We are not so different
Hello readers! Happy New Year and all that. I took a couple of weeks off for the holidays and went to visit family and friends back in Toronto. It was a time of heart-warming reconnection with people I’ve known for much of my life. But it was also a time of emotional pain: loss, disappointment, regret — stuff like that. Hence the topic of this post…
In a very cool blog called Neuroskeptic. I recently found a reference to a paper by Feinstein et al (2010, senior author Tramel), reporting on a man who had lost almost his entire limbic system.
The limbic system is a widely distributed assembly of very different structures, most notably the amygdala (responsible for emotional associations) and the hippocampus (necessary for encoding episodic memory so that events stay in mind for more than a few seconds). Some people include the ventral striatum (the foundation of anticipation and desire) and its source of dopamine, the VTA, all under the rubric of the limbic system. All these structures are “sub-cortical” — they are more primitive than the cortex. They are its underlying machinery, the stuff in the basement (though they are more advanced than other systems — the ancient engines still at work in the subbasement of the brain stem). And then there are higher structures, sometimes called limbic cortex — parts of the cortex bordering the limbic system. These include the orbitofrontal cortex, which appraises the value, likability or aversiveness of incoming stimuli, and the famous ACC (anterior cingulate cortex) which does response-monitoring, selective attention, and effortful engagement. (All these parts and their functions are described in detail in my book.)
Limbic structures are the basis of learning. They grow synapses that connect with all parts of the cortex. That’s how the sophisticated perceptions of the cortex remain anchored to an emotional self — a core self. The cortex houses the most advanced software, but its programs are grounded in meaning through the limbic system.
A man named Roger had just about all of his limbic system destroyed by a very nasty (and rare) herpes infection. Yes, herpes can be a lot worse than you think. To quote from Neuroskeptic: “…his is the worst case of herpes encephalitis damage among patients currently alive.” And he has been alive since the damage occurred 28 years ago. So what was the result? What happens when you lose your limbic system?
Roger lost his capacity to remember things from then on — called anterograde amnesia — but his mood improved! You’d think losing half your brain would make you a tad grumpy. But in the words of Feinstein et al: “He readily displays signs of positive emotion including happiness, amusement, interest, and excitement…”
The limbic system evolved with the advent of mammals. The limbic system allows us to play, to be social, to form attachments, to love, to feel our connection with others and with our own goals. And it allows us to suffer. Thanks to the limbic system, we struggle to be the best we can be so that we can partner with other mammals (mates, children, parents). And we expect the same from others. Unlike frogs, whose goals are hard-wired, mammals must learn to achieve what they want, and avoid what they fear, through emotional striving.
So the lesson I take from Roger is that the psychological qualities of creatures like ourselves come with a huge price tag: emotional pain. Roger lost the neural foundation of meaning — of what it feels like to be a human mammal — but he no longer experienced suffering. He became a happy camper in a shallow world.
To my mind, and to other students of addiction, like Gabor Mate, we drink or take drugs to reduce the fundamental pain of life — the emotional suffering that constitutes the background music of the mammalian nervous system. Like other evolutionary achievements, the limbic brain is a double-edged sword. And we use drugs and alcohol in order to protect ourselves from its savage blade. That’s why addiction is an inevitable byproduct of human evolution.
Informed by unparalleled neuroscientific insight and written with his usual flare, Marc Lewis’s The Biology of Desire effectively refutes the medical view of addiction as a brain disease. A bracing and informative corrective to the muddle that now characterizes public and professional discourse on this topic.” —Gabor Maté, M.D., author of In The Realm of Hungry Ghosts: Close Encounters With Addiction
Such an interesting post… Reminds me of my grandmother who suffered from severe depression off and on throughout her adult life. Then, “sadly,” she had a series of small strokes that went largely unnoticed at first, until she started showing clear signs of dementia. We feared “the worst”: Alzheimer’s. Indeed, over a period of time she lost most normal cognitive capacities including her short and long-term memory and eventually even her language (she whistled instead). But here is the rub: As her dementia got worst, her mood improved dramatically. By the end of her decline, she was almost always joyful, smiling, silly and thrilled to see anyone. Basically the opposite of much of her previous life moods. Interestingly, it wasn’t Alzheimer’s (which isn’t caused by strokes), and it was one of the differentiating diagnosis aspects: positive mood. I have no idea the brain correlates of her decline vs Alzheimer’s which often is accompanied by extreme negative emotions, but in both types of cases, you have loss of memory. Hmmmm…
Interesting points and a heart-rending story. I think Alzheimer’s involves destruction of grey matter in the cortex due to uncontrolled growth of white matter. So….what you lose includes the capacity to inhibit negative emotions, including fear and anger. That’s a typical scenario.
What your grandmother and Roger may have had in common is damage to limbic areas whose job is not to inhibit but to get you to feel, remember, and strive. Almost the opposite. It would be fascinating if limbic loss and cortical loss really do have opposite effects on emotional feeling and expression.
I think Margaret Mead made a similar point in her essay “Three cheers for our age of anxiety”. She said that everything before this was the ‘age of terror’ in which life was full of danger, and that contemporary anxiety is an adaptive response to keep us alive. She felt that it was a small price to pay for our relatively safe and bountiful existence.
I disagree somewhat with the last point. I think that alcohol and some other drugs have an indirect but incredibly important social function. Social intercourse is necessary for emotional well-being, but sober people are boring, especially when you’re sober. Hence, we drink so that we can tolerate and enjoy social interaction and relieve a little bit of our anxiety and loneliness. The same is true for cigarettes: now that smoking indoors is taboo, people in apartments are forced to stand together and, sometimes, connect with one another.
And drunk people are even more boring, especially when you’re sober. But I see your point. I don’t think that drugs and alcohol are “just” valuable for pain relief. On the other hand, as indicated by your own comments, there is a lot of overlap between social lubrication and anxiety relief. So perhaps it would make sense to say that drugs and alcohol trim or soften our limbic needs and impulses. They don’t abolish them, certainly, but they get rid of the rough edges.
Hi Marc,
Sorry we misses you on this last trip.
Hope to see you next time.
Canada’s Liberal Party is proposing to legalize marijuana.
What’s your take on that?
Didn’t Chretien promise that as health minister in the 70s? And didn’t Harper’s new crime bill increase the sentences on pot, even when the courts throw out pot charges because of backlogs?
I guess we shouldn’t be holding our breath (pun intended). But I secretly suspect that pot is more fun when it’s illegal. Here in the Netherlands, as everyone knows, you can pick your pot or hash from a menu at “coffee shops” all over town. But the Dutch rarely indulge, and even the tourists start to look pretty bored sitting there after a few hours.
Hi Marc,
It seems from your discussion of Roger that his emotional capacity*and* memory were affected. And of course there are ’emotional memories.’
I guess my question is this: Can’t just loss of memory account for this shallow, happy state your describe for Roger. Another issue, too, is loss of self, which is dependent on memory. Having an emotional life depends on having a sense of self, not just who you are, but your history, including emotion-laden events.
Wouldn’t some addictions also affect the memory system; not just black outs that alcoholics report, but earlier segments of life? Would that be part of the balm offered by certain drugs and alcohol?
Great points, Hal. I used to think of memory and emotion as pretty distinct domains of mind. But after years of reading Don Tucker and Walter Freeman, I’ve come to think of them as not only intertwined but as parts of the same meta-system. And this is supported by direct and dense connections between the amygdala and hippocampus. They literally share what’s perceived as the importance of events, but each does its own job in maintaining the information.
So…I guess that the self is a product of meaningful, i.e., emotional, memories, which are certainly arranged along an autobiographical sequence — the memory of one’s life. Roger’s loss of self may have been a product of destruction to both structures, or even just one. It only takes one hole for a balloon to run out of air.
Yes, addictions do screw up memory, and that may be part of their soothing potential. Yet addictions generally cause strong emotions, including shame, so they actually reinforce aspects of the sense of self that are rather painful to experience. Maybe addicts go back to their substances again and again to try to keep the “non-self” predominant and avoid falling back into the self — with its fresh gouts of shame, guilt and anxiety.
Hi Marc:
Happy 2012 to you too, Twenty-Twelve, there’s a meditation right there.
I read of another case years ago where a guy experienced a head injury and was severed from his emotions as the author titled the piece. He made a radical personality change and proceeded to leave his wife and marry a prostitute as well as other changes which seemed to the author to show a pattern of completely rational calculation without the tempering of any sort of emotion whatsoever. The author suggested that the subject had concluded that the best way to have your needs met thoroughly with the least possible emotional context and least cost was to marry a prostitute. As you might imagine the author suggested that this was a perfectly terrible outcome but I was not sure about that. I was and am inclined to support that view but have always wondered about that brain state. There would be a diagnosis if a person came to this without a massive kinetic trauma but this is not really the same as this kind of horizontally split brain effect, if you will.
However this case you refer to know seems to be an even more thorough going severing as the entire basis for emotion seems totally destroyed. Is this your take? I have found the article and will read it closely but I do have this thought.
In Ancient Greece it was taken that forgetfulness was a real virtue. Imagine that you awoke daily and knew who you were but had no other memory. As I recall the classical description it sounds like this form of amnesia only covering a full life history. The person according to the Greeks has no other deficits and takes each day as it comes.
The most supported position is that there is a survival bias built into our opportunity evaluation system. Number one is that an agency is assumed for any sensory effect you acquire. So, in Stone Age terms if you hear a noise behind you the programmed assumption is some malicious creature is making it and it is not just a coconut falling from a tree or some other innocuous source so you are better served to expend the energy running away at full speed rather than waiting to see if it is an actual lion or not.
The other bias is that bad events are remembered with much more permanence and emphasis than good events. The account is that a good event ( getting a coconut) is not likely to kill you while a lion most certainly will so you are more likely to survive assigning great salience to traumatic outcomes and can actually afford to let pleasant memories fade.
I am just wondering if these survival biases might be the basis for granting us longer lives at the price of being more miserable, jumpy and anxious. That is to say that our memory preloads us for both unhappiness and a sense of insecurity. A person like Roger who is fine other than he has NO MEMORY!! The seat of what might be called angst are the biases of long term memory storage?
I am working my way back to addiction here 🙂
Hi Mike. Happy New Year to you too. The case you describe sounds very much like a sociopath (psychopath), who makes choices according to rational calculations without emotional strings attached. But sociopaths have brain damage, so to speak. Their amygdalas are underactive from an early age, and their orbitofrontal cortices (the OFC is sort of an advanced amygdala) lose power as they go through adolescence. It’s just brain damage that occurs naturally in development, as it were, rather than through disease or a bonk on the head. Also consider Phineas Gage, the famously classic case of a guy who lost his emotional brain. Got a steel rod shot through his ventral PFC (which is part of the orbitofrontal cortex, closely connected with the amygdala). But he was described as becoming highly impulsive, probably because he felt little anxiety or remorse.
The Greek ideal you refer to sounds almost like a Buddha. Something we try to achieve after twenty years of meditation. Indeed, the commitments of the constructed self seem to condemn us to constant striving and loss. I’ll try to keep on meditating, but I’ll try to avoid mind-fucking without protection — sorry: that herpes-related pun just had to come out at some point.
Your remarks about ascribing intentions and about enhanced memory of negative events are both spot on. For the former, see Daniel Dennett’s intentional stance (http://wikipedia.org/wiki/Intentional_stance). But anyway, these biases do seem to be built in for their survival value. And you’re right to say that they also condemn us — very specifically — to a life of anxiety and concern. Since the memory system (both hippocampus and amygdala — see my response to Hal) strings together the most critical/concerning/worrying events into a sequence, and we seem to take that sequence as a read-out of “the self”….then indeed evolution has played another nasty trick, a double-edged sword. Our highest quality mechanisms also come with the highest price-tag. (I still think upright spines and backaches are the best example)
I guess the same goes for expensive cars.
I just read that part about a double edge sword in Gabor Mates book, and I’m in the middle of reading your book. Very inspirational Thanks. Did you get the email of my transcript? could yous all the help I can get… Thanks again
Reg’ Richard Henry
I’m sorry but I do enough editing for my remaining graduate students. But I wish you good luck with your book, and thanks for the reminder that Gabor Mate makes the same analogy about the double-edge sword. He’s good company. And I’m glad you like my book. It gets pretty dark, but there’s a happy ending in store.