Neuroanthropology

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Archive for March 3rd, 2008

Decision Making and Emotion

Posted by dlende on March 3, 2008

Economists and policy makers are coming to the realization that rationality, in its multiple forms, doesn’t always explain why people make the decisions that they do.  By rationality, I mean both the assumption of “economic man” (a utilitarian cost/benefit analyzer) and the emphasis on education and knowledge as the privileged means of shaping behavior.   

Let’s take three recent headlines: “Why Sadness Increases Spending,” “Craving the High That Risky Trading Can Bring” and “Teenage Risks, and How to Avoid Them.”  All point to the role of emotion in decision making (any surprise here?). 

The first article states, “A research team [of Cynthia Cryder, Jennifer Lerner, and colleagues] finds that people feeling sad and self-focused spend more money to acquire the same commodities than those in a neutral emotional state.” 

The second provides an Aristotelian summary: “The findings, while preliminary, suggest — perhaps unsurprisingly — that traders who let their emotions get the best of them tend to fare poorly in the markets. But traders who rely on logic alone don’t do that well either. The most successful ones use their emotions to their advantage without letting the feelings overwhelm them.” 

The third tells us, “Scientific studies have shown that adolescents are very well aware of their vulnerability and that they actually overestimate their risk of suffering negative effects from activities like drinking and unprotected sex…  ‘It now becomes clearer why traditional intervention programs fail to help many teenagers,’ Dr. Valerie Reyna and Dr. Frank Farley wrote. ‘Although the programs stress the importance of accurate risk perception, young people already feel vulnerable and overestimate their risks.’  In Dr. Reyna’s view, inundating teenagers with factual risk information could backfire, leading them to realize that behaviors like unprotected sex are less risky than they thought. Using an analytical approach of weighing risks versus benefits is ‘a slippery slope that all too often results in teens’ thinking that the benefits outweigh the risks,’ she said.” 

This type of research provides small steps forward vis-à-vis traditional Western assumptions about decision making and rationality.  But my question is, Why don’t they go further?  Why do they simply seem to affirm our common sense view of the world? 

Read the rest of this entry »

Posted in Decision Making, Emotion | 6 Comments »

Postmodern Medicine

Posted by dlende on March 3, 2008

Harvard Magazine has an excerpt from Charles Rosenberg’s new book, Our Present Complaint: American Medicine, Then and Now, in this month’s issue.  I have pasted the entire article below, as I find it a strong evocation of how disease is as much a social entity as a biological phenomenon.  It captures much of what is difficult to understand, that our biology is inevitably and essentially social.

Postmodern Medicine

We are all “medical citizens,” embedded as potential or actual patients, with physicians, in a system of social, moral, and organizational understandings. So writes Monrad professor of the social sciences Charles E. Rosenberg in Our Present Complaint: American Medicine, Then and Now (Johns Hopkins, $50; $19.95 paper), touching on sources of unease.


Disease has become a bureaucratic—and, thus, social and administrative—as well as biological and conceptual—entity.What do I mean when I describe disease as a “social entity”? I refer to a web of practice guidelines, disease protocols, laboratory and imaging results, meta-analyses, and consensus conferences. These practices and procedures have over time come to constitute a seemingly objective and inescapable framework of disease categories, a framework that increasingly specifies diagnostic criteria and dictates appropriate therapeutic choices. In America’s peculiar hybrid health-care system, layers of hospital and managed care administrators enforce these disease-based guidelines. The past generation’s revolution in information technology has only exacerbated and intensified these trends—in parallel with the research and marketing strategies of major pharmaceutical companies…. This web of complex relationships has created a new reality for practitioners and patients alike. Physicians have had their choices increasingly constrained—if, in some ways, enhanced. For the sick, such ways of conceptualizing and treating disease have come to constitute a tangible aspect of their illness experience.

Of course, every society has entertained ideas about disease and its treatment; patients have never been blank slates.…Think of the generations of sufferers who were bled, sweated, puked, or purged to balance their humors. But never has the infrastructure of ideas, practices, thresholds, and protocols that comes between agreed-upon knowledge and the individual patient been so tightly woven and bureaucratically crafted.…

Yet, as I have emphasized, we are left with that inconveniently subjective object, the patient—in whose body these abstract entities manifest themselves. This is the characteristic split screen that faces today’s clinician: the tension between illness in the individual patient and disease as crystallized and made socially real in the laboratory’s and the epidemiologist’s outputs and inscriptions, practice guidelines, and algorithms.…Bedside, clinic, and physician’s office are the points at which the mandates of best—and increasingly most economically rational—practice bump up against the unique reality of the individual patient and challenge the physician’s traditional autonomy.…

It engenders a feeling of paradox, the juxtaposition of a powerful faith in scientific medicine with a widespread discontent at the circumstances in which it is made available. It is a set of attitudes and expectations postmodern as well as quintessentially modern

Posted in Medical anthropology | Leave a Comment »

 
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