This phenomenon is not limited to developed/industrial countries. Nicholas Kristof writes:

If the poorest families spent as much money educating their children as they do on wine, cigarettes and prostitutes, their children’s prospects would be transformed. Much suffering is caused not only by low incomes, but also by shortsighted private spending decisions by heads of households.

And it’s not just premature deaths and worse education, these types of behaviors cost a lot. Just take the May headline, Governments’ Drug-Abuse Costs Hit $468 Billion, Study Says. Most of those costs were in health or law enforcement, with just 2 percent spent on prevention, treatment, and research.

This is where we need really innovative approaches to understanding consumption, human decision making, and how we regulate our behavior. Behavioral economics is not all that; we do WEIRD research, instead of MYOPICS studies; we say poverty poisons the brain, but forget about just how poverty comes to be; we blame bad behavior on bad hormones, rather than doing more substantive work to understand people’s behavior.

Neuroanthropology can offer novel approaches, from understanding the development of addiction in four steps to better grasping the integrated dimensions of post-traumatic stress disorder to examining different components of food, obesity and eating and understanding the complexities of video games and other modern obsessions.

These problems are not all caused by biological mechanisms or social construction, they are not all rooted in human psychology or deviations from rationality. They are human phenomena, requiring that we integrate ideas across multiple domains. To do that, anthropology needs psychology and neuroscience, just as they need anthropology. The impact of what we DO is enormous. And I’m betting that understanding what we do better will help us become more human – to find ways to deal with our own decisions and flaws, not just through technical fixes or imposed solutions, but also through finding ways to better promote our potential.

One of the ‘Quotes of the day’ in Time Magazine on the 21st of April 2010 was:

“They have made the mistake of letting the Marlboro Man into the country. “

A photo is featured alongside the quote. In the photo, there is a billboard advertising L.A. Lights cigarettes and an upcoming Kelly Clarkson concert in Indonesia. The Tapei Times writes: “Just a few kilometers after passing a towering Marlboro Man ad, a second billboard off the highway promotes cigarettes with a new American face: Kelly Clarkson.” Radiosophie report: “The marketing ploy comes two years after Alicia Keys objected to a similar tobacco-fuelled sponsorship deal in Indonesia.” The Los Angeles Times and Jakarta Globe also covered the story.

Since the scandal, Kelly Clarkson has allegedly cancelled her tour and her Tobacco-company sponsorship, but the same cannot be said for the Tobacco-company sponsored tours of Incubus (Jakarta, 5 March 2008), James Blunt (Jakarta, 21 May 2008), or Jamiroquai (Bogor, 8 April, 2009). Tickets to these concerts cost little more than Four US dollars ($US4), so it is clear that without huge sponsorship deals from Tobacco companies, the big artists simply would not perform in Indonesia. It makes me wonder, how many other Pop artists escape the Paparazzi radar and perform with Tobacco-company sponsorship in Indonesia?

For me, these billboards exemplify what globalisation brings and what it doesn’t bring to the developing world. It brings the products but not the ethics. 

One of my early fieldwork conversations was with a middle aged gentleman who was explaining to me why so many people smoke in his country. “It’s to help our economy,” he said, “People in the developed world are buying less cigarettes and a lot of our economy depends on Tobacco. So we have to buy more cigarettes because you are buying less.” 

From this man’s words, it suddenly became apparent to me that the widespread middle-class ethics that encourage people in the developed world not to smoke had effects in the developing world that I had never thought of before. Packets of cigarettes in Indonesia may have a wrapper that states “Merokok dapat menyebabkan kanker” (Smoking can cause cancer), but the shere quantity of smokers in Indonesia indicates that these few words have little effect on cultural habits. As the developed world weens itself off nicotine, is the developing world compensating for our lack of demand?

I remembering talking more with this gentleman as we walked down a busy litter-filled street. I unwrapped a snack and looked for a rubbish bin but saw none in sight. I pocketed the plastic wrapper and continued attending to the conversation. My companion stopped. “I love that about foreigners,” he said.
“What?” I asked.
“I love that foreigners look after their environment like you just did and don’t throw their rubbish everywhere. Us, we don’t do that. I really admire that you kept your rubbish.”
I really didn’t know what to say because keeping the wrapper until I could dispose of it appropriately seemed so natural to me. In fact, I was surprised that this man even noticed my behaviour. Judging by the amount of rubbish around the streets, in public parks and even in rice paddies, I just assumed that littering was not something they really thought about. I would have liked to know more about this gentleman’s thoughts on the matter but unfortunately I didn’t find the right question to ask. We started to talk about other matters. After a short while, the gentleman pulled out a packet of cigarettes to have a smoke. He peeled off the plastic wrapping and threw it on the ground by the side of the road. Products may be expediently transported and consumed through the global economy, but ethical behaviour takes a longer time to adopt.

Vegas baby, Vegas!

So you’ve finally made it out to Sin City, setting aside a few hundreds dollars to gamble. Maybe even a thousand. You’re hoping to get lucky and have some fun. A few hours and a half-dozen drinks into your weekend, you find yourself at the craps table, dice in hand. You’re feeling good, ready to turn your recent down streak into big bucks. Where does that leave you?
Right where the casino wants you.

The game is rigged. Everyone loses money eventually, if not immediately. But just like gamblers grab hold of that lever and pull, society has stepped up to the gambling craze. And now gambling is pulling people for all they’re worth: emotionally, mentally and, most notably, financially.

This post will look more closely at casino’s techniques to draw gamblers back to the slot chairs and the tables, focusing on both physiological aspects and engaged decision making. Ultimately, these observations will demonstrate that casinos create more than entertainment; they develop an entire compulsive experience.

The Gambler’s Rush

The casino’s greatest asset might be the very personal, very intense rush that gamblers experience as they step up to the blackjack table or slot machine, hoping to strike it rich. This characteristic “rush” or “high” stems from the series of steps and actions that are involved in addictive behavior. Stimulation from the surrounding atmosphere and the thrill of a big risk drives the “high”. Ultimately, the “rush” from gambling can be as intense as a drug fix.

Dealing Emotions

Excitement, making a quick buck, or even the possibility of financial independence is enticing. From experience, most people know that emotions are difficult to control. From a neurological standpoint, the amygdala is situated in the limbic system and is one main centers of emotion (pdf) in the human brain. Other parts of the brain, like the prefontal cortex, display less activity (pdf) during the act of gambling.

The response of the limbic system in producing emotion has been supported in studies conducted with pathological gamblers (individuals that exhibit persistent and recurrent maladaptive gambling behavior). A 2003 psychiatric study (pdf) compared the responses of pathological gamblers and control subjects to videotapes depicting happy, sad, and gambling content. Participants rated their emotional and motivational responses in addition to the brain imaging.

For gamblers, the gambling references elicited urges and temporary changes in brain activity patterns in frontal, paralimbic, and limbic brain structures. This evidence points toward a connection between gambling and the limbic system in producing a “high” from an emotional response.

Furthermore, when viewing gambling cues, pathological gambler subjects also showed relatively decreased activity in brain regions associated with impulse regulation. The urges of the gamblers to use (or in this case to go gamble) indicates a signal to engage, not to regulate. Thus, the emotional response that gambling can elicit along with the suppression of impulse control make the gambling rush one fiscally dangerous “high.”

Engaging the Senses

Gambling also engages the senses. Neural pathways extend from sensory locations to the appropriate association areas in our brains. These areas integrate visual, auditory, somatic, and other stimuli into our perception of the world around us. This interpretation of sensory stimuli means that perception is not always reality.

More often then not, the perceived stimulus is different from the actual stimulus. For instance, the multitude of lights and colors seen within the casino are received on photoreceptors as light waves of different frequencies. Ultimately gamblers perceive them as several colors, not waves of energy. In addition, the soothing sounds that are on repeat in the casino hit the ear as pressure waves, quickly interpreted into sound waves.

What we’re getting at is that the atmosphere, which includes the lights and repetitive music, helps in shaping the intended activities and emotions that the casinos want their participants to have. The brain controls emotions, perception, and rational thought. The casino industry uses tactics which seek to manipulate each of these functions, often with devastating results.

So the question is, how do they do it?

Casinos: Experience and Decision Making

With countless algorithms, computer-programmed slot machines, bright lights and enough cameras to protect a small country, casinos work hard to make sure that your gambling experience is both highly predictable and highly profitable. For them.

While the “tricks of the trade ” that casinos use to keep gamblers betting are well-documented (such as absence of clocks or natural lighting, complementary drinks and endless amenities), one of the more intriguing focuses of the casino atmosphere is its encouragement of engaged decision-making. As discussed by William Eadington (1999, pdf), casinos go to great lengths to convince gamblers that they are making rational, reasonable choices with their money while betting.

Eadington provides the example of an amateur craps player who spends three days in a casino, and bets on 1,000 rolls of the dice. Taking the odds of craps into account, the probability that they will be ahead after 1,000 of these craps bets is just 33% (a fact that casinos are well aware of). Casinos must work against the often steep odds that gamblers face in order to keep them gambling. For Eadington, casinos must work to encourage gamblers’ beliefs that they are making smart decisions with their money. To this end, casinos use methods such as slot machines with progressively growing jackpots to promote the illusion that “big money” is just one roll of the dice or pull of the lever away for gamblers.

MIT Professor Natasha Schull describes the casino as a site of “intensified technological stimulation” (pdf), a place where gamblers, amateur and compulsive alike, can lose themselves in their gambling experience. Casinos perpetuate this sensorial gambling experience, as it allows gamblers to enter into what Schull calls a “zone” state, enabling them to “forge an insulated, autonomous space of play in which they can set and reset their own bet level, rhythm, and pace.” According to Schull, the ideal customer is someone who stays until they lose all their money – it’s called “player extinction.”

Once gamblers enter this zone, they can bet for hours without interruption or consideration of the economic value of their decision-making. In order to convince their patrons that they are engaging in productive profit-seeking methods, casinos place a heightened emphasis on engaging gamblers, and making gambling an exceptionally sensorial experience.

Now that you’re in the “zone,” you have everything under control and the jackpot money is yours for the taking…or so you think.

The Illusion of Control

Players literally “hold the cards” in games such as blackjack and poker, providing them the feeling that they have a certain amount of control over events that are, in fact, governed by the laws of mathematics. Just picture the craps player blowing on dice for luck.

Casino chips, for example, are almost laughable in their simplicity. They allow gamblers to part quickly and painlessly with an abstract form of their money. Yet the chips themselves make gambling a corporeal experience – something you touch and control, an idea that sites like Full Tilt Poker actively promote.

Chips must be traded in for cash in order to have any worth in the world outside the exciting casino. Although a seemingly basic task, walking through the casino for a chance to exchange chips may lead to one more game, especially when that certain glowing, beckoning slot machine catches the gambler’s eye. Clearly, casinos use this and other methods to maintain a cycle of continuous, fast-paced gambling while trying to minimize the noticeable effects of losing money for their customers.

In 1975 psychologist Ellen Langer captured the essence of this sort of phenomena when she defined the theory of the illusion of control (Langer 1975). The theory of illusion of control is “an expectancy of a personal success probability that exceeds the objective probability of the outcome.” Langer proposed that this type of overconfidence is likely when an event that is at least partially determined by chance is characterized by factors that normally lead to enhanced outcomes under skill-based situations, such as choice, stimulus or response familiarity, competition, and active involvement.

Applying this theory to casinos, the illusion of control is likely when an individual plays games which are at least partially determined by chance (poker, craps, slots, etc.) and are also characterized by choice (“Hit me!”), competition (beating the dealer), and active involvement (rolling the dice or pulling the lever).

The choice, competition, and active involvement that casinos offer boost an individual’s perceived control over an outcome. According to Langer that leads to an “unrealistic subjective probability of success.” Furthermore, the larger the role that skill can play in determining the outcome (“knowing” how to bet, or performing “winning” rituals) the more pronounced this illusion of control becomes.

In 2006 Langer’s theory was applied to a study done in a natural setting in Reno casinos. In this study, patrons of Reno casinos were observed placing craps bets on their own and another patron’s dice rolls. The hypothesis was that subjects would play riskier by placing higher bets and more “difficult” bets on their own rolls (when they would be under the illusion of control). The results of the study, as well as work on the gambler’s fallacy of the “hot hand” (pdf), help support the Langer hypothesis. The illusion of control is well at work in casinos, and gamblers are most likely losing more money the more they feel like they can affect the outcome.

Against the Odds

But casinos do more than keep you glued to the tables; they set you up to lose. This house advantage grows more likely and inevitable the longer one gambles – it’s the House Edge. Although a gambler may have a “lucky” win, continuing to gamble makes loss almost unavoidable. The techniques of casinos acknowledge this, encouraging gamblers to keep gambling.

From Craps to Keno to Roulette, the house always has an edge that grows more evident as their techniques keep gamblers from leaving the casino. Slot machines, for instance, remain one of casinos most popular draws and clearly demonstrate the manner in which casinos make money. A quarter slot machine, innocently taking only small change from gamblers at a time, results in about a $360 loss within 10 hours. Other popular casino games also post statistics that favor the house.

Clearly, gamblers normally end up paying the casinos instead of hitting the jackpot. It proves easy to look at these numbers when outside of a casino and belittle those who see gambling as a chance to win big. However, when placed in the casino atmosphere, the thrill of entertainment and the seemingly endless possibilities encourage gamblers to go for that one “last” game.

Maybe you could become a millionaire against the odds. But, once removed from the stimulation of casinos, it becomes much easier to acknowledge that the house ultimately wins.

Casinos play the odds, people play the games. In the end, that means the casinos play the people.

For more information:

Getting Help for a Gambling Addiction

The National Council on Problem Gambling

Problem Gambling – A Canadian Perspective

Problem Gambling Guide

Wikipedia – Problem Gambling

Gambling Industry

Stop Predatory Gambling Foundation

Casino Watch

Gambling Industry Association

American Gaming Association

Responsible Gambling Council

Research

E-Gambling (Journal of Gambling Issues)

Institute for the Study of Gambling and Commercial Gaming

Cambridge Health Alliance Division of Addictions

National Center for Responsible Gaming

Gaming Research Weblog

Video Resources (YouTube)

Winning at Slots
Winning at Roulette

Losing at Slots
Losing – “He took everything”

Excalibur Walk-in – see the casino layout

Compulsive Gambler’s Recovery Story – “You always lose more than you win”
Compulsive Gambler’s Story & Critique of Industry – “an ex casino gambling degenerate”

Martha Frankel and Getting hooked on online poker (podcast)

So who wants to know why the brain isn’t green? CRED – Center for Research on Environmental Decisions – where they use behavioral research and decision science to understand “the green mind” (or lack thereof). As seems de rigeur today, any topic where we don’t act on the information available and seem to make irrational decisions is the target of this new decision science.

CRED has the primary objective of studying how perceptions of risk and uncertainty shape our responses to climate change and other weather phenomena like hurricanes and droughts. The goal… is to finance laboratory and field experiments in North America, South America, Europe and Africa and then place the findings within an environmental context.

So what are the problems? We’re bad at long-term decision making; we see environmental problems as far away from our everyday lives; we seem to have a “finite pool of worry” and make an occasional decision to help the environment while continuing on with our overall lifestyle.

Beyong covering the decision science, Gertner’s basic point is that we need to expand our notion of the usual culprits for why we aren’t more effective at addressing environmental problems – “the doubt-sowing remarks of climate-change skeptics, the poor communications skills of good scientists, the political system’s inability to address long-term challenges without a thunderous precipitating event, the tendency of science journalism to focus more on what is unknown (will oceans rise by two feet or by five?) than what is known and is durably frightening (the oceans are rising).” He came away from his interactions with CRED wondering “if we are just built to fail.”

The article goes give an interesting discussion of decision science – uncertainty, time, potential gains, potential losses, group effects – in relation to environmental topics. And Weber makes a great point that the vast majority of research dollars is going into the physical and technological sciences as we try to address problems like climate change. That is unbalanced itself, revealing our technological and money-oriented ideology in the first place.

And that brings me to my point. Asking is your brain green? kinda misses the point. It is like saying that because we make some irrational decisions from time to time, we don’t have a “capitalist brain.” Well, we obviously have an imminently capitalist brain (even a globalized brain?) and have created an entire capitalist system. But we also have an emotional brain, and can make hateful and wasteful decisions, and we certainly have a brain attuned to power, so the people with most control over capital can often make terribly damaging decisions for their own benefit.

As Elke Weber, one of the directors of CRED, says early in the article: “Let’s start with the fact that climate change is anthropogenic. More or less, people have agreed on that. That means it’s caused by human behavior. That’s not to say that engineering solutions aren’t important. But if it’s caused by human behavior, then the solution probably also lies in changing human behavior.”

And that’s the rub. I think we have a brain that is perfectly suitable to being green. But the system? Not so much… And I’d look at capitalism and its use of resources as well as our long cultural history of placing ourselves as above, outside and better than nature. That’s a powerful explanation –a production system and an ideology that then shape behavior.

Jon Gertner focuses on immediate policy, the sort of nudges and small-ball policy favored by people like Richard Thaler. And that might help with creating some different sort of connections in our Braintrust. But will it get us past security? Will it give us a hero to go in there and do something?

In other words, CRED’s theory is largely built from questions asked in the lab. CRED’s results from people in real-life situations paint a broader picture. One study of urban versus rural Alaskans’ views of climate change showed that “Among other things, the results suggested that experience of climate change is a relative thing: something happening to another part of your state, or to a different cultural group, doesn’t necessarily warrant a change in your own response. It likewise hinted at the complexity of instilling feelings of climate-related urgency in Americans.”

Certainly there a wonderful group of naturalists and environmentalists who have helped push the environment to the forefront of our collective conscious, even if we don’t always act on it. And certainly part of the reason we DON’T see it as a problem lies in the decision sciences. But that doesn’t explain why these naturalists and environmentalists do. The answer is simple – their values, coupled with personal experience, turn a relative thing into something that was wrong. Thus, the complexity of the issue – and most issues are – became simple in human terms. Something must be done.

The question is, “What practical knowledge have we gained by looking at decision-making in the brain that we didn’t already have, either through introspection or behavioral studies?”

His answer is, “The best answer, I think, is that learning about the brain can help constrain our theories. We haven’t decoded the cortex or solved human nature – we’re not even close – but we can begin to narrow the space of possible theories.”

That is both an elegant and a practical answer – it claims neither too much nor too little for neuroscience, and provides a way to think about neuroscience. Ways of thinking are often much harder to grasp than what to think, where neuroscience churns out an enormous quantity of information but not necessarily an enormous range of hypotheses about people as people.

Lehrer’s answer echoes my own view of evolutionary theory, that its greatest utility is in limiting the range of possibilities when confronting the diversity and commonality of people’s behavior lives today and in the recent past. People are often aghast when I say this – but what about all the predictions, the selective forces, Darwin’s genius? But there is evolution’s strength – certain possibilities are more likely, and others are often not on the table. Combine that with the mechanistic understandings from neurobiology–the outcomes of evolutionary adaptations and present function–and suddenly the range of possibilities is constrained further.

But the brain and evolution are both clever than you are, so its constraints are often very unlike the way we think of constraints based on favored theories and often unrecognized assumptions. So it proves useful to do two things, first to have some evidence on the introspection and behavior side.

I prefer ethnography for that, since it can be just as systematic and rigorous as a good quantitative or experimental study and provides what people say and what people do in spades. These sorts of data then provide a way to match evolutionary and neuroscientific possibilities to the real world.

For the other thing, I like Stan Katz’s recent post on The Utility of Useless Knowledge. Katz takes on the recent essays on humanities needing to justify themselves, and writes, “Until we can redefine ‘utility’ to encompass the notion that it is the full range of learning that is necessary to save ourselves, I fear we will be unable to help ourselves, the country, or the world very much.” The humanities extend our notion of self and of human nature, and combat those assumptions that evolutionary biologists and neuroscientists bring to the table. The humanities help to further define the range of possibilities.

As for answering the question Jonah got, I’d say that neuroscience has reached the stage where its consideration of processes and its focus on mechanisms and interactions help us think through problems of behavior and experience in ways that Freud and Hume and William James and Virginia Woolf could not. It’s not just the space of possibilities but how you navigate them that is important. And here neuroscience helps considerably, though obviously I think other approaches also help considerably.

One last note – the comments to Jonah’s post are fascinating, for they illustrate a range of reactions to neuroscience, from it being good to bad to interesting in itself. In one sense, they are all reactions to the perceived social utility of neuroscience today. Jonah’s point is more subtle, that we will get to some actual utility by starting to consider the range of possibilities and from there move on to forging connections to what was known before, what we work on today, and how we might address problems based on that overall process.

“You study sin,” my dinner companion said with a smile at a recent conference. I reached for my wine, and after a modest sip (really!), replied, “Vicio. In Colombia it’s called vicio. Vices.”

In Colombia vicio covers a whole range of activities—video games, playing pool, and yes, drugs. Even better, when vicio becomes the adjective “enviciador,” favorite snacks and sweets come into the picture. People start to eat, and it’s hard to stop until every piece of candy is gone.

I like the Colombian category of vicio, because I see something common in the way people get hooked on things, the way they want and crave this or that. I have seen it with food, with sex, with gambling and smoking cigarettes in both the United States and Colombia. But I have seen “getting hooked” best with drugs.

In today’s world drugs stand in for sin pretty well. Just in April Pope Benedict XVI declared drug use a deadly sin. In the United States drug users are often seen as moral degenerates. In this moral model of addiction, people lack willpower. As the tagline to a recent HBO series on addiction went, Why can’t they just stop?

But with addiction, the disease model has slowly come to the fore, highlighted by Alan Leshner, the then-head of the National Institute of Drugs Abuse, declaring in Science that “Addiction Is a Brain Disease, and It Matters.”

Morals versus brains. Or culture versus biology. Just yesterday in a talk someone asked about gender, “So is this biology or is this culture?”

How can we escape this constricting dichotomy? As I discussed in an interview with Jonah Lehrer over at Scientific American’s Mind Matters, I think a focus on concrete problems is the way to go. Specifics will help get us to where we need to go, not theories based on old ideas.

Indeed, grand pronouncements of consilience or some over-arching theory forget about Newton and his very concrete apple. As the poet Lord Byron wrote:

When Newton saw an apple fall, he found
In that slight startle from his contemplation –
‘Tis said (for I’ll not answer above ground
For any sage’s creed or calculation) –
A mode of proving that the earth turn’d round
In a most natural whirl, called “gravitation;”
And this is the sole mortal who could grapple,
Since Adam, with a fall or with an apple.

Today we’ve got the physics of an apple down, and we are turning back to the problem facing Adam. The tree of knowledge is both tempting and sweet. So just how are we to understand the apple of my eye?

Translation

My concrete problem has been craving, that compulsive desire drug users can experience and which plays such a powerful role in relapse in excessive use and relapse. In both the popular accounts and scientific literature on addiction, dopamine often takes the blame for addiction. In understanding dopamine function, two prominent ways have been developed over the past decade – one focused on incentives and motivation, and the other on computation and learning. With addiction, the incentives and motivation approach has gained more traction, largely through the “incentive salience” work of Terry Robinson and Kent Berridge. Robinson and Berridge have often glossed dopamine function as “wanting” – and wanting just needs a little push to get to craving.

Their elegant work and sophisticated hypothesis testing have helped tease out a particularly thorny problem around addiction, that of pleasure versus desire. Earlier behaviorist theories largely assumed that pleasure was the ultimate reinforcer; no other mechanism was necessary to account for why animals went towards something rewarding. The work by Robinson and Berridge helped separate “wanting” versus “liking,” or as I explain to my students, the difference between that late-night craving for pizza, just a phone dial away, and that first exquisite bite of cheese and sauce and dough.

So the leap from lab to real life can be perilous. It’s a leap that I think anthropologists are better equipped to make than most. For my research on compulsive wanting and craving, what really made the difference was the combination of two strange bedfellows – evolution and ethnography. While for many that combination would be sinful in itself, the two helped take research on dopamine function and translate it into something I could use.

Evolutionary theory placed a brain-centered theory in the context of how people make adaptive decisions. Rather than an evolutionary naïve view that drugs only signal “false fitness benefits,” evolutionary theory brought a concern with the adaptive design of the mesolimbic dopamine system and with the behaviors involved in addiction (Lende 2007 in this edited volume). This linking of decision making with specific behaviors provided a framework to then think about what “compulsive wanting” actually looked like on the ground.

That is where ethnography – or qualitative research more broadly – came into the picture. Ethnographers talk to people, we spend time with people, we understand things from their point of view. That helped me solve the translation problem, as I detailed in the posts on craving and how I came to measure it.

Integration

Neuroscientists, much like anthropologists, want to see their field as causal – the brain causes addiction or culture causes addiction. To get beyond this one-cause approach, we can take the translation model one step further. Neuroanthropology presents different data about what matters with a particular behavioral phenomena and offers ideas about how to integrate disparate areas of research. Our focus on practices, meaning, embodiment, inequality, social contexts, relationships, language and knowledge matches up well with the move in brain sciences away from a hard-wired, determinist approach to a more interactive and dynamic view of brain function.

Let me take a couple lines from a 2008 Robinson and Berridge review article (pdf): “[A]ddiction is caused primarily by drug-induced sensitization in the brain mesocorticolimbic systems that attribute incentive salience to reward-associated stimuli. If rendered hypersensitive, these systems cause pathological incentive motivation (‘wanting’) for drugs (3137).”

Here the case of Giovanni, discussed in the Scientific American piece, highlights other ways to understand the causes of craving. The interaction with a bus driver, the tough situation he faced at that moment, his desire for his past life—these were as much a part of his craving as the surge in dopamine.

Similarly, as I wrote in the compulsive involvement piece:

What I found was that both cultural symbols and an individual’s sense of self impact what users experience. One girl who smoked marijuana nearly every day explained what she sought from using: “estar en un video,” to be in a video, where attention was shifted away from how she felt in her traumatic yet culturally valued family environment. Sure, the dopamine helped produce that shift in attention, but the idiom of “a video” was something cultural. In the end that was what she really wanted, to feel those “so present sensations” from marijuana that put her in a video that seemed, for a moment, far from home.

Neuroanthropology

Understandings of our brain have undergone a major shift over the last decade. Instead of hard-wired circuits and innate modules, we see a growing emphasis on plasticity, embodiment, development, and interaction. These views excite many social scientists, because they provide us ways to take brain research and use it in creative fashion in our own work. Economics, history, sociology – all these fields have seen recent books and articles drawing on neuroscience research.

What makes neuroanthropology different are the historical strengths of anthropology – evolution, culture, variation, and ethnography. These make an ideal partner for the advances in neuroscience. Evolution deepens out insight into dopamine function and why people get hooked on drugs in societies marked by both excess and inequality. Culture helps us get at patterns of excess and inequality, and how different societies manage our various vices in such contrasting ways.

Comparative variation gets us beyond a disease model, a one-size-fits-all to recognize what is a basic fact about drug use: most people who try never get addicted. Why is that? And ethnography gets us out of the lab. Take hard-core methamphetamine users in Atlanta, who used drugs in a functional way, not just to get high or self-medicate (Lende et al 2007). Thus, anthropology challenges brain research with contrasting theories and insight into people’s everyday lives; that work can enrich what brain science tells us about ourselves. That is neuroanthropology, combining everyday life and our cultural brain.

So I study sin, as I said. Los vicios, the things that get us hooked. When those vices turn destructive, we try to explain that destruction using either a moral model of addiction or a brain model of addiction. I am looking forward to the day we have a people model of addiction. That is the apple in my eye, the neuroanthropologist who can move between brain and morals, function and imagination, nature and nurture, biology and culture.

A long-time research project of mine has been to understand how adolescents get hooked on drugs. Querer más y más, as they say in Colombia, to want more and more. When people get addicted – whatever the substance may be – they often report urges, cravings, and obsessive thinking as a primary force in why they keep using or relapse. Knowing the consequences often doesn’t matter, especially in those moments when that desire feels hot as a knife.

The easiest analogy for me to help people understand this type of desire is to ask people to think about that one time they really craved something to eat. Yes, that time, when you just had to have it. Most people have experienced this one time or another. With substance abuse, craving like this often becomes an unpredictable constant, something that comes on in the morning or while walking by a favorite bar or seeing a friend who has that gleam in his eye and a crooked smile on his face.

So here is what I found in Colombia, reported in a 2005 Ethos article entitled Wanting and Drug Use: A Biocultural Approach to Addiction (click for the full paper: Lende Wanting pdf). The abstract goes:

The integration of neurobiology into ethnographic research represents one fruitful way of doing biocultural research. Based on animal research, incentive salience has been proposed as the proximate function of the mesolimbic dopamine system, the main brain system implicated in drug abuse (Robinson and Berridge 2001). The research presented here examines incentive salience as the mediator of the wanting and seeking seen in drug abuse. Based on field work with adolescents at a school and a drug treatment center in Bogotá, Colombia, this article addresses: 1) the development of a scale to measure the amount of incentive salience felt for drugs and drug use; 2) the results from a risk-factor survey that examined the role of incentive salience and other risk factors in addiction; and 3) the ethnographic results from in-depth interviews with Colombian adolescents examining dimensions of salience in the reported experiences of drug use. Incentive salience proved to be a significant predictor of addicted status in logistic regression analysis of data from 267 adolescents. Ethnographic results indicated that incentive salience applies both to drug seeking and drug use, and confirmed the importance of wanting, a sense of engagement, and shifts in attention as central dimensions of experiences related to drug use.

Several years later, I like to highlight several things about this research. First, different domains of subjective involvement can be linked to dopamine –wanting more and more, the sense of an urge or push to use (often not a conscious desire), and the heightened focus on places and actions and times that lead to using. The scale I developed showed good internal consistency, adding support that these three senses of compulsive involvement are linked. If you want to know more about the scale, I have done a separate post detailing the compulsive involvement scale in both Spanish and English versions.

Second, the original theory of incentive salience and addiction was developed by Terry Robinson and Kent Berridge at the University of Michigan. (Here’s a recent summary paper of theirs on incentive salience and addiction.) Incentive salience has generally focused on the desire to use drugs, on motivations to use, and separated those from the pleasure or high associated with actually using drugs. My ethnographic research clearly showed that hard-core drugs users often felt surges in desire while using, not just in deciding to go use or seeking out drugs. Querer más y más, to want more and more, often referred to what happened while using. This effect helps to explain the often extraordinary amounts of drugs that some addicts use. It is that rabid urge to continue, to have more, and not just tolerance to a drug, that helps drive the excess often associated with substance abuse.

Third, neuroscientists are plain wrong if they try to reduce craving or desire to the combination of the pharmacological drug action and brain circuits. This common approach does not answer what it is that hard-core users want – it assumes that sensitization and chemicals account for everything (or at least everything that counts). Put differently, why do addicts want drugs?

A disease model or a moral model of addiction cannot answer this question because they assume cause already – it’s a biological problem or a failure in willpower. That avoids addressing what people themselves can tell us about their use. Brain imaging in humans also doesn’t answer the “why” question – scans can show neural correlates associated with craving, but they cannot get at the content of our experiences and our thoughts.

Anthropology can! The question that I devised to help hard-core users explain to me why was rather simple. “Think of your experiences while using as an imaginary place. What sort of place would that be?” For an anthropologist, or anyone interested in subjective experience, this question had one all-important point – it gave me data; it helped my respondents articulate their experiences in words that I could then analyze. It may be not be quite as fancy or expensive as neuro-imaging, but it too let me peer inside someone else’s head.

I will also admit that the question thrilled me because I knew some hard-core neuroscientists and the way they thought about the brain and addiction. Wanting, that’s just dopamine, they argued. Most of them struggled significantly more with imaginary places.

But the best thing about the question was the answers. Kids who had never used did not understand this question at all. But teenagers who used frequently, they got this question immediately. I still remember one of the first boys, a recovering cocaine addict at a local school who was now a heavy smoker. I asked him the question first about smoking. He looked down at his hand and put his fingers together like he held a cigarette. “A world in there? No,” he said. “But cocaine, oh yeah.”

In the end, what I found was that both cultural symbols and an individual’s sense of self impact what users experience. One girl who smoked marijuana nearly every day explained what she sought from using: “estar en un video,” to be in a video, where attention was shifted away from how she felt in her traumatic yet culturally valued family environment. Sure, the dopamine helped produce that shift in attention, but the idiom of “a video” was something cultural. In the end that was what she really wanted, to feel those “so present sensations” from marijuana that put her in a video that seemed, for a moment, far from home.

Val Curtis

She knew that over the past decade, many companies had perfected the art of creating automatic behaviors — habits — among consumers. These habits have helped companies earn billions of dollars when customers eat snacks, apply lotions and wipe counters almost without thinking, often in response to a carefully designed set of daily cues.

“There are fundamental public health problems, like hand washing with soap, that remain killers only because we can’t figure out how to change people’s habits,” Dr. Curtis said. “We wanted to learn from private industry how to create new behaviors that happen automatically.”

The companies that Dr. Curtis turned to — Procter & Gamble, Colgate-Palmolive and Unilever — had invested hundreds of millions of dollars finding the subtle cues in consumers’ lives that corporations could use to introduce new routines.

If you look hard enough, you’ll find that many of the products we use every day — chewing gums, skin moisturizers, disinfecting wipes, air fresheners, water purifiers, health snacks, antiperspirants, colognes, teeth whiteners, fabric softeners, vitamins — are results of manufactured habits. A century ago, few people regularly brushed their teeth multiple times a day. Today, because of canny advertising and public health campaigns, many Americans habitually give their pearly whites a cavity-preventing scrub twice a day, often with Colgate, Crest or one of the other brands advertising that no morning is complete without a minty-fresh mouth…

“Our products succeed when they become part of daily or weekly patterns,” said Carol Berning, a consumer psychologist who recently retired from Procter & Gamble, the company that sold $76 billion of Tide, Crest and other products last year. “Creating positive habits is a huge part of improving our consumers’ lives, and it’s essential to making new products commercially viable.”

Habits

Habitual behavior is one topic that concerns brain science, psychology, economics and anthropology, each with disciplinary specific ways of trying to explain these everyday patterns. However, most of those explanations have two flaws: some variety of rationality as the way to understand habits, and some causal force (e.g., genetics, reward, subjective utility, culture) as forming the pattern. But things are not quite so simple, as “Habits May Be Good For You” shows:

Those and other studies revealed that as much as 45 percent of what we do every day is habitual — that is, performed almost without thinking in the same location or at the same time each day, usually because of subtle cues.

For example, the urge to check e-mail or to grab a cookie is likely a habit with a specific prompt. Researchers found that most cues fall into four broad categories: a specific location or time of day, a certain series of actions, particular moods, or the company of specific people. The e-mail urge, for instance, probably occurs after you’ve finished reading a document or completed a certain kind of task. The cookie grab probably occurs when you’re walking out of the cafeteria, or feeling sluggish or blue…

“Habits are formed when the memory associates specific actions with specific places or moods,” said Dr. Wood, a professor of psychology and neuroscience at Duke. “If you regularly eat chips while sitting on the couch, after a while, seeing the couch will automatically prompt you to reach for the Doritos. These associations are sometimes so strong that you have to replace the couch with a wooden chair for a diet to succeed.”

The researchers at P.& G. realized that these types of findings had enormous implications for selling Febreze. Because bad smells occurred too infrequently for a Febreze habit to form, marketers started looking for more regular cues on which they could capitalize.

The perfect cue, they eventually realized, was the act of cleaning a room, something studies showed their target audience did almost daily. P.& G. produced commercials showing women spraying Febreze on a perfectly made bed and spritzing freshly laundered clothing. The product’s imagery was revamped to incorporate open windows and gusts of fresh wind — an airing that is part of the physical and emotional cleaning ritual.

“We learned from consumer interviews that there was an opportunity to cue the clean smell of Febreze to a clean room,” Dr. Berning said. “We positioned it as the finishing touch to a mundane chore. It’s the icing that shows you did a good job.”

In a sense, a product originally intended for use on piles of smelly, dirty clothes was eclipsed by its exact opposite — a product used when women confronted a clean and tidy living room. And the more women sprayed, the more automatic the behavior became.

Today, Febreze is one of P.& G.’s greatest successes. Customers habitually spray tidied living rooms, clean kitchens, loads of fresh laundry and, according to one of the most recent commercials, spotless minivans. In the most recent fiscal year, consumers in North America alone spent $650 million buying Febreze, according to the company.

Here we have cues, meaning (doing a good job), specific contexts, business and more, all wrapped up in one. Proctor & Gamble have a pragmatic knowledge of what works and what does not. While still not an explanation for habitual behavior, it does prove useful in applied anthropology.

The Anthropologist at Work

Val Curtis saw potential for this sort of approach, for trying to generate habits that would lead to public health outcomes rather than for-profit behavior change. The situation she confronted was not one of lack of resources or lack of cultural knowledge—providing more soap or educating them about germs were not the best solutions. Rather, it was taking advantage of what was already there.

For Dr. Curtis and the Global Public-Private Partnership for Handwashing With Soap, such tactics offered enormous promise in a country like Ghana.

That nation offered a conundrum: Almost half of its people were accustomed to washing their hands with water after using the restroom or before eating. And local markets were filled with cheap, colorful soap bars. But only about 4 percent of Ghanaians used soap as part of their post-restroom hand-washing regime, studies showed.

“We could talk about germs until we were blue in the face, and it didn’t change behaviors,” Dr. Curtis said. So she and her colleagues asked Unilever for advice in designing survey techniques that ultimately studied hundreds of mothers and their children.

They discovered that previous health campaigns had failed because mothers often didn’t see symptoms like diarrhea as abnormal, but instead viewed them as a normal aspect of childhood.

However, the studies also revealed an interesting paradox: Ghanaians used soap when they felt that their hands were dirty — after cooking with grease, for example, or after traveling into the city. This hand-washing habit, studies showed, was prompted by feelings of disgust. And surveys also showed that parents felt deep concerns about exposing their children to anything disgusting.

So the trick, Dr. Curtis and her colleagues realized, was to create a habit wherein people felt a sense of disgust that was cued by the toilet. That queasiness, in turn, could become a cue for soap.

A sense of bathroom disgust may seem natural, but in many places toilets are a symbol of cleanliness because they replaced pit latrines. So Dr. Curtis’s group had to create commercials that taught viewers to feel a habitual sense of unseemliness surrounding toilet use.

Their solution was ads showing mothers and children walking out of bathrooms with a glowing purple pigment on their hands that contaminated everything they touched.

The commercials, which began running in 2003, didn’t really sell soap use. Rather, they sold disgust. Soap was almost an afterthought — in one 55-second television commercial, actual soapy hand washing was shown only for 4 seconds. But the message was clear: The toilet cues worries of contamination, and that disgust, in turn, cues soap.

“This was radically different from most public health campaigns,” said Beth Scott, an infectious-disease specialist who worked with Dr. Curtis on the Ghana campaign. “There was no mention of sickness. It just mentions the yuck factor. We learned how to do that from the marketing companies.”

The ads had their intended effect. By last year, Ghanaians surveyed by members of Dr. Curtis’s team reported a 13 percent increase in the use of soap after the toilet. Another measure showed even greater impact: reported soap use before eating went up 41 percent.

In other words, changing a proximate behavior was the key to getting a larger outcome. The process mattered. Not changing the genetics, psychology, economics, or culture. The one-cause approach did not prove useful in trying to design an effective campaign. Instead, Val Curtis, as she argues in a recent article, focuses on behaviors and emotions in context and how those get connected into belief systems—biological anthropology and cultural anthropology need to work together.

Larger Application

Other researchers and public health officials are already getting on the bandwagon, as Charles Duhigg reports in the conclusion to his article:

Today, public health campaigns elsewhere for condom use and to fight drug abuse and obesity are being revamped to employ habit-formation characteristics, according to people involved in those efforts. One of the largest American antismoking campaigns, in fact, is explicitly focused on habits, with commercials and Web sites intended to teach smokers how to identify what cues them to reach for a cigarette.

“For a long time, the public health community was distrustful of industry, because many felt these companies were trying to sell products that made people’s lives less healthy, by encouraging them to smoke, or to eat unhealthy foods, or by selling expensive products people didn’t really need,” Dr. Curtis said. “But those tactics also allow us to save lives. If we want to really help the world, we need every tool we can get.”

Here at Neuroanthropology, Greg has addressed how understanding behavior, particularly skilled, habitual actions, can lead to improvements in physical education and in preventing falls in elderly people.

I have not spoken much here about how this sort of approach applies to addiction (it does!), but certainly compulsive substance abuse represents a cycle of behaviors and experiences that proves very difficult to break (especially when reinforced by inequality). However, I did lay out some larger patterns in globalization in Cellphones Save the World, and habits represent one major proximate (or everyday) aspect of those people-driven processes.

And for those of you wondering about the ethics of such a move, there is an interesting debate among readers over at the Economist’s View about the Duhigg article. Greg, in providing his own take on the article, speaks of his “ethical vertigo” in the switches back and forth between marketing “new needs” and public health campaigns. My off-the-cuff take? These techniques are already being used against us. Why don’t we put them to use in some more positive ways?

There are some major public health problems out there, and changing laws and raising awareness and all the other rationally-derived approaches have not had as much impact as we might hope. The habit approach might prove more effective.

Let me begin by just giving you the essay excerpts.

In general, every recollection refers not only to the remembered event or person or object but to the person who is remembering. The very essence of memory is subjective, not mechanical, reproduction; and essential to that subjective psychology is that every remembered image of a person, place, idea or object invariably contains, whether explicitly or implicitly, a basic reference to the person who is remembering.

The “rigid divide,” [Giacomo] Rizzolatti and Corrado Sinigaglia write in their new book, Mirrors in the Brain, “between perceptive, motor, and cognitive processes, is to a great extent artificial; not only does perception appear to be embedded in the dynamics of action, becoming much more composite than used to be thought in the past, but the acting brain is also and above all a brain that understands.”

For Edelman, then, memory is not a “small scale model of external reality,” but a dynamic process that enables us to repeat a mental or physical act: the key conclusion is that whatever its form, memory itself is a [property of a system]. It cannot be equated exclusively with circuitry, with synaptic changes, with biochemistry, with value constraints, or with behavioral dynamics. Instead, it is the dynamic result of the interactions of all these factors acting together.

Together, subjective psychology, an acting and embedded brain, and representation and action that are dynamic and relational present us with a new starting point when we talk about the intersections of neuroscience and psychology with anthropology. Starting with their conclusions, making it the beginning of something better, that would have been a really exciting essay for me to read.

As I wrote a couple days ago, Howard Gardner does get us closer to this new individuality. “Gardner brings a refreshingly unique take, neither the individual of science, bounded and rational, or the individual of philosophy and art, lone thinker and creative genius. Nervous system, individual experience, and subjective interpretation move us into a radically different domain—an individuality that lies firmly in the continua Gardner describes.”

What do I mean? Let me go back an old post, Pattern #2, where I wrote:

[There are] a variety of ways that neuroanthropology can engage mental illness: (1) the links between specific aspects of the brain, experience and behavior, and cultural context; (2) more global human biobehavioral patterns, lived contexts, and cultural practices which can shape the expression and impact of disorders; and (3) the mix of environmental, ecological and cultural factors that connect with everyday experience in varied domains, and thus also shape mental illness… In work on mental illness and behavioral disorders, there is often a great deal of focus on either #1 or #3 (which generally carry assumptions about nature or nurture, biology or culture). But I am increasingly persuaded that basic patterns in human experience and behavior are an important way to understand variation in mental health as well as a way we might build more explicit cross-cultural comparisons in anthropology.

Subjective psychology, an acting and integrative brain, representation based on global properties and systemic dynamics—these are the concepts that will help us link pattern #1 (say, dopamine, desire, and drug use) into pattern #2 (a cycle of addiction, each experiential/behavioral step leading to the next). Categorical ideas, whether in neurobiology or in psychology (“reward” is a good example), just are not going to do the trick. The problem is, most of psychology is built on this sort of break-it-down-into-categories-and-let’s-go-all-scientific-on-it approach.

To take one example, stress is often conceived of as bio-psycho-social, with the fight-or-flight phenomenon acting as the reductive structure that shapes psychosocial stress. However, this approach completely misses both the evolutionary phylogeny of stress (we are a social species) and the social construction of stress (we disenfranchise people, poverty poisons the brain). Understanding the evolutionary and cultural dynamics of stress places renewed emphasis on understanding the experiential and behavioral dynamics of stress, whether in marathon running, in our relations with new technology, or in eating comfort food.

Recently Mo at Neurophilosophy covered six iconoclastic discoveries about the brain—but they are all recent! These discoveries—about plasticity, regeneration, and basic brain function—put us in a position to overturn old dogmas about the brain, many of which boil down to treating the brain as a computer-like machine. Many of the new metaphors, it seems to me, are about treating the brain more like a person—an acting brain, a whole more than the sum of its parts, subjective and embodied. But we still need some actual persons to put around that brain!

Vaughan at Mind Hacks pointed us this week to an interview with Jennifer Hornsby over at Philosophy Bites. Hornsby makes the same basic point—we do not need the language of mental states, reducible to brain parts, to understand human agency. (Agency is the new willpower, for the most part; our ability to do something, and thus central to understanding why people do what they do.) She makes a strong stand against the adequacy of using “beliefs and desires” and brain “twitches” as the way to provide causal explanations of human action. These create internal, hidden accounts that then get reified in scientific language and brain images.

Rather than looking inside people for causal chains (the typical approach), Hornsby proposing putting people back in our chains of causation. To do that, she proposes we begin with the sort of naïve explanations we use everyday—if a woman is crossing the street to catch the 59 bus, it’s not about the belief that the 59 bus will arrive soon, it’s about getting home. This woman is doing one thing to accomplish another, and to understand that, you have to know her and know the context in which she operates.

I would emphasize a similar point about the statement that “every remembered image of a person, place, idea or object invariably contains, whether explicitly or implicitly, a basic reference to the person who is remembering.” If there is a basic reference to a person who is remembering, then there is also a reference to a cultural context and a social history. Memory, in terms of its basic function, is as social and cultural as it is neurobiological. It doesn’t fit into any one academic category.

So what to do about that? Let’s take one concrete example, decision making. Behavioral economics and neuroeconomics are all the rage—if we blend two categories, we’ll just have to get something better! Some interesting new data and some middling concepts, I agree, but nothing like a theory of agency that Hornsby wants or a true subjective psychology per Rosenfield and Ziff. Recent research on decision making does indicate the need for real change away from a rational choice assumption; but even recognizing emotion in decision making represents but a first step towards a more contextual and grounded understanding of human choice.

Emotion and decisions gets us moving from pattern #1 into pattern #2. But pattern #3? How about what women want and our everyday appetites, the sorts of things where the cultural rubber meets the human road.

That still means developing a richer theoretical and methodological approach to what is in the middle. That remains a significant challenge. But every journey begins with a single step.