PTSD and Traumatic Brain Injury: Trauma Inside Out

by Drew Matott and Drew Cameron
by Drew Matott and Drew Cameron
By Zoë H. Wool

Jake was fond of saying that even though he had become dumber, he wasn’t quite dumb enough. He knew that the improvised explosive device (IED) in Iraq had mangled his body, brain and self.

Jake (a pseudonym) lost 30 IQ points due to Traumatic Brain Injury (TBI) from that IED blast. According to the military, he was still smart enough to function and hold down a job, so they didn’t plan to include TBI in his disability rating.

He fought them on this, just as he fought them on the decision not to amputate his leg. After countless surgeries and rehabilitation techniques, his leg was almost useless, allowing him maybe 30 minutes of use before it started rebelling against its reconstructed form. The pain that caused was excruciating; he simply couldn’t use it more.

Eventually Jake won his battle to lose his leg. It was the best thing that happened to him during the year I got to know him while doing my dissertation fieldwork at Walter Reed Army Medical Center in Washington, D.C. (yes, that Walter Reed).

Dealing with, or writing about, TBI is rarely as clear as an amputation. The same is true of TBI’s nearly constant companion, Post Traumatic Stress Disorder (PTSD). TBI and PTSD are not injuries that you can see, unlike a lost leg. Despite the high numbers of TBI and PTSD cases from Iraq and Afghanistan, the relationship of these conditions to more obvious forms of combat trauma remains a fraught one: Witness the debate about PTSD and the Purple Heart.

Most people think that the Purple Heart, that most iconic of military honors, is awarded to American military members injured in combat. As with most issues military, it is not quite that simple.

In 2008, after months of consultation, the decision was made not to award the Purple Heart to those suffering from PTSD because, in part, the medal “recognizes those individuals wounded to a degree that requires treatment by a medical officer, in action with the enemy or as the result of enemy action where the intended effect of a specific enemy action is to kill or injure the service member.” PTSD doesn’t count.

Though the decision was officially framed in rather bureaucratic terms, the debate which surrounded it raises much deeper issues about the nature of trauma. Thinking through these issues has led me to think about the Cartesian split between the (internal) mind and the (external) body and the nature of trauma inside and out.

Continue reading “PTSD and Traumatic Brain Injury: Trauma Inside Out”

Catching Happiness: Christakis and Fowler and the Social Contagion of Behaviors

Christakis & Fowler Obesity Network
Christakis & Fowler Obesity Network

“Is Happiness Catching?” is the feature article in this week’s New York Times Magazine. Clive Thompson writes about the Framingham Heart Study, which has followed 15,000 people starting back in 1948. Originally framed as a study of physical disease, the data are now being turned to social ends.

Nicholas Christakis, a medical sociologist and doctor at Harvard, and James Fowler, a political scientist at UC San Diego, have taken this data set to examine a question that dates back to Durkheim and his ideas about collective effervescence, anomie, and suicide – how do our social relationships affect what we experience and do? As Thompson frames it:

By analyzing the Framingham data, Christakis and Fowler say, they have for the first time found some solid basis for a potentially powerful theory in epidemiology: that good behaviors — like quitting smoking or staying slender or being happy — pass from friend to friend almost as if they were contagious viruses. The Framingham participants, the data suggested, influenced one another’s health just by socializing. And the same was true of bad behaviors — clusters of friends appeared to “infect” each other with obesity, unhappiness and smoking. Staying healthy isn’t just a matter of your genes and your diet, it seems. Good health is also a product, in part, of your sheer proximity to other healthy people.

Their research shows that common explanations for problem behavior, such as individual being at fault or peer pressure, are inadequate. What we experience and how we act spreads further than we think. Take a major illness affecting a mother late in life, and the strain and stress her daughter experiences caring for her mother. That strain can affect the daughter’s husband, who in turn shapes his friend’s life.

Christakis saw this through his clinical experience, and with Fowler, decided to study the impact of social networks. One of their main findings is that in the Framinghamn study, “drinking spread socially, as did happiness and even loneliness. And in each case one’s individual influence stretched out three degrees before it faded out. They termed this the ‘three degrees of influence’ rule about human behavior: We are tied not just to those around us, but to others in a web that stretches farther than we know.”

When a Framingham resident became obese, his or her friends were 57 percent more likely to become obese, too. Even more astonishing to Christakis and Fowler was the fact that the effect didn’t stop there. In fact, it appeared to skip links. A Framingham resident was roughly 20 percent more likely to become obese if the friend of a friend became obese — even if the connecting friend didn’t put on a single pound. Indeed, a person’s risk of obesity went up about 10 percent even if a friend of a friend of a friend gained weight.

Christakis and Fowler’s work provides an in-depth description of the functioning of social networks – not a examination of why loneliness spreads so much as an examination of how it does. In other words, there is not a theory of social contagion of behaviors, but an examination of the role of social networks in loneliness. As they write in an in-press paper co-authored with John Cacioppo:

Results indicated that loneliness occurs in clusters within social networks, extends up to three degrees of separation, and is disproportionately represented at the periphery of social networks. In addition, loneliness appears to spread through a contagious process even though lonely individuals are moved closer to the edge of social networks over time. The spread of loneliness was found to be stronger than the spread of perceived social connections, stronger for friends than family members, and stronger for women than for men.

Continue reading “Catching Happiness: Christakis and Fowler and the Social Contagion of Behaviors”

Neuroanthropology and the Contemporary Culture of Entertainment

Thriller Ipod
By Peter Stromberg

Over the last century, anthropologists have often chosen to study exotic symbolic systems — rituals, myth, art — and frequently managed to illuminate the cultural logic underlying what seem initially to be “irrational” practices.

So why haven’t anthropologists leapt to study one of the most exotic and powerful symbolic systems in human history? I’m talking about the Western (and predominantly American) system of “entertainment”. Not only is this system central to contemporary Western culture, it has arguably played a major role in the breakdown of the cultures of many indigenous communities.

Entertainment should be a significant focus of anthropological inquiry. Alas, it is not.

Admittedly, some interest in the topic has emerged in the last couple of decades. Much of this material is promising; often authors pursue the insight that in some ways entertainment activities are similar to rituals. This is not only an accurate observation, but it points to the possibility of beginning to map how entertainment works to establish some of the central meanings of contemporary life.

Continue reading “Neuroanthropology and the Contemporary Culture of Entertainment”

Trance Captured on Video

A great discussion on the Medical Anthropology listserve focused on good films for trance. I’ve provided the list below, complete with links to the films, extra notes in brackets, and some YouTube clips.

Joshua Moses asked:

Dear colleagues, I was wondering if people could recommend film footage of trance states of various kinds–rituals, dance, shamanic, church based etc.
The geographical region is not important. I would be grateful for you assistance. Thank you.

The Replies:

Sheila Cosminsky (Rutgers): A classic film on trance is Margaret Mead’s Trance and Dance in Bali, which shows dancers with knives under trance [also recommended by Beverly Bennett of Cultural Ideas].
Also, Jero on Jero, a Balinese Trance Seance Observed [also Balinese Trance Seance, included in the DVD, was recommended by Geraldine Moreno at Oregon].
Other films are: N/um Tchai: the Ceremonial Dance of the !Kung Bushmen, and Macumba, Trance, and Spirit Healing.

Michelle Ramirez (University of the Sciences in Philadelphia): There’s always the classic “Holy Ghost People” by Peter Adair, which shows folks in Appalachia (in what very much looks like trance-like states) handling snakes.
[You can also get this documentary in a series of six YouTube clips starting here; I’ve embedded below another clip that contains some of the most relevant footage]

Continue reading “Trance Captured on Video”

Gambling and Compulsion: Neurobiology Meets Casinos

Slot MachinesBy Jarred Carter, Andrew Cavanagh, Elizabeth Olveda, and Meredith Ragany

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.

Continue reading “Gambling and Compulsion: Neurobiology Meets Casinos”