Consciousness in a Coma?

We have always advised people who visit patients who are unconscious to assume that the patients can hear them, even if they cannot respond. So, family members read to them, tell them about their day, and go out into the hall to have conversations that might upset the patient (as in a negative prognosis from the doctor).

The question is not one of sensation. Soundwaves will make the eardrum vibrate, sending the sound energy to the middle & inner ear, where it will be transduced into an electrochemical transmission that is sent to the brain.

The question is whether there is perception, i.e., does the brain understand the transmission?

Now, some research by Caroline Schnakers, published in Neurocase, has shown that some existing technology can help doctors "reveal consciousness trapped inside a lifeless body."

Using electroencephalography (EEG) on a woman who had had a stroke and was in a coma-like state, when they instructed her to pay attention to her own name, "the woman's EEG signal showed an exaggerated P300 response to her name, compared with when she was instructed to just listen passively. The P300 is a spike of activity recorded from the parietal lobe, which is thought to be a marker of consciousness or decision making."

14 days later the lady moved her finger in response to instructions.

At least two good things came out of this research:

1) There is way for doctors to determine if there is consciousness in a comatose state. "There is someone in there!"

2) EEG technology can be done bedside, which will encourage doctors to use the technology more freely than other technologies that require the patient be transported, or require an invasive procedure.

6-Year-Old Boy Flies in Balloon...NOT

Listen, when I was six I got caught playing with matches, ran, and hid in the woods at the end of Churchill Court for hours. Why is it so hard for 24-hour-news-addicted Americans to believe that yesterday's 6-year-old was just acting like a 6-year-old? No family dysfunction, no sick ulterior motive on the part of the parents. Just a 6-year-old hiding from his dad who had yelled at him, and then having every reporter in the world ask him, "Why did you do that?".

Don't know what I'm talking about? You must have been in a cave yesterday. Check it out on YouTube. I am confident that multiple verisions of "Falcon's Great Adventure That Wasn't" are posted on it. (I know that the t-shirts are already being sold on the internet.)

Here it is, in a nutshell: A family had built a weather balloon. When they "launched" it, the rope designed to keep it close to the ground came untied and the balloon flew away. The 6-year-old wasn't in the yard and his brothers said that they thought he had crawled into the balloon before it flew off on its one-hour flight at 8,000 feet. Everyone scrambled to try to figure out how to save the boy before the balloon crashed. When it finally crashed and was found to be empty, they found him hiding in a box in his attic.

Now, people - from news reporters to on-air psychiatrists - are mad at the parents. There are calls for the parents to pay for every last cent it cost the government to scramble to the boy's rescue.

Why? Here are at least 5 explanations I have heard in the last 12 hours.

1. The family had previously appeared on a TV reality show. (This must be a publicity stunt.)

2. The parents were storm chasers. (They must be abusive parents to take their boys that close to dangerous storms.)

3. The father is an inventor/scientist. (He had no business inventing something like a weather balloon at his house that his son could climb into and fly off in.)

4. The parents knew their sons were fearless & curious. (Why would they have something like that around boys like that?)

5. The kid said to his dad on live TV, "You said to do it for the show." (Ah, ha! The parents have been caught in a lie!)

Why are we doing this?

Leon Festinger, the Father of Cogntive Dissonance Theory, would raise his hand and answer, "Cognitive Dissonance."

We (American adults) like to think of ourselves as pretty sophisticated and intelligent. But then we are caught up believing that a weather balloon could bear the weight of a 6-year-old kid. We stay glued to our TV sets for hours watching it. We believe the boy is in that balloon. We experience great anxiety. Mothers of young boys aren't able to watch it.

Woops, we were wrong. That doesn't feel good. We don't like this Cognitive Dissonance: I'm smart/I was fooled. Leon Festinger says there are only three ways to resolve Cognitive Dissonance:

1. Change the behavior. Woops, too late. We did it/believed it/watched it.
2. Change our cognition about ourself. "I guess I'm not so smart." We never like this option.
3. Create a NEW cognition. The above 1-5 are all new cognitions.

"Why was I fooled, and why did I waste hours watching the stupid thing?" Hmm... the dad is a nut! It's HIS fault!

Cognitive Dissonance relieved. "Phew, I feel better now. This doesn't tell you anything negative about me. It tells you something about the dad!"

The reality is that this 12-hour diversion tells us something about ourselves and Cognitive Dissonance, not anything about the boy or his parents.

"Become the Bat"

In the movie Awakenings Robin William's physician character (based on a real doctor) is ridiculed by other doctors when he suggests that the reason some of his catatonic patients catch a ball when he throws it at them is because, "They become the will of the ball." As with most movies based on real life, entertainment was probably chosen over accuracy, and the movie doctor probably over-stated what the real doctor believed.

But some recent research by Lucilla Cardinali and colleagues, reported in Current Biology, sugests that the idea of "becoming the ball" might be close to what champion athletes actually do.

"Elongation of time" is a phenomenon that has been well-documented. World-class goalies and batters talk about how time seems to go in "slow motion" when the puck or pitch comes toward them, giving them time to react to it.

Now, Cardinali's research shows a similar "extension of the athlete's own body" can happen as well.

For several minutes, research participants used a 16-inch-long "grasping device" to reach for a block. "After several minutes using the grasping tool, the participants' subsequent reaching movements with their hand were... as if their own arm was now perceived as longer." Results appeared to last as long as 15 minutes.

This phenomenon might help explain why some champion athletes wield a bat, tennis racket, golf club, or some other "extension device" so much better than most of us. They "become the bat." They experience "extension of body" the same way others experience "elongation of time." Swinging the bat/racket/club is like swinging their body, easy to control.

To my students on our softball and baseball teams: "Become the bat."

Can You Intentionally Forget?

Do not let your wife read this, or you may never hear the end of it.

You forget things all the time, admit it. Your anniversary, your wife's birthday, the fact that your wife told you tonight is the night you go to the opera, what we celebrate on Columbus Day, the $20 you owe me.

The question is, can you INTENTIONALLY forget something?

It is implied that you can when someone says to you, "Forgive and forget."

Now, some research by Peter Delaney and colleagues, reported in The Quarterly Journal of Experimental Psychology, suggests that, indeed, we can intentionally forget things we want to forget.

His research is unique because usually we are interested in how accurate our memories are, and why we can't remember things we WANT to remember.

Researchers devised several variations on a basic task of memorizing some sentences by two different people, then being unexpectantly told to forget one person's sentences in order to better remember the other person's.

"The students were able to follow the forget instruction so long as the sentences about Tom and Alex were of random meaning, with no discernible theme... [They] recalled just 28 percent of them... [compared to] 39 percent [by the control group]."

This, of course, leads to the question, "How do we deliberately forget?"

The research dealt with new information being memorized, not previously memorized facts. So, part of the answer might lie in what we have to do to encode information to begin with. If we want to commit something to long term memory we have to use intentional strategies to encode it and work on it in short term memory. If we don't mentally rehearse it, we don't remember it.

It is thought that research participants stopped rehearsing the information they were told to forget in order to rehearse the information they were told to remember.

This is kin to, "The reason you never remember what I tell you is because you never really listen to me!"

Your wife could be right about you. Remember the three most important words in marriage: "Maybe you're right."

The Impact of Divorce on Children

Prologue: I am pro marriage and anti divorce. Which is one reason I have been a marriage & family therapist for almost 30 years. That said...

I heard a disturbing sermon last Sunday. It came at the end of a great series on the family. I was sorry the series ended on the note it did. My church invited an "expert" to give it, a psychology professor who is also a marriage & family therapist. (No, it was not me, even though 2/3 of that description fits me, all except the "expert" part.)

He gave all kinds of statistics on the harm that divorce does on children of divorced parents. My heart went out to all of the people in the audience who were divorced or the children of divorce.

As a marriage & family therapist for almost 30 years, who has worked with lots and lots of conservative Christians, I can tell you that no one hates divorce more than divorced Christians. A sermon like Sunday's does not help. You cannot "scare" people into not divorcing. For at least two reasons: 1) many times it is their spouse that initiates the divorce against their will, and 2) the pain in marriage gets too deep to stay in it. (Immediate relief is a more powerful force than potential negative consequences in the future.) All a sermon like Sunday's does is heap guilt on top of their pain.

Even though he gave the last 3 minutes of his 30-minute sermon to "things you can do to help your children" it was too little, too late. He read two PowerPoint slides of "things children tell us help" without explaining or teaching them, not even time to write them down. By that point the depression was like a pall in the air. "I have obviously ruined my kids' lives by getting divorced." "My parents have ruined me for life by getting divorced."

My wife and I both said to each other after church, "I guess we just THOUGHT Jennifer & Kristi are healthy, happy, fully-functioning, productive spouses, parent & members of society." They were 5 & 7 when their parents divorced, 7 & 9 when Yvonne & I married, 9 & 11 when I adopted them. They are now 39 & 41.

Let me talk a little more specific psychology, on why lectures like Sunday's bother me.

#1 - Statistics show that 75% of children of divorce have no more adjustment problems in life than those of intact families. Do they have problems? Nod your head yes. But only 25% have more problems than most. Not every problem in life is caused by divorce.

#2 - (LISTEN TO THIS!) Every one of the statistics used to show the harm of divorce is the product of correlational research. That is important because correlation does not imply causation. You cannot use that kind of research and statistics to say that divorce CAUSES the problems. You can only say that they are found together. If you just use the data itself, you can with as much confidence say that the kid-problems caused the divorce. There is always a third possibility, that something else caused BOTH the problems & the divorce.

#3 - An example of a third possibility is that the "damage" done to children of divorce is not done by the divorce but by the climate in the family BEFORE the divorce. The problems that show up in the children of divorce also show up in children who live in a divorce-free but dysfunctional, pain-filled family. Even if the parents do not divorce, the problems often show up anyway. Was there a divorce? Nod your head yes. Did the kids have problems? Again, yes. But, the problems may have been caused by everything that they experienced BEFORE the divorce, not the act of divorcing.

#4 - Research shows that the self-esteem of children whose parents divorce takes a hit, but it bounces back to within the "normal" range by the time they become adults. One thing that does not seem to bounce back is their belief that there are some things in life that are beyond their ability to control. (Nothing they did kept their parents together.) Children of divorce just seem to learn that fact earlier in life than the rest of us. The reality is, there ARE things in life that are beyond our control.

This final observation may be wrong, but I think our preacher had the same kind of reaction to the sermon because he did a great job as he closed out the assembly acknowledging that there were many people present who had experienced divorce. He talked compassionately about God's grace, the power of forgiveness, hope, and specific things we as a church are doing to make a difficult experience less painful, and encouraging people to take advantage of them.

Divorce is not destiny, for you or your child. If you have divorced, you have not pre-destined your child to permanent problems or pain.

Woo. This post sounds like a sermon. Sorry.

Live Poor & Die Younger?

The British journal, Lancet, recently reported a disturbing correlation: "the higher up you are on the corporate food chain, the longer you live." By extension: the lower you are, the shorter your life.

Nancy Adler, PhD, professor of Medical psychology at the University of California San Francisco, wanted to know why. Most everyone suspected that it was related to stress but that is "a difficult variable to measure, and one that gives contradictory results." The other variable, Social Economic Status, is also a "hazy" construct to measure.

Adler and her colleagues developed an extremely simple way to measure SES - the MacArthur Scale of Subjective Social Status. It is a simple ladder, and people are asked to place themselves on one of the rungs of the ladder to indicate their SES. With that tool in place, they were able to clarify the relationship of stress to SES and why it affects those at the lower end of the SES ladder more than those higher up.

As reported in the October 2009 Monitor on Psychology, "Repeated exposure to stress [is] often associated with lower SES... Over time, that stress builds and makes one more vulnerable to disease - a process known as allostatic load... [A] misfortune like a flat tire might be a trivial event for a person of higher SES, but it's much more stressful to someone who then has to make the decision between feeding his or her family or getting a new tire. Furthermore... even ambiguous events look more threatening to people of lower SES. Constantly being vigilant against potential harm is itself very taxing."

Stress negatively affects the immune system and the cardiovascular system. It is greater when you have limited resources to cope with the stressor, possibly affecting length of one's life.

Information on the MSofSS can be found at: http://macses.ucsf.edu/.

Our Brains Never Rest

Our brains never stop working. Even when we sleep there is brain activity. One dream theory is that dreams are created by our minds trying to make sense out of the random neural firing that occurs while we sleep.

Stage 4 sleep, the deepest sleep, is characterized by the longest and highest brain waves, Delta waves. The brain waves have slowed down from our awake waves (Beta & Alpha waves), to Theta, to Delta, then go back to Beta & Alpha waves in REM sleep, in which we dream. The neurons are randomly firing, rather than responding to external stimuli. Our mind creates dreams (stories) out of the random firing.

The question is, why does our brain contine to work? Now some research by Neil Albert and colleagues offers an answer. The brain may be working on motor control issues.

Their article, in Current Biology, describes their research on motor control. Half of the participants were given a malfunctioning joystick to control a computer image. They had to constantly figure out new ways to move the joystick so it would work. The other half were given a joystick that worked and was easy to control. All participants were given three EEGs: when they were resting before the task, during the task itself, and when they were resting after the task.

The brains of the participants that simply had to do the motor skill slowed down after the exercise. The brains of the other half, that had to constantly figure out new motor skills to control the joystick, had two neural pathways that remained active. One of those networks "wasn't even present in the control participants."

The research seems to support the theory that neural activity while we sleep is the brain continuing to "work" to solve problems presented while we are awake.