Explaining psychopathologies

My friend, Louis Sass, has said he thinks people attracted to philosophy are at least schizotypal.  Seems a bit confining to me, but explaining oneself and one’s academic colleagues can be challenging.  And it is not just all fun and giggles. Apparently Kissinger said that the reason academic politics is so nasty is that the stakes are so small. I’m inclined to think it’s the reverse; academic politics is so nasty because many academics are the sort of people to fight over very small stakes.

One of the things I have found attractive about cognitive neuroscience is that it gives us a largely new take on what in the world is going on with us.  And it is one free of the dark weapon that Freudian approaches can turn out to use.  In too many people’s hands, Freudian explanations completely epistemically disenfranchise the subject, and then advance demeaning explanations.  People who cannot understand creativity, for example, happily tell themselves that someone dedicated to a project is really self-promoting.  “You may think you were trying to help, but you were really trying to … ” goes a too familiar refrain.  Even feminists who are skeptical about objective truths will be convinced they understand another’s soul.

But cognitive neuroscience invites us to think about the complexity that can underlie a pattern of human behavior. At what points in that complex of person and environment is that problem arising? And the explanation of behavior can be enlightening. Or it can be extremely puzzling.

One thing many cognitive neuroscientists endorse is the view that human beings need to act and react much more quickly than reason can accommodate. (Yes, just as Hume said.) And, simplifying a bit, that need is served in part by structures in the brain that can send send something like alarm signals. The alarms go off very quickly, more quickly than we can think. For example, most human beings get a negative kick when they have visibly hurt someone. Think of scolding a colleague and see their eyes well up. Most of us will stop and back up. Not everyone. I have a friend who will later call you up and start in again, perhaps just to make sure the message got in. It’s a good bet he doesn’t have much in the way of von economo cells in his anterior cingulate cortex, since they provide the kick in human beings.**

I think chimps have some sparse amount of von economo cells, and elephants remain a possibility. But frankly, my dear, most of our animal friends don’t give a damn, though some learn to fake it. (OK, there’s a bit of speculation there.)

And another alarm goes off when norms are broken in most people. If I’m in some supposedly cooperative game with you and I give you a mean share, or you do that to me, an alarm will go off in my anterior insula. And maybe yours too. But not in everyone’s.  A recent article in Science claims to have found a neural marker for borderline personality disorder. And it is precisely a deficit in the anterior insula.

The classic description of BPD people is that they are unstable. They have emotional swings and rages and an inability to establish long term relationships. They also fear abandonment; they are a sort of natural tragedy since their behavior seems geared to bring about what they most fear. Other characteristics include harming themselves; they can be cutters. They apparently go in for splitting; that is, things are black or white, people are good or bad. A friend of mine who was a therapist tells me that they are very manipulative and typically very successful at it.  Some people claim that the BPDs among academics have  very distinctive characterisitics, though others say we’re unlikely to have it (which is one down, anyway).

It is very recent work in Science claims that a distinguishing factor in BPD is a deficit in the anterior insula,  In particular, the BPD participants had no trouble detecting  that they were doing an injustice.  What they didn’t seem to get was when an injustifice  was being done to them.  Or at least they didn’t get the rapid alerm going off.

It is very difficult to understand how a lack of a perception of injustice inflicted upon one would lead to any of the syndrome’s features.  The authors conjecture that BPDs really have severe problems understanding other people, which perhaps brings the marker in closer  to the syndrome.

I suggest there is a whole area for philosophical investigation here.  What is it about norm violation and the failure to detect it that might play an explanatory role in BPD?  We are learning from cognitive neuroscience that traditional distinctions among perception, action and emotion may be quite mistaken and that there is something like affective perception.  We might wonder whether a knowledge of norm violation has a  first and third person variations, some of which are more tied into something like the automatic and instinctive kind of reactions the anterior insula may give us. 

So back to Freud:  what’s the fole of unconscious desires, the id and the ego?  What seems to me to be the highly capitalistic assumption that we are doing what we  want  may be passing away.  Instead, we are products of a much larger complex that includes the environment and our ability to see what is going on.

There is a new science of the self being constructed.  It would be wonderful to have more feminist scholars participating, though the women already in the field are certainly doing their share.

**Much of the work on von economo cells has been done by John Allman at Caltech.

What is choice or autonomy without options?

Lots of pathologies limit alternatives.  Certainly, abusive situations can do this when, for example, an abused women finds herself caught in a relationship since leaving may involve real risks to her and her children’s lives.  Some people use their anger to stop things, leaving others without reasonable alternaitives. (Thanks to KW for a recent reference that describes this dance.)  And there’s the tragic situation of borderline personality disorder sufferers, whose behavior is particularly apt to bring about the abandonment they so fear.  

We might think of violence in a neighborhood as not very analogous to individual pathologies or pathological acts, but it can have very similar effects.  If bullets whiz around your neighborhood, you really should want to go out less.  So what is the solution?  How about bringing in the armed police?  Well, see what you think of what doing that looks like in practice:

HELENA-WEST HELENA, Arkansas (AP) – Officers armed with military rifles have been stopping and questioning passers-by in a U.S. neighborhood plagued by violence that’s been under a 24-hour curfew for a week.

On Tuesday, the Helena-West Helena City Council voted 9-0 to allow police to expand that program into any area of the city, despite a warning from a lawyer with the American Civil Liberties Union of Arkansas that the police stops were unconstitutional.

Police Chief Fred Fielder said the patrols have netted 32 arrests since they began last week in a 10-block neighborhood in this small town on the banks of the Mississippi River long troubled by poverty.

The council said those living in the city want the random shootings and drug-fueled violence to stop, no matter what the cost.

“Now if somebody wants to sue us, they have an option to sue, but I’m fairly certain that a judge will see it the way the way the citizens see it here,” Mayor James Valley said. “The citizens deserve peace, that some infringement on constitutional rights is OK and we have not violated anything as far as the Constitution.”

However, such stops likely violate residents’ constitutional rights to freely assemble and protections against unreasonable police searches, said Holly Dickson, a lawyer for the ACLU of Arkansas who addressed the council at its packed Tuesday meeting. Because of that, Dickson said any convictions coming from the arrests likely would be overturned.

There is a curfew in effect, one that all evening service workers, for example, will run afowl of.

There are multiple levels at which alternatives have been lost. Removing the police would restore some, but is that a good alternative? What do you think?

(Many thanks to NG for the story.)