Sunday, May 19, 2013
The boundaries of Neurology
Andrew D Atkin
What neurologists can't see:
Science is based on what can be observed and measured. The problem with neuroscience today is that it can't see and measure far enough. More specifically, not far enough to show us the relationship between mental information (the data) and neurological processes.
This needs to be clear: Let's say I placed you in a chair, and then hooked you up to an EEG machine to examine your brainwaves, and in response to a stimulant to be introduced later. As the stimulant, I shoot your spouse dead in front of you. From here, your brainwaves would function differently as shown on the EEG scan, as a result of the trauma.
So the changes we see in your brains activity would be a response to information: The raw information from seeing your spouse killed goes to your visual and acoustic centres, and then the meaning of the event is understood and processed emotionally, which translates to trauma, which in turn drives a neurobiological response in your brain.
So this is what I mean by information driving neurological processes. Though the relationship is obviously real, from a clinical perspective it is invisible. We can't, from an external viewpoint, see the information - we can only see the brain's reaction to it.
The only person who can "see" information is the subject themselves. So we need the subject to tell the neurologist: "Hey, the reason why your EEG scan went crazy is because I just watched my wife get killed".
Now here comes the interesting bit. In practice, if I blew your wife's brains out, the trauma might be so severe that your brain totally gates the event from your conscious mind. So, the information driving your brains reaction is not just invisible to the neurologist (who can only see what's going on within his scans) it is invisible to you as well.
From here on in, your brains hyper-inflated amygdala, panic attacks, chemical imbalances, depression and post-traumatic stress-disorder, etc, become a great mystery to both the neurologist and yourself. You don't know where your symptoms are coming from and neither does he.
And from here, you and your neurologist make what might be a great (though understandable) mistake. You both assume that the problem is with your brain itself, and not the unconscious information driving it.
The nature of trauma:
But then in comes empirical research, kindly provided by those who observe and quantify human behaviour (at its surface). They notice a striking correlation between childhood trauma and later mental disturbance. So we know from this research that information really does damage the brain, or at least damages the way it functions.
That's all very well, but there's still a problem with our lack of understanding leading to false, or possibly false, assumptions. There are basically two assumptions:
One idea is that trauma hits the brain like a missile hits a ship. The trauma hits, does its damage, but once the trauma has happened it has nonetheless been and gone. You have the breakage but the traumatic event, in itself, is gone.
Ok, now if it really did work like that then the current focus of neurologists would be about right. They see a broken brain on their EEG's and MRI's, and so their focus is to try and fix the brain. They try to 'plug the holes' with either drugs or surgery, to correct the imbalances that they see.
But this approach is riding on an assumption that is ultimately questionable. It's especially questionable considering that interventions based on this "broken ship" assumption have been delivering mixed results at best. Enduring drug dependency (with harsh side-effects) is hardly a cure, and this is what the mental health industry has been largely resorting to.
Now the other assumption relates to trauma-imprint theory. The idea is that the trauma is not a been-and-gone reality, like a missile strike, and the brain is not broken as such, but that the observed distortions within the brain are actually a normal reaction to an abnormal input. So the trauma, as it occurs, becomes imprinted information that later acts as an enduring (albeit unconscious) force on the brain. So the 'event' of the trauma is there...doing its damage from the unconscious, where it has been internalised and repressed.
In turn, the focus of those who sign-up to trauma-imprint theory has been to remove the traumatic imprint itself. They claim that if you do this, the imbalances within the brain will take care of themselves. Think of a good loudspeaker producing a distorted sound due to a bad electrical input. Don't touch the speaker - get to the input.
Dr Arthur Janov, who has been the central leader in the development of trauma-based therapy, claims to have had success with this approach for over 40 years. Though Janov has induced notable opposition from competitors, his work, or more importantly his theory, have yet to be discredited.
Regardless of who is right or wrong, what we can see is a theoretical black hole. I don't ask neurologists to sign up to trauma-imprint theory (which is not, I believe, the current assumption they operate on) but I do ask them to respect it as a substantial possibility. Because the truth is we don't and can't yet know which theory is correct (from a strictly objective measure), because our tools simply can't penetrate that far to tell us, today.
No-one can argue that information is not a real force on the brain. It is. What we need to do is clarify the nature of that force, or at least clarify our assumptions and likewise what we do and do not know about it.
The relationship between information and the brain, especially traumatic information, should be a hot topic for study in the world of brain science. I do respect that this is a difficult territory to navigate, due to its nature. We will need to see a close marriage between theoretical thinking and clinical observation, because this is how we penetrate past what is directly observable. We should not accept direct observations leading to only cheap and undisciplined assumptions.
Note: Though I have a lot of confidence in trauma-imprint theory and for many reasons, in this piece I am writing with respect to what I can and cannot prove. My argument is for neurologists to investigate trauma-imprint theory. Or more specifically, the impact of unconscious information on the brain. At the very least, this focus can be respected as credible and important.