Neuroscience, Addiction and the Gospel

1. Neuroscience, Addiction and the Gospel Dr Alan Gijsbers

2. OUTLINE • The challenge to ISCAST • Issues in neuroscience • Reductionism • Mind-body as seen through the emotions • Addiction and emotions • Emotional maturity and relationships • Interaction between emotions and reason

3. GOSPEL MINISTRY • Has dispassionate individualistic rationalism robbed the Gospel of vital elements? • Do the results of neuroscientific reflection point to a different way forward? • Does addiction management suggest a different way of evangelism?

4. A VISION FOR ISCAST • Scientific tent-makers in secular Australia • Scientifically sound, theologically able, spiritually discerning • Creating an open dialogue between science and faith to their mutual enriching • By that dialogue encouraging people to come to the light of the world.

5. Neuroscientific issues • Complexity vs reductionism • Mind/body issues via the emotions • Addiction and its meaning • Addiction and relationships • Insight and its lack in our patients

6. NEUROSCIENCE Contains within it a number of sciences from • Basic neurophysiology and neuropharmacolology • Neurology • Neuroimaging • Neuropsychology • Biological psychiatry • Psychology • Psychiatry • Sociology • Spirituality

7. REDUCTIONISM “you, your joys and sorrows...are no more than a vast assembly of nerve cells and their associated molecules...the idea that man has a disembodied soul is as unnecessary as the old idea that there was a Life Force.” Crick, F 1994 The Astonishing Hypothesis New York Simon & Schuster. Quoted in Jeeves MA, Berry RJ. Science, Life and Christian Belief: Apollos 1998:135 Alan Gijsbers RMH Addiction Medicine

8. COMPLEXITY Emergent systems You cannot understand water by looking only at hydrogen and oxygen You cannot understand wetness by only looking at a water molecule You cannot understand a waterfall by looking at a drop of water. There is a degree of autonomy about each layer – though the layers above are dependent on the layers below. Alan Gijsbers RMH Addiction Medicine

9. ENGEL’S BIOPSYCHOSOCIAL MODELAmerican Journal of Psychiatry 1980;137:535-544 Alan Gijsbers RMH Addiction Medicine

10. Layer Relationships • Emergence • Supervenience • Meaning • Top-down as well as bottom-up causation

11. Emergence At the next level new systems emerge which were not predicted from the level below Each new level brings a new way of seeing reality, eg chemistry to biochemistry, biochemistry to model making, L-dopa receptor considerations to Parkinson’s disease. Alan Gijsbers RMH Addiction Medicine

12. ENGEL’S SYSTEMS ANALYSIS Used to describe the events surrounding the death of Mr Glover from a heart attack • Coronary occlusion • Intervention of employer • Unsuccessful arterial puncture • Cardiac arrest • Defibrillation Alan Gijsbers RMH Addiction Medicine

13. AN EXAMPLE OF TOP-DOWN CAUSATION Fatman, 21 Kt. Dropped on Nagasaki 8 September 1945 Alan Gijsbers RMH Addiction Medicine

14. A More Benign Version of Top-Down Causation Alan Gijsbers RMH Addiction Medicine

15. Neurobiology of Emotions

16. EMOTIONS - definition • “Move out” • Ecstasy – similar concept • Sense of transport outside of ourselves • Subjectivity seems central but...scientific research sees it differently...

17. “The movements of expression give vividness and energy to our spoken words. They reveal the thoughts and intentions of others more truly than do words, which may be falsified.” Charles Darwin The Expression of Emotions in Man and Animals

18. What are the Emotions? • The modification of neural activity that animates and focuses mental activity. • Created by physiological activity that selects certain streams of information over others, shifting the body and mind to higher or lower degrees of activity, agitating the circuits that create scenarios and selecting ones that end in certain ways. The winning scenarios are those that match goals programmed by instinct and the satisfaction of prior experience. Wilson EO. Conscilience 1998:123-4.

19. THE SCIENCE OF EMOTIONS • Animal neural systems that control “emotional behaviour” and associated physiological responses. • Emotional systems are said to have evolved as “behavioural (sensorimotor) solutions to problems of survival.” • Emotional responses do not require feelings. Joseph LeDoux. Emotions viewed through the brain. In Russell RJ, Murphy N, et al. Neuroscience and the person. 1999.

20. EG • Responses to danger • Freeze • Physiological responses to this freeze which support or are a consequence of the freeze behaviour • Further responses which will anticipate subsequent events (eg flight/fight) • Reaction, Action, Habitual action. • Feelings are a late accompaniment in brains that are conscious, and lead to considered action

21. James-Lange Theory of Emotion • Physiological Response • Visceral • Muscular Mental Perception Stimulus

22. Damasio’s Schema of Emotions Emotionally Competent Stimulus Triggering the emotion Execution of the emotion Emotional state Thoughts that follow Feelings: intentionality of the above

23. BASIC NEUROSCIENTIFIC VIEW • Feelings are not the function that emotion systems were designed to perform(!) • Emotion systems did not evolve to produce feelings • Emotional feelings are what happens when emotion systems are present in brains that are conscious. • The problem of feelings is another aspect of the mind-brain problem. Joseph LeDoux. Emotions viewed through the brain. In Russell RJ, Murphy N, et al. Neuroscience and the person. 1999.

24. HENCE WE ARE DIRECTLY INTO THE MIND-BODY PROBLEM How can neural networks and synapses give rise to such a rich inner emotional life [intentionality, qualia] as we humans experience?

25. One Model of Basic Emotions • 4 Opposites • Joy sadness • Anger fear • Anticipation surprise • Trust disgust

26. ROBERT PLUTCHIK’S MODEL OF EMOTIONS http://www.fractal.org/Bewustzijns-Besturings-Model/Nature-of-emotions.htm

27. MULTIPLICITY OF EMOTIONS (From GFR Ellis ) Damasio suggests primary emotions are: P1. happiness P2. sadness P3. fear P4. anger P5. surprise P6.disgust (acceptance and expectation are not in this model ) and characterises developmentally emergent secondary emotions as: S1: embarrassment, shame, guilt S2: contempt, indignation S3: sympathy, compassion S4: awe/wonder/elevation, gratitude, pride S5: jealousy, envy.

28. EMOTIONS – NEGATIVE DESCRIPTIONS • Disorganised interruptions of mental activity • “Rule your feelings, lest your feelings rule you” (PubililiusSyrus C1) • A disorganised response, largely visceral, resulting from a lack of an effective adjustment Dylan Evans. Emotion: The science of sentiment. OUP 2001

29. EMOTIONS POSITIVE DESCRIPTIONS • An organizing response because it adaptively focusses cognitive activities and subsequent action. • Processes that arouse sustain and direct activity Dylan Evans. Emotion: The science of sentiment. OUP 2001.

30. NEGATIVE RELATION OF EMOTIONS TO REASON • Plato: emotions are obstacles to intelligent action. • Locke’s Punctual self. • Hume’s “Reason is the slave of the emotions.” • Romantics: conflict between cold reason (society) and warm heart (nature). Hence back to nature. Adapted from: Dylan Evans. Emotion: The science of sentiment OUP 2001.

31. POSITIVE RELATION OF EMOTIONS TO REASON • Emotions are vital to individual and social existence • Emotions the thread that weaves together the fabric of society. • It is rational to be emotional. • No science of the mind is complete without also addressing the heart. • Thinking more clearly is not opposed to feeling more deeply. • Emotions are a universal language that binds humanity together into a single family. Dylan Evans Emotion: The science of sentiment OUP 2001

32. RELATION OF THE EMOTIONS TO REASON • Reason the arbiter of action which are implemented by the will to the control of feelings • Fact - faith - feeling train • “Reason is the slave of the emotions” – Hume • Reason steers; emotions drive – emotions as energy • Emotions commit; reason justifies – reason as rationalisation

33. Affective Neuronal Darwinism (AND)- GFR Ellis and JA Toronchuk • Edelman’s Neuronal Darwinism • Panksepp definition of the basic emotions • AND combines these two views into a meta-theory

34. 1: Neural Darwinism • Biological Complexity is generated in each individual by a developmental process based on reading the genetic informationstored in the sequence of bases in DNA: • - Creates a highly structured organism out of differentiated cells • - Influenced byinformation from the environment. • -[Gerald Edelman] Principles of Darwinian natural selectionapply when utilising genetic information in each individual for brain development (hence Neural Darwinism): • both because the stored information is far too little to control brain development by itself, Cf. the Human Genome Project: 45,000genes but 1013 cells and 1011 neurons • even if read mtultiple times and in different combinations • and because this allows the brain to optimally adapt to the local environment

35. 2: Affective Neural Group Selection • In the cortex, broad functional areas are determined; then neurons send out random connections to other neurons • Those that have a positive survival value are strengthened, • others are killed off or allowed to decay • [hence Neural Darwinism: Edelman and Tononi] • A value system is required to decide which should be regarded as `positive’ or `good’ from a survival viewpoint • This is provided by the primitive emotions whose seat is the • pre-cortical area of the brain, sending out neuro-transmitters • characterised in detail by Panksepp [ Affective Neuroscience]

36. ‘The initial set of relatively non-specific synaptic connections are refined to produce a precise pattern of connectivity’ - Neurotransmitters alter gene expression

37. From Edelman and Tononi Neurotransmitters spread to entire brain Value system Source is in the Limbic system Noradrenaline, Dopamine, Serotonin

38. Intellect Emotion Instinct The value system originates in the limbic (affective) system

39. The basic (primitive) values The basic emotional systems identified by Panksepp (1998), based on structures in the limbic system, are the following: E1: The SEEKING system: general motivation, seeking, expectancy E2: The RAGE system: rage/anger E3: The FEAR system: fear/anxiety E4: The LUST system: lust/sexuality E5: The CARE system: providing maternal care/nurturance E6: The PANIC system: panic/separation, need of care E7: The PLAY system: roughousing play/joy On the present view: it is the basic emotional systems [particularly the SEEKING system] that underlie brain development and intellect - relates to evolutionary development and to animal behaviour

40. The basic hypothesis Hypothesis: The basic emotional systems E1-E7 identified by Panksepp, together with inputs from the endocrine and immune systems, are necessary and sufficient to provide the value system of neural Darwinism identified by Edelman and Tononi. On this view, the primary emotions E1 to E7 characterised above [with endocrine and immune system inputs] become the lynch-pin linking neurophysiology to experience and the social and physical environment. They link macro-events to neural micro-structure by top-down action from the macro to the micro scale. Consequently they are a key both to brain physiological development and to evolutionary development of secondary emotions and higher cognitive functions. The assumption is that nothing else is left out: this is the total value system.

41. Hence • Hardwired emotions send out connections to the higher centres • Those circuits that are used remain and those that are not used wither • Emotions expressed in a social environment drive the development of those higher connections.

42. Peter Hobson“The Cradle of Thought: Exploring the origins of thinking” OUP 2002 How...the creative, flexible and imaginative thinking that characterises humans emerges in the course of human development. How a baby develops a subjective mental capacity – seeing bodies and apprehending minds Integrating the body with the mental and the individual with the social

43. “Teach these souls to fly”

44. Artificial Intelligence “Any thinker needs the appropriate kind of body and capacity to feel and act in order to connect with the world that contains the object of thought...It is not just that computers do not have the right kind of relations with things around them – it is also that they do not have the right kind of relations with each other. If computers want to think they had better get a social life.”

45. Vaillant’s Positive Emotions • Faith, love, hope, joy, forgiveness, compassion, awe and mystical illumination are important limbic system drivers of human flourishing • Are parasympathetic and soothing as opposed to the negative emotions which are sympathetic and arousing • Are long-term and reach out: negative emotions are immediate and protective

46. Positive emotions create relational bonds which build community rather than the negative emotions which protect the immediate relations Humans thus seen are members of community rather than individuals and the emotions (especially the positive emotions) are designed to build community and the individual in that community

47. Limbic is lyrical Lexical is lame

48. DAMASIO’S CLAIM • Clinical observations on neurological patients show that reasoning is impossible without intact emotional neurological apparatus. • Hence Descartes’s error was not only separating the mind from the brain but reducing the mind to pure reason rather than the integration of reason and emotion. Antonio Damasio. Descartes Error: Emotion, reason and the human brain. Penguin 1994.

49. HENCE • Emotions and reason can be seen as in partnership rather than in conflict • Emotional maturity arises out of good relationships • Emotional maturity creates good relationships

50. WHILE NEUROBIOLOGISTS PONDER... • Emotional dysregulation is a particularly common problem in addiction • Patients coming off addictive agents often feel terrible, not just because they are withdrawing but also because they need to come to terms with the emotional state they were escaping by their drug taking • AODs make me feel good: stopping AODs makes me feel bad.