limited solely to behavior without directly addressing metaphysical questions related to the mind itself.


Obvious Test Cases


Having proposed the criteria for mind control, it is important to test them. This is best done by asking whether the criteria account for cases of obvious mind control while excluding cases that are obviously not mind control.

For a clear example of mind control, we must (fortunately) look beyond the current practice of DBS into its murkier past. One such case was published in 1963 in the journal Science by a psychosurgery group working under Dr. Robert Heath at Tulane University (Bishop et al., 1963). This article detailed a “self-stimulation” experiment in which a 35 year old man was implanted with electrodes in eight different brain structures, including in the head of the caudate, the septal area, and the amygdala. These electrodes were labeled by researchers as either “rewarding” or “aversive” and the subject was given a lever and a button which, when operated, would activate one of the electrodes. As the experiment proceeded, the researchers varied the electrodes which the lever and button activated and also varied the stimulation parameters delivered through the electrodes.

This experiment was based on studies previously done in rats, cats, dogs, goats, monkeys, and bottle nosed dolphins (Olds, 1962) which had shown that the animals’ behavior could be predictably controlled by placing stimulating electrodes into “rewarding” and “aversive” regions of the brain and then correlating stimulation through the electrodes to elements of the animals’ environment. Therefore, the researchers had good reason to anticipate specific behavioral responses in the human subject. Further, at no point do the authors say that the subject, who was referred to as “clearly nonnormal,” gave consent for the experiment or understood why the experiment was conducted.
Looking back to the proposed criteria for mind control, we see that this case satisfies all three. First, electrical stimulation of the brain was employed in a manner that clearly influenced the subject’s behavior, satisfying the Result Criterion. Second, at no point did the authors state that the patient gave consent to have his behavior manipulated in this manner, satisfying the Consent Criterion. Finally, the behavior change was anticipated by the researchers controlling the stimulation of the subject’s brain, satisfying the Intent Criterion.

Next, we must ask is there an example of altering brain function which obviously is not mind control and, also, is correctly excluded by the Result, Consent, and Intent Criteria? Consider the treatment of essential tremor with DBS. It is safe, effective, and has been approved by the FDA (Koller et al., 2001). It is believed to work through altering the function of the brain (more specifically by causing a reversible, functional lesion (Grill et al., 2004) in a malfunctioning part of the brain), ultimately permitting the patient to accomplish routine daily activities free from the violent hand tremors that are the hallmark of the disease. This relief of symptoms is the direct result of the electrical pulses in the brain, which alter its standard pattern of firing; however, it is not an instance of mind control.

Why is DBS for the treatment of essential tremor not an example of mind control? After all, it could be argued that one is altering the behavior of the patient’s hands, from a tremulous grasp to a stable grip, and that this was explicitly the purpose of the individual programing the DBS device. However, while this example meets the requirements of the Result Criterion as well as the Intent Criterion, it fails to meet the Consent Criterion because in all cases of DBS for essential tremor, all patients give consent for stimulation with the explicit desire to see this behavioral change. Interestingly, DBS for essential tremor could be thought of as “mind freedom,” as opposed to “mind control” because, instead of preventing the patient from carrying out a desired behavior or forcing an undesired behavior, it allows the patient to act on his choices with less difficulty.

The same argument also holds for DBS treatments of psychiatric diseases like depression (Lozano et al., 2008). One might make the argument that being a psychiatric disease, depression is classically described as a disease of the mind. Therefore, if one can control the patient’s disease one must be controlling the patient’s mind, i.e., committing an act of mind control. The proposed criteria would exclude this case of mind control because, as in the case of DBS for the treatment of essential tremor, the effect on the patient was with the patient’s consent, and, thus, it fails the Consent Criterion.


Non-Obvious Test Case


While it is important that the criteria capture one’s intuition, they should also go beyond and clarify murkier territory. The criteria should be able to help one examine non-obvious cases and arrive at a reasoned judgment about their status as mind control or as non-mind control. Thus, the criteria above are especially useful when attempting to identify borderline instances of mind control.

Turning again to the past, consider the following case of an experiment conducted by Jose Delgado and his collaborators Drs. Obrador and Martin-Rodriguez into the stimulation of the caudate nucleus of an epileptic patient:
As shown by direct observation and by analysis of the record, within 30 s after application of caudate stimulation there was a significant change in the patient’s mood. During controls, he was reserved, his conversation was limited and he was concerned about his illness. After caudate stimulation, his spontaneous verbalization increased more than twofold and contained expressions of friendliness and euphoric behavior which culminated in jokes and loud singing in a gay cante jondo style, accompanied by tapping with his right hand, which lasted for about 2 min. The euphoria continued for about 10 min and then the patient gradually reverted to his usual, more reserved attitude. This increase in friendliness was observed following three different stimulation sessions of the caudate, and did not appear when other areas were tested (Valenstein, 1973).
In the above description, the researchers are attempting to correct the patient’s epilepsy with the use of electrical current. In testing one of their hypothesized targets, they managed to elicit a strong behavioral effect. The patient’s attitude changed from quiet reserve to expressive joviality, i.e., the researchers significantly altered the patient’s behavior and in doing so satisfied the Result Criterion, as well as the Consent Criterion because they did not have the patient’s consent to alter his behavior in this manner. At this point one could argue, correctly, that this was an accident. The experimenters had no a priori knowledge that the patient would respond to stimulation in this fashion so it could not have been their intention to do so; thus, they failed to satisfy the Intent Criterion.

The essential issue arose when the stimulation was repeated, three different times, without any documentation that the patient wanted to have his personality manipulated in this manner. While this might, at first, seem like nit picking, it is important to appreciate that the experimenters now had reason to believe that the behavior of the individual would be affected in a specific way. When they activated the stimulation and produced the anticipated effect, it was purposeful. In this way, the experimenters fulfilled the Intent Criterion. As in the case of a schizophrenic patient subjected to the self-stimulation experiment above, it seems clear that the researchers’ motivation was intellectual curiosity and not malice. Nevertheless, both of these cases demonstrate that malice is not necessary for mind control.


Serendipity and Mind Control


The above case raises a critical question with regard to several recently published studies in which subjects received DBS in an effort to treat one illness, but instead saw serendipitous improvement in a comorbid psychiatric illness. One serendipitous discovery was reported by Kuhn et al. (2007) who attempted to treat a man with anxiety disorder by placing DBS electrodes into his nucleus accumbens, a major component in the reward circuit of the mammalian brain. While the patient’s anxiety did not improve, he did see significant remission in his alcohol dependency, leading the group to propose the target as a potential treatment for alcoholism and addiction.

A second example comes from Hamani et al. (2008) who used DBS of the hypothalamus in an effort to help control a patient with morbid obesity. Although the patient continued to gain weight (a fact left out of the primary article and only included in the online supplemental materials) he did experience a flashback while receiving intra-operative test stimulation. This led the researchers to do a battery of studies to determine if stimulation to the same area at a lower level, which did not cause a flashback, could improve memory. To the surprise of the researchers, they found a significant increase in the subject’s verbal memory. Based on this finding the authors proposed the anterior fornix (a structure adjacent to the hypothalamus) as a target for the treatment of dementia and began enrolling patients to study it further.

Finally, Israël et al. (2010) describes a case in which a woman was receiving DBS of the subgenual cingulate gyrus (Cg25) for treatment of depression. The authors noted that, although the patient continued to have relapses of major depression, she stopped experiencing symptoms related to a significant comorbid anorexia nervosa. Based on the remarkable improvement the patient experienced, despite her less remarkable improvement for her depression, the authors proposed Cg25 as a target for the treatment of anorexia nervosa.

There are several curious similarities among the cases above. First, the intended effect of DBS was either not seen or was not particularly robust. Second, the serendipitous effect on the comorbid illness (or enhancement of normal faculties in the case of anterior fornix stimulation for memory) was remarkable. Third, based on these cases all authors proposed that the stimulated sites be tested as targets for monotherapy for the responding illness. A final common feature was that at no point did the authors describe the patient receiving informed consent for the managing of the comorbid illness or for enhancing the patient’s faculties (Earp et al., 2014), with DBS. The only paper that commented on informed consent was Hamani et al. which stated:
The procedure was approved by the University Health Network Research Ethics Board, and written informed consent was obtained under the guidance of a hospital ethicist, who served as a consent monitor. The basis of the approval for this man was the refractory nature of the obesity, the exhaustion of reasonable therapeutic alternatives, and the possibility of reducing the health risks of chronic obesity should the intervention prove successful (Hamani et al., 2008).
In the passage above, the authors clearly stated a reasonable approach for obtaining informed consent for the treatment of the patient’s obesity. However, they did not describe receiving the patient’s consent for the use of DBS in order to enhance his verbal memory. Despite not reporting the patient’s informed consent to have his memory augmented, they proceeded to run a battery of tests on the patient’s memory function and, furthermore, did not mention discontinuing the treatment once it became apparent that DBS was not effective for the treatment of obesity.

The above cases raises a critical question: were these examples of “mind control”? The patients had unexpected alterations in their behavior and it appears, based on the descriptions of the cases, that the DBS was continued primarily because of these unexpected results. Further, the authors did not report that they repeated the informed consent process for the serendipitous alteration in the patient’s behavior. The authors of this paper could conjecture that, once the researchers realized the unexpected effect DBS was having on their patient they consulted with him or her and received his or her blessing to continue therapy. Nonetheless, if they (or others) had not secured the consent of their patients for these new treatment indications, then they would be satisfying the Result (behavior change) Consent (happening without patient’s consent) and Intent (behavioral change was the goal of DBS) criteria of mind control. Therefore, it is critical for clinicians and researchers to secure additional consent in the case of serendipitous therapeutic benefit in order to avoid the charge that they are committing an act of mind control.


Conclusion


We have argued that DBS is not synonymous with mind control; however, if not appropriately safeguarded, patients can be victims of mind control even without malice on the part of those controlling the stimulation, especially in the case of serendipitous treatment of co-morbid psychiatric illnesses. While many instances of mind control are easily identified, there are certain instances where the distinction is more ambiguous. This paper outlines a clear set of criteria to help more effectively and reliably clarify those ambiguous cases. For an act to be considered mind control it must alter the individual’s behavior (Result Criterion) without his consent (Consent Criterion) and this alteration to the behavior of the individual must be the goal of the person or group controlling the alteration (Intent Criterion). Relying on the researchers’ or clinicians’ intuitions alone is not sufficient because those intuitions might easily become clouded such as in the serendipitous discovery of an effect of DBS. It is, therefore, important to note that in cases of serendipitous treatments of psychiatric illness patients also require the explicit consent for the treatment of the co-morbid illness, or else the case would qualify as mind control. It is the intention of the authors to minimize the risk of such accidents by clarifying the underlying concepts.

Conflict of Interest Statement


The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


References at the Frontiers site

Why a Physics Revolution Might Be on Its Way (via Live Science)

Physicist Nima Arkani-Hamed believes we are on the verge of another revolution in physics, an opinion delivered during a live lecture from the Perimeter Institute for Theoretical Physics in Waterloo, Canada.

In essence, relativity and quantum mechanics have been unable to adequately explain the universe, both separately and together.

Why a Physics Revolution Might Be on Its Way


by Kelly Dickerson, Staff Writer | November 09, 2014 

 

Credit: agsandrew | Shutterstock.com

The field of physics may be turned on its head soon, said renowned physicist Nima Arkani-Hamed during a live lecture from the Perimeter Institute for Theoretical Physics in Waterloo, Canada.

For one, he said, the tried and true physics of relativity and quantum mechanics don't get along well. The problem is that in some sense, the principles behind these theories seem to be impossible when physicists dig a little deeper into them, Arkani-Hamed said. Scientists run into a lot of problems when they try to apply these theories to the entirety of space and time.

The two ideas are also incredibly constraining, and they make it challenging for physicists to think outside the box and develop new ideas and theories, Arkani-Hamed said. [The 9 Biggest Unsolved Mysteries in Physics


"It's almost impossible to monkey around with the rules and not be wrong immediately," Arkani-Hamed said.

Physicists have known about this disparity for a while, but progress on fundamental questions in physics takes a long time. Scientists proposed the existence of the Higgs boson particle, for example, decades before it was actually discovered.
An unexplained macroscopic universe

One problem is that conventional physics doesn't really account for why the universe is so large, Arkani-Hamed said.

Albert Einstein's theory of relativity showed that a huge amount of energy exists in the vacuum of space, and it should curve space and time. In fact, there should be so much curvature that the universe is a tiny, crumpled ball.

"That should make the universe horrendously different than what it is," Arkani-Hamed said.

But quantum mechanics also poses a problem. The theory is good at describing the very small realm of particle physics, but it breaks down when physicists try to apply it to the universe as a whole.

"Everything that quantum mechanics is, is violated by our universe because we're accelerating (referring to the idea that the universe is expanding) – we don't know what the rules are," Arkani-Hamed said. "When you try to apply quantum mechanics to the entire universe, quantum mechanics cries 'uncle.'"
Physics frontiers

One possible way to solve the problem is with an entirely new theory beyond the Standard Model, the reigning theory of particle physics, the physicist said. [Sparticles to Neutrinos: The Coolest Little Particles in the Universe]

One idea is called string theory, which proposes that particles aren't actually fundamentally particles. Instead, the particles and all the matter in the universe they make up are composed of tiny, vibrating strings. The equations that support string theory appear to work, but that doesn't mean there are no other viable formulas or explanations, Arkani-Hamed said.
Supersymmetry is another possible "new physics" explanation. Under this idea, all subatomic particles have a "superpartner" particle that physicists have yet to discover. Supersymmetry would also open up extra directions that the particles can move in. The discovery of supersymmetry would bolster the Standard Model of physics, scientists have said.

"It's the last thing nature can do to make itself compatible with the general principles of physics that already exist," Arkani-Hamed said.

When the world's largest atom smasher, the Large Hadron Collider (LHC), is up and running again next year, physicists will be looking for the extra particles that supersymmetry suggests should exist.

Either way, after a year or two of running the LHC, the question of whether supersymmetry exists should be answered, Arkani-Hamed said.

The experiments over the next few years will likely tell physicists if they need to fine-tune existing theories or if the field of physics is due for a much deeper and more dramatic paradigm shift.

The questions on the table now are the underpinnings of space and time, and the origin and fate of the universe, Arkani-Hamed said.

"Today we finally have the theoretical framework in place to ask these kinds of big questions," Arkani-Hamed said. "The next step will likely be a revolution."
Follow Kelly Dickerson on Twitter. Follow us @livescience, Facebook & Google+. Original article on Live Science.