Greg Wu

I’ll Be There for You

by Kiara Mehta

art by Laura Zang

Who is your best friend? Perhaps it is someone you met years ago from your hometown or simply someone you met this year in school, at your job, or enjoying a hobby. Think about how you established a friendship with this person and how much they impact your life. Did your relationship come naturally? Does it feel as though your friend makes up an essential part of who you are? Can you imagine your life without this person? While these questions might not be the first that come to mind when you think of your best friend, they are the basis of what allows us to understand why we chose to be friends with certain individuals and how they impact who we are. Making friends and establishing relationships is a fundamental human behavior affected by multiple factors, including culture, age, interests, etc. The human brain, among these, resides as an equal, if not more influential, part of who we seek to call our friends. The human brain plays a part in not only who we choose to establish friendships with, but how our friends shape, influence, and change our brains.

 

Who Do Humans Consider Friends?

 

From the people we see on a daily basis, to those who we confide in with our thoughts and typical worries, it can be challenging to pinpoint what a friend is. That is why there is no exact definition for a friend, as it varies individually. However, Lauren Brent, a neurobiology professor at Duke University, defines ‘friends’ as “pairs of individuals that engage in bi-directional affiliative (nonaggressive, nonreproductive) [nonsexual] interactions with such frequency and consistency so as to differentiate them from nonfriends” [1]. From this, friends seem to be two individuals that chose to continually surround themselves with each other on a regular basis. Nevertheless, the subjective nature of friendship needs further examination. For example, are we truly limited to only one friend? What degrees of frequency and consistency are necessary to consider  individuals friends—are people who we feel fond of but see twice a year not actually our friends? If nonreproductive behavior is excluded, do other types of friendships such as those of sexual nature count? While the answers to these questions vary from person to person, Christopher Roberts-Griffin, a researcher who studies frequent and desired qualities of friendship, notes that similarity, among other factors, deeply affects what those answers could be [2].

 

How Does the Human Brain Influence and Decide Who Are Friends?

 

Have you ever come across someone that you were able to get along with so well despite recently meeting them? If you have, you might have experienced the act of “clicking”. One of the most influential factors that our brain takes into account when deciding who our friends are is our ability to click with certain people. In other words, when the key components of an individual’s personality fit with someone else’s so much so that, over time, establishing a friendship becomes almost natural, these two individuals have clicked. However, the underlying science of how people click stems past face value into the world of complex neural processes and components. Carolyn Parkinson, a psychology professor at the University of California Los Angeles, measured the brain activity in individuals to see how likely they were to become friends based on their response to watching a movie. Parkinson notes, “more generally, people who responded more similarly to the videos shown in the experiment were more likely to be closer to one another in their shared social network, and these effects were significant even when controlling for inter-subject similarities in demographic variables, such as age, gender, nationality, and ethnicity” [3]. Because of this, Parkinson concludes that similar brain activity in parts of the brain like the nucleus accumbens and amygdala makes us click with certain people and thus makes friendships more likely. Our nucleus accumbens plays a major role in our motivation, actions, and reward experiences, while our amygdala is vital for basic emotions by processing our responses to external stimuli [4]. Together, the nucleus accumbens and amygdala influence our everyday actions and emotional responses to others and the environment. Our motivations, goals, and emotional responses play a critical role in today’s society. Perhaps individuals whose brain activity shares similar emotional and motivational characteristics are able to click with one another. This may be due to the weight that our motivations, goals, and emotional responses have in today’s society. Thus, how similar individuals are is a fundamental factor in establishing friendships.

 

While clicking with certain people is vital to establish formative friendships, first impressions are just as important. Daniela Schiller, a researcher at the Center of Neural Science at New York University, demonstrates that within seconds of meeting someone, the amygdala and posterior cingulate, which plays a role in cognition, form conclusions and quick decisions about people [5]. Not only does the amygdala take on important roles such as processing our environment and emotions, but it also enables us to form quick ideas and make assumptions about people around us. Ultimately, our amygdala considers these ideas to decide if we should continue becoming close friends after initial first impressions.

 

How Does Brain Activity and Behavior Reflect Those of Friends?

 

Spending an extensive amount of time around our friends can lead to our brain activity and behavior reflecting theirs. For example, Tanya Chartrand, a professor at Duke University, refers to a concept known as the chameleon effect, where people perform “nonconscious mimicry” of those around them [6]. Across three experiments, Chartrand showed this effect by observing participants in his study who unintentionally matched certain behaviors. In the first experiment, the participants’ motor behaviors inadvertently matched the motor behavior of strangers when working on a task together [6]. In the second experiment, mimicking posture and movement was correlated with interactional flow (smoother interaction). Imitating posture and movement was also positively correlated with likeness among participants. [6]. Finally, the third experiment demonstrated that individuals who were shown to be more empathetic carried out the chameleon effect to a greater extent than others [6]. While there is much more to learn about why and how the human brain unconsciously picks up our friends’ behaviors, Chartrand’s results show that by unintentionally mimicking the actions and behaviors of those around us, even just through simple tasks, we become more fond of them. We then continue to strengthen relationships, which, in turn, increases the frequency of the chameleon effect. This provides valuable insight into how our ability to click with others and cooperate is a way for our friends to influence how we carry out our actions. 

It is clear that how we are a reflection of our friends stems from a neurological basis. If our friends affect our physical behaviors, does this mean they are directly affecting our brain’s behaviors too?

Yes, but not in the way you think. Referring back to Parkinson’s research, friends have “exceptionally similar neural responses” compared to individuals who are distant in a social network. Parkinson chose a cohort of friends to watch a collection of video clips that varied in topics and genres to keep familiarity among the participants constant and attention constrained. Despite this, all participants were shown the same video clips in the same order to account for individual differences in the way stimuli were processed. Activity in the hippocampus (which plays a role in memory), putamen (which aids in movement), and amygdala was recorded. FMRIs of the amygdala and putamen showed that friends are very similar to each other in terms of how they “perceive, interpret, and react to the world around them”. Emotionally, we are very similar to our friends on a neurological basis. As a result, we tend to surround ourselves with individuals who not only think but also feel the same way we do. In addition to behaving analogously to our friends, our brain activity shows we are emotionally alike as well. Nevertheless, Parkinson notes further research must be done in order to determine if neural response similarity is a “cause or consequence of friendship” [3].

 

How Do Friends Change the Human Brain?

 

The human brain has a predominant role in choosing our friends. But how do our own friends influence and change our brains over time? Brittany Woods, a psychologist at Boston University, notes that close friends positively affect one another’s brain by lowering response in the lateral prefrontal cortex. The lateral prefrontal cortex is believed to deal with affect reappraisal, the process of reevaluating emotionally salient situations to respond and cope differently by decreasing overcontrol of positive emotions, resulting in an overall more positive affect [7]. Woods also noted, “neural response to their own close friend relative to an unfamiliar peer was related to greater activation in a cluster that encompassed both the caudate head and the septum, a region implicated in many affiliative processes such as unconditional trust” [7]. It is important to recognize that while some individuals vary with their amount of trust when initially meeting someone, that over time, they may learn to become more trusting as a result of establishing formative friendships.

 

Conclusion

 

Given the research that has been done exploring how our brain influences who our friends are and how our friends affect our brain, it is clear that our brain plays a prominent role in our social life. However, that is not to say that the brain is the sole factor that affects how we make friends. Making friends, as straightforward and natural as it may seem, is the result of a very complex process. Even more so, this process differs from person to person. With these underlying variations, it may be beneficial to research why the process of making friends is so different among people. Furthermore, more research can provide insight into why, neurologically, some individuals have a more difficult time establishing close and lasting friendships compared to others. In any case, it is important to recognize that our friends affect us in different ways and that our brain is a direct reflection of their effect on us as well as our decision to establish friendships with them. So, the next time you are around your best friend, remember your friendship, in part, stemmed from your very own brain.

 

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The “Iron Man” of Biological Salvation: Biofeedback Use in Disease Mitigation

by Sujay Edavalapati

art by Leia Marshall & Nicole Cobb with Dream AI

Everyone knows that one Marvel fanatic, whether it be your friend or your sibling, who has watched all of the movies three times over; this means you are likely familiar with Tony Stark’s beloved piece of augmented reality technology, J.A.R.V.I.S, from the Iron Man movies. J.A.R.V.I.S was designed by Tony Stark, who used his own thoughts to control the AI which gave him formidable power amongst the Avengers. What was only an idea to Stark materialized into reality as a result of his creativity. Although the Iron Man movies failed to explain how Stark was able to create such technology, it seems that the modern world found the solution without Stark’s help. As an idea first coined by researchers at Harvard University, the mechanism of biofeedback has taken the world by force [1]. However, instead of becoming a formidable military weapon like in the Marvel universe, biofeedback technology in the real world serves as one of the premier sources of information to understanding human physiology and disease. 

Prescription drugs have been a longstanding vision of medical treatment in modern society. However, if the evolution of modern epidemiology has taught society anything, it is that medicine is never black and white. Hence, biofeedback provides an alternative approach to understanding certain diseases whereas prescription drugs may not either be effective or available at all. Biofeedback is the technique of using sensor-related data connected to an individual’s body to measure and monitor bodily processes and gather information for providers [2]. For example, neurofeedback, a form of biofeedback, is able to track information such as vitals through attachment of electrodes to the brain, which was one of the ways J.A.R.V.I.S. was able to process Stark’s vitals [3]. Stark was able to create a neural interface that connected to his armor, which allowed him to receive critical sensory and vital information during many of his important battles. 

Now, biofeedback isn’t as convoluted as the Iron Man movies may have made it seem; in reality, it works in four main steps for the average user. The first step involves monitoring one’s vitals to collect data about average heart rate (HR), breathing rate, blood pressure (BP), pulse, and temperature to extremities . This information acts as a baseline for feedback and can give more insight to researchers what type of stress a particular patient is experiencing [4]. Notable physiological indicators of stress include higher HR, high BP, and lower temperature and sensation in extremities [5]. Individuals who use biofeedback therapeutically try to mitigate and relieve these stress indicators to help promote greater well-being. 

After the collection of this data, a biofeedback technique is employed on patients. The biofeedback technique is specifically focused on receiving information about one’s own physiological data, which allows them or providers to understand further courses of action. A common misconception is that biofeedback refers to one specific technique that can be applied to all patients. However, biofeedback therapy falls within a larger subset of positive adaptive coping techniques, which are therapeutic activities that many people follow in their life without noticing. Some biofeedback techniques include progressive relaxation exercise, meditation, yoga, exercise, deep breathing, or even discussion of the issue [4]. The goal of implementing one of these exercises is to assess the vital information before, during, and after the technique to monitor fluctuations and provide positive feedback upon receiving the results. This leads into the second step, which is linking the data received to physiological processes in the human body. For example, if there is an increase in skin temperature, this is associated with increased blood circulation in the body. The third step is to channel that feedback signal as a learning tool towards improving physiological responses, which will allow an individual to control his or her body’s response to certain stimuli by changing thoughts, actions, or behaviors. For example, after receiving the feedback signal from the machine that their temperature levels are elevated, an individual can practice relaxing techniques such as slower and deeper breaths to increase blood flow throughout their body [4]. The last step is to prolong this response over weeks or months to gain greater control of the body’s physiological response, ultimately without the use of a biofeedback device, to help tackle stress and other harmful behaviors. While this treatment does not result in an immediate response, if done correctly, it can serve to have long-term, sustainable treatment benefits that can be more effective than medication [4]. 

Indeed, it has been shown that people who complete a biofeedback treatment sequence experience health benefits. In 2016, a study was performed amongst managers at a particular workplace dealing with stress, where subjects were told to keep a daily stress diary and would also wear wearable technology that detected changes in blood volume and heart rate over a five week period. Overall, subjects reported lower resting heart rate, less stress and anxiety, more energy, less fatigue, better health perception and social functioning [6]. Biofeedback has also been shown to improve those who have been struggling with mental health because it can be performed using wearable technology, or through unconventional methods like video games, to help regulate anxiety and stress levels and promote higher well-being [7]. At a biological level, biofeedback helps inhibit an increase in cortisol, a hormone induced by chronic stressors. This is why those who use biofeedback experience lower cortisol levels over the treatment period. The contributions of biofeedback are also prevalent in physical health like the use of EMG-feedback after knee surgery to help improve the knee’s range of motion or limb rehabilitation in elderly patients [8]. Yet, we can’t forget about its applications to neuroscience, can we? A form of biofeedback, neurofeedback, utilizes the brain’s neuroplasticity, or the ability of the brain to change its functionality over time, to help regulate homeostasis, mitigate disease, and strengthen the stability of the body [9]. 

Biofeedback has been generally regarded as a safe procedure but there are some risk factors like having certain heart rhythm problems or skin conditions [10]. Biofeedback has still not been tested for every condition, and there is not sufficient evidence currently to say that it will completely treat a disease but research is still ongoing at many institutions into gaining a better understanding of its applications and effects on numerous human diseases. Some key limitations to biofeedback research include too small of a sample size in studies as well as lack of consistency between treatment groups, which can occur due to difference in triggers and compliance between subjects [11]. However, future studies hope to compensate for these limitations by including longer treatment durations with larger sample sizes, more physiological parameters, a method to track the change in symptoms over the treatment, and a long-term follow-up appointment to record anxiety and physiological levels after the treatment [12]. 

Biofeedback has been an upcoming therapy technique in the medical field of the recent decades, and while its effects are still fully being studied, it has helped encourage a dramatic revolution in the way people view medical treatment. Current research has shown how instrumental a tool biofeedback has been in not only relieving a plethora of medical conditions but also its functionality for the average person in helping to mitigate detrimental stressors. Although modern biofeedback therapy must make significant strides to become as advanced as J.A.R.V.I.S., its clinical applications to th

 

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Head Transplants: Medicine or Experimental Indulgence?

by Elena Perez

art by Victoria Amorim

Eerie music begins to play, fog fills the room, lightning strikes, and a man in a white lab coat exclaims, “IT’S ALIVE!” A figure sits up from the cold metallic examination table, only to look down at their body and discover it is not their own, but someone else entirely. You might recognize elements of this scene from Mary Shelley’s Frankenstein. However, in our story, the mad scientist is not Dr. Frankenstein but Dr. Sergio Canavero, an Italian neurosurgeon, and the creature is not a man brought back from the dead but someone who has experienced HEAVEN. To me, what Canavero calls HEAVEN seems more occult than it is angelic. The head anastomosis venture (HEAVEN) is a surgical procedure in which a head is transplanted from one body to another. Canavero claims the procedure could bring mobility back to people with quadriplegia (paralysis of all four limbs), restore quality of life for individuals suffering from neurodegenerative diseases such as Spinal Muscular Atrophy or Amyotrophic Lateral Sclerosis, and even pave the way for immortality. Some call him a visionary, others call him a nutcase. Although this might sound like an outlandish endeavor, never meant to escape the realm of science fiction, Canavero and his team have already made significant headway. When someone has a faulty organ, it can be replaced with a live organ transplant, so why would someone not have their head transplanted from a faulty body to a healthy one?

 

The Surgical Procedure

No easy feat, the 36 hour procedure would involve four teams of surgeons, each including a variety of medical personnel (surgeons of different specialties, anesthesiologists, nurses, and technicians) [1]. To begin, the teams would anesthetize, intubate, and cool the body of a brain-dead body donor and the transplant recipient to 15 degrees Celsius [2]. Deliberate hypothermia slows down metabolic processes, reducing inflammation and cell death, which allows the surgeons about one hour before tissue damage occurs [3]. Cutting both patients’ necks, the surgeons link the blood vessels from the head of the transplant recipient to the blood vessels of the donor body via tubes. The most critical phase of the procedure comes next, in a process called the GEMINI spinal cord fusion protocol, in which the doctors sever each patient’s spinal cord and place the head of the transplant recipient onto the donor’s body [2]. They use a substance called polyethylene glycol (PEG) as a “biological glue” to help promote spinal cord fusion [4]. Then, the team sutures the muscles and blood vessels of the head to those of the body. To assist the healing process, the patient is put in a medically induced coma for about one month, and the medical staff carries out extensive immunosuppression protocols to reduce the chances of the immune system rejecting the transplant [2].

Endless Possibilities versus Empty Claims

Over the past decade, Canavero has worked with Xiaoping Ren, a Chinese orthopedic surgeon, to refine the procedure and perform experiments on mice, dogs, and even human corpses [1,5,6]. As you can imagine, many medical professionals are skeptical of the feasibility of the procedure for a live patient. In response, Canavero and Ren emphasize that only 10% of descending spinal tracts (neuronal pathways that send motor signals from the brain to the spinal cord) are required for voluntary movement [7]. The GEMINI spinal cord fusion protocol, has a success rate of up to 20% reconnection, which Ren and Canavero have demonstrated is sufficient to allow some motor function in mice and dogs [2,5]. This is largely due to the use of an extremely sharp blade, which cleanly cuts each neuron’s axon in the spinal cord, and the use of PEG, which promotes axon reconnection. Before these techniques, animals who underwent head transplantation were left paralyzed from the neck down [8]. Although PEG-mediated axonal recovery is not perfect, the return of some motor control is a feat in itself. Even the subject surviving the procedure is an accomplishment. The ischemic period, that is, the time that the brain is without blood flow (due to induced hypothermia), can cause massive cell death. One mouse study by Ren shows 12 out of 80 mice surviving past 24 hours [9]. However unfavorable this might seem, a 15% survival rate for head transplantation in a mouse model would have been thought impossible 20 years ago. 

As impressive as Ren and Canavero’s progress has been, the procedure still contains many practical limitations. While the GEMINI protocol does induce some axon regeneration, the effects of such minimal nerve recovery on the spinal cord’s many other functions, including the transmittance of sensory information, pain sensation, and proprioception are uncertain [10]. However, functional outcomes are of little importance if immune rejection occurs. Transplant recipients must take immunosuppressive drugs (often for the rest of their lives) to reduce the chance of the body’s immune system attacking and destroying the foreign organ or tissue [11]. Still a prevalent obstacle, about 85% of hand transplant recipients experience acute immune rejection within the first year [12]. 

Even if the immune response is controlled, coming to terms with having an entirely new body might make someone lose their mind. Transplant recipients frequently experience depression or psychosis as a result of mind-body dissonance [13,14]. The recipients of the first hand transplant and the first penile transplant can attest to this, as the severe psychological distress that ensued led to them having their transplants removed [15]. Considering that head transplantation is a more extreme change in appearance than a single organ transplant, critics argue that the procedure could drive patients to insanity and suicide [16]. Canavero contends that the “self is highly plastic and easily manipulatable”, so with a combination of immersive virtual reality (IVR) and hypnosis, the individual would psychologically adapt. Seemingly unfazed by the weaknesses of the procedure, Canavero continues in his pursuit to push the boundaries of modern medicine, proclaiming that every life saving procedure was deemed outrageous or impossible at some point [7]. 

 

Immortality Imagined

Canavero proposes that the surgery could be used to transcend the laws of man and let us live forever. In his book, Head Transplants and the Quest for Immortality, Canavero posits that by taking the head of an aging body recipient and transplanting it onto the body of a younger clone, a person’s life could be extended for up to 40 years [17]. Supposedly, the blood from the young body would have rejuvenating effects on the brain [18,19]. In his vision of the future, individuals would body swap with younger clones of themselves in an ongoing cycle [17]. At a press conference in Vienna, Austria, in 2017, Canavero said this:


“For too long nature has dictated her rules to us. We’re born, we grow, we age and we die. For millions of years humans have evolved and 100 billion humans have died. That’s genocide on a mass scale. We have entered an age where we will take our destiny back in our hands. It will change everything. It will change you at every level.”


As Canavero puts it, aging is genocide, and our only hope is HEAVEN. This places Canavero at the heart of the transhumanist movement, which advocates for the enhancement of the human race using science and technology to extend life spans and improve cognition [20]. It is human nature to fear death and fight against it, but it is also our biological nature to die. In disputing death, Canavero assumes himself a god. After Dr. Frankenstein’s monster comes to life, he exclaims, “in the name of God, now I know what it feels like to be God!” [21]. Perhaps delusions of grandeur are just the trademark of a mad scientist. But still, this begs the question, should head transplantation really be done, or has Canavero’s inflated ego clouded his judgment?


Cerebrocentrism in the Era of Embodiment

While head transplantation possesses many operational flaws, Canavero’s proposal suffers from one principal philosophical pitfall: cerebrocentrism [10]. Fundamentally, the HEAVEN protocol assumes that personhood, selfhood, and identity are localized to the brain. Thus, the body is merely a physical conduit through which the brain can interact with the external environment. Similarly, mind-body dualism, coined by 17th century French philosopher Rene Descartes, defines the mind and body as completely separate entities that can exist independently of one another. As Descartes famously said, “cogito, ergo sum,” meaning “I think, therefore I am” [22]. But are we actually nothing more than our thoughts? Consider the “brain in a vat” thought experiment proposed by Gilbert Harman, a 20th century American philosopher. Imagine your brain was removed from your body, placed in a vat, and connected to a supercomputer that supplied your neurons with all the same electrical impulses that your body normally would. Your “disembodied” brain would register these virtual stimuli as a conscious reality. Many philosophers have tackled the “brain in a vat” scenario to question how one can ever know that what they are experiencing is real and not just a bunch of electrical impulses from a supercomputer [23]. But I would like to pose the question: If you were just a brain in a vat, would you still be you? This thought experiment, as well as Ren and Canavero’s HEAVEN, work off of the assumption that a person is their brain. Or rather, the essence of a person is merely made up of electrical impulses and that the body is expendable to the human experience.

 To me, this 17th century philosophy seems a bit out of date. We live in an era of embodiment, which recognizes that our bodies are integral to our personal identity and our experience of being. In many ways, our bodies characterize who we are, to ourselves and others, defining how we move throughout the world [24]. As Dr. Thomas Fuchs, a professor of philosophy and psychiatry, puts it in his book In Defense of the Human Being, the brain “is only the necessary, but by no means sufficient condition for personal experience and behavior. It is not the brain, but the living person who feels, thinks, and acts” [25].  Indeed, advances in the field of embodied cognition show us that our bodies influence emotion, personality, and identity in profound ways. For instance, the enteric nervous system (ENS), often called a “second brain”, controls the gastrointestinal tract, and has five times more neurons than the entire spinal cord [26]. Research shows that the ENS might have a significant influence over our emotions and mental wellbeing [27]. The gut-brain connection is further governed by the gut microbiome, referring to the collection of microbes (bacteria, fungi, and viruses) that live inside the gut [28]. Gut microbiota can influence sociality, perceptions of stress, and even the development of neurological disorders [29,30,31]. Although the roles of the ENS and gut microbiome in shaping personhood are not fully understood, evidently the body is integrated with cognition in complex ways. Ren and Canavero’s stance that bodies are transient frames that can be arbitrarily switched out without distortion to the self is an irresponsible one that completely disregards the prevailing rhetoric of embodiment. 


Takeaways

Understandably, the prospect of functionally curing every disease or injury that does not impact the brain is enticing, however unrealistic. The 10 million dollar procedure strikes me more as a pompous passion project than an altruistic undertaking. Canavero’s radical and idealistic mission generates many more ethical dilemmas than one commentary can engage with; provoking questions about body sourcing, animal experimentation, and accessibility. This is not to say that there are no practical benefits to his work. Ren and Canavero’s advancements in the understanding of neuronal plasticity and axon regeneration in the spinal cord could be applied to helping those with spinal cord injuries, tens of thousands of which occur every year [32]. From a utilitarian perspective, the greatest good that could come of this research would be that which improves the lives of the most people [33]. But alas, Canavero is not a utilitarian, and perhaps neither are you. I urge you to consider the evidence presented here and decide for yourself: Is head transplantation ethically supportable? Should humans pursue immortality, and at what cost? Are you your brain, why or why not?


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Out of Body, Out of Focus: The Disconnect Between Mind and Body

by Drew Lawless

art by Charlotte Kaufmann

             Without warning, our minds have the terrifying power to separate us from being in focus to swimming in a sea of disorientation. This feeling, known to most as “dissociation,” is a bodily response that causes one to feel disconnected from their thoughts, emotions, and surroundings, which can be a startling and abstract experience. Sometimes, this cognitive response can go beyond its general function; this is the area of dissociation that can be officially recognized as a disorder. This article aims to explain the neuroscientific perspective of why dissociation occurs, what causes it to go haywire in the form of a disorder, and how it varies from person to person. 

             The origins of the documentation and study of dissociation can be traced as far back as the late 18th century. Only after the Vietnam War in the late 1970s was dissociation truly recognized as a legitimate psychological state of being. Over time, it also began to be identified as a common symptom of other mental disorders [1]. This was primarily due to dissociation being tied to post-traumatic stress disorder, or PTSD for short. This disorder is now known to be heavily influenced by dissociation, mainly due to how it was seen to confuse the traumatic event (such as gunfire or an explosion) with non-traumatic, everyday stimuli (such as a car backfiring) [2]. The sounds and sights of wartime carried over into certain veterans’ post-war lives, leaving them to suffer through an unknown “out-of-focus” sensation when triggered by their environment [2]. Following this period, various tests and DSM (Diagnostic and Statistical Manual for Mental Disorders) classifications were developed for the “subcategories” of dissociation and disorders that have it as a major symptom. It has now become a major source of psychological research and inquiry [1]. 

Unfortunately, dissociation is still a relatively unexplored field of neuroscience. Consequently, psychologists and therapists lack the knowledge to fully accommodate the needs of their patients. There is not much general knowledge on dissociation, as well as no true definition of the condition. Such a large variety of related symptoms and perspectives exist that it is difficult to pinpoint what it exactly means to dissociate or have a dissociation disorder [1]. Generally, however, dissociation can be grouped into two separate sub-experiences: depersonalization and derealization. Depersonalization describes “out-of-body” moments, while derealization is associated with “out-of-focus” moments. These sub-experiences range in terms of how extreme they are, how often it is noticed in varying individuals, along with all the other symptoms experienced during dissociation. 

From a physiological perspective, dissociation is the human body trying to protect us from negative external or internal stimuli. This can be in the form of a stressful situation or general anxiety. From a neuroscience perspective, research points to the brain’s fear response and emotion-processing centers as the primary cause [3]. The lack of signals being sent and relayed to other brain regions prevents the individual from being able to comprehend what is actually happening. Electrical signals from active brain cells, or neurons, are slowed down. This means that fewer activating messages or commands are being sent to these regions and that they take much longer to reach their designated target. Thus, they have no lasting effect on this region of the brain known as the “Cortico-Limbic System,” the portion of the brain that associates our thoughts or awareness with our emotions [3]. The overarching result of this is a lowered sensory awareness of one’s self and their surroundings [3]. 

            What happens, however, when this natural response occurs without a reasonable or legitimate stimulus? This is where general dissociation turns into a dissociative disorder. Various dissociative disorders exist, but three very prevalent disorders worth focusing on are dissociative amnesia, depersonalization-derealization disorder, and dissociative identity disorder. While plenty of other mental disorders are involved with dissociation, these three, in particular, showcase very explicit and/or extreme dissociative symptoms. 

Dissociative amnesia is categorized as an unusual inability to recall information or memories related to a traumatic or stressful event in one’s past. It is usually developed in response to trauma at a young age, mainly due to how critical those years are for our brain’s development [4]. However, there are, of course, instances of adults experiencing severe trauma and developing the disorder as well. This is because the person’s mind works extra hard to shut out the traumatizing stimuli, to the point that it is quite debilitating and prevents easy memory retrieval related to that time or event [4]. 

Depersonalization-derealization disorder is just like it sounds: it features extreme, maladaptive cases of both depersonalization and derealization symptoms. The person diagnosed might feel lifeless or aimless, as if they were watching a movie of their life instead of actually experiencing it. Obviously, they are still conscious, active humans, but they internally function much differently when going through an episode of the disorder [5]. The symptoms can be brought on by the biological response to stress or for no apparent reason; however, it is  kicked into overdrive and makes the observer hyper-aware of their “trance-like” state [5].

Dissociative identity disorder, easily one of the most interesting and debated mental disorders, is what was once referred to as “multiple personality disorder.” It can be defined as the creation of alternate “senses of self” that appear to most outside observers as distinct personality changes. This occurs in response to intense childhood trauma, abuse, or neglect, mainly to protect the original personality from the stressful stimulus or pain being suffered. The dissociation aspect specifically involves the mind, causing the original personality to forfeit control of the body and awareness of their surroundings to an alternate personality [6]. This is not a voluntary action by the primary self; to them, it is as if time has skipped forward, and they have no memory of what happened between their last thought and now. Of course, this changes for everyone who has the disorder, but some very extreme cases, such as someone having 27 personalities, have made the illness a major cultural spectacle. Psychologists and neuroscientists have studied the illness for decades. Despite the major belief that it was not a real disorder, based on more recent scientific evidence, it has been proven to have a biological basis as a legitimate chronic disorder [6].

In regards to these and other disorders related to dissociation, treatment is a feasible yet abstract process for those suffering through its wide range of symptoms. No specific medication is available to target areas of the brain responsible for dissociation, and there is not one definitive therapy option or style in use. However, a mixture of various therapeutic strategies and particular medicine available can improve one’s well-being [7]. Common examples of this include talking through the traumatic stimulus that causes the symptoms with a licensed therapist or psychiatrist, learning how to bring oneself back into focus when dissociating with a strategy called “grounding,” and regulating the stress itself with medicine [7]. 

Since most disorders related to dissociation involve issues with the body’s stress response system, antidepressants, anti-psychotics, and anti-anxiety medications can help lower the afflicted mind’s natural tendency to pull one’s consciousness away from their surroundings. The intended result of this is to lessen the severity of the dissociative symptoms and their frequency. Neurotransmitters, chemicals responsible for changing the electrical activity (or inactivity) of certain brain regions, are the main focus of these medications [8]. These include serotonin, which controls mood; dopamine, which controls feelings of reward and happiness; GABA, which inhibits anxiety or stress; and glutamate, which controls learning and memory [8]. 

Current research on dissociation is done with attempts to find the more accurate source of dissociative problems in the brain. A recent study from Stanford found interesting evidence pointing to new areas of the brain and even our cells that might be the root cause for these dissociative feelings. More specifically, these are the posteromedial cortex, which controls subjective thought, and ion channels on the cell membrane, which control the sending of signals via neurons. By stimulating and/or accessing these regions of the body in humans diagnosed with epilepsy (those with recurrent seizures), they experienced mild dissociation but no seizure whatsoever [9]. Although this might not be a complete solution to the dissociation symptoms, this research can provide great assistance in understanding mechanisms of neural signaling that can also cause dissociation when underactive, compared to being overactive as seen in Epilepsy. We now also have a better idea of where to look for the cause of dissociation [9].

Due to the complex nature of dissociation, there is not one correct answer. Despite these unfortunate circumstances, there are various means to seek help for symptoms. The amount of research available on dissociation is inadequate to properly understand and treat its many facets. With time, resources, and continued support for the neuroscience community, there is great hope for what can be discovered and done for those dealing with any form of dissociative and related disorders. What can be done now is informing oneself on what people go through with these unfortunate dissociative mental disorders. Although the average person can’t change dissociation in a single night, it helps tremendously to be aware of dissociation in general and how prevalent it actually is in human life.

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