Tag Archives: memory

The Bidirectional Relationship Between the Brain and Behavior

Memory and Medicine

Cameron Hay is a cultural anthropologist who specializes in medical and psychological anthropology. Her research endeavors revolve around understanding, experiencing, and coping with illness and disease from the perspective of patients, family members, and health care providers. The goal of her research is to facilitate mutual understanding between patients, physicians, and public health experts in order to allow for enhanced communication, ultimately leading to better health outcomes. Specifically, she hones in on the social distribution of medical knowledge, health disparities, health literacy, empathetic communication, healer-patient communication, health care decision making, experiencing chronic illness, and psycho social stress and health. Hays is currently a professor and the chair of the department of Anthropology at Miami University in Oxford, Ohio. She also serves as the director of the Global Health Research Innovation Center and the coordinator of the Global Health Minor at Miami. Her secondary position is at the University of California in Los Angeles where she works as a researcher at the Center for Culture and Health at the Semel Institute for Neuroscience and Human Behavior.

Hays conducts ethnographic research in Lombok, Indonesia. Her case study titled, “Memory and Medicine”, that was featured in the book, “The Encultured Brain”, is a comparative study of the memory systems of Sasak healers and American physicians. This chapter is an analysis of contrasting medical practices of rural traditional Indonesian healers from the island of Lombok and urban biomedical doctors from California. Knowledge, memory, and memorization are the three key concepts that are employed in both healing systems. However, the extent to which each of these is deferentially used is crucial to understanding how medical information is socially and neurologically organized. Hays believes that different medical traditions utilize different types of memory systems which bolster the neurological memory processes in different ways. Three key arguments that shape her research are that memory and medicine co-evolve within local contexts, the co-evolution of these processes are not only evident in the analysis of medicine, and in order to understand her argument, we have to mend the gap between biological science, social sciences, and humanities.

Hays believes that the reason why neurological differences exist between these two types of healers is not because one practitioner is more intelligent than the other, but rather the neurological processes elicited in the memory encoding, organization and retrieval processes are intertwined with social, technological, and institutional traditions specific to that culture. In order to heal, the Sasak use jampi, or memorized formulas that are solely orally transmitted to selected individuals. Anxiety invoked during memorization is believed to enhance the memory encoding process. In America, formal training consisting of learning through evidence based scientifically published articles. In contrast to the Sasak, emotional anxiety is discouraged and viewed as a breech of clinical objectivity. Sasak medical tradition utilizes episodic memory which elicits the use of the hippocampal associative systems and is bolstered by emotional reactivity of the amygdala. American medical tradition utilizes a combination of episodic memory, semantic memory and procedural memory. The integration of medical knowledge is facilitated by the hippocampus but once schemas, or representative models are formed, schemas can be accessed independently of the hippocampus. Overall, Hay’s main argument is that any knowledge set is biocultural and influenced by differences in local assumptions, information distribution, learning and remembering processes, and the strengthening of certain neural pathways.

This article reminds me of several articles that I have read about fire walkers. Fire walkers are oftentimes able to recall specific details about their experience during this rite of passage.  This enhancement in memory is because the event was emotionally significant, causing their amygdala to become highly active, which assists with memory storage. Similarly, better memorization of a jambi formula may be due to the anxiety invoked when slapped on the arm. The ability to recall particular details about one’s fire walking practice or a specific jambi line is associated with the consolidation of episodic memories. This article also reminds me of the idea of synaptic pruning and the brains remarkable plasticity. For example, the brains of blind individuals show weakened neural associations within the visual cortex but enhanced neural associations in other brain regions such as those associated with sound.

I enjoyed reading this article but was also hoping she would have included articles in support of her suggestions. I wished there was an accompanying study depicting neurological evidence of a correlation between higher rates of neural activation in certain brain regions and specific health care providers. She mentions that the bridging of disciplines in order to enhance biocultural understanding is valuable, however, she fails to display this transdisciplinary and collaborative research essence in her own work. I also recognize that she may have other studies that do exactly what she proposes. What I did not fully see in her article is the applicability of her research. I understand why it is important that the brain is able to shift and differentially allocate resources to certain regions but other readers may wonder why it is important to know that some healers predominately use a specific type of memory. How is this research valuable and applicable to us? Most grant proposals and published articles require an explanation of the “bigger picture”. What I did not grasp as well was this “bigger picture” and exactly what her research contributes to the field of neuroanthropology.

Questions to Consider

  1. How can we benefit from this newly learned knowledge about the influence of cultural practice on neural pathways and the recollection of memories?
  2. What type of hypothetical research project could we propose to test the validity of the idea that health care traditions strengthen certain specific neural pathways?
  3. How can you use the “use it or lose it” phenomena to explain why certain neural pathways are augmented in healers cross-culturally?

Body, Brain, and Behavior: The Neuroanthropology of the Body Image

Charles D. Laughlin is currently a professor of religion at the University of Ottawa and is a professor emeritus of the Carleton University in Ontario, Canada where he previously taught anthropology and religion. Laughlin is interested in a theory that he and his friends, Eugene G. d’Aquili and John McManus, developed during the 1970s and 80s. The theory of biogenetic structuralism is a type of neuroanthropology that incorporates the brain, consciousness, and culture. Laughlin has devoted a large part of his career to collecting ethnographic data in Northeastern Uganda. Later, his interests in consciousness and the ways in which societies structure and interpret alternative states of consciousness led him to live in various Tibetan Buddhist monasteries in Nepal and India.

Lauglin’s article titled, “Body, Brain, and Behavior: The Neuroanthropology of the Body Image”, focuses on how an individual’s neurocognitive model of his or her body is comprised of a combination of internal and external sensory systems. He defines body image as, “a dynamic set of models within their cognized environment that integrates currently anticipated and remembered perceptions of their body, as well as all other habitually entrained neural networks producing affect, cognitions, and habitual motor patterns related to their body”. He proposes that the model of the body is already present within each individual upon birth but develops and takes shape through genetic predispositions and subsequent sociocultural influences. Prior to explaining his position, Lauglin provides the reader with a list of traits associated with the neuroanthropological theory of body image. He states that the body image is a construct of the nervous system, the body is transcendental relative to body image, and behavior controls perception so that the body perceived matches what is expected. This means that the ability to acknowledge one’s body is innate, developing prenatally, the actual physical body is much more complex than the nervous system’s model of it, and lastly, behavior provides a negative feedback loop so that individuals act in accordance with their desired body image.

Lauglin describes how the nervous system models the environment within the body by explaining the neural networks that are involved with body image development. He lists the different types of memory images and indicates that eidetic imagery, or images that occur vividly but are not perceived as real, may be used to change one’s body image. Lauglin also explains how the multiple representation model, or the belief that verbal and imaginal systems are distinct and independent modes of representation, is the most widely believed model, as opposed to collapsing both systems. He breaks down this model by explaining how the right hemisphere predominantly processes nonverbal imagery while the left hemisphere processes verbal symbolism. Lastly, Lauglin discusses how body image may be changed by using clinical methods that utilize ritualized visualizations and guided imagery may prove to be therapeutic and help change negative body image.

I enjoyed reading this article because body image is such a fascinating topic and a very salient topic as well, especially on a college campus. This article reminds me of the use of cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) to help alter maladaptive thought patterns. Lauglin’s article also relates to other articles I have read that discuss how facial and physical symmetry are one of the few characteristics that are seen as attractive and desired features of a prospective mate cross-culturally. I believe that from an evolutionary anthropology perspective, physical and facial symmetry are subconscious indicators of health and fertility. Symmetry may be an indicator of superb genes and people may subconsciously seek more symmetrical mates in order to reproduce with an individual who is more fertile and more likely to yield healthier offspring.

With respect to physical body size, the notion of attractiveness also varies from culture to culture. Some regions in the Middle East and Africa believe that larger body size indicates wealth since they can afford to eat and become large. Furthermore, larger body size may also be indicative of health and reproductive capacity since being undernourished may cause for fetal termination since it may not have enough nutrition to survive to birth. On the other hand, in America, it is believed that those who are thinner are wealthier since they have the means and resources to purchase higher quality foods or can afford to spend their money on gym memberships and their time exercising instead of working. Neither of these “indicators” may actually be true but this article led me to wonder about how body image disorders develop and why.

Questions to Consider

  1. What are some current ways in which body image disorders are currently being treated and how can we improve upon these methods according to Lauglin?
  2. Do you think that certain cultures have an increased incidence or prevalence of body image disorders compared to others? Ie. Do women in America have more rates of anorexia because thinness is portrayed in the media? Or do women in South Africa have more rates of binge eating disorder because being overweight is valued in that culture?
  3. Tying in Hay’s article, do you think that the neural pathways associated with negative body image are strengthened over time while positive body image pathways are weakened? Do you think this impacts one’s memory encoding, organization, and retrieval processes in any way?

Remember, remember

Giving a detailed account of the history and use of the Wechsler memory scale, and offering improvements on the method of comparing immediate and delayed memory, Tulsky, Chelune, and Price’s “Development of a new delayed memory index for the WMS-III” is invalvuable for understanding the use of the Wechsler memory scale. In particular the analysis of the test and how it can be adapted to suit the experimental purpose should play into the method of the proposal. Of particular interest are the revise General Memory Index (GMI) and Immediate Memory Index (IMI) that allow more transparent comparison. Having a means of comparing long term and short term memory is essential to a study of attention, encoding, and learning, especially in the classroom. Without them, the study would not be significant or interesting in the broader context of education and retention.

Tulsky, D. S., Chelune, G. J., & Price, L. R. (2004). Development of a New Delayed Memory Index for the WMS-III. Journal Of Clinical & Experimental Neuropsychology26(4), 563-576.

Education, Age, and Neurological Measures

Lam, Eng, Rapisarda, and Subramaniam in “Formulation of the Age-Education Index” aim to determine the validity of different measures of one’s education level using cognitive batteries. Unfortunately from the perspective of the proposal, their measures and methods did not have a clear relation to attention. Nevertheless, they give an important account of how neurological tests are affected by education. Most importantly for the proposal, they note that these tests are particularly influenced by language and literacy. Their focus is more on using these neurological measures and education level to assess individuals facing memory and other cognitive deficits, which is beyond the purpose of the attention proposal, but might be useful elsewhere.

Lam, M., Eng, G. K., Rapisarda, A., Subramaniam, M., Kraus, M., Keefe, R. E., & Collinson, S. L. (2013). Formulation of the age–education index: Measuring age and education effects in neuropsychological performance. Psychological Assessment25(1), 61-70. doi:10.1037/a0030548

Recall Your Way to Health

Biographical Sketch

Dr. Cameron Hay is a premier cultural anthropologist in the study of health, medical systems, and medical knowledge, her major project being ethnography and comparison of the Sasak people of Lambok, Indonesia and their medical practice to American people. She cites her father as her strongest intellectual influence for his empathy and critical eye. Jon Andelson and Ron Kurtz sparked her interest in anthropology at Grinnell College. At Emory University, Dr. Hays earned her MA and  Ph.D. in anthropology with a biocultural focus. Earning a NSF Advanced Fellows award helped her continue her postdoctoral studies at UCLA, where she currently holds her secondary position as an associate research anthropologist.  She published her her first major paper in 1999 in the Medical Anthropology journal under the title “Dying Mothers: Maternal Mortality in Rural Indonesia.” Since then she has published 18 other papers and a book, Remembering to Live: Illness at the Intersection of Anxiety and Knowledge in Rural Indonesia.

Challenging Understanding of Medical Learning

Hay hopes to demonstrate three things about medical practice in particular and the effect of culture on the neurology of learning as a whole. The cultural context of medical learning affects how important different types of knowledge appear, in turn changing what and how we recall information. What information we tend to recall and how we recall it over time affects the tradition and practice of medicine.This process of ‘co-creation’ between medical knowledge and medical practice extends to “anytime learning takes place” (142). The process of learning then is generalized, not compartmentalized as academia would make it seem. Knowledge affects how we learn and is both culturally contextual and holistic.

Sasak Medical Tradition

Sasak tradition practiced in impoverished, rural community that continues to deal with the consequences of “domination, exploitation, and extraction.” Their history contributes to malnutrition, low wealth, low literacy, and life expectancy being around 50 years. Nevertheless, they have a self-sufficient medical practice, one not dependent on outside aid, in the form of jampi, “inherently potent sequences of words.” These words are memorized and used sparingly so as not to diminish their efficacy.

Although the Sasak medical tradition is vastly different from American medical practice and the communities American practice thrives in, Hay maintains that they can both be understood in terms of medical terminology, organization, and retrieval co-evolving to suit the needs of the community.

The Sasak regard biomedical care as speeding recovery but not healing like jampi. Jampi act as memorized responses to illness and are precious in part because they are not written down.  Giving and receiving jampi requires isolation. To limit degredation of memory, Sasak employ “multiple constraints:” consistent form, limited words around the limit of human memory capacity, the association of jampi with great importance leading to heightened arousal and thus encoding, self-concept of healers reinforcing already strong recall, and the intentional encoding based on future need. Because of the importance of memorization, Sasak tradition relies on the hippocampus, medial temporal lobes, and prefrontal cortex.

American Medical Tradition

American practice relies on several assumptions. Skilled practice is supposedly scientifically sound, with medical education valuing semantic knowledge over episodic. By being consistent, American practice hopes to avoid individual variation, especially through guidlines, even though American students are not good at memorization. American practice also assumes that it can be wrong, and thus can always be improved. Physicians tend to become more skeptical the more experience they have reading journals and practicing. Finally, American practice does not transfer knowledge of how medicine works in practice, but expects students to gain a holistic view over time.

Embodied cognition offers a way to understand why practical experience and episodic memory serve physicians better than semantic memory. Cognitive action can stimulate motor action, generating procedural memories. Procedural memory and episodic memory combine to make schemas, maps of one’s knowledge and appropriate response; the process of memory consolidation is closely tied to the hippocampus and neocortex, which takes over the cognitive burden. Over time and with enough reinforcement schemas become hippocampal independent and automatic, employing the basal ganglia and caudate.

Diagnosis and Motivation

Illness not recognized immediately push both Sasak and American healers toward more effortful recall. In Sasak communities, when few people gather, there are fewer jampi and low anxiety, but larger groups talk more often about illness, increasing anxiety and the stress response. Stress leads to release norepinephrine, activating the amygdala and thalamus, increasing attentiveness and potentially leading to activation of the hippocampus, facilitating recall. Since American healers tend not to rely on recall as much, stress pushes physicians to external resources, which might then be reintegrated by the stimulated hippocampus into their schema of treatment. Each of these strategies have a use: the Sasak reliance on memorization and connection to specific individuals helps when someone does not have personal experience treating an illness, whereas the American dependence on schemas and skepticism is suited to developing procedures for and diagnosis of new diseases.

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