Embodied Souls — Lessons from Neurology V.S. Ramachandran
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0:20 (upbeat music)- Thank you for coming this afternoon.
0:47 My name is Paula Varsano and I'm a professor of East
0:51 Asian languages and cultures and the chair of the Foerster Lectures Committee.
0:56 We, along with the graduate council, are very, very happy to present V.S.
1:03 Ramachandran, this year's speaker in the Foerster Lecture Series.
1:08 I'm also very pleased to tell you a bit about how the endowment
1:12 supporting the Foerster lectures on the immortality
1:15 of the soul came to UC Berkeley.
1:18 It's actually a story that really exemplifies the ways in which this campus
1:23 is linked to the history of California and in particular to the Bay Area.
1:28 In 1928, Miss Edith Zweybruck established the Foerster
1:33 Lectureship to honor the memory of Agnes A.
1:36 Foerster and her husband, Constantine E.
1:40 Foerster.
1:41 Edith was a public school teacher for many years in San Francisco.
1:45 And the teaching profession, in her eyes,
1:48 was the perfect opportunity to develop a true knowledge and love
1:52 of the spiritual values of life in the young minds entrusted to her care.
1:59 Edith's beloved sister, Agnes A.
2:01 Foerster shared her high ideals and her hopes,
2:04 as did Agnes' husband, Constantine.
2:08 A lawyer by profession,
2:10 he was a man of high intellectual achievements and of rare personal charm.
2:20 Although he passed away at the age of 37,
2:23 he had achieved an enviable place at the San
2:27 Francisco Bar as one of its most highly respected members.
2:31 For several years prior to his death,
2:34 Foerster was a law partner of none other than Alexander F.
2:37 Morrison, one of the most prominent of San Francisco attorneys,
2:41 for whom our Morrison Memorial Library is named.
2:47 In her last days, Miss Edith Zweybruck expressed
2:50 her deep and abiding interest in the spiritual
2:53 life by creating this lecture series
2:56 on the subject of the immortality of the soul.
3:00 She believed that through the medium of great
3:03 universities and the words of scholarly lecturers
3:06 she might shed new light upon a subject
3:08 that has interested the world for centuries.
3:11 So we have to thank Edith Zweybruck.
3:14 And now about our lecturer.
3:16 Sometimes the best way to characterize a person is to consider
3:20 what kinds of questions he or she likes to ask.
3:24 And here's a question that is always being asked in various ways by our speaker.
3:30 And I quote him here.
3:32 How can a three pound mass of jelly that you
3:36 can hold in the palm of your hand imagine angels,
3:40 contemplate the meaning of infinity,
3:42 and even question its own place in the cosmos?
3:47 Now, what kind of person can ask
3:49 this question in a way that doesn't sound rhetorical?
3:52 Poets can do that.
3:55 And Doctor V.S.
3:56 Ramachandran is, indeed, a poet of sorts.
3:59 Officially, however, he serves as the director of the Center for Brain
4:04 and Cognition and is a distinguished professor at the University of California,
4:08 San Diego, as well as an adjunct professor of biology at the Salk Institute.
4:16 He has also been called the Marco Polo of neuroscience by Richard Dawkins,
4:20 and the modern Paul Brokaw by Eric Kendau.
4:25 But as pithily impressive as these titles and these epithets may be,
4:30 they actually do very,
4:32 very little to reveal the mind-teasing pathway he has followed
4:36 and on which he leads us in the work that he does,
4:39 and in the contributions that he makes.
4:43 Doctor Ramachandran is renowned for his ongoing inquiry into the field
4:48 of cognitive neuroscience that is
4:51 the intersection of neurology and perceptual psychology.
4:55 To steal a few words from the title of one of his books,
4:58 he is actually a neuroscientist on a quest for what makes us human.
5:04 Building on his early work on visual perception,
5:07 Ramachandran has led pioneering experiments in behavioral neurology,
5:12 taking cues from malfunctions in perception,
5:15 including phantom limbs, synesthesia, and xenomelia,
5:19 to delve into the unique ways in which
5:23 the human brain forms and deforms the workings of mind.
5:28 Laypeople are perhaps most familiar with his controversial assertion of mirror
5:34 neurons as playing a central role in the unique evolution of humans.
5:40 His approach to neurology has been to revisit classic syndromes,
5:44 bring them to the lab, determine their broader significance,
5:47 and devise new treatments where possible.
5:51 Of course, Ramachandran, many of you know, is a very prolific author,
5:55 and he's published over 180 papers in scientific journals,
5:59 five of which were invited review articles for Scientific American.
6:05 He's the co-author with Sandra Blakely of "Phantoms in the Brain,
6:10 1999," which has been translated into nine languages,
6:14 and formed the basis for a PBS special.
6:17 His BBC Reith lectures were published in 2003 in a volume titled
6:23 "The Emerging Mind," and were dubbed by the Nobel Laureate David Hubel as bold,
6:29 irreverent, original, and ingenious.
6:32 His latest book, a New York Times bestseller,
6:35 is "The Telltale Brain." After training
6:39 as a physician in Stanley Medical College in Madras,
6:42 India, Ramachandran attained a PhD from Trinity
6:46 College and the University of Cambridge.
6:48 He's an honorary fellow of the Royal College of Physicians,
6:51 London, and the recipient of two honorary doctorates.
6:55 Ramachandran has received many accolades throughout his career.
6:59 He was awarded the Henry Dale Medal in 2005 and was elected
7:05 to an honorary life membership to the Royal Institution of Great Britain.
7:10 The president of India conferred on him the highest honorific title in India,
7:17 Padma Bhushan, in 2007.
7:20 And besides the BBC Reith lectures he delivered in the UK,
7:24 he also gave the Gifford Lectures in Scotland.
7:28 Time Magazine named him one of the most influential
7:32 people in the world in their 2011 Time 100.
7:38 Finally, before I cede the stage to Doctor Ramachandran,
7:42 I would like to leave you with a few words by Ted Cruiser,
7:45 US Poet Laureate from 2004 to 2006, who also asks what makes us human.
7:54 He words it differently though, and much more mournfully than our speaker does.
8:00 Here we will not find the mind's brain
8:02 imagining angels or contemplating the meaning of infinity.
8:07 In the closing lines of Cruiser's poem "In the Hall of Bones," after cataloging
8:13 the array of skeletons that he found
8:15 in what seems to be a natural history museum,
8:18 he writes these words: "And then, here's man,
8:23 "all matchsticks, wooden spoons, "and tongue depressors, wired together.
8:29 "A rack supporting a leaky jug of lust and worry.
8:33 "Of all the skeletons assembled here,
8:36 "this is the only one in which once throbbed a heart "made sad
8:41 by brooding on its shadow." It's
8:45 my pleasure to welcome Doctor Ramachandran to Berkeley.
8:49 (audience applauding)- Well thank you for that amazing introduction.
9:03 I'm delighted to be here and honored to be
9:05 invited by the committee to do this lecture, Foerster Lecture.
9:09 When the committee first phoned me up about
9:11 this and said I was to talk about the soul, the immortality of the soul, I said,
9:14 "Well, that's easy, I'm happy to do it." (audience laughing) And then
9:19 I did a double take and I realized what I was getting into.
9:22 But then fortunately they reassured me that in fact,
9:24 it doesn't have to be anything directly related to the soul,
9:26 but so long as it's tangentially relevant,
9:29 which means essentially all phenomena in the universe.
9:33 So I'm gonna approach the problem of the soul not so much the soul but the self.
9:36 It's after all the immortality of the self that we're all concerned about.
9:40 We call it the soul.
9:41 And I'm gonna use two approaches.
9:44 Mainly one approach,
9:45 but I'm not gonna deal with the metaphysical question of soul,
9:48 which is extensively dealt with in Indian
9:51 philosophy and in Western philosophy as well...
9:56 But if you sort of pause and introspect on the self,
9:59 there are many attributes, it's kind of common sense,
10:01 but roughly speaking, there's embodiment.
10:04 One of the most obvious aspects of the self is,
10:05 it's you're anchored in one body.
10:07 I'm not anchored in Tony's body, I'm right here.
10:10 But we'll call that into question in a minute.
10:12 Then there's a sense of continuity in space and time.
10:15 You all have a calendar.
10:17 Sense of agency.
10:18 Sort of like the free will.
10:20 Sense of unity and coherence,
10:22 despite a diversity of sense impressions and memories over a lifetime.
10:26 You feel like one person.
10:27 I'm one guy, one name, one bank account, one spouse, so on and so forth.
10:33 And a sense of privacy and individuality.
10:37 And then finally, most mysterious of all, self awareness.
10:40 Self is not aware of its self.
10:41 Sort of like an oxymoron.
10:43 There's a curious, recursive quality to it which is hard to come to grips with.
10:48 I'm not gonna talk about all the attributes of the self.
10:50 That would take a whole week.
10:51 But let's talk about embodiment and partly about privacy.
10:56 And from the point of view, cognitive neuroscience and neurology.
11:00 And the way we deal with this, the way we study this, is by looking at patients.
11:08 We can do brain imaging, it's one thing we do,
11:10 but mainly we do behavioral, old-fashioned, 19th century behavioral neurology.
11:15 We look at patients who have sustained an injury
11:17 or a change in a small part of the brain,
11:19 and then producing characteristic changes in their behavior
11:23 and trying to correlate structure and function,
11:25 trying to explain the changes in behavior in terms
11:26 of the anatomical organization of the normal human brain.
11:30 To give you some insight into the question
11:34 of what's mediating that particular function.
11:37 So let me begin with a bang and talk
11:39 about a syndrome which few people even heard of.
11:43 It's called xenomelia.
11:45 Xenomelia is the name we gave it,
11:47 but it's also known as apotemnophilia, unpronounceable name but apotemnophilia.
11:51 These are first patients...
11:53 I'll mention one example, second example of it,
11:55 dean of an engineering school who came to see me at the age of 70,
11:59 had just retired at 70 years old, and he had harbored, through his entire life,
12:03 he'd harbored a secret urge, as he described it,
12:06 to amputate his own healthy arm.
12:09 Going back as far back in childhood as he can remember.
12:12 He's a perfectly normal guy in every respect,
12:14 not obviously psychotic or depressed or mentally disturbed,
12:18 no neurological findings, completely normal, led a normal family life,
12:22 had friends, had a job as a dean.
12:25 Everything seemed normal,
12:25 except for this one particularity that he had this urge.
12:28 And by then I discovered that many of these people, it's not that rare.
12:31 It is rare, but not that rare.
12:34 And about one third of them to half of them go and get it amputated.
12:38 This is not some mild obsession these people have.
12:41 There's few serious clinical consequences, the loss of the limb.
12:45 So then I said, "Why did you come to see me?
12:47 "Do you want us to treat you or cure you?" He said,
12:51 "No, I enjoy it, I don't wanna be cured.
12:53 "I want you to remove the arm, give me a letter "so I can go get it removed.
12:56 "And I can't do it here in this country.
12:58 "I'll go to Mexico, across the border,
12:59 "it's legal to get a healthy limb amputated." I'm not making this up,
13:02 this is what he said.
13:03 Later I checked on this and it's true:
13:05 you can get it amputated in Mexico and in Canada, but you can't do it here.
13:08 So many patients travel north or south to get it amputated.
13:12 And what would cause this?
13:13 The first thing (mumbles) is,
13:14 one of the things you learn in clinical medicine is first talk to the guy.
13:18 You know, 90% of the time you figure out what's
13:19 going on in his brain by just talking to him.
13:22 You don't need to do brain imaging, you don't need to do even clinical testing.
13:25 I said, "Do you feel like this arm doesn't belong to you?" He said,
13:29 "No, no it's the opposite.
13:31 "It feels like it over belongs to me.
13:32 "It's intrusive.
13:33 "It's intruding itself on me.
13:35 "And I want it removed." I said, "Okay," and I started thinking about this.
13:41 And I said, maybe what's gone wrong is you look at the surface of the brain,
13:45 that's the somatosensory cortex, so there's one,
13:48 it's called the Penfield map of the body surface.
13:50 And the entire surface of the body,
13:53 the body skin surface is mapped onto the post sympathizer...
13:56 There's a vertical cleft going down the side
13:57 of the brain called the central surface.
13:59 Behind that cleft there's a vertical strip of cortex, it's shown in brown there.
14:04 So that'd be the left hemisphere, if you were going to touch my right side,
14:06 closer to that is on the left hemisphere.
14:09 There's a complete map of the body's surface on that post-central gyrus there.
14:13 That map is shown in the next slide.
14:15 Many of you may have seen this before.
14:18 It's got some peculiar features which I will come back to.
14:20 But I said, well maybe in this guy, it was a very naive,
14:23 phrenological hunch, maybe in this guy that part of the brain is missing.
14:27 The hand is not there.
14:29 You don't know how much of this map is present,
14:31 the scaffolding is present at birth, and how much of it is shaped by experience.
14:35 And I'm gonna talk about that in a few minutes.
14:37 But for now, let's assume it's hardwired, partly.
14:40 Maybe it's congenitally missing the arm,
14:43 and that's why he feels it's alien or it doesn't belong to him.
14:46 So we did the obvious experiment of galvanic skin response,
14:49 poked him with a needle, gently, in different parts of the body,
14:52 and obtained electrical skin conduction responses.
14:55 And we thought we would find no responses.
14:57 One of the things that clued us
14:58 in to this as being a neurological rather than a psychological disorder,
15:02 if you ask him where did he want it amputated, he'd take a felt pen,
15:05 and he would draw an exact line just above
15:07 the elbow or below the elbow or just above the hand.
15:10 Very precise line, often irregular line, sloping line,
15:14 and then if you let him go home, don't tell him you're gonna retest him,
15:16 but bring him back after six months, he'll draw exactly the same line.
15:19 Unless he's being deliberately deceptive, got it memorized.
15:22 It's very unlikely he's doing that.
15:23 So this suggests that...
15:25 Why would the precise line matter?
15:26 Some vague inclination to get the arm removed,
15:28 why would the precise line matter?
15:30 In fact there are many psychological theories of this.
15:32 One psychiatric theory holds that it's a cry for attention,
15:34 that's why they want their arm removed.
15:36 Why arm?
15:37 Why not remove the nose or the ear or something like that?
15:40 Why the arm always, or the leg, right?
15:44 Seems pretty drastic way of getting attention.
15:46 Another theory, believe it or not, the Freudian theory,
15:48 the guy wants his arm removed in order to create an amputation stump,
15:52 to resemble the giant penis.
15:55 I'm not making this up.
15:56 You can see this in the literature.
15:58 So we thought we'd come up with a neurological,
16:00 phrenological theory of what's going on.
16:02 Then we drew the line with the felt tip,
16:06 poked him with a needle in different parts of the body,
16:08 to see if the galvanic skin response is normal
16:11 below the line as opposed to above the line.
16:13 We expected a diminished galvanic skin response below the line,
16:16 because that part of the arm is not represented in the brain,
16:20 according to our theory.
16:22 Well we found the opposite.
16:24 As often happens in science.
16:25 We found below the line there's a huge galvanic skin response.
16:28 Above the line, is perfectly normal as you would expect.
16:30 Is that clear?
16:31 Okay if you poke somebody with a needle, unless it goes to S1 of course, and S2,
16:37 the somatic representation of the body,
16:39 but it also goes to an area called the insular cortex,
16:41 and from there it gets into the anterior singular
16:44 and from there messages cascade down the sympathetic nervous system,
16:47 producing sympathetic arousal to the pain.
16:49 And then this manifests as a change in sweating of the skin,
16:53 which in turn can be measured as a change in skin resistance.
16:56 You put two electrodes in the palm and I scare you
16:58 with a needle or I scare you with a lion, you start sweating.
17:02 This registers as a fall in skin resistance.
17:05 Base of lie detectors.
17:07 Any anxiety, any panic will produce resistance.
17:10 So clearly, he was registering a higher response to the alienated
17:15 part of the limb than to the normal part,
17:19 which is opposite of what we predicted.
17:21 But hang on a second.
17:22 So we said, well our basic, early theory was wrong, so what's going on here?
17:25 Then we resorted to brain imaging.
17:29 I don't have any pictures to show you,
17:30 but basically what we found was this map was normal,
17:36 the one I just showed you, S1 is normal.
17:37 S2, which represents joints, muscles, and light touch, that was also normal.
17:44 We said what's going on here?
17:46 Everything's normal.
17:46 Then we went to in superior parietal lobule, SPL, wherever four is,
17:52 superior parietal lobule is where you create
17:56 a polysensory representation of your body image.
17:59 You close your eyes,
18:00 your vivid impression of your own body, inhabiting your own body,
18:03 the movements of your arms and legs and all that, that sense
18:05 which was called body image by Henry Head and Lord Russell Brain,
18:09 two real neurologists, by the way, who called this the body image.
18:14 And that combined sensation from hearing, touch,
18:17 and vision is in the superior parietal lobule.
18:21 In that map, there is no response from the hand.
18:26 So that map was abnormal.
18:28 There's a hole, to put it crudely,
18:29 corresponding to the hand he wanted amputated.
18:33 So what's going on in this patient is, the messages from the hand and arm
18:37 are reaching the somatosensory cortex completely normal.
18:40 So the messages, sensory signals are normal,
18:42 sensory cortex is normal, S2 is normal, but they have nowhere to go to, 'cause
18:45 there's a hole in that region of the brain.
18:49 So this creates a discrepancy between the incoming sensory input and there's
18:53 no place for them to go to, and the brain aborts discrepancy,
18:56 that signal goes to the insular and possibly the amygdala,
18:59 generating a galvanic skin response.
19:00 (grunts) right?
19:03 So here we have an example of...
19:05 We've taken the Freudian theory and discarded it.
19:08 By and large, that would be completely wrong,
19:10 and then replaced it with an anatomical theory,
19:13 which we can test in a few hours using a GSR machine,
19:17 and then do more sophisticated brain imaging
19:20 and show that we're on the right track.
19:21 This shows the power of this approach, cognitive neuroscience.
19:24 We can take a bizarre, seemingly incomprehensible neurological disorder,
19:28 a person wanting his arm removed,
19:30 and reject the traditional explanation in favor of an anatomical explanation
19:35 based on the known neuroanatomy of the sensory pathways in the brain.
19:41 Now, can you cure the disorder?
19:43 We haven't found a way of treating it yet.
19:44 In fact, they don't wanna be cured, as I said before.
19:48 But the next topic I'm gonna deal with...
19:51 So this is typical of what we do.
19:53 We take syndromes that have been known for a long time,
19:55 either rare ones or common ones, like synesthesia is very common.
19:57 I'm gonna talk about that later today.
20:00 Phantom limbs are quite common, I'll talk about that as well.
20:03 Our rare ones, and bring them from the clinic
20:05 to the laboratory and then do systematic experiments,
20:08 to find out what's going on, and sometimes
20:10 we're actually able to help the patient.
20:12 Now this at the start it doesn't always work, looking for anomalies.
20:16 Because every now and then...
20:17 You only hear of the success stories.
20:19 Nine out of 10 times it's a wild goose chase.
20:22 Anomalies in neurology.
20:23 Neurology and psychiatry are full of anomalous syndromes.
20:27 Nine out 10 times a wild goose chase.
20:28 You only hear of the success stories.
20:30 I'll give you three examples of wild goose chases.
20:33 Very briefly.
20:34 There's a syndrome called De Clerambault Syndrome.
20:38 How many of you know about De Clerambault Syndrome?
20:41 Nobody.
20:42 See?
20:42 Pretty obscure.
20:43 Even most neuro and psychiatrists haven't heard of it.
20:46 It refers to a syndrome that's
20:47 defined as, it's accepted in psychiatry textbooks,
20:50 a young woman, typically young woman,
20:52 who develops the delusion that an old, rich,
20:56 famous man is madly in love with her but is in denial about it.
21:00 (audience laughing) Funnily enough,
21:03 the converse of the syndrome has not been described,
21:05 where an older gentleman develops a delusion
21:07 that a young hottie is sexually interested in him, but is in denial about it.
21:12 This is much more common, I can assure you.
21:14 (audience laughing) Another bogus syndrome is chronic underachievement syndrome.
21:21 This is actually found in textbooks.
21:22 Chronic underachievement syndrome.
21:24 My day it used to be called stupidity.
21:26 (audience laughing) The third syndrome,
21:29 my favorite, is oppositional defiant disorder, ODD.
21:34 This young spirited youngster daring to challenge the establishment.
21:37 The psychiatrist challenged her parent...
21:42 The man who invented the syndrome is genius,
21:43 because any attempt by the patient to disprove the syndrome,
21:46 the pretend syndrome, can be construed as additional evidence for the diagnosis.
21:52 Leaving that aside, every now and then you
21:54 stumble on legitimate syndromes that give you key insights.
21:56 So for example, apotemnophilia.
21:59 Now I'm gonna talk about something else, this you heard before,
22:00 many of you, but I'm gonna repeat it, the gist of it.
22:04 Phantom limbs.
22:05 An arm or leg were amputated and you continue
22:07 to feel its presence is called a phantom limb.
22:10 Some years ago, nearly 15 years ago we had a patient with a left arm amputated
22:13 and we made a specific prediction based on work
22:16 on monkeys run by Mike Merzenich and others.
22:19 So nobody had tested it on humans, so we had a patient sitting in my lab,
22:23 whose left arm had been amputated, we blindfolded him and simply took a Q-tip
22:27 and touched different parts of his body,
22:29 and asked him, "What do you feel?" He said, "It's my right shoulder,
22:31 and my chest." So here's a patient sitting in the chair,
22:34 blindfolded, took a Q-tip, touched different parts of his body,
22:37 did a routine sensory neurological exam.
22:39 "What's that?" "That's a Q-tip." "What are you touching?"
22:41 "Right chest." "That's my right shoulder, my left shoulder.
22:47 "Left upper arm.
22:50 "Oh my god you're touching my left phantom thumb.
22:54 "And my phantom pinky, and my phantom index finger." We found there's
22:58 a complete map of the missing arm on the face,
23:01 and you can actually plot receptor fields.
23:04 You can plot receptor fields.
23:06 Like the thumb was there.
23:09 Ball of the thumb, index finger, pinky.
23:12 And you can send him home,
23:13 bring him back after a month and it's exactly the same.
23:16 No way he could've memorized that.
23:19 And why is this going on, happening?
23:20 Well we can do a bit of detective work.
23:24 Go back to the Penfield map.
23:28 Notice that the map is completely,
23:32 as a map should be, continuous, except for one fact:
23:35 the face is not near the head,
23:38 where it's supposed to be, near the neck, it's below the hand.
23:41 Is that clear?
23:42 So we said, what's going on?
23:44 And when you amputate the arm,
23:44 these sensory signals don't get to be handed in the brain.
23:48 Signals from the face can normally go into the face area,
23:51 invade, and cross and invade the territory vacated by the missing hand.
23:56 So there's this cross-wiring.
23:58 You ignore the arm and the hand,
24:00 there are no signals coming to this region of the brain, the hand region.
24:04 That region's hungry for new sensory input.
24:06 The sensory input not coming from the face came to the face area,
24:09 invades the territory corresponding to the missing hand, activates the cells,
24:12 and those cells misinterpret the signals
24:14 as coming from the missing phantom hand.
24:16 So when you touch the face he thinks you're touching his hand.
24:20 So you can have fun with this.
24:21 We took a Q-tip and put it in ice-cold water and put it on his face,
24:24 and he said, "Oh my god, my thumb feels ice-cold,
24:27 doctor." So the reorganization is morality-specific, it's not higgledy-piggledy.
24:30 Touch goes to touch, warm goes to warm, cold goes to cold.
24:34 On one occasion, water started trickling down his face,
24:37 accidentally, and he said, "Oh my god,
24:38 I can feel the trickle of the water!" And he took his other hand,
24:41 normal hand, and followed the trickle,
24:43 "It's coming down here, "it's coming down here,
24:45 oh it stops here at the wrist." Where the water stopped.
24:48 So it's exquisitely precise, the reorganization.
24:51 Just for fun I said, "Raise your stump and point to the ceiling."
24:55 The phantom is pointed to the ceiling, upward.
24:56 Then I put the water here, started trickling down, I said,
24:59 "What do you feel?" He said, "Oh my god the water is trickling upwards,
25:02 "defying the laws of gravity." You knew the patients often enough,
25:05 you realize that they don't make up stories like that.
25:11 Alright, I can continue along these.
25:13 I'm running out of time soon, I'm gonna skip a lot of stuff.
25:16 Can do brain imaging to show the reorganization has indeed occurred.
25:21 The other interesting thing about phantom limbs is,
25:23 the patient can often move the phantom.
25:27 Majority of patients can move the phantom.
25:28 But about a third of them, the phantom is fixed or immobilized.
25:31 And often in a painful position.
25:33 The patient will say,
25:34 mimic the phantom positions with his normal hand and will say,
25:37 "It's like this, doctor." Occupying it's like this.
25:39 "My hand is extending, hyper-extending,
25:42 "so my knuckles are touching the back of my wrist.
25:45 "It's anatomically impossible,
25:46 but my hand is doing it." And it's like that movie, what is the movie?
25:50 Where the head spins around?
25:51 (audience member mumbles) Yeah,
25:52 so it's anatomically impossible and it's excruciatingly painful,
25:55 "I wish I could straighten my wrist "and the pain
25:56 will go away." "So why don't you try?" "I'm trying,
25:59 I'm trying, I'm sweating, I can't do it." I'm gonna cut a long story short,
26:04 we hit on the idea of putting a mirror
26:07 there and showing the reflection of the mirror,
26:10 we can go into detail during the question and answer later,
26:14 put a mirror inside a cardboard box, and the phantom,
26:18 the clenched phantom, often they will say, "The fingers are biting into the...
26:23 "The nails are biting into the palm, doctor,
26:24 "and it's excruciatingly painful." There's no nails,
26:26 there's no palm, there's no hand.
26:27 It's a phantom.
26:30 It's a serious clinical problem.
26:31 Become profoundly depressed, lose their jobs,
26:33 on occasion they contemplate suicide.
26:36 So you put a mirror there and you have
26:38 the patient clench the normal hand and look at the reflection
26:41 of the normal hand in the mirror so that the reflection
26:43 of the normal hand is superimposed optically on the phantom hand,
26:46 so you visually resurrected the phantom.
26:49 Then you say, "Okay send symmetrical commands
26:52 "to both hands to open or close." He says,
26:54 "I know you're telling me that I can do that, "my left hand,
26:57 it will not open." I said, "Just take a look in the mirror and see." He said,
27:01 "Oh my god it looks like it's opening.
27:02 "And my god it also feels like it's opening, "it doesn't merely look like it's
27:05 opening." Which is not surprising, it's optics.
27:08 But it feels like it's opening,
27:09 and the clenching spasm is removed, it's gone, the pain is gone.
27:13 Then I said, "Remove the mirror." I removed the mirror.
27:15 Then try with your eyes closed and imagine it, and, "No it doesn't work,
27:17 I keep trying but it doesn't work." Put the mirror and then,
27:20 "Wow, it's opening, it's opening, it feels good." So I said, "Well, maybe...
27:25 "You can't carry around a mirror all the time.
27:28 "Maybe you can get to a point where you
27:30 can practice "with the mirror one hour a day,
27:33 "and after about a week or two or a month, "you can dispense with the mirror,
27:36 "you can just move it on its own." He can just unclench it whenever he wants to.
27:40 So I sent him home with a box, only $2, sent him home with a box.
27:44 And then after two weeks I phoned him up and I said,
27:46 "Have you been practicing?" He said, "Yes I've been practicing.
27:48 "When I keep my eyes open, the pain gets relieved "for about an hour,
27:51 and then it comes back "with a vengeance.
27:53 "And then I put the mirror back and it goes back again.
27:56 "So I keep doing refills.
27:58 "I know you want it to go away permanently,
28:00 but it doesn't." I said, "Fine, c'est la vie,
28:02 you know?" Then after a week he phones me, and he's all agitated on the phone.
28:06 I said, "What's wrong, Derek?" He said,
28:07 "You're not gonna believe this." I said, "What?" "It's gone," he says.
28:11 I said, "What's gone?" I thought maybe the box was gone.
28:14 He said, "No, no, no, not the box.
28:15 "The phantom limb which I've had for the last 13 years.
28:19 "The phantom limb is gone, it's disappeared." I said,
28:22 "What do you mean?" He said, "It's gone." I said, "When?" "Like three days ago.
28:26 "I've been trying to reach you." And I was
28:28 a bit worried about this because human subjects and ethics,
28:30 because I've permanently modified this guy's body image,
28:32 if what he's saying is true.
28:34 Then I said, "Well does it bother you?" He said,
28:36 "No, the pain that I had "in my phantom elbow,
28:38 my phantom wrist, "and my phantom fingers, I've never had those pains.
28:41 "In the last three days I don't have a phantom."
28:44 We can go into the question of why this happens later,
28:47 but clinically, this has been tried in several clinical trials,
28:50 one in the New England Journal of Medicine, so you can see the...
28:55 Published in the New England Journal of Medicine from Walter Reed.
28:58 You can see with the mirror they say the pain drops to almost no pain.
29:03 With the covered mirror and visual imagery the pain actually goes up
29:08 until they crossed over and then the pain drops again in the mirror.
29:11 And now it's widely used in clinics around the world.
29:17 Now, surprising, curing pain in a phantom
29:20 limb with a mirror is surprising enough.
29:22 Now as you see there's a lot of variability.
29:24 Only about half the patients are helped.
29:26 In about half of them the mirror does nothing,
29:28 typically patients who've seen them for a long time.
29:30 These variables need to be studied.
29:32 There's another disorder which I want to tell you about.
29:34 Speaking of mind and body and Lekov here has done more
29:37 than anybody else to talk about links between mind and body.
29:40 But here is a powerful example you see in the clinic.
29:43 Ordinarily we think of pain as one thing.
29:44 But there's in fact two kinds of pain.
29:46 There's chronic pain and acute pain.
29:48 Acute pain, you touch the kettle
29:49 and you withdraw to prevent further tissue injury.
29:52 Obvious adaptive value.
29:53 Chronic pain is the opposite.
29:55 Immobilize the arm.
29:56 You've a tiny metacarpal bone fracture, and your finger becomes painful,
30:01 immobilized, there's a reflex immobilization
30:04 to prevent further injury to the finger,
30:06 and it gets swollen and it gets inflamed and it gets warm and it gets red.
30:11 All signs, it remains swollen, warm, red, painful, and inflamed.
30:16 And then the bone heals after two weeks, all the change is reversed,
30:20 the inflammation subsides, pain goes away, the finger starts moving again.
30:23 That's normal, 99% of people.
30:26 In about one or two percent of people that does not happen.
30:28 The injury heals, the bone heals, in x-ray,
30:32 but the pain persists with a vengeance.
30:34 It continues to be immobilized, paralyzed.
30:37 It gets swollen, it gets warm.
30:41 Normally then it spreads to the entire hand.
30:43 Entire hand gets warm, swollen, painful, immobilized, paralyzed.
30:46 Entire arm gets paralyzed, swollen, immobilized,
30:49 from the starting from the little metacarpal bone fracture.
30:52 So what's going on here?
30:53 I don't know.
30:54 We still don't know.
30:55 But one thing, the paralysis I think is
30:57 partly due to what we call learned paralysis.
30:58 Every time you attempted to move this finger,
31:00 move the arm, brain was sending a single, "Ouch, it's painful,
31:04 stop moving it." So there's a habean link between
31:07 the very attempt to move the hand and the excruciating pain.
31:10 So the brain gives up and says "Stop moving
31:11 your hand." So you get this pseudo-paralysis arising from punishment.
31:16 So we said, "How do you cure this?" Well let's put a mirror here, of course.
31:21 And put the other hand there, and send a symmetrical command,
31:24 you're gonna get a visual illusion that the paralyzed,
31:26 swollen, painful hand is actually moving with impunity.
31:29 But he's not actually moving it.
31:30 There's an optical twin that's moving.
31:32 He's seeing the reflection of his normal hand moving.
31:35 But with that unlearned the learned pain phenomenon.
31:38 But this is a wild hunch, even by my standards, and we're setting out to do it,
31:44 fortunately another group did it, Halligan, Marshall and Wall, in England.
31:49 And they...
31:51 That shows you an example of RSD.
31:59 They did a similar experiment with a mirror and found dramatic recovery.
32:04 In fact, what's astonishing is, when you put the mirror there...
32:08 Here's a guy for months he's been
32:10 swollen and paralyzed and inflamed and painful.
32:13 He moves the normal hand, in a few minutes the inflammation stops,
32:17 not only the pain, but the mobility returns and the swelling starts subsiding.
32:23 And the temperature starts falling.
32:24 You can't fake a fallen temperature.
32:26 So that convinced me that it was real.
32:28 And then when I saw one of the authors was Patrick Wall,
32:31 who's the world's leading expert on pain,
32:33 he's experimented on placebos as well, so his name was in the papers,
32:36 I figured this must be a real phenomenon.
32:37 Since then, there's been about four or five controlled studies,
32:42 there's been blind controlled studies, placebo controlled studies,
32:44 also now it's the accepted first line
32:46 of approach treating RSD in clinics around the world.
32:49 It's an extraordinary example to me of mind-body interaction.
32:53 That a mirror is producing changes...
32:56 Vascular changes in sympathetic pain, changes in swelling,
32:59 all of it, temperature, all of that.
33:03 All online.
33:06 It's also being used for stroke by the way now, mirror rehab,
33:09 and also for neglect, which I won't go into now, for a lack of time.
33:13 Now just when I thought I was done with phantom limbs,
33:17 I came across another phenomenon.
33:19 I started reading Rizzolatti's work on mirror neurons.
33:23 I speculated on this, and jumped off my seat when I first heard the talk.
33:27 Everybody here knows about mirror neurons, especially here in Berkeley.
33:31 They're neurons in the front of the brain,
33:32 prefrontal cortex, roughly homologous to Brocal's area, B5.
33:37 These neurons normally are the garden-variety motor command neurons which when
33:40 a monkey or a person reaches out and grabs a peanut,
33:44 a neuron fires, orchestrating the series
33:47 of motor twitches required for grabbing the peanut.
33:51 About 10% of these neurons Rizzolatti found.
33:54 They'll also fire when I watch George here reaching out and grabbing a peanut.
33:58 They've been quickly dubbed monkey see, monkey do neuron, or mirror neurons.
34:03 So they're sort of simulating doing a virtual
34:05 reality simulation of your impending action, is the claim.
34:10 Now, there's also sensory mirror neurons, they're equally interesting.
34:14 Discovered by Christian Kaiser in S2, the sensory cortex.
34:18 Remember I showed you the map of the sensory areas of the brain.
34:21 When you touch my left hand, right somatosensory cortex,
34:25 S1, S2 cells are activated, there's a map.
34:28 This has been known for a long time since Lord Adrian,
34:30 goes back 70 to 100 years.
34:33 Now, a subset of these neurons,
34:35 about 10% of them will react to my watching George's thumb being touched.
34:40 So this is very interesting because we can call them empathy neurons.
34:44 Because the neuron is effectively saying,
34:46 what's happening to George is similar to what
34:49 would happen to you if your thumb were touched.
34:51 So empathize with George, you know what it's like to feel his touch.
34:54 Same thing with pain, you go to anterior singular,
34:55 there are neurons sensitive to pain.
34:57 If you poke my thumb with a needle, it goes to my anterior singular and I say,
35:01 "Ouch." But if you poke George's thumb with a needle,
35:04 a subset of the same neurons fire and I can empathize with George.
35:09 But here's an interesting question: Wouldn't I shout,
35:12 "Ouch" when he's poked with a needle?
35:13 The same neurons are firing.
35:15 Wouldn't I withdraw my hand and I will simply watch George's hand being poked?
35:21 A couple of possibilities.
35:22 One possibility, obvious possibility,
35:23 is I wear my normal skin sending a veto signal saying,
35:26 "Don't worry, you're not actually being poked.
35:28 "Empathize with George, by all means, "but don't dissolve into him.
35:33 "Don't withdraw your hand suddenly "because that's maladaptive,
35:35 it'd be a waste of time.
35:38 "So empathize with him, know what it's like to be George,
35:41 "in George's shoes right now, "but don't withdraw your hand,
35:44 that would be foolish." So I looked at this and I said,
35:46 "Well the obvious prediction is if I amputate
35:48 my arm "and look at George being poked,
35:50 "I should feel the pain in my phantom." Because the afferent signals are gone.
35:55 There's no veto signal.
35:55 Is that clear or obscure?
35:58 So in the hundred years that we've known about phantom limbs,
36:01 nobody answers this question.
36:02 If you poke somebody with a needle when a phantom limb patient is watching,
36:06 does he feel the poke in his phantom?
36:07 The answer is yes.
36:08 We've seen in three patients now, they watch another patient being poked,
36:12 they feel the pain in their phantom.
36:15 So we call these empathy neurons or Gandhi neurons.
36:18 (audience laughing) Now there's some debate
36:21 about whether mirror neurons are significant,
36:25 whether they're important or the same mysteria of the minds,
36:28 action understanding action, production,
36:31 all of this, just is it old-fashioned psychology,
36:33 new words to describe empathy and things like that.
36:36 We won't go into that.
36:37 This patient went home and he had a smart
36:40 idea and we talked about it before he went home.
36:43 He feels excruciating phantom pain in his phantom arm,
36:46 cramped, phantom cramping pain.
36:48 He can't do anything about it.
36:49 We were already getting ready to start him on the mirror protocol,
36:52 before that he simply watched his wife's hand being massaged.
36:58 And of course he felt a phantom massage in his phantom hand, he claimed.
37:03 'Cause he needed to relieve the phantom pain.
37:06 This is not, unlike the mirror procedure, this has not been tested in clinics,
37:10 in a clinical setting using placebo controls.
37:12 But if it works, it'll be a clear example
37:14 of a practical application of the idea of mirror neurons.
37:17 Leaving aside all the arcane,
37:19 theoretical debates about how significant they are,
37:21 practically, in the clinic, to alleviate phantom pain.
37:23 That guy doesn't care (mumbles) the theory or the mind or what it is.
37:27 His pain goes away.
37:30 Now another prediction we made, this is kind of cute, actually.
37:33 Going back to the motor neurons,
37:36 there's a condition called OCD, obsessive-compulsive disorder.
37:39 In one particular variation which is particularly
37:41 troubling to the patient is ritual hand washing.
37:44 A person accidentally touches a doorknob,
37:47 this mere minor contamination elicits acute anxiety, almost panic,
37:50 and the guys incessantly wash their hands,
37:54 to the point of erosion of the hand, fingers and skin.
37:58 And then we said, "Well what if he
37:59 simply "watches another guy washing his hand?" Sounds stupid.
38:03 Some of my best experiments begin as jokes, by the way.
38:06 (audience laughing) So I said,
38:09 "What if he watches somebody..." There's an experiment done with Jalal,
38:11 Baland Jalal, a student in my lab.
38:14 So sure enough, in about two thirds of the patients we've seen with OCD traits,
38:20 hand washing compulsions,
38:21 they watch another person washing his hands, they get relief.
38:26 And the interesting thing about this is it
38:28 can't be response bias because they're surprised by it.
38:30 "How the hell...?
38:31 "Why should him washing his hand produce relief in me?
38:34 "It doesn't make any sense." They express surprise.
38:37 So I think we're on to something, a potential treatment for OCD.
38:41 Because you could have an app that shows you, as soon as you get the urge,
38:45 you look at your self washing your own hand,
38:47 you don't have to go to the toilet and spend half an hour, right?
38:50 So another example of a clinical application for something like OCD.
38:54 It's a topic that I know very little about, by the way.
38:58 I'd like to switch gears now
38:59 and talk about phenomenon which we call synesthesia.
39:03 Which was documented first by Francis Galton,
39:07 in 19th century, first cousin of Charles Darwin.
39:09 He noticed some otherwise normal people in the general population.
39:12 He said it was rare, one in 1,000, one in 500,
39:15 now we know one in 50 people have synesthesia.
39:18 So this condition is one where a person is otherwise completely normal.
39:22 If he sees a printed number on a white sheet of paper, like five is red,
39:26 six is blue, seven is green, eight is chartreuse,
39:28 nine is indigo, and so on and so forth.
39:29 The color remains constant for any
39:32 particular individuals over years, stable over years.
39:35 It's different for different people, not the same colors for different people.
39:37 Although there are trends, we can get to that if you want.
39:40 Now since the discovery of synesthesia by Galton,
39:47 there have been hundreds of case reports,
39:48 but no attempt to understand what's going on in the brain or what causes it.
39:52 And in fact, people brushed it aside, classic example of an anomaly in science,
39:56 a Kuhnian anomaly, which people brush under the carpet and say,
39:59 "It doesn't make any sense.
40:00 "What do you mean five is red, six is blue?
40:01 "It doesn't make any sense." Well often anomalies can pave
40:05 the way to new discovery and new areas of research.
40:09 So we thought, well why not study these people?
40:12 And the standard explanation of synesthesia, by the way,
40:15 one explanation is these are just crazy.
40:18 That's not an explanation.
40:19 Even if it's true, let's put that aside for the time being,
40:22 come back to it as a last resort.
40:24 Second explanation is, they're high on drugs.
40:28 And sure enough, it's about seven times more common in Berkeley than at UCSD.
40:32 (audience laughing) But leaving that aside,
40:36 the fact that drugs influence synesthesia is
40:38 not evidence against synesthesia being a legitimate phenomenon.
40:41 It makes it more interesting.
40:42 Why would some drugs enhance this propensity to see numbers as color?
40:47 The third explanation is they're just childhood memories.
40:50 They've been playing with the refrigerator magnets and five was red and six was
40:53 green and seven was blue and eight was yellow and so on and so forth.
40:56 This doesn't make any sense to me because why does it run in families?
41:00 Galton himself showed that synesthesia runs in families
41:02 and possibly in a Mendelian fashion, so it's inherited.
41:06 So you have to see the same madness
41:08 as being passed on from generation to generation, which didn't make much sense.
41:11 But you had to keep in mind the possibility.
41:15 And then if it's true, if it's just magnets, why don't we all have synesthesia?
41:18 Why only a subset?
41:20 Obvious questions.
41:21 The fourth possibility is more ingenious but a bit vague.
41:25 Along the lines that George and I have been thinking.
41:27 I'm not saying you're vague, but I'm vague.
41:30 That is that maybe they're being metaphorical when they say five is green.
41:34 Maybe it's like oh, say, F sharp is blue.
41:37 It's like saying cheddar cheese is sharp.
41:39 The cheese isn't sharp.
41:40 You rub it on your skin it's soft.
41:42 You say, "No, no, no, the taste is sharp." But there's a circularity there.
41:45 Why do you use a gustatory metaphor,
41:47 a tactile metaphor to describe a gustatory sensation?
41:50 There's a whole area of research that this leads
41:53 to which we don't have time to go into.
41:57 But this may be on the right track,
41:59 as you can see, this is what I'm gonna argue.
42:01 First of all, are they crazy?
42:03 We did a number of experiments to show that they are not.
42:05 It's a legitimate phenomenon.
42:07 And in a subset (mumbles) there are two kinds of synaesthetes,
42:10 the projectors and the associators.
42:12 Projectors are the minority, maybe about 10 to 15%, synaesthetes,
42:15 and we stumbled on two of them,
42:18 luckily when we started doing the research on synesthesia.
42:21 Associators are more difficult to study.
42:23 They constitute 80 to 90% of them.
42:24 So let's talk about projectors.
42:27 So we said, "How do you know they're
42:28 not making it up?" Well we designed this display.
42:32 You've got a synaesthete who sees numbers as color.
42:36 So we show normal people this panel of fives with some two scattered among them.
42:42 Can you find the twos?
42:43 One there, one there, one there.
42:45 They form a shape, either a square or a triangle or a circle.
42:48 And it takes ages.
42:49 Takes 20, 30 seconds before you spot the upside down triangle.
42:55 A synaesthete looking at it sees it much faster.
42:57 He says, "Oh I see an upside
42:59 down red triangle." If you're a projector synaesthete.
43:03 Now if he's crazy, how come he's better than us?
43:07 This has been confirmed by Jamie Warr,
43:08 by the way, in London, in a larger group of...
43:11 This experiment done with Ed Halbert,
43:13 he used to be a student here at Berkeley before he turned into a grad student.
43:18 Also there's phenomenology.
43:19 You talk to these patients,
43:21 for them it's not a patient, subject, sorry about that.
43:25 Synaesthete I saw recently said, "Eight is blue." And I said,
43:29 "Do you see the blue in your mind's eye?
43:32 "Like when you think of Cinderella "you think
43:33 of a pumpkin or you think of a chariot?
43:35 "Or do you literally see it blue?" And she said,
43:39 "No, no, I actually see it blue.
43:41 "It's not like Cinderella and the pumpkin.
43:42 "Because there I can think of Cinderella and her gown, "Cinderella and mice.
43:46 "Whereas here I can only think of blue.
43:48 "The irresistible urge to see blue.
43:50 "And not only that, in my case, it spills out of the color,
43:53 "Spills out of the letter and forms a halo,
43:55 "a dusty halo around it." Now why would that be?
43:58 The first thing I did was simply put an amoeba around it,
44:02 and the halo gets blocked, part of the halo gets blocked by the amoeba.
44:05 These kinds of phenomena you can't
44:07 explain in terms of vague psychological associations.
44:10 Suggests strongly that they're sensory in character.
44:12 You can even put an illusory contour around
44:14 the A, it gets blocked by the illusory contour.
44:17 We can get back to where that's happening in a minute.
44:19 So what's happening in synesthesia, what's going on?
44:22 Rumor that it runs in families, that's one clue.
44:25 It's also (mumbles) that synesthesia is seven
44:26 or eight times more common among artists,
44:28 poets, and novelists and other creative people than in the normal population.
44:31 That's another piece of the puzzle.
44:32 We've got all these pieces of the puzzle.
44:34 Why is it eight times more common among novelists, poets, and artists?
44:38 Why?
44:38 We'll see in a minute.
44:41 And in the subset of synesthesia we've got the projectors,
44:45 we stumbled on, the anatomy is straightforward.
44:48 Greg Hubbard and I were looking at brain atlases.
44:51 We saw that the area for numbers shown in the red,
44:55 discovered by Stanislas Dehaine and Tim Ritger in our lab,
45:03 in our department, shows where graphemes are represented, including numerals.
45:08 And the green path is (mumbles) Z4.
45:13 This is involved in processing color.
45:15 We said, "What's the likelihood of the most common "type of synesthesia,
45:17 number-color synesthesia "and these two are right next to each
45:20 other "in the fusiform gyrus of the brain?" Well we said,
45:25 "It's very unlikely to be a coincidence.
45:26 "Maybe there is some accidental cross-wiring "between number and color."
45:30 So every time they see a black and white
45:31 number it activates a number node and cross-activates
45:34 a color node spontaneously so they see a particular color.
45:37 Now why would there be cross-activation of this kind in these people?
45:40 Remember the clue comes from the fact that it runs in families.
45:43 Remember that in the fetus, in early embryology,
45:45 in early, early childhood, perhaps, everything is connected to everything.
45:49 That's an overstatement, but a tremendous redundancy of connections.
45:53 But then these excess connections are pruned away by pruning
45:56 genes to create a modular architecture that characterizes the adult brain,
45:59 including number area and color area.
46:01 So if these pruning genes are mutated, there's defective pruning,
46:05 then some redundant connections are gonna be left behind,
46:10 for example the mutant pruning gene is selectively
46:15 expressed by transcription factors in the fusiform gyrus alone,
46:18 you get this quirky number-color synesthesia.
46:22 And what about the higher synaesthetes?
46:23 Where it's not just the number that produces,
46:25 visual appearance of the number that produces...
46:27 So-called associators, what about them?
46:29 Well we did a simple experiment on these people, these projectors.
46:33 We said, we asked a very simple question which had not
46:36 been asked about synaesthetes since the 100 years we've known about it,
46:38 since Galton's time.
46:40 Instead of showing them a five, why don't you show them a V, a Roman five?
46:45 Instead of showing them an Arabic six or an Arabic seven,
46:47 I should call them Indian by the way, but instead of showing an Arabic number,
46:51 why when you show them a Roman five, what do they see?
46:53 Do they see a color?
46:54 The answer is, I've never met a synaesthete who's seen color in a Roman number.
46:57 So it's not the concept of the number creates the color,
47:00 it's the visual appearance,
47:01 which fits the idea that fusiform gyrus encodes the visual appearance,
47:05 not the higher level concept of numerosity,
47:08 ordinality, cardinality, and all that good stuff.
47:12 Which, by the way, I think happens in the angular gyrus.
47:14 We've long known that the angular gyrus,
47:17 if the left angular gyrus is damaged, you get discalculius.
47:19 If you ask him to subtract 17 from 21, he'll say,
47:24 "Oh it's 14." He will glibly say it's 14,
47:27 and is sure that he knows it for certain.
47:31 Discalculia's another whole lecture.
47:37 So I think in the projector synaesthetes, the cross-wiring gene is expressed,
47:41 you have the cross-wiring gene, we get number-color synesthesia.
47:45 In the associator synaesthete, it's expressed higher up so the idea of sequence
47:50 is mapped onto higher color areas in the brain.
47:54 In the color processing hierarchy.
47:56 So it's expressed higher up.
47:58 I can show you a diagram later.
48:01 In the vicinity of the angular gyrus
48:02 you get higher synaesthetes or lower synaesthetes.
48:04 Which would explain why some of these higher synaesthetes also experience
48:08 not only numbers as color but days of the week as color.
48:14 Monday is red, Tuesday is blue, Wednesday is chartreuse.
48:17 And months of the year as color.
48:19 Again, it seems completely and utterly incomprehensible.
48:21 What do they all have in common?
48:23 Months of the year, days of the week, and numbers?
48:24 Sequence.
48:26 So I think the angular gyrus is where the action is.
48:28 And now there's some research using DT imaging by Rumka Holt in our lab,
48:33 she's visiting our lab, she has shown that in fact, if you do DT imaging,
48:37 there's more white matter in the vicinity of the angular gyrus
48:40 in the associators and in the fusiform gyrus in the projectors.
48:43 But this is still very preliminary, I should add a note of warning.
48:47 Okay here's another fun example, and we can play games with these people.
48:51 How many of you can read that?
48:53 Raise your hand.
48:55 Very tough.
48:56 Now squint your eyes.
48:58 (audience laughing) George you can't read it yet?
49:03 Remove your glasses.
49:09 Okay.
49:11 Alright, now guess what happens when you show this to a projector synaesthete?
49:16 Projector synaesthete says, "Well I see a jumble of colors but I don't know why,
49:19 "because you know I can't see any letters." Then they say,
49:23 "Oh wait a minute, I know why that's red.
49:25 "It's an N.
49:27 "It's an O, that's why it's blue.
49:29 "S, E, oh I see, ha ha ha." Okay so
49:33 they're seeing the colors being activated but it's hidden numbers.
49:37 Before they reach consciousness and register as graphemes.
49:40 So the blind side for numerals in synaesthetes.
49:43 So what I'm claiming is, in these individuals,
49:48 those hidden numbers are activating the color area of the brain,
49:52 and then they're evoking a proper (mumbles)
49:55 they're evoking a number area of the brain.
49:58 Activating the number area.
49:59 Evoking the appropriate color even before the message is
50:01 sent higher up to be recognized as a grapheme.
50:05 So you're seeing the colors and using the colors to infer what the grapheme...
50:08 The most striking example of this I've seen is two colorblind synaesthetes.
50:13 Sounds like an oxymoron.
50:15 This person could see a limited range of color
50:17 because of vision cone pigments in the eye.
50:19 Limited range of color in the external world, but when they saw numbers,
50:22 they would see colors that you would never see in the external world.
50:24 They call them, charmingly refer to them as martian colors.
50:28 And the reason again...
50:30 We've seen two patients like this.
50:31 The reason again is because the cone pigments are
50:34 deficient so they can't see colors in the real world,
50:37 they see only limited range.
50:39 But they saw a number,
50:40 the number activates a number node and cross-activates color neurons which can't
50:45 experience those colors in the real world because the receptors don't exist.
50:49 It's hardwired for seeing quote-unquote martian colors.
50:52 Is that clear?
50:53 This again eliminates any possibility
50:54 of learning being the basis of synesthesia.
50:56 How can you learn a color you've never seen?
50:59 Another phenomenon Galton,
51:00 the astute Galton noticed was what he called number lines.
51:04 When I ask any of you to imagine numbers in front of you, one to 10,
51:07 you may be crudely going left to right, one, two,
51:12 three, four, and it's very vague, there's nothing really clear.
51:15 But in some individuals, Galton noticed, and again we find this about one in 50,
51:19 to one in hundred, will see a vivid,
51:21 three-dimensional layout of numbers in the visual field.
51:24 One is here, two is here, and it's convoluted, not straight line left to right.
51:29 It's convoluted, 1, 2, 3, 4, 5, 6, 7, 8, 9,
51:31 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20.
51:34 And often doubles back on itself like this.
51:36 So fifteen may be close to two,
51:39 instead of being close to 16 or 14 in Cartesian space.
51:43 And this has been ignored for 100 years and Ed Hubbard and I
51:47 and David Brian did some experiments to establish
51:49 that the people are not faking it.
51:50 We used the number-distance effect, I don't have time to go into it.
51:53 So they're not faking it.
51:55 The number line affects their reaction time to numbers.
51:58 So then there'd be mixed results on this phenomenon.
52:01 But everybody agrees with me about the phenomenon,
52:04 the question is why does it arise?
52:05 Why would some people see numbers and imagine numbers like...
52:12 Again, it's a classic example of an anomaly in science.
52:15 And people ignore it for that reason.
52:17 I don't know the answer to why they see it this way,
52:19 unlike the grapheme color synesthesia where I had a clear answer.
52:23 But only one reason, the one thing I can think of is arithmetic
52:25 and numbers and mathematics is a recent event in human evolution,
52:29 maybe 5,000, 10,000 years old.
52:31 And the brain can't invent a completely
52:33 new algorithm from scratch to handle numbers,
52:36 ordinality, sequences and all of that.
52:38 So what it does is, it adopts a trick using preexisting maps in the brain.
52:43 Maps go back into Ionian times in our fish-like ancestors.
52:46 Brain is full of maps.
52:47 So you map on the ideal concept of numerical sequence,
52:50 ordinality and cardinality and quantity.
52:52 Onto spacial map to create a graph.
52:55 If something goes awry with this remapping
52:57 of this concept of sequence onto a spacial map,
53:01 you get these peculiar number lines.
53:03 Now how do you test this idea?
53:04 I have no idea.
53:07 But it's an interesting idea nonetheless.
53:10 Now some of these people also have, I'm almost done...
53:14 Some of these individuals,
53:15 and we've studied a number of these, David Brian has studied them in our lab.
53:19 Have what we call calendar lines.
53:21 Here is a woman we studied recently.
53:25 And when I ask any one of you to imagine a calendar in front of you,
53:29 typically most people imagine a rectangular calendar.
53:33 Like a real calendar, January, February, March,
53:35 and then you know, so on and so forth.
53:38 Very vague, nothing very clear.
53:40 It's in your mind's eye.
53:41 These people see a very clearly laid-out,
53:44 three-dimensionally laid-out calendar, always circular, never rectangular,
53:48 and never in the cardinal plane but in the transverse plane,
53:51 like a hula hoop going through their chest.
53:53 January, February, March, April, May...
53:55 Current month always occupies the ego of the calendar.
54:01 You see this repeatedly in different subjects.
54:04 And here's an interesting one that George would like.
54:08 You'll do interesting experiments on them like
54:10 what if you tilt their head like this?
54:12 Does the calendar tilt?
54:14 The answer is no, it stays like a water level, where it is.
54:17 Here is the best part.
54:19 If you ask them to rotate their head like this, what happens to the calendar?
54:24 The calendar's here like a hula hoop.
54:25 Rotate their head like that to the right, what happens to the calendar?
54:28 Calendar, in this particular case, remains attached to the head.
54:31 Sorry, attached to the body.
54:33 It's in sort of...
54:34 Put it crudely, body-centered, not head-centered.
54:37 But the exciting thing is, she noticed that the left side of the calendar
54:41 became fuzzy as she rotated her head, like a real, physical calendar.
54:46 Why in the hell would a mental calendar be like a physical calendar?
54:49 And she said also, she organizes her life, her time and space and calendar,
54:53 using this calendar helps her organize
54:54 her otherwise chaotic and meaningless life.
54:58 And then she looks back and she looks on the other side the opposite happens.
55:02 So she can use this mental calendar
55:04 to organize her daily activities and her future,
55:08 project herself into the future.
55:09 Surely a vital part of what you call the self.
55:12 And not only that, here's what we're testing currently.
55:16 If she does this, memories, episodic memories,
55:19 events that happened in January, February, become fuzzy.
55:21 She has to look there to retrieve memories.
55:24 She's an undergraduate student, I don't think she's read Lekov's book,
55:28 so I don't think she's making it up, but we don't know yet for sure.
55:31 We're testing her.
55:32 Lovely example of embodied cognition,
55:34 her neck muscles are gaining access to memories, episodic memories.
55:39 Now, where is it happening?
55:42 This is what we always do, when we look at peculiar phenomenon,
55:44 to nail it down, show what's going on, so it's a real phenomenon,
55:47 the patient's not making it up,
55:48 and try to figure out what's going on in the brain
55:50 and a possible cure if it requires curing.
55:53 What's going on in the brain?
55:54 Well, I said the angular gyrus must play a critical role in sequence.
55:58 I think it plays a critical role in calendars.
56:00 This can be tested.
56:02 But then, what about hippocampus?
56:04 It's got play cells,
56:06 it's got two kinds of cells involved in spatial and temporal labeling of events.
56:11 And now it turns out, looking at atlases,
56:15 there are direct connections between the angular gyrus and the hippocampus,
56:17 the inferior longitudinal fasciculus.
56:21 And that's shown in the next slide.
56:24 So I'm claiming that the human mental calendar,
56:26 which we take for granted but we use for organizing our lives,
56:29 life would be completely meaningless...
56:30 People usually attribute it to fondle structures.
56:33 I think fondle structures only involve paying
56:34 attention to specific regions of the calendar.
56:36 Calendar itself is constructed by interactions between
56:38 the left angular gyrus and the hippocampus.
56:44 Okay I'll just conclude there by saying that all
56:46 of these problems which are tangentially related to the problem of self,
56:50 how you construct the body image, how you feel a hand cut inside your body,
56:54 embodied cognition, projecting yourself into the future
56:56 and creating a calendar around which your life revolves,
56:59 your problems are considered intractable but we can
57:01 sort of begin to just scratch the surface.
57:03 Thank you.
57:05 (audience applauding)- Hi, my name is Eric.
57:13 So I have a question about synesthesia.
57:15 Sure.
57:16 You mentioned that synesthesia runs in families.
57:18 So there's a genetic factor.
57:20 In your studies, did you notice that the same synesthesia,
57:25 the color-number synesthesia is hereditary, or is it different?
57:30 It's a problem statistically because the most
57:32 common form is number-color or letter, grapheme-color.
57:36 I think there is a tendency for the same form to be inherited,
57:38 but it's not been...
57:39 The only thing we know for sure is if you have one type of synesthesia,
57:42 you're much more likely to have another unrelated type of synesthesia as well.
57:45 Which supports my defective pruning theory.
57:48 The same transcription factors are expressed
57:50 in two different regions in the same brain.
57:53 And you're gonna get two unrelated types of synesthesia co-occurring,
57:55 more often than by chance.
57:57 Are these like functional areas that are sort of...
58:02 The function's kind of fused together?
58:03 To give you an example,
58:05 the number-color synaesthetes are often the ones with the calendar synesthesia.
58:09 And often the ones with tone-color as well.
58:12 They don't always have to occur together but often do,
58:15 or much more often than by chance.
58:17 Thank you.
58:18 Sure.
58:19 I didn't mention about creativity, but I'll get to that later.
58:23 Hi, thanks for a great talk.
58:24 I wanted to say something here a little more about the metaphorical
58:28 views or the anthropomorphism involved with talking
58:31 about the neurons in the brain.
58:33 When you say that an area that normally
58:37 corresponds to an amputated limb or something,
58:39 when you say it's starved for stimulation or it's
58:44 hungry or something like that, so what is that describing?
58:48 Why would a non-stimulated area in the brain
58:52 care whether or not it was stimulated or not?
58:55 So in what sense is there a causal explanation for saying...
58:58 Or the cross-wiring sounds a little more plausible than saying oh
59:04 it's hungry or it's starved or stimulation wants to move around?
59:09 I was just being loose with the terminology.
59:12 Sorry.
59:14 It's a legitimate question.
59:16 I forget the name of that syndrome where somebody wants to have an amputation.
59:21 Xenomelia.
59:22 Xenomelia?
59:23 Yeah.
59:24 Great.
59:25 Just a question of ethics in that regard.
59:30 Before it's not done yet.
59:31 Well but do we mutilate somebody because their heart wants to look differently?
59:37 That's the kind of issue that has come up and have
59:40 you seen some advances in figuring that ethical question out?
59:44 I'm interested in those issues,
59:45 but it doesn't come up in our case because the patient,
59:48 no surgeon will ever do the amputation.
59:50 They have to go across the border to get it done.
59:53 At least in the US.
59:54 At least in the US.
59:55 Thank you.
59:58 Hi.
59:59 Do you have any thoughts of what is going on in schizophrenia, for example?
1:00:04 The self is broken or I don't know how...
1:00:08 Maybe do you have some thoughts about it?
1:00:11 I've thought about it, but not enough to say anything intelligent.
1:00:16 Thank you.
1:00:20 These unexplained thought forms like synesthesia,
1:00:24 any evidence or maybe a feeling of immortality of the soul?
1:00:32 (audience laughing)- It's a question for George.
1:00:40 Quick question.
1:00:41 You didn't wanna touch on, in this talk,
1:00:44 but just a brief background from you on the ancient civilizations of India,
1:00:52 the whole Vedic tantra Agama literature.
1:00:58 How do you connect it yourself with some
1:01:02 of the phenomena that you've talked about today?
1:01:05 There's the metaphysical issues that are being
1:01:06 dealt with in Vedic literature or (mumbles).
1:01:10 In Hebrew literature, in neo-Christian literature which I haven't touched
1:01:14 on because I don't have any expertise in that.
1:01:15 I'm very interested in it, obviously.
1:01:18 The self is something that I can come to grips with, at least partially,
1:01:21 so I focus my attention on that.
1:01:23 But I like sharing this quotation from the Upanishads,
1:01:28 where he says that the individual self, human beings are like windows.
1:01:32 Let the light pass through.
1:01:33 And there's a central light illuminating the building from inside,
1:01:36 which is called (foreign language),
1:01:38 or universal spirit or consciousness or whatever.
1:01:40 When an individual dies, the window shuts,
1:01:43 but the universal spirit continues shining through other windows.
1:01:46 It's a comforting thought but I don't have any deep thoughts about it.
1:01:52 Thank you.
1:01:53 It's a good question, though.
1:01:55 I wondered if you'd done any research on photophobia?
1:01:57 People's feeling pain with regards to color.
1:02:01 I know a couple students who have that.
1:02:02 We haven't studied it.
1:02:04 Fascinating question.
1:02:06 But I can't tell you anything about it.
1:02:08 Like whether pain's...?
1:02:09 Okay.
1:02:10 Thanks.
1:02:12 Hi.
1:02:13 You just briefly mentioned that you hadn't explored creativity in synesthesia,
1:02:17 and I'm just wondering about work done on...
1:02:20 I know with music, different composers
1:02:23 who are very skilled who have synesthesia,
1:02:26 different composers see different colors, like Scriabin and Messiaen.
1:02:31 These composers...
1:02:32 Has there been any research on where
1:02:35 that happens or what's the effect that's going on in the brain and why they each
1:02:39 see different colors with sound and all of that?
1:02:42 Well we can't get that specific, but I do have a theory about why
1:02:44 synesthesia is so much more common among artists,
1:02:46 poets, and novelists, why it promotes artistic talent.
1:02:50 The reason is, I think that the same gene that's expressed selectively
1:02:54 in fusiform gyrus or angular gyrus
1:02:56 producing this quirky association of synesthesia,
1:02:58 if it's expressed throughout the brain,
1:03:01 there's gonna be creative cross-connectivity throughout the brain,
1:03:03 and ideas and concepts are also in far-flung regions of the brain,
1:03:06 like when you say Juliet is the east and Juliet is the sun.
1:03:09 So Juliet is the sun, does that mean she's a glowing ball of fire?
1:03:12 You don't say that.
1:03:13 You say she's warm, she's nurturing, she's radiant like the sun,
1:03:16 she rises in bed like the sun rises in the east.
1:03:19 She's the center of my solar system like
1:03:21 the sun is the center of the solar system.
1:03:22 You can make as many associations as you want.
1:03:25 And these people have excess connections connecting far-flung brain regions,
1:03:29 have a greater propensity to link seemingly unrelated ideas.
1:03:32 And this is what we call artistic creativity or facility in metaphor.
1:03:37 In fact, you can even think to put it in phrenological terms,
1:03:40 each node has a penumbra of meaning,
1:03:44 like Juliet of the sun has a penumbra of meanings associated with it.
1:03:48 And because of the excess connections, the penumbra is bigger in synaesthetes.
1:03:52 There's greater zones of overlap between two seemingly unrelated ideas,
1:03:55 so it makes them more creative.
1:03:57 Hence the higher incidents of...
1:03:59 And hence, by the way, the higher prevalence of synesthesia gene.
1:04:03 Why would one in 50 people have this quirky ability of linking five and red?
1:04:07 Because there's a hidden agenda because the gene makes
1:04:09 the outliers in the population more creative and imaginative in general.
1:04:13 And the penalty you pay for that is the minority
1:04:15 who sees five as red but doesn't do them any harm.
1:04:18 Otherwise there would be no selection process
1:04:20 to maintain this gene in the population,
1:04:21 it would've drifted away a long time ago.
1:04:24 Thank you.
1:04:25 Thank you.
1:04:26 But regarding specific details of colors and all that, we haven't studied that.
1:04:31 It's a good question.
1:04:33 On the same subject of creativity, I'm coming from linguistics like literature,
1:04:39 and I'm trying to bring new findings of neurolinguistics
1:04:46 into how the brain acts and reacts in writing.
1:04:50 And I know a little bit about words
1:04:53 that has to do with visual and kinesthetic and auditorial,
1:04:58 but I wonder if there's something that is written on the subject
1:05:03 of the self seeing itself in words or not seeing, you know?
1:05:09 Did you write anything about it?
1:05:11 'Cause you said you—- There are literatures dealing
1:05:12 with that but I'm not the right person to ask, but it's a good question.
1:05:16 There is literature pertaining to that which
1:05:18 I can't think of it off hand, but...
1:05:22 Okay because the last doctor that you
1:05:25 said that you're not gonna discuss is self-awareness.
1:05:28 And I wonder if there's some passages
1:05:32 there in terms of self-awareness in creativity.
1:05:36 No?
1:05:38 Not that I know of.
1:05:41 I had a question regarding the phantom limb.
1:05:43 Did you try using different mirrors like concave and convex mirrors
1:05:46 and seeing what kind of effect it would have in removing the pain?
1:05:49 Or was it just?
1:05:51 So the types of mirror that you used in the phantom experiment...
1:05:54 Yes.
1:05:55 The only thing we've seen is if you use a magnifying mirror,
1:05:57 the phantom looks bigger, the pain also is amplified, momentarily, fortunately.
1:06:03 So there is a direct correlation in terms of...
1:06:06 Yeah.
1:06:07 Hasn't been studied carefully but appears to be, yeah.
1:06:11 Good question.
1:06:12 Thank you.
1:06:14 So I had a question about the case
1:06:16 of martian colors and the correlation of synesthesia.
1:06:18 So is there a difference between people who develop colorblindness later in life
1:06:22 due to macular degeneration or those who
1:06:24 are colorblind from birth so congenital?
1:06:27 We only studied the ones who are from birth.
1:06:29 Okay, alright thanks.
1:06:30 Two of them, but it's a good question.
1:06:34 I have a question about synesthesia.
1:06:37 You seem to argue in your talk that synesthesia is more inborn, not learned...
1:06:43 Or no?
1:06:44 It doesn't make any sense if synesthesia is inborn.
1:06:46 You're not born with letters of the alphabet and numbers.
1:06:50 Right that's what I'm wondering about.
1:06:51 What I meant to say was the propensity to link
1:06:54 arbitrary shapes like numbers and colors is inborn in some people.
1:06:59 Not that the phenomenon of synesthesia is inborn.
1:07:02 But why would it be always letters and numbers?
1:07:04 And why is always letters or numbers...?
1:07:08 There's a tendency for that region
1:07:10 of the fusiform to represent arbitrary shapes,
1:07:12 and there are rare cases of synesthesia with faces showing colors,
1:07:15 and faces are also in the fusiform gyrus,
1:07:17 as Charlie here has shown many years ago, very elegantly.
1:07:21 Alright, thank you.
1:07:25 Hi, thanks for being here.
1:07:26 Sure.
1:07:27 Two short questions.
1:07:28 One is, you mentioned something about neck muscles
1:07:33 and memory at the very end of your talk and I missed—- What I meant to say was
1:07:38 that in the person with episodic memory who claims,
1:07:40 we're not testing this rigorously by measuring her repeatedly
1:07:43 after a few weeks and a few months,
1:07:45 giving her some striking episodes and not telling her about it,
1:07:48 but if you go by what she's saying, if she looks to the right,
1:07:53 a portion of the calendar is on the left becomes fuzzy,
1:07:57 as it would if it were a real calendar.
1:07:59 She said the memories of those events become
1:08:02 fuzzy too and hard to drudge up in consciousness,
1:08:06 until she turns around and looks directly at the calendar.
1:08:09 So it's helping her to...
1:08:10 That's what I meant with the neck
1:08:11 muscles gaining the access to episodic memories.
1:08:16 That's the extreme version of the hypothesis.
1:08:18 Okay.
1:08:20 Also, what do you think is happening when
1:08:23 someone sees someone getting massaged across the room,
1:08:27 and let's not use the anomalous case,
1:08:30 let's just say anybody, they see somebody getting massaged...
1:08:34 Can they start feeling a little bit better or...
1:08:37 I know you haven't studied that but...
1:08:40 Like what do you think is happening?
1:08:41 Seems to me that because of your afferents,
1:08:43 you know that you're not being massaged, and that kind of silences it.
1:08:45 So I doubt very much you'd experience any benefit from that.
1:08:48 But there are a group of people
1:08:52 who congenitally have some (mumble) of hyper-empathy.
1:08:56 It's claimed by Sarah Blakemore.
1:08:58 I haven't seen subject myself, but I trust her judgment.
1:09:02 So what you're saying may be true of a minority of the population,
1:09:06 20% of the population.
1:09:07 But in the case of phantom limbs, the majority of the phantom limb patients
1:09:10 experience this hyper-empathy syndrome because of the deafferentation.
1:09:15 Okay thank you.
1:09:17 Thank you.
1:09:17 I have a question about the soul.
1:09:20 Okay.
1:09:22 Largely because of you, I got invited to the Gifford Lectures after you came.
1:09:27 And these are the Gifford Lectures on natural theology.
1:09:30 And I couldn't resist putting in stuff on the soul so I said,
1:09:35 look if the soul has to not, to exist after you die,
1:09:40 and goes to heaven, et cetera, or the other place,
1:09:44 then it has to, the question is,
1:09:47 it has to not have anything that is required by a body.
1:09:51 So the question is, what is required by a body?
1:09:54 And if it's required by a body, the soul can't have it.
1:09:56 So you can study the properties of the soul that way.
1:10:01 So can the soul see?
1:10:02 No.
1:10:03 Hence, can't see, doesn't have a visual cortex, et cetera.
1:10:07 Can the soul hear?
1:10:08 Sorry, doesn't have the hearing apparatus for that.
1:10:13 Can the soul feel touch?
1:10:15 No.
1:10:16 Doesn't have the appropriate part of the cortex, et cetera.
1:10:20 And you go through this list.
1:10:22 Can the soul remember?
1:10:24 Doesn't have what is required for memory for that.
1:10:29 And so you go through that, and the next question is,
1:10:32 does the soul have a personality or your personality?
1:10:37 So the question is does personality depend upon the brain in any way?
1:10:43 And this is a question I asked Nina, who knows much better than I do,
1:10:47 and she pointed out that the Phineas
1:10:50 Gage phenomenon would say that it's lost control,
1:10:54 it doesn't have inhibition, et cetera,
1:10:57 sort of like Donald Trump or you know, (laughs).
1:11:03 That's certainly one kind of personality change,
1:11:07 but also there could be larger brain injuries
1:11:09 that could produce sort of positive changes of all sort
1:11:13 and if that's the case then the soul would
1:11:16 not have a fixed personality and therefore not your personality,
1:11:21 so in what case is it your soul?
1:11:25 So the question about personality is something I really wanted to ask you about,
1:11:29 if you've thought about that at all?
1:11:32 Short answer is no, I haven't.
1:11:35 We should chat at length and develop the idea further.
1:11:39 Okay good.
1:11:41 What's it like for a man like you
1:11:43 to be living in what I call deep south California?
1:11:47 It's a strange culture down there that we have no understanding of up here.
1:11:52 No I mean you've lived down there for how many years?
1:11:55 25, 30 years.
1:11:56 25 years, yeah.
1:11:57 It's very surreal.
1:11:59 Ah.
1:12:01 You have a favorite example?
1:12:03 (audience laughing)- I still have to think about it.
1:12:07 (audience applauding) (cheerful music)