The underlying biodynamics of déjà vu is probably ascribable to some sort of tingling neurons in a certain part of the brain, yet this doesn’t tell us why they exist. They seem to me to be a signal from a larger point of view that wants to remind us that our lives are distinct, that they have meaning, and that they occur throughout a span of time. We are important, and what makes us valuable to the universe is our sentience and our curse and blessing of perpetual self-awareness.
OCCAM’S RAZOR
KATINKA MATSON
Artist; cofounder, Edge.org; president, Brockman, Inc.; author, Short Lives
Keep it simple.
DEEP TIME
ALUN ANDERSON
Senior consultant and former editor-in-chief & publishing director, New Scientist; author, After the Ice: Life, Death, and Geopolitics in the New Arctic
There is one simple and powerful idea that strikes me as both deep and beautiful in its own right and as the mother of a suite of further elegant theories and explanations. The idea is that of “deep time”—that the Earth is extremely old and the life of our species on it has been extremely short. When that idea first emerged, it stood against everything that was then believed, and it was to eventually change people’s view of themselves as much as did the earlier discovery that the Earth revolves around the sun.
We know when the idea of deep time was born, or at least first vindicated, because a University of Edinburgh professor named John Playfair recorded his reaction in 1788. “The mind seemed to grow giddy,” he wrote, “by looking so far into the abyss of time.”* He had traveled to the Scottish coast with his geologist friend James Hutton, who later put his ideas together in a book called Theory of the Earth. Hutton was showing him a set of distinct patterns in the rocks that could be most simply explained by assuming that the present land had been laid down in the sea, then lifted, distorted, eroded, and once again covered by new seafloor sediments. The Earth was not 6,000 years old, as then-accepted Biblical calculations decreed; nor had the strata precipitated out in a vast flood, as prevailing scientific views, informed by the best chemistry of the time, said.
It was an enormous shift to see the world as Hutton did. Appreciating the vastness of space is easy. When we look up at the stars, the immensity of the universe is both obvious and awe-inspiring. The immensity of time does not lie within human experience. Nature, observed on a human scale, passes only through the repeated cycle of the seasons, interrupted by occasional catastrophic earthquakes, volcanic eruptions, and floods. It is for that reason that creationist and catastrophic theories of Earth’s origins appeared more plausible than those that were slow and gradual. But Hutton had faith in what he saw in the rocks, exhorting others to “open the book of Nature and read in her records.”
His thinking about time created fertile ground for other grand theories. With huge spans of time available, imperceptibly slow processes could shape the natural world. After Hutton came modern geology, then the theory of evolution to explain how new species slowly arose, and eventually a theory of the gradual movement of the continents themselves. All are grounded in deep time.
Hutton’s views were a huge challenge to religious orthodoxy, too, for when he wrote at the close of his book that “we find no vestige of a beginning—no prospect of an end,” he challenged the idea of both a creation and a judgment day.
The beauty of his idea remains. If we look into the abyss of time we may not grow giddy, but we can feel our own insignificance in the Earth’s 4.6-billion-year history and the significance of the precise moment in this vast span of time in which we live.
PLACING PSYCHOTHERAPY ON A SCIENTIFIC BASIS: FIVE EASY LESSONS
ERIC R. KANDEL
University professor and Kavli Professor of Brain Science, Columbia University; author, The Age of Insight: The Quest to Understand the Unconscious in Art, Mind, and Brain, from Vienna 1900 to the Present
How did psychoanalysis, once a major mode for treating non-psychotic mental disorders, fall so badly in the estimation both of the medical community in the United States and the public at large? How can that be reversed? Let me try to address this question, putting it in some historical perspective.
While an undergraduate at Harvard College, I was drawn to psychiatry—and specifically to psychoanalysis. During my training, 1960–1965, psychotherapy was the major mode of treating mental illness, and this therapy was derived from psychoanalysis and based on the belief that one needed to understand mental symptoms in terms of their historical roots in childhood. These therapies tended to take years, and neither the outcome nor the mechanisms were studied systematically, because this was thought to be very difficult. Psychotherapy and psychoanalysis, when successful, allowed people to work a bit better and to love a bit, and these were dimensions that were considered difficult to measure.
In the 1960s, Aaron Beck changed all that by introducing several major obvious but nevertheless elegant and beautiful innovations:
First, he introduced instruments for measuring mental illness. Until Beck’s work, psychiatric research was hampered by a dearth of techniques for operationalizing the various disorders and measuring their severity. Beck developed a number of instruments, beginning with a depression inventory, a hopelessness scale, and a suicide-intent scale. These scales helped objectify research in psychopathology and establish better clinical-outcome trials.
Second, Beck introduced a new short-term, evidence-based therapy he called cognitive behavioral therapy.
Third, Beck manualized the treatments; he wrote a cookbook, so method could be reliably taught to others. You and I could in principle learn to do cognitive behavioral therapy.
Fourth, he carried out, with the help of several colleagues, progressively better-controlled studies showing that cognitive behavioral therapy worked more effectively than placebos, and as effectively as antidepressants, in mild and moderate depression. In severe depression, it did not act as effectively as an antidepressant but acted synergistically with antidepressants to enhance recovery.
Beck’s work was picked up by Helen Mayberg, another of my heroes in psychiatry. She carried out fMRI studies of depressed patients and discovered that Brodmann area 25 was a focus of abnormal activity in depression. She went on to find that if—and only if—a patient responded to cognitive behavior therapy or to antidepressant SSRIs (selective serotonin reuptake inhibitors), this abnormality reverted to normal.
What I find so interesting in this recital is the Edge Question: What elegant, deep explanation did Aaron Beck bring to his work that differentiated him from the rest of my generation of psychotherapists and allowed him to be so original?
Beck trained as a psychoanalyst in Philadelphia but soon became impressed with the radical idea that the central issue in many psychiatric disorders is not unconscious conflict but distorted patterns of thinking. He conceived this novel idea by listening with a critical—and open—mind to his patients with depression. In his early work on depression, Beck set out to test a specific psychoanalytic idea: that depression was due to “introjected anger.” Patients with depression, it was argued, experienced deep hostility and anger toward someone they loved. They could not deal with having hostile feelings toward someone they valued, so they would repress their anger and direct it inward, toward themselves. Beck tested this idea by comparing the dreams—the royal road to the unconscious—of depressed patients with those of non-depressed patients and found that in their dreams depressed patients showed, if anything, less hostility than non-depressed patients. Instead, in their dreams, as in their waking lives, depressed patients have a systematic negative bias in their cognitive style, in the way they think about themselves and their future. They see themselves as “losers.”
Beck considered these distorted patterns of thinking not simply a symptom—a reflection of a conflict lying deep within the psyche—but a key etiological agent in maintaining the disorders. This led him to develop a systematic psychological treatment for depression that focused on distorte
d thinking. He found that increasing the patients’ objectivity regarding their misinterpretation of situations, or their cognitive distortions and negative expectations, resulted in substantial shifts in their thinking and subsequent improvements in their affect and behavior.
During his work on depression, Beck focused on suicide and provided for the first time a rational basis for the classification and assessment of suicidal behaviors, making it possible to identify high-risk individuals. His prospective study of 9,000 patients led to the formulation of an algorithm for predicting future suicide that has proved to have high predictive power. Of particular importance was his identification of clinical and psychological variables such as hopelessness and helplessness to predict future suicides. These turned out to be better predictors of suicide than clinical depression per se. Beck’s work on suicide—and that of others, such as John Mann at Columbia—demonstrated that a short-term cognitive intervention can significantly reduce subsequent suicide attempts.
In the 1970s, Beck carried out the aforementioned controlled trials. Later, the National Institute of Mental Health carried out similar trials, and together these established cognitive therapy as the first psychological treatment shown to be effective in clinical depression.
As soon as cognitive therapy was found effective in the treatment of depression, Beck turned to other disorders. In a number of controlled clinical trials, he demonstrated that cognitive therapy is effective in panic disorder, post-traumatic-stress disorder, and obsessive-compulsive disorder. In fact, even before Helen Mayberg’s work on depression, Lewis Baxter at UCLA had imaged patients with obsessive-compulsive disorder and found an abnormality in the caudate nucleus that was reversed when they improved with cognitive behavioral therapy.
Aaron Beck has recently turned his attention to patients with schizophrenia and has found that cognitive therapy helps improve their cognitive and negative symptoms, particularly their motivational deficits. Another amazing advance.
So the answer to the decline of psychoanalysis may not simply lie in the limitation of Freud’s thought but much more in the lack of a deep, critical, scientific attitude of many in the subsequent generation of therapists. I have little doubt that insight therapy is extremely useful as a therapy, and there are studies supporting that contention. But an elegant, deep, and beautiful proof requires putting a set of highly validated approaches together to make the point in a convincing manner and perhaps even providing us with an idea of how the therapeutic result is achieved.
TRANSITIONAL OBJECTS
SHERRY TURKLE
Abby Rockefeller Mauzé Professor of the Social Studies of Science and Technology, MIT; author, Alone Together: Why We Expect More from Technology and Less from Each Other
I was a student in psychology in the mid-1970s at Harvard University. The grand experiment that had been “Social Relations” at Harvard had just crumbled. Its ambition had been to bring together the social sciences into one department—indeed, most of them into one building, William James Hall. Clinical psychology, experimental psychology, physical and cultural anthropology, and sociology—all of these would be in close quarters and intense conversation.
But now everyone was back in their own department, on their own floor. From my point of view, what was most difficult was that the people who studied thinking were on one floor and the people who studied feeling were on another.
In this Balkanized world, I took a course with George Goethals in which we learned about the passion in thought and the logical structure behind passion. Goethals, a psychologist who specialized in adolescence, was teaching a graduate seminar in psychoanalysis. His focus was on a particular school of analytic thought: British object-relations theory. This psychoanalytic tradition kept its eye on a deceptively simple question: How do we bring people and what they mean to us “inside” us? How do these internalizations cause us to grow and change? The “objects” of the theory’s name were in fact people.
Several classes were devoted to the work of David Winnicott and his notion of the transitional object. Winnicott called “transitional” the objects of childhood—the stuffed animals, the bits of silk from a baby blanket, the favorite pillow—that the child experiences as both part of the self and of external reality. Winnicott writes that such objects mediate between the child’s sense of connection to the body of the mother and a growing recognition that he or she is a separate being. The transitional objects of the nursery are destined to be abandoned; yet, says Winnicott, they leave traces that will mark the rest of life. Specifically, they influence how easily an individual develops a capacity for joy, aesthetic experience, and creative playfulness. Transitional objects, with their joint allegiance to self and other, demonstrate to the child that objects in the external world can be loved.
Winnicott believes that during all stages of life we continue to search for objects we experience as both within and outside the self. We give up the baby blanket, but we continue to search for the feeling of oneness it provided. We find this in moments of feeling “at one” with the world—what Freud called the “oceanic feeling.” We experience these moments when we are at one with a piece of art, a vista in nature, a sexual experience.
As a scientific proposition, the theory of the transitional object has its limitations. But as a way of thinking about connection, it provides a powerful tool for thought. Specifically, it offered me a way to begin to understand the new relationships people were beginning to form with computers—something I began studying in the late 1970s and early 1980s. From the beginning, as I began to study the nascent digital culture, I could see that computers were not “just tools.” They were intimate machines. People experienced them as part of the self, separate but connected to the self.
A novelist using a word-processing program referred to “my ESP with the machine. The words float out. I share the screen with my words.” An architect who used the computer to design went even further: “I don’t see the building in my mind until I start to play with shapes and forms on the machine. It comes to life in the space between my eyes and the screen.” After studying programming, a thirteen-year-old girl said that when working with the computer, “there’s a little piece of your mind, and now it’s a little piece of the computer’s mind, and you come to see yourself differently.” A programmer talked about his “Vulcan mind meld” with the computer.
When I began studying the computer’s special evocative power, my time with George Goethals and the small circle of Harvard graduate students immersed in Winnicott came back to me. Computers serve as transitional objects. They bring us back to the feelings of being “at one” with the world. Musicians often hear music in their minds before they play it, experiencing the music from within and without. The computer, similarly, can be experienced as an object on the border between self and not-self. Just as musical instruments can be extensions of the mind’s construction of sound, computers can be extensions of the mind’s construction of thought.
This way of thinking about the computer, as an evocative object, puts us on the inside of a new inside joke. For whenever psychoanalysts talked about object relations, they were always talking about people. From the beginning, people saw computers as “almost alive” or “sort of alive.” With the computer, object-relations psychoanalysis can now be applied to, well, objects. People feel at one with video games, with lines of computer code, with the avatars they play in virtual worlds, with their smartphones. Classical transitional objects are meant to be abandoned, their power recovered in moments of heightened experience. When our current digital devices—our smartphones and cell phones—take on the power of transitional objects, a new psychology comes into play. These digital objects are never meant to be abandoned. We are meant to become cyborgs.
NATURAL SELECTION IS SIMPLE BUT THE SYSTEMS IT SHAPES ARE UNIMAGINABLY COMPLEX
RANDOLPH NESSE
Professor of psychiatry and psychology, University of Michigan; coauthor (with George C. Williams), Why We Get Sick: The New Sci
ence of Darwinian Medicine
The principle of natural selection is exceedingly simple. If some individuals in a population have a heritable trait associated with having more offspring, that trait will usually become more common in the population over the generations.
The products of natural selection are vastly complex. They are not merely complicated in the way that machines are complicated; they are organically complex in ways that are fundamentally different from any product of design. This makes them difficult for human minds to fully describe or comprehend. So we use that grand human gambit for understanding, a metaphor—in this case, the body as machine.
This metaphor makes it easy to portray the systems that mediate cell division, immune responses, glucose regulation, and all the rest, using boxes for the parts and arrows to indicate what causes what. Such diagrams summarize important information in ways we can grasp. Teachers teach them. Students dutifully memorize them. But they fundamentally misrepresent the nature of organic complexity. As John Scott Haldane noted in a prescient 1917 book, “a living organism has, in truth, but little resemblance to an ordinary machine.”* Machines are designed; they have discrete parts with specific functions, and most remain intact when turned off. Individual machines are manufactured following identical copies of a single blueprint. In contrast, organisms evolve. They have components with indistinct boundaries and multiple functions that interact with myriad other parts and the environment to create self-sustaining reproducing systems whose survival requires the constant activity and cooperation of thousands of interdependent subsystems. Individual organisms develop from unique combinations of genes interacting with one another and with environments to create phenotypes, no two of which are identical.
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