Showing posts with label Pleasure. Show all posts
Showing posts with label Pleasure. Show all posts

03 October 2014

Evolution, Depression and Suicide.

Is it possible that "mental illness" is an evolutionary adaptation to prevent us committing suicide when we feel like ending it all? It seems unlikely, but this is the subject of an article tweeted by @sarahdoingthing September 28, 2014.
C A Soper. "Anti-suicide mechanisms as a general evolutionary explanation for common mental disorders". University of Gloucester. [The article appears to be formatted for a publication, but no publication details are included. It's hosted at academia.edu where you can also find my academic work]. 
Since I have a long interest all three subjects (evolution, depression and suicide) I started to try to discuss the article on Twitter, but could not compress my thoughts into 140 characters. So this essay critically examines Soper's approach to evolution. 

Soper argues that (1) "Common mental disorders are too common not to exist for a reason." and that (2) "On this evidence it is reasonable to deduce, as evolutionary psychologists do, that common psychiatric disorders must have their origins in natural selection" and that (3) "When two traits routinely occur together in this way, it is reasonable to infer that a single process is at work behind both, and a mechanism offered to explain one must be flawed if it cannot also explain the other." I want to look at these three underlying claims specifically and consider whether this is credible approach to evolutionary psychology and thus whether the conclusions drawn are valid.


Evolutionary Psychology

The field of evolutionary psychology is the approach of trying to find evolutionary explanations for (i.e. applying the idea of natural selection to) the ways our minds work. If our minds can be shown to work in a particular way, then we assume that this has some evolutionary advantage that has been selected for in the sense that people with this trait are more likely to survive and produce viable offspring. Evolutionary psychologists try to identify what that advantage is or speculate on what it might be. The second prong to this approach is to try to locate genes specifically associated with this function. This has produced the, usually spurious, media syndrome of reporting that "the gene for X has been found". Soper is not concerned with the second approach, only with trying to explain a puzzling phenomenon of the co-morbidity of some well-known problems.

On the whole I find evolutionary psychology a compelling hermeneutic. The idea that traits emerge and are preserved not just in our anatomy, but also in our neuro-anatomy and therefore in our brain function and behaviour, and that this anatomy is determined by our genome, all sounds quite reasonable. Amongst the more credible proponents of this theory include Robin Dunbar, Justin Barrett, and Robert McCauley. Dunbar has cogently argued that behaviours like laughter, singing and dancing helped to lower the time burden of maintaining social relationships (by enabling one to many relationships that replaced one to one grooming in ways not available to our ancestors or to present-day chimps) and made living in larger groups practical after our increased neocortex size made it possible. Larger groups have benefits in terms of protection from predators and thus help individuals in groups to survive. Justin Barrett has argued that our predilection for seeing agency in events makes us alert to being hunted and allows us to avoid becoming food for a predator, but as a side effect also primes us for believing in supernatural agency. And so on. 

Soper's main sources for the evolutionary approach seem to be textbooks specifically related to evolutionary psychiatry. I'm not familiar with these authors or their work so I can't comment on them, though I am surprised not to find reference to more fundamental research on evolutionary psychology in his article.


Mental Disorders and Evolution

Soper's specific claims begin with this: "Common mental disorders are too common not to exist for a reason." By "reason", here, he means for a positive reason. Soper wants to argue that every common trait must, by definition, give us an evolutionary advantage or it wouldn't have survived (which is the most simplistic reading of evolution). But in this he is wrong. For example hair colour and eye colour are common traits and there's no plausible evolutionary advantage to having different coloured hair and eyes. By way of contrast, we know that skin tone is directly related to long term habitation in certain latitudes. If a group lives on the equator for a few thousand years their skin will be darkened by melanin. And if a group lives at 50 degrees north for thousands of years their melanin decreases and they become pale. It's a positive adaptation to the amount of sunlight and vitamin D synthesis and it occurs over relatively short time scales as evolutions goes (and thus is probably epigenetic - a change in gene expression rather than a mutation of a gene). Importantly it makes a mockery of the concept of colour-based race. One must always be alert to other sources of change or variety.  One thinks also of the impact of our microbiome (the sum total of microscopic life that lives in and on our bodies and plays significant and often vital roles).

Think also of the common trait of susceptibility to being infected by viruses. On Soper's logic -- that susceptibility to depression conveys an evolutionary advantage -- our susceptibility to viral infections, such as influenza or ebola, is so common that it must also confer some evolutionary advantage. Viruses exploit vulnerabilities in surface features of our cells that evolved for other reasons. For example sperm use a similar mechanism to deliver their DNA to an ovum. These diseases are virulent and indiscriminate. Before modern medicine an influenza outbreak could kill millions of people. The 1918 influenza pandemic which killed 50-100 million people worldwide is a good example. And influenza is constantly mutating so that there is no immunity conferred from having had the disease once. The best evolutionary argument might be that such diseases weed out the weaker members of the species: i.e. that influenza is natural selection in action. This has the indirect advantage of allowing stronger members to live with less competition. In the simple version of evolution, then, we have positively evolved to allow weak members of our species to be eliminated by disease, though I don't find this a compelling argument and this the opposite of what Soper is arguing for depression. Unlike viral disease which reduces competition by killing weaker members of the species, Soper is arguing that mental illness, specifically depression, prevents those who are susceptible to suicidal ideation from actually committing suicide. Thus it acts to preserve people who carry a trait that in the cold light of day makes them less fit in an evolutionary sense (and I say this as a life-long sufferer of depression). On the face of it Soper is describing anti-evolution.

As already suggested Soper makes an extraordinary assumption in his view of evolution. He assumes that evolution is the only force at work on our mental states. Another aspect of our history he takes no account of is the massive changes that began to occur ca 12000 years ago as our ancestors began to form stable settlements: i.e. civilisation. As Robin Dunbar points out (Human Evolution) for primates being in large groups of strangers is stressful. Of course we find ways of coping with that stress - clear evidence of alcohol use begins around the same time as large scale settlements in Anatolia. 12,000 years is enough time for our skin to change the levels of melanin produced, but it is not enough time for major changes to the genome, especially under the kind of NeoDarwinian paradigm that Soper unquestioningly adopts. Dunbar, again, notes that we are evolved to live in groups of ca 150 with progressively weaker links to units of ca. 500 and ca. 1500. just as present day hunter-gathers still live. Limits are imposed on group size by the amount of neocortex in the brain which has not changed significantly in the last 200,000 years since anatomically modern humans first emerged in East Africa. We cannot keep track of more than 150 relationships (on average) and groups considerably larger lose coherence. Indeed in present day hunter gatherer society most groups spend the night in groups of about 50 that have close links (often by marriage) to two other groups of 50. City dwellers are forced to adapt to their situation by adjusting how much time they spend on the different layers of their social structure (generally more time spent with less people), but the average number of Facebook "friends" is still ca. 150.

Thus simply living in settlements creates enormous stresses on humans that no other primate has ever faced. Since civilisation brings many changes in terms of how we spend our time (eps. work) and what we eat (esp. the gross over-availability of calorie rich foods) it is clearly one of the most important factors in considering the health, mental or otherwise of modern humans. In many ways one could argue that we are not well adapted to modern life - slumped over a keyboard developing bad posture, carpal-tunnel-syndrome and occupational overuse syndrome, while gorging on foods laden with fat, salt and sugar so that we overflow the poorly designed chairs we sit on for most of our sedentary day is hardly an advert for evolution. If anything many of us are not evolutionarily fit for this environment and increasing numbers are having civilisation-related or "life-style" illnesses like coronary heart disease, type II diabetes, etc. 

One of the strengths of Professor Robin Dunbar's work is his ability to compare his results with other primates and to extract evidence from fossilised remains. It allows him to take a genuinely evolutionary view of the traits he is examining by showing how things have changed over time. When we only examine modern humans, have no reliable data for change over a time scale beyond ca. 50 years, and have little reliable data from outside Europe and America the method is very much weaker. Soper presents no data from other primates on mental illness and suicide for example. I suspect that this is because there is none. Animals don't, on the whole, deliberately kill themselves though they do show analogues of some kinds of mental illness and are susceptible to addiction (at least in laboratories). 

The first challenge of any evolutionary study of suicide is to try to determine when humans began to kill themselves. And of course it's impossible to tell because the kind of evidence we need is unavailable. So the theory that we evolved this behaviour is already on very shaky ground. There is no history, no fossil record, none of the evidence over time that is crucial to all evolutionary arguments. The second challenge is to explain why humans do and other primates do not kill themselves. No explanation is presented for this either, except that Soper simply states that it must have an evolved in humans. Indeed he treats present rates of suicide as evidence of suicidality as part of "human nature". Now there is a slippery concept if ever there was one: human nature. It's entirely out of place in a scientific article. And the idea that present data represent historical data is simply mistaken. All we know for sure is that there are some ancient literary records of suicide (see my article Suicide as a Response to Suffering for a survey of suicide in the Pāli texts; where, coincidently, alcohol is described as leading to madness). We can associate suicide with settled human culture, for a few thousand years, but there is no evidence whatever for the evolution of suicide, it's simply an assumption that everything evolved because in the paradigm every trait is the positive result of evolution. 

"Other addictive, obsessive and compulsive behaviours may function as dis-tractions, effectively keep-ing a person in danger of suicide mentally and physically preoccupied.

Depression may be understood equally as a means to incapacitate a potentially suicidal indivi-dual:" (Soper p.2)
Soper cites a number of opinions on suicide and its aetiology, but noticeably absent is the monumental, if a little dated, study of suicide by Durkheim. One of Durkheim's main points is that suicide seems to be strongly associated with social isolation. This jibes well with other evolutionary psychology authors. As social animals we thrive if and only if we are part of a thriving community. Modern humans evolved for participation in a community of ca. 150 people. In fact we moderns frequently live in massive conglomerations of hundreds of thousands, if not millions, of people almost all of whom are strangers. Modern life allows a sizeable minority to become isolated and alienated from society. Many moderns live in social isolation to some degree. We're surrounded by strangers and have none of the intimate exchanges that bond primate groups, not even the sublimated activities of laughing, singing, dancing or praying together (cf Dunbar). What the effects of this have been over the long term, we are only just beginning to understand. Clearly some thrive in this new configuration, but some do not. And those who do not, I would argue, are those who develop so-called mental illness. Of course there are other, often organic, causes of mental illness as well and this is not a causal argument yet, but highlighting a correlation that begs to be investigated. Importantly, there is no unitary phenomenon here that can be ascribed to a single simple cause. Not even the depression that Soper focusses on has a singular aetiology. But Durkheim's original observations on suicide seem to stand up. 

Soper argues that (3) "When two traits routinely occur together in this way, it is reasonable to infer that a single process is at work behind both..." By two traits here, Soper is specifically referring to addiction and depression. His solution is argue that depression, with its associated lethargy, contributes to suppression of the suicidal ideation that occurs in the addict. This assumption appears to stem from his conclusion, not the other way around. He also flirts with the fallacy that correlation indicates causation. Certainly a strong correlation is interesting and deserves further study, but I doubt it is reasonable to infer from the outset that a common mechanism is at work when there's no common mechanism for depression in it's various forms nor one for suicide.

Importantly Soper presents a caricature of depression as involving lethargy. But he does not account for the phenomenon of depression associated with irritability and anger that is common, but under-reported and poorly understood, in men. Cf. Irritability, Anger Indicators of Complex, Severe Depression; or Depression & Men. Indeed the popular media representation of depression often focusses on women who have a big collapse, can't get out of bed for 6 months and then recover. That's not typical of depressed men, nor for the people who suffer repeated bouts of major depression or those who suffer long-term depression. The different aetiology of depression in men may be why men are twice as likely (15 per 100k) than women (8 per 100k) to commit suicide (WHO). Some will say that men need to talk about their problems more, but this is a simplistic and unhelpful generalisation. I've commented on this elsewhere so won't say more here. But if a supposedly singular problem is characterised by at least two unrelated traits (lethargy or anger), manifests differently in the sexes, and can be acute or chronic, then we've most likely been too superficial in our explanation and need to look more deeply. There's no one problem called "depression".

One of the most important and productive ways of looking at depression is to see the popular "chemical imbalance" explanation as having a behavioural cause. Over-stimulation of various brain mechanisms leads to problems. Constant anxiety—with activation of flight-or-fight response—can lead to lethargy and unresponsiveness, both characteristics of depression (I first experimented with this by examining the fight-or-flight response of earthworms more than 30 years ago for a high-school science class). Over-stimulation of pleasure mechanisms (through drugs, porn, eating, etc.) leads to an inability to experience pleasure—both through endorphin mediated pleasure/well-being, and through dopamine mediated anticipation and reward—also characteristic of depression. I can offer no explanation of the anger or rage felt by depressed men as yet.

One observable result is consistently lower serotonin levels in depressed people. But even after many decades there is no evidence for a causal relationship between serotonin (a hormone that has multiple roles in the body) and depression. Indeed the fact that antidepressants raise serotonin levels almost immediately, but (when they do work) take two to four weeks to lift mood, suggests something far more complex is going on.

Soper is also interested in the co-morbidity of depression and addiction. Robin Dunbar makes an interesting aside in Human Evolution. Alcoholics do not become addicted to alcohol per se, they become addicted to the endorphins that alcohol stimulates. Endorphins are one of the primary hormones produced in primates by mutual grooming and produce the sense of well being and contentment that comes from being a well established group member. Laughing, singing, and dancing in groups have the same hormonal effect. We're 30 times more likely to laugh at a comedy in a group than we are alone. This is consistent with the neuroanatomy of pleasure that I outlined in The Science of Pleasure, based largely on a book called The compass of Pleasure by David Linden (well reviewed here). See also my 2013 essay Pleasure, Desire and Buddhism

Addicts, according to David J Linden's recent account of addiction, overstimulate the part of their brain that is also responsible for the feelings of well-being associated with positive social interactions. Addicts who over-stimulate this function, progressively become unable to experience that feeling of well being, or only associate it with their drug of choice (the exception being nicotine addicts who use the frequent but weak stimulation of smoking as a way of bonding). There are in fact at least two mechanisms working in tandem: addicts gradually become less able to experience well-being and/or pleasure in the absence of their drug; and they make poor decisions and become unreliable as a result of the effects of the drug and thus become socially isolated. All too often drug abuse is initiated by some lingering unhappiness or dissatisfaction that might have led to, or already caused, depression anyway. The obvious example is that abuse and neglect in their various forms, especially at crucial developmental stages, can leave people vulnerable to depression.

By Robin Dunbar's argument, social alcohol use persists, despite the risk of addiction in some people, because it plays an important role in allowing us to operate in larger groups than we would otherwise have time for (with all the benefits that large groups provide). Disinhibition makes for fun, laughter, singing and other promoters of a sense of well-being and communality. This is not natural selection in the usual sense, in that we are not genetically programmed to make and consume ethanol, but it is natural selection in that societies which used alcohol to enhance social bonding seem to have prospered.

These mechanisms that mediate the experience of pleasure, well-being, and anticipation and reward clearly have evolved and we know them in quite a lot of detail now: which areas of the brain are involved, when those areas evolved, which neurotransmitters are involved and the more generalised impact of disrupting these mechanisms. Any evolutionary approach to mood disorders or addiction really needs to get to grips with these mechanisms and show how they are involved, preferably by citing clinical evidence, just as Dunbar and Linden do and Soper does not.

Soper speculates that addiction might "distract" the person from acting on suicidal impulses. Some addicts use substances in an attempt to control how they feel, to compensate for the lack of pleasure or reward or to suppress feelings of shame or anger. But is this really an evolutionary argument? Does our potential to abuse substances really convey an advantage? In the end the substance of choice in addiction is often the means of suicide (albeit slowly), just as many depressives over-dose on their anti-depressant medication. Is the alcoholic who does not commit suicide, but whose behaviour causes the breakdown of supportive familial and working relationships, and who suffers liver and brain damage really ahead on points? The deleterious effects of drugs during pregnancy are so severe (e.g. Fetal Alcohol Syndrome) that they must surely outweigh any perceived advantage from merely being alive to pass on one's genes. Soper's argument here is facile at best.  


Conclusion

Soper's key claim is that the lethargy commonly associated with depression acts as a defence against suicidal ideation. Maybe. But we also know that people with depression are far more likely to commit suicide that people without it. So if it is a mechanism, it's not a very good one. One suicide prevention website reckons that [in the USA] "15% of those who are clinically depressed die by suicide." and "The strongest risk factor for suicide is depression." (Save) Suicidal ideation and impulses are one of the most common features of the experience of depression.

Suicide is a terrible problem. It is the fifteenth most common cause of death worldwide (WHO). Depression is a leading cause of suicide (and to date I think it is under estimated because of the failure to fully recognise how it affects men). When someone kills themselves their family and friends are often left shocked, sad and angry. Suicide often seems like a betrayal. On top of everything, people are angry because the suicide has broken off the relationship, has not reached out, has not apparently reciprocated the love they feel. Death is never easy, but to most people suicide seems so preventable because it involves a conscious choice. As @sarahdoingthing says it's hard to understand because it is sui generis (self generated). How do the living empathise with the wish to be dead? Mostly they do not. The difficulty is to see how the choice is made by a disordered mind in a person who has frequently lost the ability to experience a sense of connection and does not have the perspective to see that the situation is temporary. Depression feels like solitary confinement.

Because it's so difficult to imagine what depression or addiction is like, most people who have not experienced it find they cannot empathise easily with sufferers. Very often the problems are ascribed to personal weakness such as a "weak will" or a moral failing (an example of the fundamental attribution fallacy). This can have the effect of increasing the social isolation of the person afflicted with depression. This is part of the stigma of mental illness.

The best thing you can offer someone who suffers is to listen to them without judgement and deal with your own discomfort discreetly. Whatever you do, don't offer unsolicited advice. If you're concerned about someone's safety encourage them to seek professional help. If you feel certain someone will harm themselves take whatever action you feel appropriate, but don't expect to be thanked (at least not right away).

In any case we need to be careful when constructing arguments based on evolution. It is no doubt a powerful and at present fashionable explanatory framework. There's no doubt in my mind that we evolved into our present form. But modern humans are unusual in the animal world in having the ability to over-ride evolution using culture and civilisation. While our genes are the blueprint for our neuro-anatomy, experience is a powerful shaper (both literally and figuratively) of the brain.

Without clear evidence of change over time evolution is a weak explanation. It may well be the explanation, but we cannot show why. Sometimes a trait has an obvious evolutionary advantage - language, mentalising, and laughter all provide demonstrable advantages and fit well with other areas of the theory. The potential to suppress suicidal impulses might confer an advantage, or it might have a deleterious effect on the population. Who is to say that suicide is not an instrument of natural selection? How do we weigh up the costs and benefits in these complex problems? I find no answer in Soper's article.

Even though we can identify commonalities depression and addiction likewise have multiple causes. When combining traits with many causes we multiply the complexity. Seeking unitary causes for complex problems is understandable, but often leads to fallacious thinking. Seeking a single generalised evolutionary explanation in terms of conferred advantage looks ideological. And in this case the premise looks flawed at best. So the interpretation of the data is unlikely to be trustworthy. For all these reasons I find Soper's theory unconvincing. Scarily, Soper is already making suggestions on implications for therapy as though his theory was sound. 

~~oOo~~


Bibliography

Barrett, J.L. (2004) Why Would Anyone Believe in God? Walnut Creek, CA: AltaMira Press.

Dunbar, R.I.M. (1992). 'Neocortex size as a constraint on group size in primates.' Journal of Human Evolution 22 (6): 469–493. doi:10.1016/0047-2484(92)90081-J 

Dunbar, Robin. (2014) Human Evolution: a Pelican Introduction. Pelican.

Durkheim, Emile. (1897) Suicide : a study in sociology. The Free Press, 1951.

Jayarava. (2004) 'Suicide as a Response to Suffering.' Western Buddhist Review.

Linden, David J. (2011) The Compass of Pleasure: How Our Brains Make Fatty Foods, Orgasm, Exercise, Marijuana, Generosity, Vodka, Learning, and Gambling Feel So Good. Viking.

C A Soper. "Anti-suicide mechanisms as a general evolutionary explanation for common mental disorders". University of Gloucester.

31 May 2013

Pornography, Desire, and Buddhism

Pornography is much in the news in the UK at the moment as various authorities try to figure out how to respond to the problem of exposing young children to graphic sexual images. When I was a youngster porn was relatively hard to get access to, and relatively benign - pictures of naked or semi-naked women. Today the internet delivers all kinds of sexual imagery to our screens, some of it involving violence. But the other thing that happened recently that made me want to try to write something about it, was a naive post in a Buddhist forum asking if porn was "OK for Buddhists".

I can only write about this from a heterosexual man's point of view. No doubt there are things to say from other points of view and I don't mean to exclude or downplay those other points of view. But it's easier for me to write if I'm able to tap into my own experience. If you have a different view then feel free to add to the picture in a comment. 

The first thing to say is that pornography is an industry. It has long roots. William Blake complains about sexually explicit engravings on sale in London in the early 1800s. Being an industry, the primary purpose of pornography is to make money. And it is reportedly a very successful way of making money. This fact alone ought to give us pause for thought. 

I've written about pleasure before - see particularly The Science of Pleasure. In many ways sexual pleasure is no different from other forms of pleasure. On the other hand we all know it's much more loaded. Sex involves other people (real or imaginary) and thus it partakes of relationship dynamics. Some will characterise relationship dynamics purely in terms of power, but I'm wary of this post-modern analysis. Certainly issues of power and status come into play in relationships, but relating is about more than this as well. 

Being like other pleasures, sex has a similar dynamic. Sensual stimulation produces a response which involves many bodily systems. We experience appetite, anticipation and arousal, seeking out, engaging, and satiation. All of these stages produce particular kinds of pleasure. However if we seek pleasure as an end in itself, if we short circuit the process, then we find we get diminishing returns. If for example we over-ride a lack of appetite and just have sex for pleasure, we will, generally speaking, enjoy it less. If we do this frequently and habitually, we will get diminishing returns. Similarly if we ignore signs of satiation and go back for more. As with eating, there are many motivations for having sex: procreation, intimacy, pleasure, loneliness, seeking favours, financial gain, etc. Stimulated we become sexually aroused. The problems, if there are problems, relate to seeking out stimulus in order to experience the pleasure of orgasm. 

The naive post I referred to above spoke about having a high sex-drive and using porn to self-stimulate in order to facilitate masturbation. I believe this person has fallen into a false view. Firstly the purpose of viewing pornography is to stimulate sexual desire. It may or may not be present to start with, but my guess is that with most men it's often absent. So this person who regularly views pornography claims to have a high-sex drive. My response is to wonder how much sex drive he might have if he stopped chronically stimulating himself with pornography. I asked are you masturbating in response to sexual arousal, and porn is just an adjunct to that process; or are you using pornography to stimulate arousal in order to masturbate and achieve orgasm. My hunch is that he views pornography with a view to achieving orgasm when he is not in fact sexually aroused to begin with. And this I think is neurotic or potentially harmful. 

Responding to bodily appetites is not a problem. We breath, eat, and have sex, all other things being equal, because we are responding to natural urges. I've argued on several occasions, however, that we no longer live in the natural surroundings to which our genes are accustomed. We're furnished with drives optimised for scarcity, but live in abundance (at least in the developed world). Thus the characteristic health problems of our societies are not communicable diseases on the whole, but problems brought on by over indulging in salt, fat and sugar, along with problems caused by synthetic chemicals. And also problems associated with not coping with our environment - stress related anxiety, depression, and other neuroses. Our main problem in the developed world, in other words, is lifestyle. The main thing we could do something about is our lifestyle. And yet our societies are characterised by the pursuit of increasingly empty and unsatisfying lifestyles. 

And thus it is with sex. Where food is concerned "we" (meaning we in the developed world generally) have become obsessed with eating vast quantities of food, laden with ingredients that give us the most intense experience of eating: fat, sugar, salt, and chilli. We crave more and more intense experiences because we keep over-riding our appetites and eat for reasons other than staying alive. And it is making us sick. In the case of sex, for men in any case, we turn increasingly to porn. And to more extreme forms of porn. More or less any sexual act you can imagine is available as a video on the internet. These days you don't really even need to pay. But pay men do. And pay and pay. 

Because feminists have identified the pornography industry as a battleground we are probably all aware of the arguments against pornography from a feminist perspective. Porn objectivises and degrades women. Women are exploited by the porn industry. I've just been listening to a teacher on the radio describing the effects on relationships between teenage boys and girls at her school and how she thinks porn has degraded those relationships. This is understandable because teenage boys are consuming vast amounts of porn. By the time they come to relate to flesh and blood girls and boys as potential sexual partners their sexual appetites are so dull as to require extraordinary stimulation to feel anything. They are so used to over-riding their natural sexual urges that they probably wouldn't recognise sexual attraction if it bit them. Research has shown that daily porn use can result in impotence - in other words men can become unable to become sexually aroused with real sexual partners because they've inadvertently set their own arousal threshold so high by hyperstimulating themselves with pornography. This is probably an exaggeration. No doubt there is a range of behaviour and responses to the availability of internet porn. But still the impact of boys using porn is quite negative, both on themselves and their partners. Girls in particular are often rushed into more risky sexual behaviour than they are comfortable with because the boys can't respond to anything else. Girls get treated like objects. It's not helping with issues that they already are socialised into. With young gay men, the potential for a positive feedback loop is frightening to contemplate.

Why do men consume porn? As far as I can tell, it seems that men respond to images more than women. No doubt some women do like porn, but the vast majority of consumers are men. Looking at women's bodies is arousing for hetero men. I can't even describe it. I just respond. As I would respond to music. It's an aesthetic response as much as a sexual one. I find women beautiful and attractive. Not in an overpowering way, not in a way that I can't control, but certainly in an unconscious and unmediated way. And men can get sexually aroused looking at pictures. It's an interesting fact taken in isolation - the unmediated response to certain visual cues resulting in arousal (I'm sure it's been studied).

Getting aroused and coming is some of the most fun a man can have. So there's not much point in telling every one that porn is just bad when it's aimed at getting aroused and coming. It's like drugs. If someone tells me that drugs are totally bad, I know they haven't tried them. Drugs are fun. Especially when you're young and resilient. But they have a down side. And young people are less good at evaluating risk, or assessing long term consequences. I think honesty is important when criticising these things. Boys look at porn mainly out of curiosity and fascination with women. Men consume porn in order to become sexually aroused and have an orgasm. We do it for the fun of it; out of loneliness or boredom; out of habit; as a way of sublimating desire etc. Maybe we retain a measure of fascination with women. 

And so although women are degraded by porn, men are too. Men are targeted by porn makers precisely because we respond to the product and are willing to pay for it. Like other stimulants it's a profitable product because of diminishing returns the demand for it stays high. We soon stop responding to one image. If we want to be aroused we have to get a new one. This is because in looking at pictures we are to some extent over-riding our lack of arousal. If we use that artificially stimulated arousal to achieve orgasm we're actually worse off. The pursuit of pleasure is like an addiction in many ways, particularly in the way we build up tolerance. Men (collectively) spend a fortune on porn. The answer would be to just relax and experience whatever it is that we are experiencing. But for most adults there's an uncomfortable period of cold turkey that produces some terrible cravings to fill the gaps left by not pursuing pleasure. It's not simply sex, but all of the areas in which we are over-stimulated. 

A further problem is that pornography exists in a context. Every other product we see has a female model attached to it. Women's products and services as much as men's (which I don't really understand). Advertising is ubiquitous and very often overtly sexual. Our films and television have joined in with the zeitgeist of displaying sex more openly. In the UK we have a great comedian, Reginald D Hunter, originally from South Georgia, USA. One of the things he says he likes about the UK is that "women dress like hookers on the weekend". Or in other words many young women are choosing to express themselves by dressing in sexually provocative clothing. This is portrayed as empowering for women, though I find it hard to imagine how being a hooker is empowering. I suspect is that it has more to do with creating desire in men, and the sense of power that comes with that, than expressing liberation in women. And men are much less responsive these days precisely because they use porn, so young women out to attract men have started to dress like porn stars and prostitutes. I find it quite disturbing. I'm an advocate of a gentle modesty - for men and women. I don't feel comfortable in a world where everything is sexualized. I have interests other than sex. When everything is sexualized it drowns out other aspects of human relationships (it's like pouring corn syrup on everything until you can't taste anything but sweet). 

I'm not convinced that having sex in public is quite the same thing as being more open about sex. It is certainly a good thing that we are more open about sex. After all sex is only natural and everyone does it, and my parents generation (and their parents) were woefully ignorant of sex and their bodies. But there's nothing natural about the sex in adverts, on TV, in the movies and in porn. What some people in the UK fear is that young people are growing up to think that the sex they see in the media is in some way natural. That left to their own devices people have sex like porn stars. 

I haven't mentioned Buddhism much because I'm wary of those people who proclaim "a Buddhist view on X". I don't think there is "a Buddhist view" on pornography. There are the views of Buddhists, and my views are certainly informed by 20 years of Buddhist practice and study. So this is more like the view of a Buddhist, than a Buddhist view. 

My approach to porn is informed by what I understand to be the nature of experience, especially with respect to the pursuit of pleasure. I don't get it so much now, but people often used to ask me "are Buddhists allowed to do X". My response was usually that Buddhism has no rules as such, it's just that we have to live with the consequences of our actions and as Buddhists we do try to pay attention to those consequences. I don't want to be preaching "porn is bad" because I think people just switch off to that kind of narrative, but porn has consequences. Personal consequences, and social consequences. I understand men's attraction to porn, and I've given some thought to the various issues involved. 

Obviously one Buddhist saying 'porn will screw you up' is not going to sink a multi-billion dollar multinational industry whose consumers are often addicted (more or less). Just as the tobacco industry continues to make profits in the developed world despite our certain and widely disseminated knowledge that smoking causes diseases of various kinds, including many which leave the smoker maimed or dead. 

What I will say, is that many of our personal and societal problems come down to lifestyle. They are not genetic or environmental per se, but down to choices we make. In theory we could all just choose to live a better way. But in practice there are constant forces trying to distract us from thinking clearly; trying to hyperstimulate our desires; and generally keeping us ignorant. It is so difficult to know what is best. We live in a cacophony of lifestyle advice, most of which is produced by sincere but equally confused people.

We are very much in the position of the Kālāmas who could not make out who was telling the truth about how to live. And the Buddha's advice might be summed up as "pay attention to what is happening". Interestingly one of my secular guru's Marshall McLuhan said just this: 
There is absolutely no inevitability as long as there is a willingness to contemplate what is happening. 
The question is do we have the courage let alone the willingness? And do we have compassion when we honestly answer "no"?

~~oOo~~

26 August 2011

The Science of Pleasure

dopamine

dopamine
MOST BUDDHISTS AND MANY NON-BUDDHISTS would not be surprised by statements along the lines that desire and craving are what cause us to suffer. The message is repeated throughout Buddhist literature, both canonical and commentarial. But what is it about desire and pleasure that is problematic? I want to approach this via an overview, culled from many different sources, of the neuro- and evolutionary biology of pleasure.

The feeling of pleasure is associated with activity in a surprisingly large number of areas of the brain with no one area alone that is responsible. This may be because pleasure itself is a complex phenomenon, and it is tied into so many other functions. But we know that pleasure is correlated with dopamine and a group of endogenous (made in the body) opioid compounds known as endorphins and encephalins.

Dopamine, again, is involved in all kinds of brain and gut activity, but it is particularly correlated with such activities as determining the desirability of an object or stimulus; with anticipation and enjoyment of rewards, with alertness or arousal, and motivation. Although clearly involved in these functions dopamine is also implicated in the experience of pain and fear as well. It seems that the same physical mechanisms may be involved in both cases. Research has found that those with more hunger for stimulation, including drug addicts, have higher dopamine levels than those with less. Dopamine levels rise in anticipation of a reward.

The opioid compounds are associated with feelings of pleasure, satiation and well being. Exogenous opioids (those not produced by the body) include the various chemicals found in the juice of the opium poppy: heroin, morphine, codeine; and there are also synthetic opioids like methadone, and pethidine. Opioids are involved in the pain response, so exogenous and synthetic opioids find use an painkillers, with morphine being the strongest known pain relief drug. Most people will know that activities like sex, vigorous exercise, and even singing in groups, stimulate the production of endogenous opioids and these are thought to account for the feelings of well being engendered by these activities. Incidentally, this is probably why chanting together in groups usually leaves us with a feeling of well being, and can be ecstatic.

There are certain features of the physical side of these systems—the chemicals, synapses, receptors etc—that are salient to a discussion of the problems of pleasure. Consider heroin (I was going to write "Take heroin", but realised this might be read as an imperative!). I recently enjoyed Keith Richard's memoir, where amongst other things he describes the process of becoming addicted to heroin and getting off it. Most people find that over time they have to increase the dose this drug to get the same effect. Humans beings build up a tolerance to heroin. What happens at the level of the neuron is that a cell reaches a threshold of excitation through incoming signals coming in via it's dendrites, and discharges through it's axon - thereby exciting the dendrites of other neurons. Reaching this potential always takes a little time, and after the discharge it takes time to recharge. What happens in the synapse is that as the signal reaches the end of the fibre special organelles release neurotransmitter chemical into the gap of the synapse. These travel across the gap and bind with receptor organelles on the dendrite of the receiving neuron. The synapse also has organelles for mopping up stray molecules, and this helps to reboot the synapse ready for the next signal.

In the every day business of the neuron it seldom exceeds its operating tolerances, and has plenty of time to recharge, and to mop up after every discharge. But with intense or repeated stimulation the neuron cannot keep up. And as the individual neurons cannot keep up, the system its forms a part of cannot keep up. So for instance if we flood our blood stream with heroin which binds to all the receptors for endorphins, we get a rush of pleasure. But if we keep doing this the feedback mechanisms which moderate the production of endorphin shut down, because they assume they are not needed. This renders the heroin addict incapable of feeling pleasure or well being without their drug. And when you go cold turkey, as Keef gives heart rending testament to, you go through a period of 72 hours of hell as the body takes this long to restart endorphin production for itself. The acute lack of endorphin leads leads to vomiting, incontinence, shaking, sweating, and global bodily pain.

Of course our brain chemistry is usually operating on more subtle levels than the heroin addict. Isn't it? Not necessarily. Consider that the pleasure we feel is related to endogenous opioids. Living as we do we are exposed to a lot of intense stimulation: refined sugars and fats are not unlike heroin in terms of the neurochemistry: a huge dose of sugar and/or fat overloads our ability to deal with the stimulus and can crash the system. Repeated doses make it difficult for user to experience pleasure when eating ordinary food.

A little fact I picked up recent from the Science Blog, is that men who use pornography on a daily basis often develop erectile dysfunction. The problem appears to be related to overloading the pleasure response - the anticipation of orgasm, the intense stimulation of pornography create a situation where lesser stimuli do not lead to arousal (which is also mediated by dopamine). Following the links on this I discovered that researchers have found that having sex more often with a partner leads to losing interest in them more quickly. This usually leads either to moving on or infidelity, since the new partner freshly excites arousal (for a time); or it leads to interest in more and more intense, not to say extreme, forms of stimulation. Users of pornography often find themselves trapped in the same kind of cycle as the heroin addict - it takes more and more to get the effect you seek, and lesser pleasures lose their savour.

So what have we learned? It seems that seeking out pleasurable experiences produces diminishing returns, and the pleasure response has a natural level beyond which it cannot respond. The pursuit of pleasure is self defeating. This should be no surprise to anyone that has opened a packet of [insert name of favourite comfort food] and just kept eating. But if it is no surprise then how come we can't stop? More or less everyone I know indulges in some kind of pleasure seeking behaviour which has no other goal than to experience pleasure, be it the stimulant effects of caffeine, the 'rush' (and crash) of sugar, or the excitement of driving fast. Even the bliss of meditation can be addictive. Why is it that we do these things in the full knowledge that we'd be better off if we didn't?

I argued before that these urges are biological, evolutionary adaptations. It seems that these systems are not entirely or easily under our direct conscious control. Dieting is hard because confronted by high calorie food we naturally desire it (elevated dopamine) and we get so much pleasure from eating it that it seems a little puritanical to deprive ourselves. But it's even more difficult if we've spent a lifetime training our bodies to expect to get that pleasure, and habituating it to higher levels of stimulation. The sense of anticipation (again dopamine) overwhelms our conscious decision to lay off the chocolate biscuits (or whatever); and since we no longer feel truly satiated without the intensity of refined sugar and fat, then we don't feel satisfied till we've had it. Our pleasure response is tuned so high that we simply don't enjoy anything less.

Of course for most of us this is not a runaway process - we don't gradually build up our sugar intake over time, or have sex increasingly often. But for some it is. In the days before medical ethics committees a man had a wire implanted in his brain that stimulated pleasure. He ended up self-stimulating to such an extent that he lost interest in all other activities including eating! He would have died if the experimenters did not disconnect him, and complained when they did. It is also possible that the mystery of falling fertility rates in the Western World is simply due to the increasing availability, intensity and use of pornography depleting the reserves of sperm (it takes more than a day to replenish them). Look also at the way the media has changed in the last 50 years with increasing use of anger, violence, and sex to 'spice shows up'. We think of this as related to more liberal attitudes, but what if the driver is that we have slowly become less able to respond to more subtle forms of entertainment? It does seem that even if we as individuals manage to find some kind of equilibrium, that over generations the ability to indulge our desires is causing us to be fatter and to seek more and more extreme forms of stimulation and entertainment. Pushing the envelope can lead to experiencing new pleasures - just as someone bored with a partner can find a new person exciting (for a time). But once we start pushing the envelope, the returns diminish, and we feel the need to keep pushing. We are probably moving along the axis in the wrong direction and should be thinking in terms of less extreme forms of stimulation, indulged in less often, in order to maximise pleasure and satisfaction.

So the picture that is emerging from neuroscience and evolutionary biology is one which leads us towards conclusions that are not new. Find pleasure in what you are doing, don't do things only for pleasure. Moderation is a virtue, and abstinence does make the heart grow fonder. Spacing out intense stimulation - whether food, sex, TV, movies, drugs, or whatever - gives the body time to reset and allows us to feel pleasure more easily, more naturally. Cutting down on strong stimulation allows us to appreciate more subtle experiences.

Satisfying natural urges is probably not a bad thing, but we need to recall that we have not lived in 'natural' circumstances for something like 10,000 years (since the dawn of agriculture and civilisation). People often cite the middle way as justification for their indulgence, and I like to remind them of what the early Buddhists considered the middle way in terms of lifestyle: no family, no job, one meal a day, no possessions, no sex, several hours of meditation etc. So, what is natural? In fact most of us could do with drastically reigning in our desires and impulses and the language of early Buddhist ethics begins to seem highly relevant again. The Buddha reportedly said:
nāhaṃ, bhikkhave, aññāṃ ekadhammaṃ pi samanupassāmi yaṃ evaṃ adantaṃ, aguttaṃ, arakkhitaṃ asaṃvutaṃ, mahatp anatthāya saṃvattatīti yathayidaṃ, bhikkave, citta.

I do not see any other single thing, monks, which left untamed, unguarded, unprotected, unrestrained, leads to so much misfortune: i.e. the mind [citta].
And though this kind of thinking is deeply unfashionable these days, in light of the research I've been exploring it starts to make a new kind of sense. Guarding the gates of the senses seems more important than ever.

~~oOo~~