The Doctor Weighs In

By Dov Michaeli MD, Ph.D

I vividly remember a conversation I had with a London cab driver just before the election that unseated John Major (Conservative party) and elected Tony Blair (Labor party). I asked him who he was going to vote for, fully expecting him to make a “rational” decision and vote his economic interests. But, to my astonishment, he was going to vote for the conservatives. Why? I asked in disbelief. The answer was shocking to me. I’ll paraphrase: “because we working class blokes should know our place. The Aristocrats have been running this country forever, and they have done a bloody good job at it. And every time labor got its hands on power they made a bloody mess”.

This episode was etched in my memory, so incredible and yet so profound it was. How to explain such reverence to social hierarchy? Is it a product of generations of social brainwashing? Shakespeare, himself not an aristocrat or even a minor noble, portayed with great disdain characters of low social standing who tried to reach beyond their class. But is it really just a function of culture? Did anything change in the USSR after the revolution, when all classes were abolished with the stroke of a pen (and a bullet, for added emphasis)? Definitely not. The peasant still “knew his place”, only the superior feudal, properly addressed as “gospodin”( sir, master) was replaced by a newly minted commissar, addressed as “tovarish” (comrade).

So if it’s not purely socio-cultural, what is it?

It’s all in your head

A wonderful paper was published in the latest issue of Neuron, the neurobiology magazine. It was authored by Caroline Zink, Ph.D., Andreas Meyer-Lindenberg, M.D., Ph.D., and colleagues of the NIMH Genes Cognition and Psychosis Program.

Prior studies have shown that social status strongly predicts health. Animals chronically stressed by their hierarchical position have high rates of cardiovascular and depression/anxiety-like syndromes. A classic study of British civil servants found that the lower one ranked, the higher the odds for developing cardiovascular disease and dying early. Lower social rank likely compromises health through psychological effects, such as by limiting control over one's life and interactions with others. However, in hierarchies that allow for more upward mobility, those at the top who stand to lose their positions can have higher risk for stress-related illness. Yet little is known about how the human brain translates such factors into health risk.

To find out, the NIMH researchers created an artificial social hierarchy in which 72 participants played an interactive computer game for money. They were assigned a status that they were told was based on their playing skill. In fact, the game outcomes were predetermined and the other "players" simulated by computer. While their brain activity was monitored by fMRI, participants intermittently saw pictures and scores of an inferior and a superior "player" they thought were simultaneously playing in other rooms.

Although they knew the perceived players' scores would not affect their own outcomes or reward -- and were instructed to ignore them -- participants' brain activity and behavior were highly influenced by their position in the implied hierarchy.

What did they find?

Key study findings included:

 The area that signals an event's importance, called the ventral striatum, responded to the prospect of a rise or fall in rank as much as it did to the monetary reward, confirming the high value accorded social status.

•  Just viewing a superior human "player," as opposed to a perceived inferior one or a computer, activated an area near the front of the brain that appears to size people up -- making interpersonal judgments and assessing social status. A circuit involving the mid-front part of the brain that processes the intentions and motives of others and emotion processing areas deep in the brain activated when the hierarchy became unstable, allowing for upward and downward mobility.
•  Performing better than the superior "player" activated areas higher and toward the front of the brain controlling action planning (prefrontal cortex), while performing worse than an inferior "player" activated areas lower in the brain associated with emotional pain and frustration (amygdala).
•  The more positive the mood experienced by participants while at the top of an unstable hierarchy, the stronger was activity in this emotional pain circuitry when they viewed an outcome that threatened to move them down in status. In other words, people who felt more joy when they won also felt more pain when they lost.

Surprise?

These findings are actually not very surprising. Anybody who ever observed monkeys and apes in their natural habitat could easily pick out the alpha male and female, and the submissive behavior of the rest of rest of the clan. But a more detailed observation reveals subtle gradations in social standing among the “lower class” members. Each member of the clan ”knew his or her place”, and acted accordingly. Furthermore, violations of the boundaries of social standing were promptly punished. Is it surprising then that a specific area in the brain, called the striatum, is dedicated to assessing one’s place in a group? Furthermore, it is located right behind the prefrontal cortex, the area that is making rational decisions based on the inputs that reach it from all areas of the brain. The proximity of the striatum to the prefrontal cortex reduces the time for a message to reach the decision-making circuits--a biological testament to the importance ascribed to social animals “knowing their place” in their society.

The experiment showing that in unstable hierarchies people at the top are just as anxious and stressed as people at the bottom is truly revealing. What is the societal equivalent to “unstable hierarchies”? Democracy, of course. Today you are on top, but your position there is constantly challenged, and eventually you have to give up your exalted position. Anybody who observed our presidents at the beginning of their term, and at the end, couldn’t fail but notice how much they aged. Even a clueless president like George W has aged noticeably.

What is truly remarkable in this study is the documentation of the existence of the ‘social brain’. It has long been hypothesized that areas in the brain are specializing in directing social interactions like emulation, attunement, empathy and altruism. This study provides unequivocal neuro-anatomical proof.

By Dov Michaeli MD, Ph.D

I recently came across a news item about a tearless onion developed by scientists in New Zealand . I, for one, shed many tears over the chopping board, and all because of a substance called the lachrymatory factor. Now, using molecular engineering techniques, the Kiwi scientists silenced the gene that codes for this factor, and voilá – a tearless onion.

This got me thinking: this kind of crying is really all reflex, a direct reaction to irritation. It is the same type of reflex that causes our eyes to well up when we are poked in the eye. Another type of tears is the so-called basal tearing, which bathes our eyes every time we blink. Now, these two types of tearing are common to many animals, and their function is straightforward: Housekeeping, or more specifically, preservation of the integrity of the outer structures of the eye.

What about crying?

Believe it or not – this is unique to us humans. Not even our closest relatives, the chimpanzees, are capable of shedding emotional tears. Yes, animals can howl in pain or in anguish; my dog yawls and howls to high heaven whenever I leave the house without getting his approval; but he doesn’t shed tears. And contrary to popular belief, crocodiles don’t shed tears; but real men do. So how did it come about?

There must have been a “mistake”

The fact that chimps cannot shed emotional tears means that a mutation occurred after our genus Homo split off the evolutionary branch  common to us and the chimps, namely less than 30 million years ago. Obviously, we don’t know exactly when that occurred. For instance, if we knew whether Lucy the Australopithecus could cry we could narrow it down to 300,000 years ago. She most likely had tear ducts like ours, but so do the chimps and the dogs. At some point in our human history a mutation occurred that connected our tear glands to the limbic system, which is responsible for feelings and expression of deep emotions. This system contains such organs as the amygdala, which are the seat of intense emotions as anger and pain. Who hasn’t experienced the connection between these emotions and tears? Or the hippocampus, the seat of memories; Have your eyes ever welled up when old memories floated up from a deep, long forgotten sad life story? The reward centers are part of the limbic system as well; just watch the glistening eyes of proud parents when their child graduates from college.

All this crying is totally involuntary. The autonomic nerves cause the mentalis muscle, the one in the chin, to quiver. They cause the lump in your throat, and the corners of the lips to depress (by activating the depressor anguli oris muscle). It is almost impossible to voluntarily control these actions.

What’s the use?

If we accept the premise that this mutation, like all other mutations are random events, why did it persist? What advantage did it bestow on the newly crying-capable humans?

Crying is the first mode of communication of babies. I always marvel at the capacity of parents to “read” their baby’s cry. Some are cries of hunger. Others are cries of fatigue. Yet others are cries of pain. And the ever discriminating parental ear can tell one from the other.

We can expand on this concept. Crying is not restricted to baby- parent communication. We adults communicate in a variety of ways: body language, speech, song, dance, laughter, and yes—crying.

The reason for this rich palette of communication modes is that it has an important survival value. Being vulnerable creatures in the savannah our only hope for survival was through cooperation. Not only could we better defend ourselves better against faster and more powerful predators, but we could even turn the table on them and make them our dinner.

Te key to cooperation is socialization, and one of the traits that characterize our capacity to socialize is empathy, the capacity to feel what the other person feels. Have you ever experienced sadness when talking to a person who had just experienced a terrible loss? Or looking at Picasso's heartrending painting of "The Tragedy"? Or joy when your friend is beaming with happiness? This is your empathy in action.

Empathy is not purely a psychological phenomenon; it has a neurological basis. There are special neurons in the brain that mirror the emotional state of the other person. These neurons, called appropriately enough mirror neurons, are extra large and most numerous in the human brain. They are distributed through many areas in the brain, all having to do with emotions. The amygdala have them, and so do the reward centers.  So that when my reward centers fire when I tell you about my fantastic trip the mirror neurons in your reward centers would fire as well, I hope.

And back to crying; when a person dear to us is crying, it “breaks our heart”, and we feel like crying as well. This is a form of bonding; those misty eyes and the outpouring of salt water are part of the glue that kept us together since we got off the trees and made our first uncertain steps in the hostile savannah.