Monday, April 16, 2007

Pain Pain Pain

The readings for this week focused on pain as well as social cognition. I found one of the most interesting topics is the relationship between what is occurring on an internal level, as well as a social one. For example, pain has been proved to be hugely subjective, affected largely by cognition. Within “Why rejection hurts: a common neural alarm system for physical and social pain,” researchers discovered that the presence of social support increases an individual’s tolerance of electric shock stimulation. We will expand upon this during our presentation this week, but Carolyn and I read an article on this topic, which found that positive expectations during a painful experience actually decreased the level of pain experienced. It seems that our psychological approach to a situation actually does have an internal effect on our bodies. At several points during the semester, we have discussed the power of the mind on the rest of the body. This concept of pain as subjective seems to be another good example of that.

I was particularly intrigued by the article, “How we predict what other people are going to do” by Chris and Uta Frith. They found that “amygdala activation has been consistently shown as a sign of fear that is elicited unconsciously by viewing a face from another race. When white Americans were shown the faces of unknown black Americans, activity was elicited in the amygdala… The amygdala response to black faces was reduced when the faces were presented for 525 ms rather than 30 ms, and, associated with this reduction, there was increased activity in areas of frontal cortex concerned with control and regulation.” (Page 2) It appears that the patients tried to shift their immediate reaction, thus leading to the reduced amygdala activity. This relationship between their primary reaction and an attempt at mental control was striking for me.

Further, during their discussion of our ability to predict the actions of others, they noted that the process is not selective to a biological target (Page 4). My conference work is about emotional responses to music and I came upon a similar finding. Research has noted that learning music is about making predictions. We can guess the course of a song without ever having heard it, because of a natural understanding of pattern and structure. Additionally, we make predictions based on our prior experience with songs. Thus, when the Friths noted that we are able to make judgments about non-biological targets, I was reminded of my own research. I liked all of the readings for this week, but was continuously struck by the interplay between what is occurring internally and how that is affected by external, social situations.

Pain and Empathy

The sensation of both fear and physical pain are built into our defenses to warn us of danger, these feelings developed by our progenitor species’ in order to survive. The sensation of emotional and social pain have been developed evolutionarily within our species, not for our survival against the bigger, stronger and better predator in the wild, but for our social survival. This week’s readings focused on pain as well as one’s ability to empathize with another’s pain. The authors write about humans as social creatures, separate from our ancestors with our developed social structure and ability to attribute the mind states of others. Particular attention is paid to the idea of other minds and one’s ability to ‘mind read’ or mentalise another’s feelings.
This week’s readings struck a particular chord with me, due to the nature of my conference work regarding autism. Chris and Uta Frith’s report, “How we predict what other people are going to do” briefly overviewed our ability to infer things about others as well as applying this information to ourselves. We can watch someone encounter a certain stimulus and from their reactions to that stimulus, we can infer that that stimulus may elicit a similar response in ourselves. The particular part of this research overview that I found the most interesting was the topic of shared experiences or shared feelings. In this section they referred to the mirror neuron system, which seems to be responsible for our involuntary tendency to share another person’s experience. In the fairly disjointed reading specifically devoted to mirror neurons, the author seemed to imply that mirror neurons were a good deal of the basis for interactions between creatures with a highly developed social structure. Mirror neurons seem to have some connection to the learning process, specifically how we learn from others. Uta and Chris Frith connect this research to the “theory of mind,” which is a term I’ve found extensively in my research on autism. “The theory of mind,” without going into much depth, refers to our ability to put ourselves in the shoes of others, regardless of what we know to be true or what we feel. Inferring the mental states of others is not just that, it helps extensively in our communication with them. In attributing other states we are able to sympathize and therefore empathize with others. This is a social ability, not a defense mechanism. This ability to empathize provides no protection to our physical well being, however it can protect our social status and social well being in our society. Has our social well being evolved to be just as important to us as our physical well being? In becoming a complex society have we added to our burdens in adding the burden of the importance of social interaction? Or has this only replaced the decreased need for protection from wild creatures that are less of a threat to us than they were to our progenitors?
“Why rejection hurts” talks about the growing importance and similarities between social pain and physical pain. The authors found that both social pain and physical pain share the same neural mechanisms for processing that pain. In this article they define physical pain as ‘unpleasant sensory and emotional experience associated with actual or potential tissue damage and emotion pain as when a social relationship is threatened, damaged or lost. We seem to have become incredibly dependent on social interaction from the very beginning. Our attachment to our parents seems to be incredibly important to our physical/brain developmental as well as our social development. The article implies that this type of social attachment is unique to mammals. When I was younger I used to be fascinated with sharks and their ability to live on their own from birth (regardless of whether they are hatched from eggs or not,) what makes sharks not need that social interaction with their parents as to say, dolphins who stay in schools and care for each other their entire lives? Do all mammals do this? What causes the variation in mammals and whether or not they stay in groups? In this article they also refer to a relative over exposure to social pain as infants. We experience social pain when we are apart from our mother. We are also a species of societies in which we rely to varying degrees on others to get about our daily life. Have we developed in a way that has cancelled out the need for other defense mechanisms? How will this effect the evolution of our species?

Sunday, April 15, 2007

pain & social neuroscience

When we contrast the pain felt from the attack of a blunt or sharp object with that of lost love, it may be difficult to draw any comparison other than that they both hurt. However, research indicates that physical and social pain do have commonalities at the neurological level. The anterior cingulate cortex (ACC) has been shown to activate with the conscious, aversive experience of both kinds of pain.
Anyone with an intact somatosensory cortex, posterior insula, and nociceptors (among other things) has the biological tools to process the sensory component of physically painful stimuli, but people with lesioned ACCs do not feel it as unpleasant or distressing. Dorsal ACC activity is correlated with self-reports of perceived unpleasantness as a result of painful stimuli, as well as upsetting social situations, as revealed by Eisenberger’s (2003) experiment that showed increasing dACC corresponding with increasing self-reports of distress in subjects who were excluded in a virtual game of catch. Additional evidence of the relatedness between social and physical pain comes from the fact that opiates and strong social support relieve both. There have also been numerous findings that the frequent experience of one type of pain predicts a heightened sensitivity to the other.
As with anything else, an evolutionary explanation for the origin of the ACC’s role as a neural alarm for pain might serve best: in any species, pain is a powerful motivator to escape pain because it threatens survival. Because mammalian infants require long periods of maternal care to survive, the pain of separation from the mother would be an adaptive way to prevent such an occurrence.
A final note on the implications of the anterior cingulate cortex and the perception of pain is that one doesn’t need to be the person receiving the painful stimulus to feel it. The ACC is also activated when a person watches his/her significant other receive an electric shock. This would not be possible without one of evolution’s most ingenious creations—mirror neurons.
Mirror neurons, which are found in different areas of human and primate brains, are activated when a person (or primate) performs an action and also when one observes another performing the same action. Mirror neurons are largely responsible for humans’ ability to accurately predict other people’s mental states and future behavior. They make it easy by producing the same neural representations that would exist if we were the ones experiencing the state, and in that sense we are experiencing it (to an extent.) The above example concerning pain is just one among many of these occurrences. Mirror neurons also explain why smiles, laughter, yawning, crying, etc. are contagious, why seeing a facial expression of disgust activates the same brain regions that smelling something disgusting would, and why seeing someone being touched activates the somatosensory cortex. Without mirror neurons, we could not feel what others are feeling, and the malfunction or lack of mirror neurons in autistic individuals may give evidence to the nature of their deficit in this respect.
The skill endowed upon us by mirror neurons is often referred to as "empathy," but this is a misnomer in my understanding. If a person tells a story of how some experience elicited feelings of sadness and the listener feels sad herself, she is sympathizing or identifying rather than empathizing. The same goes for the sharing of cognitive appraisals (as opposed to emotional response). If empathy is thinking or believing what another thinks or believes, it would be necessary for the empathizer to agree with that thought or belief, thus implying sympathy or identification. But empathy does not require the sharing of thoughts or feelings. It is rather understanding someone in his/her own terms. It’s appreciating another person point of view, regardless of how they differ from our own, which the Friths refer to as "mentalizing." Good empathizers can empathize with an ideology that completely conflicts with their own simply by giving the impression that the other person’s perspective as that person knows it is understood.

Mirror Neurons and Mentalizing

This week’s set of readings focused on mental states in human beings and our ability to recognize these states in ourselves and in others. Two concepts were discussed in depth throughout the readings; mirror neurons and mentalizing. The two concepts are both related to social abilities found in humans. Mirror neurons are involved in physiological states and emotional expression whereas mentalizing is the process of attributing mental states (desires, intentions, and beliefs) to oneself and others.

Mirror neurons were discovered in the ventral premotor area in monkeys. These neurons fired in response to motor activity performed by the monkey itself and also when the monkey was observing the same motor activity being performed by another monkey. The discovery of mirror neurons brings truth to the saying ‘monkey see, monkey do’. Mirror neurons are also in humans. They allow us to share and understand another person’s experiences. For example, “seeing a painful stimulus being applied to someone’s body activates the same areas (AI and ACC) as having the same pain applied to oneself” (Frith & Frith pg 5). The ability to recognize and imitate another’s behavior is fundamental for social interaction. It reduces the risk of being socially rejected, it protects a person from danger, and it helps in the formation of group identity.

Mentalizing is the ability to recognize and take another person’s point of view. It could be argued that mentalizing builds off of the mirror neuron system. It is a higher form of imitation. Studies measuring brain activity during mentalizing found activation in the anterior paracingulate sulcus (part of the Anterior Cingulate Cortex) as well as the temporo-parietal junction. These areas of the brain were activated during mentalizing other people’s mental states as well as their own mental states. Mentalizing is not an innate process. Some components are linked to neural processes and others are learned and developed during childhood. It is a process that requires nature and nurturing.

Research on autism has led to the observation that mentalizing; being able to attribute mental states to self and others is faulty in individuals with autism. They are unable to recognize the mental states of other people. Is it possible for autistic people to learn the process of mentalizing? Ralph Adolphs in “The Social Brain” conducted an experiment with an amygdala damaged patient. She had trouble recognizing the emotion fear because she did not pay attention to the eyes of the face (the facial feature that expressed fear the most). When the experiments told her to pay attention to the eyes, she was able to identify the emotion accurately. Adolphs is currently conducting a similar experiment with autistic people. He hopes to intervene in a similar way with the autistic individuals as he did with the patient with amygdala damage. If a similar type of intervention is possible, is there a way of teaching people with autism the process of mentalizing? This would be extremely beneficial to their social interactions.
Pain and Empathy

I was assured after reading the review article “Social Cognitive Neuroscience: where are we headed?” as in the last few weeks I have become disenchanted with the preoccupation of brain imaging in neuroscience. They ask why is the field of neuroimaging important in understanding how the brain and in turn the mind works? By understanding what regions and networks are responsible in mental processes we can begin to understand what happens in the mind and in the brain that is responsible for specific behaviors. For example, there may be elements to the process of fear that would involve regions of the brain that we could not deduce through behavioral observation or could not be described by the participant because it is below the level of consciousness. There may also be areas of brain activation that overlap in mental processes that can explain the complexity behind emotions. In the study of empathy and pain they had couples perform a task where one partner suffered an electric shock and the other partners brain was scanned as they anticipated their partners pain. They found that not only were brain regions activated by the expectation of another’s pain but was overlapped by the activation of areas that signifies the experience of going through pain for ones self. Only through neuroimaging can they better explain then mental processes that occur during an empathetic episode.

I wonder then how one could define empathy with the information from modern brain imaging techniques. Does empathy exist when only one can experience someone else’s pain or pleasure? Are those who are more empathetic hold a greater mental capacity to actually experience someone else’s emotions? The article may be leaning towards a yes as it explains the role that mirror neurons play in social behavior and how there is an area in the brain that allows us to “mind-read”. Evolutionarily empathy makes perfect sense as it is a tool that helps weed out the cheats at the poker table and it becomes advantageous to be in someone’s mind while in the process of bargaining. On page 219 of the review they state, “There is some evidence that untrustworthy people might have more memorable faces than trustworthy faces”. There is a reoccurring theme of the importance of face reading in the study of empathy and I was wondering what Paul Ekman would say in regards to empathy being a skill that one can learn.

The second article I would like to address is “ Why rejection hurts” as it illustrates how neurological systems overlap in an unusual and unexpected way. They explain why rejection hurts by starting with the definition of social pain, which is the “distressing experience arising from the perception of actual or potential psychological distance from close others or a social group.” This simplistic definition gives rise to the importance of companionship for humans and other social animals and they link this to self esteem as it can be an indicator to social acceptance and integration. They focus on the anterior cingulated cortex (ACC) and specifically its dorsal subdivision (dACC) to explain how the brain reacts to physical and emotional pain. The dACC experiences neighboring and sometimes overlapping activation during the experience of physical pain and when there is a conflict or a discrepancy between two opposing facts. I wish they illustrated what they meant by “discrepancy detection” better and what type of experiments led to the detection of activation in this area. I am battling with the relationship between discrepancy detection and how that relates to social rejection. But to get to their point, they illustrate the overlap in the two systems by comparing it to an alarm system. The sensor is the discrepancy detector and pain distress is the alarm bell sounding and the overlap of these two areas may be a complementary “neural alarm system”. What is the most striking to me is how people that are in chronic pain are more likely to be preoccupied with relationship status and worried about rejection. Those too who are rejection sensitive report more stress while watching a video depicting physical pain. This reminds me of our focus on empathy and what constitutes an empathetic person in regards to their psychological make up and their brain chemistry. There is sometimes a striking difference in people’s empathetic abilities and I wonder exactly what are the neurological differences in these people against a standard norm (if this is even possible).

On a side note I was wondering how endorphins and dopamine work as I know they complement each other, but I am not sure how. I was reminded in our last class how my dad had to quite smoking and he has been smoking two packs for about thirty years (that was my spring vacation). He actually took it well, mostly because he was on some new, fancy neurotransmitter blocker. But one night he was grinding up fresh horseradish for dinner and I caught him sniffing the stuff like he was at Studio 54. I guess it made him feel better but I was trying to understand why it was helping with his cravings and anxiety brought on from his nicotine addiction.