1 00:00:00 --> 00:00:01 2 00:00:01 --> 00:00:03 The following content is provided by MIT OpenCourseWare 3 00:00:03 --> 00:00:04 under a Creative 4 00:00:04 --> 00:00:05 Commons license. 5 00:00:05 --> 00:00:09 Additional information about our license and MIT 6 00:00:09 --> 00:00:14 OpenCourseWare in general, is available at ocw.mit.edu. 7 00:00:14 --> 00:00:15 PROFESSOR: 8 00:00:15 --> 00:00:19 Good afternoon. 9 00:00:19 --> 00:00:26 10 00:00:26 --> 00:00:30 Now that all you turkeys are back from Thanksgiving. 11 00:00:30 --> 00:00:31 I shouldn't have said that. 12 00:00:31 --> 00:00:34 How was Thanksgiving? 13 00:00:34 --> 00:00:37 Good. 14 00:00:37 --> 00:00:41 As I'm wrapping up the sleep and dreams thing, I should look 15 00:00:41 --> 00:00:45 around and see whether people look like they're awake. 16 00:00:45 --> 00:00:48 How many people discharged a substantial amount of their 17 00:00:48 --> 00:00:53 sleep debt over the last few days? 18 00:00:53 --> 00:00:53 Good. 19 00:00:53 --> 00:00:58 The rest of you are still rolling around. 20 00:00:58 --> 00:01:03 I am going -- I'm going, but I'm coming back. 21 00:01:03 --> 00:01:07 22 00:01:07 --> 00:01:13 I think I'm going to depart a little from the organization of 23 00:01:13 --> 00:01:18 the lecture that's on the lecture notes, and I will trust 24 00:01:18 --> 00:01:23 on your talents to figure out where -- I might even point out 25 00:01:23 --> 00:01:27 where I've gone to -- but I'm going to re-organize things a 26 00:01:27 --> 00:01:32 bit, because it occurred to me that I can organize at least 27 00:01:32 --> 00:01:42 the first part of the lecture in the form of a sort of a 28 00:01:42 --> 00:01:46 summary statement about Freud, who I'm going to abandon 29 00:01:46 --> 00:01:48 fairly shortly here. 30 00:01:48 --> 00:01:53 And I can work two examples -- one of them about dreams and 31 00:01:53 --> 00:02:02 one of them about abnormal psych, where Freud or Freud's 32 00:02:02 --> 00:02:04 followers are wrong in both cases. 33 00:02:04 --> 00:02:09 But in one case, we can do this business that I've been doing 34 00:02:09 --> 00:02:11 for the last few lectures of saying look, we can salvage 35 00:02:11 --> 00:02:16 something important out of Freud's ideas, and in the other 36 00:02:16 --> 00:02:19 case, which will turn out to be the abnormal psych case, we'll 37 00:02:19 --> 00:02:23 say that, in this case, Freud's followers are simply wrong. 38 00:02:23 --> 00:02:31 And have been superceded by later work. 39 00:02:31 --> 00:02:36 So let me start by picking up in sleep and dreamland 40 00:02:36 --> 00:02:42 talking about dreams. 41 00:02:42 --> 00:02:45 Well, I won't ask if anybody had any good dreams over the 42 00:02:45 --> 00:02:49 course of their catching up on sleep over Thanksgiving. 43 00:02:49 --> 00:02:52 44 00:02:52 --> 00:02:53 I know what I'll ask. 45 00:02:53 --> 00:02:56 I will ask how many people did sleep and dream 46 00:02:56 --> 00:02:58 stuff in recitation? 47 00:02:58 --> 00:02:59 Not many. 48 00:02:59 --> 00:02:59 OK. 49 00:02:59 --> 00:03:02 How many people can remember? 50 00:03:02 --> 00:03:03 Not many. 51 00:03:03 --> 00:03:05 Oh, good, good, that's encouraging. 52 00:03:05 --> 00:03:08 53 00:03:08 --> 00:03:14 All right, that allows me to ask one of the things that 54 00:03:14 --> 00:03:17 tends to surprise people sometimes is that there's a 55 00:03:17 --> 00:03:21 fair degree of commonality in at least some of the 56 00:03:21 --> 00:03:23 dreams that people have. 57 00:03:23 --> 00:03:28 They seem like such idiosyncratic personalized 58 00:03:28 --> 00:03:31 stories, that it's surprising to discover that some of the 59 00:03:31 --> 00:03:37 plot lines go across individuals. 60 00:03:37 --> 00:03:38 It's a weird state, right. 61 00:03:38 --> 00:03:41 I mean it's clear there are weird aspects of 62 00:03:41 --> 00:03:43 the sleeping state. 63 00:03:43 --> 00:03:50 The normal laws of physics seem to be suspendable -- you can 64 00:03:50 --> 00:03:54 fly sometimes, do things like that. 65 00:03:54 --> 00:04:00 You can fall for hours and hours and never hit the ground. 66 00:04:00 --> 00:04:04 The normal laws of reality testing or the awake state of 67 00:04:04 --> 00:04:07 reality testing seems to be up, because you can fly and it 68 00:04:07 --> 00:04:09 doesn't strike you as weird. 69 00:04:09 --> 00:04:11 When you wake up you say that was weird, but if you think 70 00:04:11 --> 00:04:15 about it, while you were flying around or doing whatever other 71 00:04:15 --> 00:04:17 video game kind of thing you were doing in your dreams, 72 00:04:17 --> 00:04:20 yeah, that was just the way things were. 73 00:04:20 --> 00:04:24 If you have the same problem with reality testing, when 74 00:04:24 --> 00:04:32 you're awake you end up in the part of the course on abnormal 75 00:04:32 --> 00:04:33 psych that we'll get to in a minute. 76 00:04:33 --> 00:04:38 It's diagnostic of having a variety of forms of mental 77 00:04:38 --> 00:04:43 illness if you cannot tell the difference between dream 78 00:04:43 --> 00:04:46 state and awake state, that's not healthy. 79 00:04:46 --> 00:04:48 When you're dreaming you can't tell, but you're 80 00:04:48 --> 00:04:50 not clinically insane. 81 00:04:50 --> 00:04:55 82 00:04:55 --> 00:04:59 There was one other sense in which it was different from the 83 00:04:59 --> 00:05:02 awake state that I wanted to make sure that I mentioned, but 84 00:05:02 --> 00:05:04 now I don't remember what it is. 85 00:05:04 --> 00:05:10 Oh, yes, just to point out that the transfer from experience to 86 00:05:10 --> 00:05:14 episodic memory does not work well for dreaming. 87 00:05:14 --> 00:05:17 This is why you forget your dreams so readily is that you 88 00:05:17 --> 00:05:20 know when you wake up that dream is just sort of there 89 00:05:20 --> 00:05:22 sitting around in some sort of short-term buffer, and if you 90 00:05:22 --> 00:05:25 don't do something like write it down or repeat it yourself 91 00:05:25 --> 00:05:31 you discover that those normal mechanisms that take your 92 00:05:31 --> 00:05:34 experiences and transfer them into some sort of 93 00:05:34 --> 00:05:39 long-term memory, they're just not working. 94 00:05:39 --> 00:05:44 So, that said, let's see if we can conjure up--yup? 95 00:05:44 --> 00:05:47 AUDIENCE: Especially when people say they know 96 00:05:47 --> 00:05:49 they're dreaming. 97 00:05:49 --> 00:05:55 PROFESSOR: All the stuff about different states of sleep and 98 00:05:55 --> 00:06:00 awakeness should be seen as not absolutely categorical. 99 00:06:00 --> 00:06:03 So there are these borderline states -- the sort of jargony 100 00:06:03 --> 00:06:08 term is liminal states where you're in between being 101 00:06:08 --> 00:06:12 asleep and awake. 102 00:06:12 --> 00:06:14 In the course of a normal night's sleep, you'd probably 103 00:06:14 --> 00:06:17 wake up out of REM sleep and different bits of you are 104 00:06:17 --> 00:06:21 coming online at different times, and you may be aware, 105 00:06:21 --> 00:06:23 still asleep, but I'm not quite asleep. 106 00:06:23 --> 00:06:26 How many people have had the experience of saying I'm waking 107 00:06:26 --> 00:06:32 up here and I want to know how the story comes out? 108 00:06:32 --> 00:06:34 Yeah, yeah. 109 00:06:34 --> 00:06:36 It's always cause you're waking up at the good parts. 110 00:06:36 --> 00:06:39 Or how many of you have the other experience, which I think 111 00:06:39 --> 00:06:43 maybe what you're getting to which is I'm asleep here and 112 00:06:43 --> 00:06:46 this dream is not a good dream and it's time to wake 113 00:06:46 --> 00:06:47 up out of this dream. 114 00:06:47 --> 00:06:49 I'm going to wake myself up. 115 00:06:49 --> 00:06:50 Fewer. 116 00:06:50 --> 00:06:54 Now, are there people here who are experts at what's 117 00:06:54 --> 00:06:56 known as lucid dreaming? 118 00:06:56 --> 00:07:00 Lucid dreaming is a sort of a halfway state where people 119 00:07:00 --> 00:07:09 claim to be able to control the plot line of their dreams. 120 00:07:09 --> 00:07:12 There are books in the bookstore that will both claim 121 00:07:12 --> 00:07:14 that they can train you to do this, and maybe you 122 00:07:14 --> 00:07:15 can, I don't know. 123 00:07:15 --> 00:07:16 It sounds good. 124 00:07:16 --> 00:07:20 I mean all those people who said, oh man, I woke up and 125 00:07:20 --> 00:07:22 I wanted to hear out the thing came out. 126 00:07:22 --> 00:07:25 If you'd go and train yourself to be a lucid dreamer maybe 127 00:07:25 --> 00:07:27 you can go and keep it going. 128 00:07:27 --> 00:07:30 129 00:07:30 --> 00:07:34 I have these extremely frustrating dreams that I'm 130 00:07:34 --> 00:07:39 sure a good analyst would have a field day with, but I choose 131 00:07:39 --> 00:07:42 to think that they are basically nice, simple, 132 00:07:42 --> 00:07:45 transparent dreams. 133 00:07:45 --> 00:07:49 I like to ski, I dream about skiing, but in my dreams I 134 00:07:49 --> 00:07:53 spend a great deal of time getting up the mountain 135 00:07:53 --> 00:07:57 and I never get to ski. 136 00:07:57 --> 00:08:01 I get to the top and the snow melts or something like that. 137 00:08:01 --> 00:08:04 No, I don't want to hear your interpretation of what this is 138 00:08:04 --> 00:08:08 all really about or anything -- I can do that, too, and make 139 00:08:08 --> 00:08:09 up all those good stories. 140 00:08:09 --> 00:08:13 But in any case, I sometimes think I'm going to get one of 141 00:08:13 --> 00:08:17 these lucid dreaming books because dammit, before I die 142 00:08:17 --> 00:08:20 I'm going to get to ski down that mountain. 143 00:08:20 --> 00:08:22 The conditions are always a great, look a lot better than 144 00:08:22 --> 00:08:25 they do in the northeast when you actually go skiing. 145 00:08:25 --> 00:08:29 146 00:08:29 --> 00:08:35 So, let us consider a couple of plot lines. 147 00:08:35 --> 00:08:37 Some of the things, there's a sort of element that show 148 00:08:37 --> 00:08:38 up in people's dreams. 149 00:08:38 --> 00:08:42 How many people have had falling dreams? 150 00:08:42 --> 00:08:45 How how many people have ever hit the ground? 151 00:08:45 --> 00:08:48 Usually you don't hit the ground, right -- you wake up 152 00:08:48 --> 00:08:50 just before you hit the ground. 153 00:08:50 --> 00:08:55 Oh, there's a whole raft of sort of pseudo-scientific 154 00:08:55 --> 00:08:57 nonsense about--. 155 00:08:57 --> 00:09:00 How many people have ever been killed in their dreams? 156 00:09:00 --> 00:09:01 A fair number. 157 00:09:01 --> 00:09:04 Well, that's presumably a counter examples to the theory 158 00:09:04 --> 00:09:08 that if you die you in your dreams you die for real. 159 00:09:08 --> 00:09:09 It's one of those great assertions. 160 00:09:09 --> 00:09:12 How would you know that was true? 161 00:09:12 --> 00:09:13 Right. 162 00:09:13 --> 00:09:15 What were your dreaming about? 163 00:09:15 --> 00:09:16 I don't know, I'm dead. 164 00:09:16 --> 00:09:18 165 00:09:18 --> 00:09:24 But typically, typically people report that you wake up just 166 00:09:24 --> 00:09:29 before you get killed by the whatever it is that's 167 00:09:29 --> 00:09:30 going to kill you. 168 00:09:30 --> 00:09:33 But the plot lines get more elaborate than that. 169 00:09:33 --> 00:09:38 How many people have had dreams -- this is typically a dream of 170 00:09:38 --> 00:09:43 grade school, the grade school era where you show up in school 171 00:09:43 --> 00:09:47 inappropriately dressed in some fashion. 172 00:09:47 --> 00:09:53 All right, anybody care to describe one of those? 173 00:09:53 --> 00:09:56 Sorry, I heard a--. 174 00:09:56 --> 00:09:58 Somebody wave a hand if you want to actually tell us the 175 00:09:58 --> 00:10:00 -- you don't have to tell us your dream. 176 00:10:00 --> 00:10:02 It's fine. 177 00:10:02 --> 00:10:06 Nobody wants to-- How inappropriate was it? 178 00:10:06 --> 00:10:09 I mean it doesn't get much more inappropriate than I was buck 179 00:10:09 --> 00:10:12 naked, I suppose, which is the stand-- My version of it 180 00:10:12 --> 00:10:15 happened to be that -- I still vividly remember what must have 181 00:10:15 --> 00:10:18 been a kindergarten dream because I ended up in my 182 00:10:18 --> 00:10:22 kindergarten classroom of driving down the street from my 183 00:10:22 --> 00:10:28 house to my school in my crib, which presumably, by the time I 184 00:10:28 --> 00:10:32 was in kindergarten I was long out, and I ended up in school 185 00:10:32 --> 00:10:36 in my crib in my pj's. 186 00:10:36 --> 00:10:38 All right, so you don't have to tell us what 187 00:10:38 --> 00:10:41 you weren't wearing. 188 00:10:41 --> 00:10:47 There is a characteristic of this dream which is that once 189 00:10:47 --> 00:10:53 you get there, once you end up in class, what happens? 190 00:10:53 --> 00:10:57 Anybody got any intuition about the common plot line here? 191 00:10:57 --> 00:11:03 192 00:11:03 --> 00:11:04 AUDIENCE: People point and laugh. 193 00:11:04 --> 00:11:07 PROFESSOR: Oh, people point and laugh. 194 00:11:07 --> 00:11:07 Do you believe it? 195 00:11:07 --> 00:11:12 196 00:11:12 --> 00:11:14 Where's the inappropriately dressed crowd? 197 00:11:14 --> 00:11:15 Raise your hand if you were in the inappropriately 198 00:11:15 --> 00:11:16 dressed class. 199 00:11:16 --> 00:11:19 It's dropped, the numbers are dropping. 200 00:11:19 --> 00:11:21 OK, not inappropriately dressed right now, this 201 00:11:21 --> 00:11:22 is in your dreams. 202 00:11:22 --> 00:11:23 Inappropriately dressed. 203 00:11:23 --> 00:11:26 How many people agreed that what happened was they 204 00:11:26 --> 00:11:28 pointed and laughed? 205 00:11:28 --> 00:11:31 No, it's only in Russia. 206 00:11:31 --> 00:11:37 The characteristic form of this dream is that nobody notices. 207 00:11:37 --> 00:11:40 I mean that's not to say that you're weird for having the 208 00:11:40 --> 00:11:41 variant -- either that or you're making it 209 00:11:41 --> 00:11:42 up, I don't know. 210 00:11:42 --> 00:11:47 But that you would think, I would think if I showed up, 211 00:11:47 --> 00:11:50 if I drove my crib in here, everybody's going to point 212 00:11:50 --> 00:11:52 and they're going to laugh. 213 00:11:52 --> 00:11:53 But they don't. 214 00:11:53 --> 00:11:57 This is assumed to be some sort of a school anxiety dream. 215 00:11:57 --> 00:12:00 School anxiety dreams of some sort are quite common. 216 00:12:00 --> 00:12:02 They also morph as you get older. 217 00:12:02 --> 00:12:10 So, how many people have had a dream of the form where 218 00:12:10 --> 00:12:13 -- well, all right, let's rephrase this. 219 00:12:13 --> 00:12:15 We'll get the form out of you. 220 00:12:15 --> 00:12:17 Has anybody had what they would consider to be 221 00:12:17 --> 00:12:22 an exam anxiety dream? 222 00:12:22 --> 00:12:23 Anybody willing to describe that? 223 00:12:23 --> 00:12:26 I don't think they mostly involve being grossly 224 00:12:26 --> 00:12:28 inappropriately dressed. 225 00:12:28 --> 00:12:29 Yeah, OK. 226 00:12:29 --> 00:12:33 AUDIENCE: Before the psych mid-term I started [INAUDIBLE] 227 00:12:33 --> 00:12:37 psychological theories that don't actually exist. 228 00:12:37 --> 00:12:39 PROFESSOR: Psychological -- that's a novel 229 00:12:39 --> 00:12:42 form of the dream. 230 00:12:42 --> 00:12:43 Any good ones? 231 00:12:43 --> 00:12:45 Well, I won't ask you that. 232 00:12:45 --> 00:12:47 AUDIENCE: [INAUDIBLE]. 233 00:12:47 --> 00:12:51 AUDIENCE: OK, so one version is the I overslept and 234 00:12:51 --> 00:12:53 you missed the exam. 235 00:12:53 --> 00:12:55 Variance thereon? 236 00:12:55 --> 00:12:55 Yeah. 237 00:12:55 --> 00:12:58 AUDIENCE: I slept until about an hour before the exam. 238 00:12:58 --> 00:13:01 Woke up and didn't study [INAUDIBLE]. 239 00:13:01 --> 00:13:03 PROFESSOR: OK, I haven't studied enough for the exam, 240 00:13:03 --> 00:13:06 and perhaps because -- something is going 241 00:13:06 --> 00:13:07 to make it uh-oh. 242 00:13:07 --> 00:13:08 Yeah. 243 00:13:08 --> 00:13:10 They all pointed at you and laughed at you, right. 244 00:13:10 --> 00:13:13 AUDIENCE: The exam was in some other language. 245 00:13:13 --> 00:13:16 PROFESSOR: Yeah, well that happens. 246 00:13:16 --> 00:13:18 Yeah, the exam was in another language. 247 00:13:18 --> 00:13:23 How many people have had the version where you realize in 248 00:13:23 --> 00:13:27 your dream that you have an exam in this course and you've 249 00:13:27 --> 00:13:30 never been to the course? 250 00:13:30 --> 00:13:35 Medieval French -- I've got the Medieval French exam, I've 251 00:13:35 --> 00:13:37 never taken Medieval French. 252 00:13:37 --> 00:13:44 Or there are also versions of this where you get to the exam 253 00:13:44 --> 00:13:46 and you realize that there's something about the exam -- the 254 00:13:46 --> 00:13:49 different language thing is a good example of this where you 255 00:13:49 --> 00:13:50 look at the exam and you realize there's no way 256 00:13:50 --> 00:13:52 I'm passing this exam. 257 00:13:52 --> 00:13:55 Not because you didn't make up the right psych theory, but 258 00:13:55 --> 00:14:04 because I can't see the page in some weird way, or sometimes -- 259 00:14:04 --> 00:14:06 oh, somebody was telling me this morning of a great version 260 00:14:06 --> 00:14:10 where I realize I'm going to be late to the exam and it's down 261 00:14:10 --> 00:14:13 the other end of the infinite corridor, and the infinite 262 00:14:13 --> 00:14:17 corridor really is infinite. 263 00:14:17 --> 00:14:19 You're just going down it forever. 264 00:14:19 --> 00:14:25 Anyway, if you haven't had that dream don't worry, you will. 265 00:14:25 --> 00:14:28 When I was an undergrad at Princeton, somebody 266 00:14:28 --> 00:14:29 did a study of this. 267 00:14:29 --> 00:14:36 25% of the freshman class, 50% of the sophomore class, 75% of 268 00:14:36 --> 00:14:39 the junior class, and you can see where this goes. 269 00:14:39 --> 00:14:44 It's an extremely common college era type dream. 270 00:14:44 --> 00:14:45 And it doesn't get better after that. 271 00:14:45 --> 00:14:49 All that happens is that, if you stay in academia, 272 00:14:49 --> 00:14:51 is that the form moves. 273 00:14:51 --> 00:14:57 Any number of my colleagues have reported dreams where the 274 00:14:57 --> 00:15:03 -- this is the grad school version coming up here -- the 275 00:15:03 --> 00:15:07 dream where your thesis committee comes to you and says 276 00:15:07 --> 00:15:11 it was a big mistake, we're taking the PhD back, or that 277 00:15:11 --> 00:15:14 you have to take your oral exams over again -- the thing 278 00:15:14 --> 00:15:18 you crammed for months and then forgot all of it the next week, 279 00:15:18 --> 00:15:19 or something like that. 280 00:15:19 --> 00:15:23 And then if you end up in my position actually teaching, it 281 00:15:23 --> 00:15:30 just flips around the exam anxiety dream where you have 282 00:15:30 --> 00:15:33 dreams where you get up in front of the class and you 283 00:15:33 --> 00:15:36 realize Medieval French, I don't know anything about 284 00:15:36 --> 00:15:38 Medieval French, what do you mean I'm supposed to talk 285 00:15:38 --> 00:15:41 about Medieval French for the next hour? 286 00:15:41 --> 00:15:45 Now you may think that having anxiety dreams about not 287 00:15:45 --> 00:15:48 knowing what you're talking about is not that far from 288 00:15:48 --> 00:15:52 reality in the case of some of us who -- I won't say 289 00:15:52 --> 00:15:55 more about that anymore. 290 00:15:55 --> 00:15:59 But there are these sort of common themes that 291 00:15:59 --> 00:16:00 run through dreams. 292 00:16:00 --> 00:16:03 People have known this forever, and people have attempted to 293 00:16:03 --> 00:16:05 interpret dreams forever. 294 00:16:05 --> 00:16:09 So there's dream interpretation in the Bible. 295 00:16:09 --> 00:16:12 I'm sure in whatever culture you or your ancestors came 296 00:16:12 --> 00:16:17 from there's a canon of dream interpretation. 297 00:16:17 --> 00:16:23 Have I mentioned Lucretius's great book De Rerum Natura, 298 00:16:23 --> 00:16:26 On the Nature of Things? 299 00:16:26 --> 00:16:26 Yeah. 300 00:16:26 --> 00:16:27 Maybe. 301 00:16:27 --> 00:16:29 Some people think so, some people don't think so. 302 00:16:29 --> 00:16:32 Oh well, what you gonna do? 303 00:16:32 --> 00:16:36 Roman author, and it really is about the nature of things. 304 00:16:36 --> 00:16:40 It's everything, you know, it's 1801 and 801 and 900, and it's 305 00:16:40 --> 00:16:43 all rolled in one great big book. 306 00:16:43 --> 00:16:46 But he's got a nice dream theory in there in which he 307 00:16:46 --> 00:16:51 says that lawyers dream of court cases and sailors are 308 00:16:51 --> 00:16:54 wrestling with the winds and things of that sort suggesting, 309 00:16:54 --> 00:16:57 as Freud would later suggest that every dream reflects 310 00:16:57 --> 00:17:01 something about the preceding day. 311 00:17:01 --> 00:17:04 Oh, let me say something about that. 312 00:17:04 --> 00:17:06 I think I'm jumping ahead in my handout again. 313 00:17:06 --> 00:17:08 Oh well. 314 00:17:08 --> 00:17:12 This was always assumed anecdotally to be true. 315 00:17:12 --> 00:17:15 316 00:17:15 --> 00:17:16 You may have had this experience. 317 00:17:16 --> 00:17:21 You do something all day and you dream about it all night. 318 00:17:21 --> 00:17:24 319 00:17:24 --> 00:17:26 There wasn't much data on this. 320 00:17:26 --> 00:17:31 Bob Stickgold at Harvard Med has now gone off and collected 321 00:17:31 --> 00:17:32 some beautiful data on this. 322 00:17:32 --> 00:17:38 What he did was he got people to play Tetris, a lot Tetris. 323 00:17:38 --> 00:17:43 Then he sent them to bed with little wires on their head and 324 00:17:43 --> 00:17:45 when they went into REM sleep he kicked them -- pow -- what 325 00:17:45 --> 00:17:46 are you dreaming about? 326 00:17:46 --> 00:17:49 Oh man, bricks, they're falling, man. 327 00:17:49 --> 00:17:52 328 00:17:52 --> 00:17:55 Nice clear evidence -- of course, there's a 329 00:17:55 --> 00:17:57 non-Tetris control group. 330 00:17:57 --> 00:17:59 You kick them, oh I'm flying down the infinite corridor. 331 00:17:59 --> 00:18:00 You know, something else. 332 00:18:00 --> 00:18:03 The Tetris group dreamed about Tetris. 333 00:18:03 --> 00:18:08 The coolest thing about Stickgold's experiment is that 334 00:18:08 --> 00:18:12 he tested a population of amnesics -- patients with the 335 00:18:12 --> 00:18:15 same basic problem as HM. 336 00:18:15 --> 00:18:18 Remember HM, no new long-term memories. 337 00:18:18 --> 00:18:19 Learn how to play Tetris? 338 00:18:19 --> 00:18:20 Grr. 339 00:18:20 --> 00:18:20 What are you doing? 340 00:18:20 --> 00:18:21 I'm playing Tetris. 341 00:18:21 --> 00:18:22 Five minutes later. 342 00:18:22 --> 00:18:23 What were you doing? 343 00:18:23 --> 00:18:24 I don't know. 344 00:18:24 --> 00:18:25 Right, doesn't remember any of this. 345 00:18:25 --> 00:18:29 So he takes these amnesics, they play Tetris for a while, 346 00:18:29 --> 00:18:30 they're having a great time. 347 00:18:30 --> 00:18:32 You send them to bed, you kick them in the 348 00:18:32 --> 00:18:33 middle of the night. 349 00:18:33 --> 00:18:34 What are you dreaming about? 350 00:18:34 --> 00:18:36 Oh, bricks, bricks, the bricks are falling. 351 00:18:36 --> 00:18:39 They were dreaming about Tetris even though they didn't 352 00:18:39 --> 00:18:42 remember ever having played Tetris. 353 00:18:42 --> 00:18:43 That was pretty cool. 354 00:18:43 --> 00:18:45 Anyway, there's now experimental evidence for this 355 00:18:45 --> 00:18:50 notion that your dreams incorporate material from 356 00:18:50 --> 00:18:51 the preceding days. 357 00:18:51 --> 00:18:54 Freud asserted that all dreams incorporated something 358 00:18:54 --> 00:18:55 from the preceding day. 359 00:18:55 --> 00:18:56 Is that absolutely true? 360 00:18:56 --> 00:19:02 Well, that's one of those assertions like all snowflakes 361 00:19:02 --> 00:19:05 are different, that's kind of hard to prove. 362 00:19:05 --> 00:19:08 But certainly material from the preceding day 363 00:19:08 --> 00:19:09 gets incorporated. 364 00:19:09 --> 00:19:10 Is that a hand? 365 00:19:10 --> 00:19:10 That is a hand. 366 00:19:10 --> 00:19:14 AUDIENCE: I was just wondering, so there an experiment done 367 00:19:14 --> 00:19:17 where they had these animals running through 368 00:19:17 --> 00:19:18 the [INAUDIBLE]. 369 00:19:18 --> 00:19:21 PROFESSOR: Oh, yes, thank you for reminding me. 370 00:19:21 --> 00:19:24 AUDIENCE: I was just wondering that [INAUDIBLE], 371 00:19:24 --> 00:19:26 when they were in, 372 00:19:26 --> 00:19:32 when the [UNINTELLIGIBLE], their brains, I mean is a fMRI 373 00:19:32 --> 00:19:35 where it's showing activity-- 374 00:19:35 --> 00:19:37 PROFESSOR: Answer's pretty good, she's going to give 375 00:19:37 --> 00:19:39 the rest of the story here. 376 00:19:39 --> 00:19:42 None of you guys are from that lab, right? 377 00:19:42 --> 00:19:44 It's done here. 378 00:19:44 --> 00:19:51 So, if you look in the brain of, in the hippocampus of a 379 00:19:51 --> 00:19:55 rat, what you discover is the hippocampus not only is there 380 00:19:55 --> 00:19:58 encoding the rat's episodic memories in some sense maybe 381 00:19:58 --> 00:20:01 but, it's also serving as a spatial map. 382 00:20:01 --> 00:20:08 So when a rat learns a maze, it develops a map of that maze, in 383 00:20:08 --> 00:20:11 effect, in its hippocampus, and it develops cells that are 384 00:20:11 --> 00:20:14 so-called place -- it's got place cells and the place cells 385 00:20:14 --> 00:20:17 develop responses that are specific to a specific place. 386 00:20:17 --> 00:20:21 So, the rat's running around in a maze, and this cell goes off 387 00:20:21 --> 00:20:24 right here -- nananana -- go over here, different cell goes 388 00:20:24 --> 00:20:27 off -- nananana -- go over here, different cell goes off. 389 00:20:27 --> 00:20:30 And as the rat learns the maze, you, the experimenter, can 390 00:20:30 --> 00:20:34 watch the rat learning this because you can watch cells in 391 00:20:34 --> 00:20:38 the hippocampus lighting up in order, in effect. 392 00:20:38 --> 00:20:40 So now the rat does this all day -- nananana. 393 00:20:40 --> 00:20:43 OK, the rat goes to sleep, the rat goes into REM sleep. 394 00:20:43 --> 00:20:47 All mammalian species, except for the spiny anteater -- don't 395 00:20:47 --> 00:20:50 ask me why I know that -- all mammalian species 396 00:20:50 --> 00:20:51 have REM sleep. 397 00:20:51 --> 00:20:53 So you kick the rat, you ask the rat what he 398 00:20:53 --> 00:20:55 was dreaming about. 399 00:20:55 --> 00:20:58 Rat doesn't say nothing. 400 00:20:58 --> 00:21:01 But, if you're recording from his hippocampus while he's 401 00:21:01 --> 00:21:04 asleep, what you see is the same cells lighting 402 00:21:04 --> 00:21:06 up in order again. 403 00:21:06 --> 00:21:09 Who knows what the rat's actually experiencing, but 404 00:21:09 --> 00:21:13 what the rat's hippocampus is doing is running the maze. 405 00:21:13 --> 00:21:18 This is, first of all, part of the argument for sleep having 406 00:21:18 --> 00:21:20 something to do with consolidation of memory and 407 00:21:20 --> 00:21:26 learning, and it's also an argument for the possibility at 408 00:21:26 --> 00:21:33 least that the rats are dreaming away there, too. 409 00:21:33 --> 00:21:41 Well now, arguably Freud's greatest work is Interpretation 410 00:21:41 --> 00:21:43 of Dreams -- that's the name of the book -- big, fat book. 411 00:21:43 --> 00:21:48 Still kind of fun to read but it's kind of long -- from 1900. 412 00:21:48 --> 00:21:51 Remember that Freud was writing before we knew any of this 413 00:21:51 --> 00:21:55 stuff about REM sleep or anything of that sort. 414 00:21:55 --> 00:22:03 And what Freud thought was happening was that pressure 415 00:22:03 --> 00:22:06 was building up in your unconscious. 416 00:22:06 --> 00:22:09 So let's switch from sort of it dungeon model to sort 417 00:22:09 --> 00:22:10 of a plumbing model. 418 00:22:10 --> 00:22:13 Well, we've got the boiler down in the dungeon and it's 419 00:22:13 --> 00:22:16 building up pressure -- this repressed material that 420 00:22:16 --> 00:22:17 we've been talking about. 421 00:22:17 --> 00:22:20 It's building up pressure and it's going to blow the roof off 422 00:22:20 --> 00:22:23 the whole building unless we vent some of the pressure. 423 00:22:23 --> 00:22:26 And so you've got to be able to -- whoosh -- get some 424 00:22:26 --> 00:22:27 of that out of there. 425 00:22:27 --> 00:22:34 One of the ways to do it is dreams -- to release this 426 00:22:34 --> 00:22:36 while you're asleep. 427 00:22:36 --> 00:22:44 Now what Freud said was that dreams start when some hunk of 428 00:22:44 --> 00:22:50 the preceding day, that he called the day residue, some 429 00:22:50 --> 00:22:55 idea, some activity, some something made an association 430 00:22:55 --> 00:23:00 with something down in your repressed -- in 431 00:23:00 --> 00:23:02 your unconscious. 432 00:23:02 --> 00:23:04 And that allowed this unconscious prisoner to try 433 00:23:04 --> 00:23:06 and make a break for freedom. 434 00:23:06 --> 00:23:09 435 00:23:09 --> 00:23:15 The form of that break would be an effort to fulfill this 436 00:23:15 --> 00:23:18 repressed wish, if you like -- that's why it was called wish 437 00:23:18 --> 00:23:31 fulfillment -- meant that you were going to try to fulfill 438 00:23:31 --> 00:23:36 one of these repressed wishes while you were asleep. 439 00:23:36 --> 00:23:42 There's a problem with that, said Freud, which is if you 440 00:23:42 --> 00:23:46 take the materials out -- the repressed material to be this 441 00:23:46 --> 00:23:50 stuff that's repressed because it's unacceptable to you, to 442 00:23:50 --> 00:23:53 the conscious you, to the ego, what's going to happen if you 443 00:23:53 --> 00:23:54 start dreaming about it? 444 00:23:54 --> 00:23:56 Well, we've already gotten part of the answer here. 445 00:23:56 --> 00:24:00 Many people here have had dreams so awful that 446 00:24:00 --> 00:24:04 they've deliberately woken themselves up out of them. 447 00:24:04 --> 00:24:09 Now most of those dreams, I would imagine, were dreams 448 00:24:09 --> 00:24:11 where the monster's about to put the bite on you or 449 00:24:11 --> 00:24:13 something like that. 450 00:24:13 --> 00:24:16 What Freud said is that look, if you were going to start 451 00:24:16 --> 00:24:19 dreaming about, oh, let's dismember my little brother 452 00:24:19 --> 00:24:22 -- oh, look at his little guts. 453 00:24:22 --> 00:24:25 Stuff like that, that would be really gross and really 454 00:24:25 --> 00:24:28 disturbing and you would say to yourself, I don't want 455 00:24:28 --> 00:24:29 to be having this dream. 456 00:24:29 --> 00:24:30 And you would wake up. 457 00:24:30 --> 00:24:34 So what you need to do is to disguise the 458 00:24:34 --> 00:24:36 material in the dream. 459 00:24:36 --> 00:24:41 So you've got, said Freud, the latent content of the dream 460 00:24:41 --> 00:24:44 that you don't know about. 461 00:24:44 --> 00:24:51 The latent content is the repressed material that's 462 00:24:51 --> 00:24:53 trying to be vented out. 463 00:24:53 --> 00:25:03 What you see is the manifest content, which is the 464 00:25:03 --> 00:25:06 storyline of the dream. 465 00:25:06 --> 00:25:11 It's hidden material -- it is hiding the latent content from 466 00:25:11 --> 00:25:13 you so that you can sleep. 467 00:25:13 --> 00:25:17 Freud argued that the primary role of the sort of sleep 468 00:25:17 --> 00:25:21 mechanism was to protect the sleeper, to keep you asleep and 469 00:25:21 --> 00:25:25 allow you to sleep, and allow this sort of venting of 470 00:25:25 --> 00:25:32 repressed steam to take place. 471 00:25:32 --> 00:25:36 Were you to show up in analysis the reason your dreams would 472 00:25:36 --> 00:25:39 be, what Freud called the royal road to the unconscious, was if 473 00:25:39 --> 00:25:42 you could work back from the manifest content to the latent 474 00:25:42 --> 00:25:46 content, which was a job of analysis, not a job of picking 475 00:25:46 --> 00:25:49 up some supermarket guide to your dreams, but a job of 476 00:25:49 --> 00:25:51 working with you and an analyst. 477 00:25:51 --> 00:25:53 But if you could go back from the manifest content to the 478 00:25:53 --> 00:25:56 latent content, you'd know something about what it 479 00:25:56 --> 00:25:58 was that was bugging you. 480 00:25:58 --> 00:26:01 Now the fact that, like repression as a whole, the fact 481 00:26:01 --> 00:26:05 that you have these disguised dreams all the time doesn't 482 00:26:05 --> 00:26:08 mean that you're somehow sick and diseased. 483 00:26:08 --> 00:26:10 It means that's part, again, of what it means 484 00:26:10 --> 00:26:12 to be human for Freud. 485 00:26:12 --> 00:26:13 You're going to need repression, you're going to 486 00:26:13 --> 00:26:17 need to be able to bubble off some of this repressed energy, 487 00:26:17 --> 00:26:22 and dreams are a nice safe way to do it. 488 00:26:22 --> 00:26:26 That's an interesting theory, but it runs into some major 489 00:26:26 --> 00:26:28 problems, which, of course, Freud didn't know about because 490 00:26:28 --> 00:26:32 he died in 1939 and REM wasn't discovered for another 491 00:26:32 --> 00:26:33 couple of decades or so. 492 00:26:33 --> 00:26:38 When REM is discovered it becomes a lot harder to believe 493 00:26:38 --> 00:26:44 that you are boiling up this little poof of repressed energy 494 00:26:44 --> 00:26:49 every ninety minutes like clockwork. 495 00:26:49 --> 00:26:51 That's a bit surprising. 496 00:26:51 --> 00:26:53 Well, that's a bit surprising. 497 00:26:53 --> 00:26:58 More surprising is if you look at babies, a one month old is 498 00:26:58 --> 00:27:01 REMing a great deal more than you're REMing. 499 00:27:01 --> 00:27:03 How much repressed stuff does a one month old 500 00:27:03 --> 00:27:05 baby have to deal with? 501 00:27:05 --> 00:27:05 Not much. 502 00:27:05 --> 00:27:07 How about a lion? 503 00:27:07 --> 00:27:09 Lions, they REM all the time. 504 00:27:09 --> 00:27:12 Apparently predators show more REM than prey, as I recall. 505 00:27:12 --> 00:27:16 So yeah, all the mammals are sitting there doing this REM 506 00:27:16 --> 00:27:21 thing, right, you know lions, except for like Scar in the 507 00:27:21 --> 00:27:23 Lion King and stuff like that. 508 00:27:23 --> 00:27:27 There's not a lot of repressed work that a lion presumably 509 00:27:27 --> 00:27:28 has to deal with. 510 00:27:28 --> 00:27:33 Or a cow -- cows don't REM that much, but you know, ah, I 511 00:27:33 --> 00:27:35 really wanted to hurt the grass. 512 00:27:35 --> 00:27:39 I feel bad about the -- I don't know. 513 00:27:39 --> 00:27:52 So presumably, now what's going on when you dream and when you 514 00:27:52 --> 00:27:55 go into REM is that there are centers down in your brain stem 515 00:27:55 --> 00:28:03 that spray of vast amount of activity up into cortex and 516 00:28:03 --> 00:28:06 light it up as though you were awake -- that's what you 517 00:28:06 --> 00:28:07 end up seeing in REM. 518 00:28:07 --> 00:28:11 519 00:28:11 --> 00:28:15 One of the senses in which Freud was right is the sense 520 00:28:15 --> 00:28:21 in which dreaming does protect the sleeper. 521 00:28:21 --> 00:28:25 If you light up -- you're trying to go to sleep, right, 522 00:28:25 --> 00:28:28 and I light up cortex by coming into your room, turning on all 523 00:28:28 --> 00:28:31 the lights and turning the stereo way up, you have 524 00:28:31 --> 00:28:33 trouble sleeping. 525 00:28:33 --> 00:28:35 Well your brain's doing the same kind of thing when you go 526 00:28:35 --> 00:28:39 into REM sleep, but you've got to do something with all that 527 00:28:39 --> 00:28:42 cortical activity or you're just going to wake up. 528 00:28:42 --> 00:28:45 So you turn it into this storyline for who knows who 529 00:28:45 --> 00:28:50 to watch on the big wide screen TV in your brain. 530 00:28:50 --> 00:28:57 In that sense you do end up protecting your 531 00:28:57 --> 00:28:59 sleep by dreaming. 532 00:28:59 --> 00:29:04 In fact, many -- Freud wasn't thinking about alarm clocks, 533 00:29:04 --> 00:29:06 but an example of this would be how many of you have 534 00:29:06 --> 00:29:11 incorporated your alarm clock into a dream and managed to 535 00:29:11 --> 00:29:15 successfully stay asleep? 536 00:29:15 --> 00:29:18 Well that's sort of a non-Freudian sense in 537 00:29:18 --> 00:29:23 which the dream engine is protecting your sleep. 538 00:29:23 --> 00:29:25 I want to stay asleep here, there's a loud noise, well I 539 00:29:25 --> 00:29:27 don't know where this loud noise is coming from, my brain 540 00:29:27 --> 00:29:31 stem's making these loud noises all the time, so let's just 541 00:29:31 --> 00:29:35 pretend it's from the inside and not the outside and we can 542 00:29:35 --> 00:29:37 dream that we're getting up. 543 00:29:37 --> 00:29:38 Right, dream that we're getting up. 544 00:29:38 --> 00:29:41 We'll dream that we're going to class and taking the exam and 545 00:29:41 --> 00:29:44 then we wake up and it really is halfway through -- don't do 546 00:29:44 --> 00:29:46 this at the final, please. 547 00:29:46 --> 00:29:48 It's so lame. 548 00:29:48 --> 00:29:51 Particularly since the exam's at -- the 900 549 00:29:51 --> 00:29:52 final's 1:30, right? 550 00:29:52 --> 00:29:54 Got plenty of time to wake up by 1:30. 551 00:29:54 --> 00:30:00 But every year somebody wanders in at like 2:30, 3:00 o'clock 552 00:30:00 --> 00:30:02 with the big bags under the eyes, right. 553 00:30:02 --> 00:30:06 So you do sort of believe them -- I just woke up. 554 00:30:06 --> 00:30:11 Well, good, sit down, see if you can see the exam. 555 00:30:11 --> 00:30:17 Anyway, so there's that sense in which Freud had a point that 556 00:30:17 --> 00:30:19 sleep was protecting the dreamer. but is there 557 00:30:19 --> 00:30:21 any meaning to it? 558 00:30:21 --> 00:30:24 Is there any sense in which there there's meaning 559 00:30:24 --> 00:30:26 in your dreams. 560 00:30:26 --> 00:30:29 I mean after all you are dreaming because your brain 561 00:30:29 --> 00:30:34 stem decided to throw all the switches in your visual cortex 562 00:30:34 --> 00:30:37 or something and you're busy trying to stay asleep. 563 00:30:37 --> 00:30:40 I think there is a sense in which you might be able to 564 00:30:40 --> 00:30:43 argue that you could get something meaningful at a dream 565 00:30:43 --> 00:30:46 -- you're not just looking at static on the brain. 566 00:30:46 --> 00:30:49 Actually, I thought of a way to demo this, but I didn't bring 567 00:30:49 --> 00:30:52 any of the props because I only saw it when I saw this thing. 568 00:30:52 --> 00:30:56 So, a piece of paper -- I've probably got a piece of paper. 569 00:30:56 --> 00:30:58 Who's got a coin on them? 570 00:30:58 --> 00:31:00 Somebody have a coin? 571 00:31:00 --> 00:31:02 Let's see if I can make this work. 572 00:31:02 --> 00:31:05 573 00:31:05 --> 00:31:08 That looks pretty so far. 574 00:31:08 --> 00:31:09 And I also need a pencil. 575 00:31:09 --> 00:31:11 Somebody have a pencil -- it works better with a 576 00:31:11 --> 00:31:12 pencil than with a pen. 577 00:31:12 --> 00:31:14 Oh my goodness, it's coming all the way from the cheap seats. 578 00:31:14 --> 00:31:18 579 00:31:18 --> 00:31:21 Visual search. 580 00:31:21 --> 00:31:23 Oh, you wanted to do this because -- he's 581 00:31:23 --> 00:31:24 got a fancy coin. 582 00:31:24 --> 00:31:26 This is very cool here. 583 00:31:26 --> 00:31:29 584 00:31:29 --> 00:31:31 All right, pencil, got a pencil? 585 00:31:31 --> 00:31:32 Here we go. 586 00:31:32 --> 00:31:35 OK, this is my brain. 587 00:31:35 --> 00:31:40 588 00:31:40 --> 00:31:43 Thank you. 589 00:31:43 --> 00:31:47 Didn't you have something else you needed to do today? 590 00:31:47 --> 00:31:49 Well actually, it's just my cortex -- it can 591 00:31:49 --> 00:31:49 just be my cortex. 592 00:31:49 --> 00:31:55 593 00:31:55 --> 00:31:56 Well that's my cortex under there. 594 00:31:56 --> 00:31:58 This is my brain stem. 595 00:31:58 --> 00:32:02 So now I will spray activity across my cortex here, and 596 00:32:02 --> 00:32:03 let's see if this sort of works. 597 00:32:03 --> 00:32:11 598 00:32:11 --> 00:32:14 It looks like squat, doesn't it? 599 00:32:14 --> 00:32:16 Well you know what? 600 00:32:16 --> 00:32:18 That's a really boring dorkey demo. 601 00:32:18 --> 00:32:21 602 00:32:21 --> 00:32:22 It's a fidelity issue. 603 00:32:22 --> 00:32:27 I can see what-- Use a different pencil? 604 00:32:27 --> 00:32:28 A wooden pencil. 605 00:32:28 --> 00:32:29 No, no, no, no. 606 00:32:29 --> 00:32:31 It looks just fine from here. 607 00:32:31 --> 00:32:34 Here, we'll try the other side up, see if that works any 608 00:32:34 --> 00:32:37 better but I don't think it will. 609 00:32:37 --> 00:32:39 Do it at more of an angle? 610 00:32:39 --> 00:32:41 Hold the pencil up more of an angle. 611 00:32:41 --> 00:32:43 All right, we'll try this one more time. 612 00:32:43 --> 00:32:46 Oh look, maybe we're getting -- I don't know, 613 00:32:46 --> 00:32:47 what are we getting? 614 00:32:47 --> 00:32:51 We're getting nothing. 615 00:32:51 --> 00:32:52 We're getting nothing that you're going to see. 616 00:32:52 --> 00:32:54 Oh yeah, no, you can sort of see something but 617 00:32:54 --> 00:32:55 it's really boring. 618 00:32:55 --> 00:32:56 Well that was lovely. 619 00:32:56 --> 00:32:56 Here we go. 620 00:32:56 --> 00:33:10 621 00:33:10 --> 00:33:14 Here's what I was doing that didn't work but makes a 622 00:33:14 --> 00:33:17 brilliant model anyway. 623 00:33:17 --> 00:33:19 You can try this for yourself. 624 00:33:19 --> 00:33:23 If you stick a coin under a piece of paper and rub a pencil 625 00:33:23 --> 00:33:26 over it, you can actually see the shape of the 626 00:33:26 --> 00:33:28 pattern on the coin. 627 00:33:28 --> 00:33:31 Anybody here ever done brass rubbing or greystone rubbing 628 00:33:31 --> 00:33:33 or any of that sort of--? 629 00:33:33 --> 00:33:34 No. 630 00:33:34 --> 00:33:34 A few people. 631 00:33:34 --> 00:33:35 All right. 632 00:33:35 --> 00:33:40 Look, the point is that by spraying random noise across a 633 00:33:40 --> 00:33:43 structured object, in effect, I can see something 634 00:33:43 --> 00:33:45 of the structure. 635 00:33:45 --> 00:33:49 Boy, this took more minutes than it should have. 636 00:33:49 --> 00:33:53 By spraying random noise from your brain stem, across your 637 00:33:53 --> 00:33:57 particular brain, the particular dreams that you get 638 00:33:57 --> 00:33:59 are going to say something about that underlying 639 00:33:59 --> 00:34:00 structure. 640 00:34:00 --> 00:34:12 So, Attila the Hun, when he was dreaming was not dreaming about 641 00:34:12 --> 00:34:16 trains going into tunnels or stuff like that, because 642 00:34:16 --> 00:34:19 Attila the Hun didn't know anything about trains. 643 00:34:19 --> 00:34:22 You dream about trains, they may or may not -- trains going 644 00:34:22 --> 00:34:25 into tunnels, you know it's sort of a classic supermarket 645 00:34:25 --> 00:34:28 dream analysis image of a sexual dream or 646 00:34:28 --> 00:34:29 something like that. 647 00:34:29 --> 00:34:32 It may or may not be a sexual dream, but the content of that 648 00:34:32 --> 00:34:37 dream, that set of imagery, is a function of your 649 00:34:37 --> 00:34:38 particular brain. 650 00:34:38 --> 00:34:41 If your dream about Tetris after playing Tetris all day, 651 00:34:41 --> 00:34:43 it's because you were playing the Tetris, not because 652 00:34:43 --> 00:34:44 somebody else was playing Tetris. 653 00:34:44 --> 00:34:49 So it could well be if you thought you had a process for 654 00:34:49 --> 00:34:54 going back from the storyline that's there to protect you 655 00:34:54 --> 00:34:58 from waking up with all that noise in your head to the 656 00:34:58 --> 00:35:02 underlying structure of your mind, if you had a process that 657 00:35:02 --> 00:35:05 you thought worked, then it follows that you might actually 658 00:35:05 --> 00:35:08 get some sort of interesting meaning out of your dreams. 659 00:35:08 --> 00:35:10 Now it's quite a leap to decide that you actually 660 00:35:10 --> 00:35:11 know how to do this. 661 00:35:11 --> 00:35:13 Analysts think they do. 662 00:35:13 --> 00:35:16 People who write guides to dream interpretation 663 00:35:16 --> 00:35:19 think they do. 664 00:35:19 --> 00:35:23 I think I'll just leave it at that as an exercise for the 665 00:35:23 --> 00:35:26 reader to go and decide whether or not they've got deep 666 00:35:26 --> 00:35:30 meaning in their dreams. 667 00:35:30 --> 00:35:36 So that's an example where Freud didn't know the 668 00:35:36 --> 00:35:41 subsequent hundred years of sleep research, so if you 669 00:35:41 --> 00:35:44 actually read Interpretation of Dreams, a lot of it would sound 670 00:35:44 --> 00:35:45 kind of odd at this point. 671 00:35:45 --> 00:35:51 But the core ideas that sleep needs to protect you, keep you 672 00:35:51 --> 00:35:58 asleep and that it's sort of a re-packaging of this activity 673 00:35:58 --> 00:36:04 of your mind, those seem to be core ideas that can still do a 674 00:36:04 --> 00:36:06 certain amount of work for us. 675 00:36:06 --> 00:36:11 Now a place where the effort to apply Freudian ideas did not 676 00:36:11 --> 00:36:17 pan out is in the treatment of schizophrenia. 677 00:36:17 --> 00:36:20 So I'm going to jump to talking about that, and I may or may 678 00:36:20 --> 00:36:22 not manage to jump back to the other things that I claimed I 679 00:36:22 --> 00:36:24 was going to jump back to. 680 00:36:24 --> 00:36:26 But I might. 681 00:36:26 --> 00:36:30 682 00:36:30 --> 00:36:42 So, in the middle part of 20th century, mental hospitals in 683 00:36:42 --> 00:36:48 the U.S. were filled with chronic schizophrenics. 684 00:36:48 --> 00:36:53 Schizophrenia is an extremely disabling disease when 685 00:36:53 --> 00:36:56 it's in its florid state. 686 00:36:56 --> 00:37:01 So, schizophrenia, the word comes from split mind. 687 00:37:01 --> 00:37:06 As it says on the handout, for five points free on the final 688 00:37:06 --> 00:37:11 exam probably, not the same thing as a multiple 689 00:37:11 --> 00:37:13 personality disorder. 690 00:37:13 --> 00:37:18 The split in the mind is a split that 19th century 691 00:37:18 --> 00:37:22 psychiatry saw between emotional life and 692 00:37:22 --> 00:37:23 cognitive life. 693 00:37:23 --> 00:37:26 It is, in fact, sort of an unfortunate term because it 694 00:37:26 --> 00:37:30 does make people think that it's the same thing as multiple 695 00:37:30 --> 00:37:31 personality disorder. 696 00:37:31 --> 00:37:34 It's not. 697 00:37:34 --> 00:37:39 Multiple personality patients can actually function at least 698 00:37:39 --> 00:37:43 somewhat in the world reasonably well. 699 00:37:43 --> 00:37:48 Floridly schizophrenic patients do not work well out there in 700 00:37:48 --> 00:37:51 the world, that's why they end up hospitalized. 701 00:37:51 --> 00:37:58 The sorts of symptoms that you get are hallucinations, hearing 702 00:37:58 --> 00:38:04 voices, paranoid delusions often of vast conspiracies 703 00:38:04 --> 00:38:06 to control your mind. 704 00:38:06 --> 00:38:08 You can see this as sort of an adaptive response, right. 705 00:38:08 --> 00:38:13 If your mind, if some chunk of you, in a sense, knows that 706 00:38:13 --> 00:38:18 your mind is out of control, it's not an unreasonable 707 00:38:18 --> 00:38:21 irrational thought to believe that somebody else is 708 00:38:21 --> 00:38:24 doing this to you. 709 00:38:24 --> 00:38:28 So it may, in some sense, be reasonable to think, to imagine 710 00:38:28 --> 00:38:30 how people could come to believe that their mind 711 00:38:30 --> 00:38:33 is being controlled by somebody else. 712 00:38:33 --> 00:38:38 The sorts of things that led to the notion of a dissocation -- 713 00:38:38 --> 00:38:41 I shouldn't say dissociation -- of a split between cognition 714 00:38:41 --> 00:38:44 and emotion, another characteristic of 715 00:38:44 --> 00:38:47 schizophrenia is so-called inappropriate affect. 716 00:38:47 --> 00:38:51 That's just jargon for showing the wrong emotions 717 00:38:51 --> 00:38:52 at the wrong time. 718 00:38:52 --> 00:38:57 The sort of classic symptom is laughing at the funeral. 719 00:38:57 --> 00:39:01 You know, if you're just yucking it up at graveside or 720 00:39:01 --> 00:39:06 something like that, people will think that that is not 721 00:39:06 --> 00:39:11 normal, and it is, in fact, one of the characteristics 722 00:39:11 --> 00:39:13 of schizophrenia. 723 00:39:13 --> 00:39:16 And that schizophrenia's sort of a messy diagnosis -- not 724 00:39:16 --> 00:39:21 every schizophrenic has every one of these symptoms. 725 00:39:21 --> 00:39:28 But you can imagine that by the time you're gripped by 726 00:39:28 --> 00:39:32 fantastical thoughts and conspiracy theories and you're 727 00:39:32 --> 00:39:35 hearing voices and seeing things that aren't there, that 728 00:39:35 --> 00:39:41 this is pretty disabling stuff. 729 00:39:41 --> 00:39:48 730 00:39:48 --> 00:39:50 It's not so disabling that you can't be out there in 731 00:39:50 --> 00:39:51 the world, by the way. 732 00:39:51 --> 00:39:55 When I was a graduate student, the MIT Department was 733 00:39:55 --> 00:39:56 called psychology. 734 00:39:56 --> 00:40:00 One of the reasons, though perhaps not one of the more 735 00:40:00 --> 00:40:05 serious reasons, for changing the name was that my doctoral 736 00:40:05 --> 00:40:07 advisor who was chair of the department got tired of getting 737 00:40:07 --> 00:40:12 phone calls from people who wanted to know about stuff like 738 00:40:12 --> 00:40:15 abnormal psychology, which nobody at the MIT Department 739 00:40:15 --> 00:40:16 ever did anything with. 740 00:40:16 --> 00:40:19 So he would always get the phone call or his secretary 741 00:40:19 --> 00:40:22 would get the phone call and she was instructed to say, 742 00:40:22 --> 00:40:27 don't call us, they do that stuff at Harvard. 743 00:40:27 --> 00:40:32 I remember one time when I was a grad student that rather than 744 00:40:32 --> 00:40:35 phoning up, one of these people came to the lab and he wandered 745 00:40:35 --> 00:40:40 into the lab and said that he knew that we were controlling 746 00:40:40 --> 00:40:45 his mind with microwaves beamed from this location and he 747 00:40:45 --> 00:40:49 wanted us to stop right now. 748 00:40:49 --> 00:40:52 I'm there sort of uh-oh. 749 00:40:52 --> 00:40:59 But my advisor with great presence of mind I thought, 750 00:40:59 --> 00:41:02 walked over to the biggest rack of equipment in the lab, threw 751 00:41:02 --> 00:41:06 the biggest switch he could find, said there, does 752 00:41:06 --> 00:41:07 that feel better? 753 00:41:07 --> 00:41:12 The guy said yes and left. 754 00:41:12 --> 00:41:16 I'm not sure I recommend this as a treatment for delusional 755 00:41:16 --> 00:41:19 patients, but it worked in this -- and then we changed the 756 00:41:19 --> 00:41:20 name of the department. 757 00:41:20 --> 00:41:23 758 00:41:23 --> 00:41:30 In any case, it can be very disabling and it often can 759 00:41:30 --> 00:41:33 lead to hospitalization. 760 00:41:33 --> 00:41:34 What would Freud have said about it? 761 00:41:34 --> 00:41:38 What Freud said about it was these are not patients that I 762 00:41:38 --> 00:41:39 want to deal with, basically. 763 00:41:39 --> 00:41:45 He doesn't write extensively about schizophrenia and says in 764 00:41:45 --> 00:41:47 various places that look, if you're going to do 765 00:41:47 --> 00:41:50 psychoanalysis, the first thing you need is a patient that 766 00:41:50 --> 00:41:51 you can at least talk to. 767 00:41:51 --> 00:41:53 Anna O. 768 00:41:53 --> 00:41:55 With her collection of hysterical symptoms may have 769 00:41:55 --> 00:42:02 been in psychiatric trouble some variety, but you could 770 00:42:02 --> 00:42:03 talk to her about it. 771 00:42:03 --> 00:42:06 You could engage in this dialogue. 772 00:42:06 --> 00:42:13 If you've got a patient who is delusional and hallucinating 773 00:42:13 --> 00:42:16 there's not much Freud thought you could do with them. 774 00:42:16 --> 00:42:23 However, his followers thought you could and developed a 775 00:42:23 --> 00:42:30 theory growing out of Freudian psychodynamic ideas of where 776 00:42:30 --> 00:42:32 schizophrenia came from. 777 00:42:32 --> 00:42:37 So in the mid-20th century, psychiatric hospitals were 778 00:42:37 --> 00:42:41 filled with schizophrenics and filled with good Freudianly 779 00:42:41 --> 00:42:45 trained analysts attempting to treat them. 780 00:42:45 --> 00:42:50 What they thought the cause was the so-called schizophrenogenic 781 00:42:50 --> 00:42:53 parent, typically Mother. 782 00:42:53 --> 00:42:58 Schizophrenogenic is a great word. 783 00:42:58 --> 00:43:02 It's somebody who generates schizophrenia. 784 00:43:02 --> 00:43:06 Anyway, a schizophrenogenic mother, what was the problem 785 00:43:06 --> 00:43:12 here, the problem was what the therapists perceived as a 786 00:43:12 --> 00:43:16 double-bind situation that the mother was somehow 787 00:43:16 --> 00:43:17 putting the child in. 788 00:43:17 --> 00:43:20 The mother was saying come here, come here, come here, go 789 00:43:20 --> 00:43:21 away, go away, go away, I love you, I love you, I love you, 790 00:43:21 --> 00:43:23 get away, get away, get away. 791 00:43:23 --> 00:43:27 Somehow both saying come near me and get away from me at one 792 00:43:27 --> 00:43:30 and the same time, and that this was literally 793 00:43:30 --> 00:43:32 driving the child mad. 794 00:43:32 --> 00:43:34 Now why would they have come up with such a theory? 795 00:43:34 --> 00:43:42 One of the reasons was that onset of schizophrenia is quite 796 00:43:42 --> 00:43:45 typically late adolescence, early adulthood. 797 00:43:45 --> 00:43:49 Oh, that reminds me to reiterate or iterate for the 798 00:43:49 --> 00:43:51 first time, if I haven't mentioned it yet -- no, I 799 00:43:51 --> 00:43:53 think I did mention it. 800 00:43:53 --> 00:43:57 Remember what I was saying about psychiatric hypochondria 801 00:43:57 --> 00:44:03 -- the notion that if I sit around and lecture about 802 00:44:03 --> 00:44:08 psychiatric disorders, you shouldn't go and be feeling 803 00:44:08 --> 00:44:12 your brain for the rest of the term saying oh man, I'm going 804 00:44:12 --> 00:44:14 to wake up with a dissociative disorder tomorrow and that's 805 00:44:14 --> 00:44:16 going to progress to schizophrenia and dimentia and 806 00:44:16 --> 00:44:19 I'm going to be dead. 807 00:44:19 --> 00:44:26 The fact that schizophrenia has a typical onset in a population 808 00:44:26 --> 00:44:29 of about your age doesn't mean that tomorrow we're going 809 00:44:29 --> 00:44:33 to have 300 schizophrenic students in this class. 810 00:44:33 --> 00:44:34 It does happen. 811 00:44:34 --> 00:44:37 812 00:44:37 --> 00:44:44 What convinced me -- a small aside. 813 00:44:44 --> 00:44:48 When you're discussing abnormal behavior, which we are now, 814 00:44:48 --> 00:44:52 there are two senses of that. 815 00:44:52 --> 00:44:55 One sense of that is all behaviors that you care 816 00:44:55 --> 00:44:58 to measure have some variability in them. 817 00:44:58 --> 00:45:03 You can simply assert that everybody above two 818 00:45:03 --> 00:45:06 standard deviations or something is abnormal. 819 00:45:06 --> 00:45:13 820 00:45:13 --> 00:45:15 We'll see as we go along that there are times when that is 821 00:45:15 --> 00:45:19 not an unreasonable thing to do. 822 00:45:19 --> 00:45:23 There are other times when it's a whacky thing to do. 823 00:45:23 --> 00:45:27 All right, for a wacky example, virtually everybody here is 824 00:45:27 --> 00:45:29 abnormal in that sense, but then the axis is 825 00:45:29 --> 00:45:31 SAT score, right. 826 00:45:31 --> 00:45:34 Most of you are up here in the upper tail of the distribution. 827 00:45:34 --> 00:45:36 Sure it's abnormal but we don't consider it as 828 00:45:36 --> 00:45:38 pathological, right? 829 00:45:38 --> 00:45:40 At least not in this community. 830 00:45:40 --> 00:45:43 831 00:45:43 --> 00:45:47 So the other possibility is that sure, the normal 832 00:45:47 --> 00:45:52 population is distributed like this, but there is a disease 833 00:45:52 --> 00:45:55 state of some sort that looks like this that's essentially 834 00:45:55 --> 00:45:59 discontinuous with the normal state. 835 00:45:59 --> 00:46:05 Arguments have been made, notably by a psychiatrist in 836 00:46:05 --> 00:46:09 the '60s whose name is probably pronounced something like 837 00:46:09 --> 00:46:11 Shosh -- a Hungarian name. 838 00:46:11 --> 00:46:14 Anybody happen to know the right answer? 839 00:46:14 --> 00:46:19 Anyway, Thomas Szasz will do or Shosh or something. 840 00:46:19 --> 00:46:23 In any case, he made the argument that in a book 841 00:46:23 --> 00:46:26 entitled Being Sane in an Insane World, that 842 00:46:26 --> 00:46:29 schizophrenia was simply a way to adapt to the fact that the 843 00:46:29 --> 00:46:32 Russians had lots of bombs and we had lots of bombs and we 844 00:46:32 --> 00:46:34 were all going to blow each other up, and that it was 845 00:46:34 --> 00:46:39 just one position on this normal curve. 846 00:46:39 --> 00:46:41 It's an interesting argument. 847 00:46:41 --> 00:46:46 But if you actually see somebody in the midst of a 848 00:46:46 --> 00:46:53 florid schizophrenic break from reality, it's hard to believe. 849 00:46:53 --> 00:46:56 I had, when I was an undergraduate, the roommate 850 00:46:56 --> 00:47:00 of a close friend of mine had such a break. 851 00:47:00 --> 00:47:04 It's unmistakable -- it's at once fascinating and 852 00:47:04 --> 00:47:06 deeply frightening. 853 00:47:06 --> 00:47:10 This was a friend of ours who became delusional -- she was 854 00:47:10 --> 00:47:16 hallucinating, she absolutely couldn't function, and was 855 00:47:16 --> 00:47:19 scaring the heck out of her roommate and she eventually 856 00:47:19 --> 00:47:24 -- actually, she eventually did fine. 857 00:47:24 --> 00:47:28 We caught up with her like twenty years later, and people 858 00:47:28 --> 00:47:31 do recover from schizophrenia and she was doing quite 859 00:47:31 --> 00:47:31 well, thank you. 860 00:47:31 --> 00:47:35 But in any case, she was the data point, that at least 861 00:47:35 --> 00:47:39 for me, argued strongly for the notion that this is a 862 00:47:39 --> 00:47:48 different state, not just a position on a continuum. 863 00:47:48 --> 00:47:52 In any case, the psychiatrists were busy trying to treat 864 00:47:52 --> 00:47:58 this with sor of Freudian psychotherapeutic techniques. 865 00:47:58 --> 00:48:00 It wasn't working. 866 00:48:00 --> 00:48:02 This wasn't because they were bad people -- these were 867 00:48:02 --> 00:48:07 well-intentioned people doing the best by their lights that 868 00:48:07 --> 00:48:08 they could, it just wasn't working. 869 00:48:08 --> 00:48:11 It was a case where the theory was just wrong. 870 00:48:11 --> 00:48:15 Oh, one of the engines that moved theory away from this, 871 00:48:15 --> 00:48:20 by the way, were parent advocacy groups. 872 00:48:20 --> 00:48:27 You've got to imagine that having a seriously ill child, 873 00:48:27 --> 00:48:29 whether that's a physical illness or a mental 874 00:48:29 --> 00:48:34 illness, is very traumatic for parents, period. 875 00:48:34 --> 00:48:40 But imagine how you would feel if the leading theory was that 876 00:48:40 --> 00:48:45 this was your fault, that you had done this to your child. 877 00:48:45 --> 00:48:49 Not intentionally, of course, but it was you who had done it. 878 00:48:49 --> 00:48:51 Parents simply didn't believe it. 879 00:48:51 --> 00:48:54 And as science started to emerge suggesting that in 880 00:48:54 --> 00:48:57 schizophrenia's case it was much more like a brain disease 881 00:48:57 --> 00:49:05 than like the product of bad mothering, that groups, funding 882 00:49:05 --> 00:49:08 groups -- you know, the guys who send you lots of mail at 883 00:49:08 --> 00:49:11 this time of year saying send us your check and we'll support 884 00:49:11 --> 00:49:16 good research on this disease that disease or whatever, a 885 00:49:16 --> 00:49:20 number of these groups powered by parents of schizophrenics 886 00:49:20 --> 00:49:23 were helping to move the research away from the notion 887 00:49:23 --> 00:49:25 of a schizophrenogenic mother. 888 00:49:25 --> 00:49:27 But what really did it was it just didn't work. 889 00:49:27 --> 00:49:31 Nobody could make this story work. 890 00:49:31 --> 00:49:38 The psychiatric hospitals are no longer filled with 891 00:49:38 --> 00:49:42 schizophrenic patients, and that's not because of a great 892 00:49:42 --> 00:49:45 breakthrough in Freudian psychotherapy, it's 893 00:49:45 --> 00:49:47 because of drugs. 894 00:49:47 --> 00:49:51 In the '50s drugs like Thorazine, Chlorpromazine 895 00:49:51 --> 00:49:56 is the technical name, came on the market. 896 00:49:56 --> 00:50:02 In this particular case these are drugs that block dopamine 897 00:50:02 --> 00:50:05 receptors -- dopamine's a neuro transmitter, the receptor on 898 00:50:05 --> 00:50:07 the other side of the synapse. 899 00:50:07 --> 00:50:17 Thorazine decreased the uptake of dopamine, and that served to 900 00:50:17 --> 00:50:21 ameliorate the florid symptoms of schizophrenia, 901 00:50:21 --> 00:50:22 in particular. 902 00:50:22 --> 00:50:25 You put somebody on Thorazine and they didn't hallucinate 903 00:50:25 --> 00:50:30 anymore, and their paranoid dilusions slipped away. 904 00:50:30 --> 00:50:35 Oh, let me tell you another anecdote about schizophrenics. 905 00:50:35 --> 00:50:37 Schizophrenics I have known. 906 00:50:37 --> 00:50:42 We had a very interesting woman who was the librarian in the 907 00:50:42 --> 00:50:52 department here some years ago -- PhD Classicist and also, she 908 00:50:52 --> 00:50:58 was schizophrenic and successfully medicated and 909 00:50:58 --> 00:51:03 functioned well as the psych department librarian 910 00:51:03 --> 00:51:06 when on medication. 911 00:51:06 --> 00:51:09 Anytime I tell you the root of something like schizophrenia, 912 00:51:09 --> 00:51:12 the Latin and Greek roots of these words, it's because I'm 913 00:51:12 --> 00:51:15 remembering what she taught me. 914 00:51:15 --> 00:51:19 But she would slip off of her medication. 915 00:51:19 --> 00:51:22 You could tell when she was slipping off her medication 916 00:51:22 --> 00:51:25 because her handwriting, her handwritten notes would start 917 00:51:25 --> 00:51:27 getting smaller and smaller and longer and longer. 918 00:51:27 --> 00:51:31 She developed this micro-writing and very 919 00:51:31 --> 00:51:33 extensive writing, and then the content would 920 00:51:33 --> 00:51:35 start to slip, too. 921 00:51:35 --> 00:51:39 And she would also start -- if it got dim in the library you 922 00:51:39 --> 00:51:43 knew you were in for trouble because she became photophobic. 923 00:51:43 --> 00:51:46 One of the interesting problems here and one of the problems in 924 00:51:46 --> 00:51:49 treatment was that as she fell off her medicine she 925 00:51:49 --> 00:51:50 became paranoid. 926 00:51:50 --> 00:51:52 What was the nature of her paranoia? 927 00:51:52 --> 00:51:55 The nature of her paranoia was that people wanted to control 928 00:51:55 --> 00:51:56 her brain using chemicals. 929 00:51:56 --> 00:51:58 Well that was exactly true. 930 00:51:58 --> 00:52:01 But if we would tell her, you gotta start taking your 931 00:52:01 --> 00:52:04 medicine, that was just evidence for her that we 932 00:52:04 --> 00:52:07 were trying to control her brain, which was true. 933 00:52:07 --> 00:52:11 So it wasn't even really -- it's very tricky stuff. 934 00:52:11 --> 00:52:14 I mean it's funny and sad at the same time. 935 00:52:14 --> 00:52:18 Eventually, she was no longer able to control this and 936 00:52:18 --> 00:52:24 was no longer able to hold the job, which was sad. 937 00:52:24 --> 00:52:29 But it's also a real issue, a real medical ethics issue. 938 00:52:29 --> 00:52:35 When the hospitals were emptied by these drugs, the promise was 939 00:52:35 --> 00:52:38 that supports would be placed in the community that would it 940 00:52:38 --> 00:52:45 make it possible for medicated schizophrenics to function. 941 00:52:45 --> 00:52:47 It's not a cure because the medicines are imperfect. 942 00:52:47 --> 00:52:51 For instance, it's not the case that dopamine -- the problem in 943 00:52:51 --> 00:52:54 schizophrenia isn't that dopamine is bad stuff and if 944 00:52:54 --> 00:52:56 you have lots of it you're in trouble. 945 00:52:56 --> 00:52:59 It is clear that in schizophrenia, bits of the 946 00:52:59 --> 00:53:03 brain are awash in too much dopamine, but if you wipe out 947 00:53:03 --> 00:53:06 -- if you just blanket, push down dopamine, other bits of 948 00:53:06 --> 00:53:10 the brain which really like dopamine are starved for it. 949 00:53:10 --> 00:53:14 The sorts of symptoms that you get when dopamine is removed 950 00:53:14 --> 00:53:16 from these chunks of the brain are the symptoms of Parkinson's 951 00:53:16 --> 00:53:20 disease -- muscle tremors, an inability to initiate 952 00:53:20 --> 00:53:22 voluntary activity. 953 00:53:22 --> 00:53:27 So a patient overmedicated on Thorazine isn't hallucinating 954 00:53:27 --> 00:53:30 anymore, but is also sort of inert. 955 00:53:30 --> 00:53:33 So it's not trivial to just say take this pill, 956 00:53:33 --> 00:53:34 great you're cured. 957 00:53:34 --> 00:53:37 It was clear that management was going to be needed. 958 00:53:37 --> 00:53:39 It was clear in many cases that people were going to need 959 00:53:39 --> 00:53:43 housing that was like sort of halfway housing, not complete 960 00:53:43 --> 00:53:48 independence, but you could be out in the world and you 961 00:53:48 --> 00:53:50 wouldn't need to be hospitalized anymore but you'd 962 00:53:50 --> 00:53:52 need some sort of continuing care. 963 00:53:52 --> 00:53:57 The problem is that we've systematically not given 964 00:53:57 --> 00:54:01 enough, basically money and resources to that. 965 00:54:01 --> 00:54:09 The result is there are numbers of imperfectly -- perfect 966 00:54:09 --> 00:54:16 medication isn't out there yet -- but inadequately medicated, 967 00:54:16 --> 00:54:19 unsuccessfully medicated patients who ought to be cared 968 00:54:19 --> 00:54:24 for, but who are not being cared for for by the system. 969 00:54:24 --> 00:54:28 970 00:54:28 --> 00:54:30 Schizophrenics are over-represented in the 971 00:54:30 --> 00:54:35 homeless population because if you are not successfully 972 00:54:35 --> 00:54:40 medicated it's hard to hold a job, it's hard to keep an 973 00:54:40 --> 00:54:43 apartment or something like that and you end 974 00:54:43 --> 00:54:44 up on the street. 975 00:54:44 --> 00:54:47 That loops back to this issue about your paranoid delusion 976 00:54:47 --> 00:54:50 about somebody trying to control your mind. 977 00:54:50 --> 00:54:54 When is it OK then, now that you're on the street, now that 978 00:54:54 --> 00:54:58 you're floridly schizophrenic again, when is it OK for us as 979 00:54:58 --> 00:55:01 a society to come in and say guess what, we don't care that 980 00:55:01 --> 00:55:03 you think we're trying to control your mind, we're going 981 00:55:03 --> 00:55:06 to medicate you whether you want to or not because 982 00:55:06 --> 00:55:08 it's for your own good. 983 00:55:08 --> 00:55:11 You can argue yeah, it's for your own good, but there's lots 984 00:55:11 --> 00:55:14 of things that -- you know, I might decide it's for your own 985 00:55:14 --> 00:55:16 good that you should sleep eight hours a night. 986 00:55:16 --> 00:55:18 Do I get to enforce that? 987 00:55:18 --> 00:55:20 No, I don't. 988 00:55:20 --> 00:55:24 If I decide that it's good for you to take a drug that is 989 00:55:24 --> 00:55:28 going to, in fact, control your mind, when do I get to do that, 990 00:55:28 --> 00:55:31 and this ends up in court regularly, and it ends up on 991 00:55:31 --> 00:55:34 talk radio all the time, right, because it's a sort of thing 992 00:55:34 --> 00:55:37 that yakking head talk radio loves to get excited about. 993 00:55:37 --> 00:55:43 You know some judge declares that some clearly schizophrenic 994 00:55:43 --> 00:55:48 individual has a constitutional right to live under a bridge 995 00:55:48 --> 00:55:55 yelling obscenities at you, and talk radio goes nuts. 996 00:55:55 --> 00:55:57 It's an interesting question. 997 00:55:57 --> 00:56:00 It's not a question with an easy answer. 998 00:56:00 --> 00:56:04 When do you get to decide that you're allowed to take control 999 00:56:04 --> 00:56:10 over somebody else's mental life? 1000 00:56:10 --> 00:56:19 At the present, the view of schizophrenia is, as I say, 1001 00:56:19 --> 00:56:21 much more that it's a distinct state of brain 1002 00:56:21 --> 00:56:22 disease of some sort. 1003 00:56:22 --> 00:56:23 What might cause it? 1004 00:56:23 --> 00:56:30 Well, the fact that a pill that reduces the effects of dopamine 1005 00:56:30 --> 00:56:32 does something tends to suggest to people that there's a 1006 00:56:32 --> 00:56:35 biological cause there. 1007 00:56:35 --> 00:56:37 In the case of schizophrenia that well maybe true, but it's 1008 00:56:37 --> 00:56:40 important to note that that doesn't need to be true. 1009 00:56:40 --> 00:56:44 Things that are cured or symptoms that are cured by 1010 00:56:44 --> 00:56:48 pills aren't necessarily symptoms that are caused by bad 1011 00:56:48 --> 00:56:53 genes or bacteria or some biological story like that. 1012 00:56:53 --> 00:56:56 A perfectly nice example is motion sickness. 1013 00:56:56 --> 00:56:59 You go on an airplane, you get bounced around, you throw up. 1014 00:56:59 --> 00:57:01 What are you going to do about this? 1015 00:57:01 --> 00:57:05 Well, you can take scopolamine or meclizine that's Bonine -- 1016 00:57:05 --> 00:57:09 Bonine is meclizine and dramamine is scopolamine -- two 1017 00:57:09 --> 00:57:13 perfectly nice drugs that affect your vestibular system, 1018 00:57:13 --> 00:57:16 and they will keep you from getting motion sick. 1019 00:57:16 --> 00:57:19 That's not because you've got bad motion sickness genes or 1020 00:57:19 --> 00:57:22 you got the motion sickness bacteria. 1021 00:57:22 --> 00:57:25 It's a biological treatment, if you like, for 1022 00:57:25 --> 00:57:29 an environmentally caused disorder. 1023 00:57:29 --> 00:57:35 I point that out only to make the point that what cures or 1024 00:57:35 --> 00:57:38 treats a disorder doesn't necessarily tell you 1025 00:57:38 --> 00:57:40 what the cause is. 1026 00:57:40 --> 00:57:44 There's not one-to-one mapping there -- that's important 1027 00:57:44 --> 00:57:46 to keep in mind. 1028 00:57:46 --> 00:57:48 But the drugs certainly do help with the symptoms. 1029 00:57:48 --> 00:57:54 What psychopharmacologists work on a lot now is getting 1030 00:57:54 --> 00:57:56 drugs that work better. 1031 00:57:56 --> 00:57:59 All right, we want to reduce dopamine here but not here. 1032 00:57:59 --> 00:58:02 Well it turns out that there's a bunch of different dopamine 1033 00:58:02 --> 00:58:05 receptors -- let's make a drug that only acts at this location 1034 00:58:05 --> 00:58:07 and not at this location. 1035 00:58:07 --> 00:58:12 That's a sort of project that psychopharmacology works 1036 00:58:12 --> 00:58:14 on at the present time. 1037 00:58:14 --> 00:58:20 But I want to go back and talk about the possible causes of 1038 00:58:20 --> 00:58:24 mental illness, but I'll do that after we take a 1039 00:58:24 --> 00:58:25 brief break here. 1040 00:58:25 --> 01:00:09 1041 01:00:09 --> 01:00:10 OK. 1042 01:00:10 --> 01:00:16 What I want to do with the remaining portion, probably all 1043 01:00:16 --> 01:00:21 of the remaining portion, of today's lecture is to make two 1044 01:00:21 --> 01:00:25 points, which I have already alluded to. 1045 01:00:25 --> 01:00:29 One of them is that there are multiple roots into mental 1046 01:00:29 --> 01:00:33 illness, not just any sort of single root, and you're going 1047 01:00:33 --> 01:00:36 to need to work this out on a case-by-case basis. 1048 01:00:36 --> 01:00:42 The other related point is that the border between normal and 1049 01:00:42 --> 01:00:46 abnormal is not necessarily a sharp clearly marked one. 1050 01:00:46 --> 01:00:50 Oh, by the way, if you're interested in this latter 1051 01:00:50 --> 01:00:54 point, there's an article in today's New York Times science 1052 01:00:54 --> 01:00:58 section about really exactly this point in the context of 1053 01:00:58 --> 01:01:01 eating disorders -- a topic that I hope to get to before 1054 01:01:01 --> 01:01:07 the end of the course -- where it's very important to be 1055 01:01:07 --> 01:01:13 able to give a label to psychiatric conditions. 1056 01:01:13 --> 01:01:15 Why is that important? 1057 01:01:15 --> 01:01:20 In part it's important because third party payers will pay if 1058 01:01:20 --> 01:01:23 you have a disorder, but they won't pay if you're 1059 01:01:23 --> 01:01:26 just feeling a little screwed up, right. 1060 01:01:26 --> 01:01:28 So you gotta have a labeled disorder. 1061 01:01:28 --> 01:01:33 So, there's been a big movement within the American Psychiatric 1062 01:01:33 --> 01:01:37 establishment to come up with clear diagnostic criteria. 1063 01:01:37 --> 01:01:40 The nice thing about, you know you go into your pediatrician 1064 01:01:40 --> 01:01:45 and getting a throat culture for strep is that I can grow it 1065 01:01:45 --> 01:01:49 in the lab, and if you got strep you got strep, and I'd 1066 01:01:49 --> 01:01:51 give you something for strep. 1067 01:01:51 --> 01:01:55 Mental illness is almost never like that. 1068 01:01:55 --> 01:01:58 You got some collection of symptoms, are they adequate 1069 01:01:58 --> 01:02:03 to get you the definition of this disease? 1070 01:02:03 --> 01:02:09 The Times article is pointing out that therapists are having 1071 01:02:09 --> 01:02:14 a real problems with people who any idiot can see has, let's 1072 01:02:14 --> 01:02:18 say, an eating disorder, but the official criteria for 1073 01:02:18 --> 01:02:24 anorexia nervosa, the eating disorder of self-starvation, 1074 01:02:24 --> 01:02:27 are you have to have boom, boom, boom, boom and boom. 1075 01:02:27 --> 01:02:30 Well, if you're missing that boom, you can't 1076 01:02:30 --> 01:02:32 make the diagnosis. 1077 01:02:32 --> 01:02:34 What do you call them now? 1078 01:02:34 --> 01:02:36 Anyway, so today's New York Times science section, 1079 01:02:36 --> 01:02:38 go check it out. 1080 01:02:38 --> 01:02:43 In the meantime, let us return to 1900 to talk a bit about 1081 01:02:43 --> 01:02:47 possible causes of mental illness. 1082 01:02:47 --> 01:02:54 In 1900 half the patients in American mental hospitals 1083 01:02:54 --> 01:02:57 had a disorder known as dementia paralytica. 1084 01:02:57 --> 01:02:59 This is the bad stuff. 1085 01:02:59 --> 01:03:04 It's a disorder that starts with mania and grandiosity 1086 01:03:04 --> 01:03:05 as its symptoms. 1087 01:03:05 --> 01:03:09 1088 01:03:09 --> 01:03:15 If you think that you are Jesus and that you can turn water 1089 01:03:15 --> 01:03:19 into wine and stuff like that, except in the rare case where 1090 01:03:19 --> 01:03:25 that turns out to be true or something, it's a psychiatric 1091 01:03:25 --> 01:03:32 symptom and it would be a manic symptom of some sort. 1092 01:03:32 --> 01:03:35 If you think you're the reincarnation of Napoleon and 1093 01:03:35 --> 01:03:39 this time you're going to get the invasion of Russia right or 1094 01:03:39 --> 01:03:41 something like that, you know, that's the sort of thing that 1095 01:03:41 --> 01:03:44 gets you into psychiatric care. 1096 01:03:44 --> 01:03:49 In the case of dimentia paralytica, it then 1097 01:03:49 --> 01:03:51 proceeded to the other two bits of the name. 1098 01:03:51 --> 01:03:55 Dementia, people became demented, they then became 1099 01:03:55 --> 01:03:58 paralyzed, lost control their muscles and then they died. 1100 01:03:58 --> 01:04:02 This is not a good disorder. 1101 01:04:02 --> 01:04:04 It has disappeared essentially. 1102 01:04:04 --> 01:04:07 Why? 1103 01:04:07 --> 01:04:11 Does anybody happen to know the answer? 1104 01:04:11 --> 01:04:12 Yes. 1105 01:04:12 --> 01:04:14 Which person? 1106 01:04:14 --> 01:04:16 What are you looking behind you for? 1107 01:04:16 --> 01:04:19 How many people are wearing witchy hats? 1108 01:04:19 --> 01:04:22 1109 01:04:22 --> 01:04:27 How long have you thought you were a witch? 1110 01:04:27 --> 01:04:29 Anyway, you were saying. 1111 01:04:29 --> 01:04:35 AUDIENCE: This is caused by bacteria I think, or something 1112 01:04:35 --> 01:04:37 that they like [INAUDIBLE]. 1113 01:04:37 --> 01:04:39 PROFESSOR: Well, all right. 1114 01:04:39 --> 01:04:42 The problem is people know too much around here. 1115 01:04:42 --> 01:04:45 You can fish around for all sorts of interesting answers, 1116 01:04:45 --> 01:04:47 like one of the possible reasons for a diagnosis to 1117 01:04:47 --> 01:04:50 disappear is you fractionate the disorder into a bunch of 1118 01:04:50 --> 01:04:53 other stuff and we've now renamed it and this is now 1119 01:04:53 --> 01:04:55 called Alzheimers and a few other things. 1120 01:04:55 --> 01:04:57 But no, in fact, this is an outside pathogen. 1121 01:04:57 --> 01:05:03 In this case, dementia paralytica was the result of 1122 01:05:03 --> 01:05:06 tertiary third stage syphilis. 1123 01:05:06 --> 01:05:09 The reason you don't see it anymore is that nobody gets to 1124 01:05:09 --> 01:05:11 third stage syphilis anymore. 1125 01:05:11 --> 01:05:15 If you show up with symptoms of syphilis somebody treats you. 1126 01:05:15 --> 01:05:18 This was the result, by the time the organism had 1127 01:05:18 --> 01:05:21 gotten to your brain and chewed up your brain. 1128 01:05:21 --> 01:05:23 1129 01:05:23 --> 01:05:26 So it disappeared with treatment. 1130 01:05:26 --> 01:05:31 But it points out is that one of the roots to mental illness 1131 01:05:31 --> 01:05:37 is an assault, a biological assault from the outside. 1132 01:05:37 --> 01:05:41 1133 01:05:41 --> 01:05:48 So there are theories, unproven theories that a rise in autism, 1134 01:05:48 --> 01:05:51 that's been seen in this country over the last couple of 1135 01:05:51 --> 01:05:55 generations, is due to some sort of external insult to the 1136 01:05:55 --> 01:06:00 nervous system, not clear what it is, but there are proposals 1137 01:06:00 --> 01:06:01 out there that something that we're doing to the 1138 01:06:01 --> 01:06:06 environment is causing more autism, for example. 1139 01:06:06 --> 01:06:08 1140 01:06:08 --> 01:06:11 But this is an example of a clearly biologically 1141 01:06:11 --> 01:06:16 rooted mental illness. 1142 01:06:16 --> 01:06:18 1143 01:06:18 --> 01:06:25 Perhaps the extreme other end of the scale would be -- well, 1144 01:06:25 --> 01:06:26 it's more like a triangle. 1145 01:06:26 --> 01:06:37 We could have biology, we could have an environmental disorder, 1146 01:06:37 --> 01:06:40 and we could have what you might consider to be a 1147 01:06:40 --> 01:06:43 societally defined disorder. 1148 01:06:43 --> 01:06:48 The distinction here is this is a case where the environment 1149 01:06:48 --> 01:06:52 somehow really does make you insane, and this is a case 1150 01:06:52 --> 01:06:56 where we take the normal distribution and declare the 1151 01:06:56 --> 01:07:00 upper tail of the distribution to be a psychopathology 1152 01:07:00 --> 01:07:02 of some sort. 1153 01:07:02 --> 01:07:05 So let's look for examples of both of these. 1154 01:07:05 --> 01:07:08 A perfectly nice example -- not nice -- an example of an 1155 01:07:08 --> 01:07:15 environmental disorder would be what was called shell-shock in 1156 01:07:15 --> 01:07:19 World War I and would now probably be more generally 1157 01:07:19 --> 01:07:23 lumped under the category of traumatic stress disorder. 1158 01:07:23 --> 01:07:35 Exposure to extreme stress and being shot at can produce 1159 01:07:35 --> 01:07:39 a range of disabling psychiatric symptoms. 1160 01:07:39 --> 01:07:45 So, in World War I when people were fighting this insane 1161 01:07:45 --> 01:07:50 warfare of having vast numbers of people in entrenched 1162 01:07:50 --> 01:07:55 positions shelling each other and just charging at each 1163 01:07:55 --> 01:08:00 other, some fraction of the population of 1164 01:08:00 --> 01:08:02 soldiers cracked up. 1165 01:08:02 --> 01:08:04 They just couldn't function. 1166 01:08:04 --> 01:08:07 They would cry hysterically, they would just lie there 1167 01:08:07 --> 01:08:10 and not do anything. 1168 01:08:10 --> 01:08:15 The first reaction of the military to such things is 1169 01:08:15 --> 01:08:18 to decide that this is insubordination and to shoot 1170 01:08:18 --> 01:08:22 you or something of that sort for failing to obey orders. 1171 01:08:22 --> 01:08:28 But it became clear to medical folks during World War I that 1172 01:08:28 --> 01:08:33 this was not a voluntary act, this was a psychiatric problem. 1173 01:08:33 --> 01:08:38 1174 01:08:38 --> 01:08:42 They went and pulled people back behind the lines, worked 1175 01:08:42 --> 01:08:45 very hard to treat them so that they could return them to the 1176 01:08:45 --> 01:08:49 war in a sort of a sick irony. 1177 01:08:49 --> 01:08:56 But this is a disorder that is clearly environmental. 1178 01:08:56 --> 01:09:00 Now there's probably some -- not everybody who's placed 1179 01:09:00 --> 01:09:05 under stress produces a post traumatic stress disorder, so 1180 01:09:05 --> 01:09:09 it's clear that there's some underlying variation of unknown 1181 01:09:09 --> 01:09:12 nature that makes some people vulnerable to it and 1182 01:09:12 --> 01:09:13 some people not. 1183 01:09:13 --> 01:09:17 But the precipitating cause here is environmental. 1184 01:09:17 --> 01:09:21 Now this is something that's a topic of a lot of current 1185 01:09:21 --> 01:09:27 interest in psychiatry and in clinical psychology. 1186 01:09:27 --> 01:09:31 Because as it's been appreciated that this sort of 1187 01:09:31 --> 01:09:39 trauma does produce psychiatric symptoms, efforts are made to 1188 01:09:39 --> 01:09:42 prevent this when it's clear it's going to happen. 1189 01:09:42 --> 01:09:48 So, first responders, the police and firemen who are 1190 01:09:48 --> 01:09:51 going to be the first guys that crash scenes or into burning 1191 01:09:51 --> 01:09:56 buildings, are going to see really terrible stuff, and it's 1192 01:09:56 --> 01:10:01 known that that's going to produce a collection of 1193 01:10:01 --> 01:10:02 psychiatric symptoms. 1194 01:10:02 --> 01:10:07 So, an interesting question is well if you know that, what 1195 01:10:07 --> 01:10:11 could you do perhaps to ameliorate the situation? 1196 01:10:11 --> 01:10:16 One very popular idea has been that after a crisis -- I mean 1197 01:10:16 --> 01:10:23 you hear this all the time when something really bad happens 1198 01:10:23 --> 01:10:26 like a school shooting or something, one of the things 1199 01:10:26 --> 01:10:28 you do is you immediately pour in a bunch of therapists, and 1200 01:10:28 --> 01:10:32 the idea is is you get people together to talk about it. 1201 01:10:32 --> 01:10:35 One particular modality of therapy is you basically get 1202 01:10:35 --> 01:10:40 all your firefighters who were at this scene into a room 1203 01:10:40 --> 01:10:45 together to talk it through, and that this has been proposed 1204 01:10:45 --> 01:10:49 as a mechanism for preventing these stress disorders. 1205 01:10:49 --> 01:10:53 Unfortunately, a big study came out last year suggesting 1206 01:10:53 --> 01:10:56 sounds lovely, doesn't work. 1207 01:10:56 --> 01:10:59 Not that it does anything particularly bad or anything, 1208 01:10:59 --> 01:11:01 it just doesn't work. 1209 01:11:01 --> 01:11:05 1210 01:11:05 --> 01:11:10 What it points out is that the state of the art is a little 1211 01:11:10 --> 01:11:12 like the problem I was talking about with Freudian attempts 1212 01:11:12 --> 01:11:16 to explain schizophrenia. 1213 01:11:16 --> 01:11:21 These are difficult problems where good well-meaning 1214 01:11:21 --> 01:11:25 clinicians try stuff out that doesn't necessarily work. 1215 01:11:25 --> 01:11:28 Very hard to get a clear feeling from this, from reading 1216 01:11:28 --> 01:11:32 the popular press where you get one miracle cure after the 1217 01:11:32 --> 01:11:36 other and then the miracle cure fades away, but it fades away 1218 01:11:36 --> 01:11:38 in the literature somewhere -- you don't get to see this very 1219 01:11:38 --> 01:11:43 clearly if you just sit there reading the science section 1220 01:11:43 --> 01:11:48 of Time magazine or something of that sort. 1221 01:11:48 --> 01:11:55 Anyway, so third stage syphilis munches up your mind, trench 1222 01:11:55 --> 01:11:58 warfare munches up your mind. 1223 01:11:58 --> 01:12:05 Are there diseases that are defined purely by society 1224 01:12:05 --> 01:12:08 and what does that mean? 1225 01:12:08 --> 01:12:09 Are those legitimate? 1226 01:12:09 --> 01:12:12 Well, let's talk about one that's not terribly legitimate. 1227 01:12:12 --> 01:12:16 I don't think anybody here is deeply familiar with the 1228 01:12:16 --> 01:12:19 disorder called drapetomania. 1229 01:12:19 --> 01:12:22 Any drapetomania experts? 1230 01:12:22 --> 01:12:23 No. 1231 01:12:23 --> 01:12:25 OK. 1232 01:12:25 --> 01:12:28 Any Greek scholars? 1233 01:12:28 --> 01:12:28 No. 1234 01:12:28 --> 01:12:30 So we're not going to get anybody to tell 1235 01:12:30 --> 01:12:31 us what the root is. 1236 01:12:31 --> 01:12:35 So, it's not a manic desire to put up drapes. 1237 01:12:35 --> 01:12:40 It's drapeto comes from a Greek root having to do 1238 01:12:40 --> 01:12:45 with wandering off, and the mania's the mania part. 1239 01:12:45 --> 01:12:48 So it's an insane desire to wander away. 1240 01:12:48 --> 01:12:51 All right, that sounds like it could be insane. 1241 01:12:51 --> 01:12:57 This is a disorder discovered by a doctor named Cartwright 1242 01:12:57 --> 01:13:02 in Louisiana in the 1840s. 1243 01:13:02 --> 01:13:06 He writes about it in a book endearingly titled, 1244 01:13:06 --> 01:13:09 Peculiarities of the Negro Race. 1245 01:13:09 --> 01:13:13 So you need to think -- all right, time to review 1246 01:13:13 --> 01:13:15 your AP American history. 1247 01:13:15 --> 01:13:18 Right, 1840s, Louisiana. 1248 01:13:18 --> 01:13:23 If you are a member of the negro race you are what? 1249 01:13:23 --> 01:13:24 A slave. 1250 01:13:24 --> 01:13:26 If you are a slave you might do what? 1251 01:13:26 --> 01:13:30 1252 01:13:30 --> 01:13:36 Well you might wander off or run away. 1253 01:13:36 --> 01:13:38 It wasn't that Cartwright discovered this. 1254 01:13:38 --> 01:13:40 People knew that slaves ran away. 1255 01:13:40 --> 01:13:44 But rather like earlier attitudes towards people 1256 01:13:44 --> 01:13:47 cracking up on the battlefield, the standard attitude towards 1257 01:13:47 --> 01:13:52 the slave that ran away was that's a bad slave. 1258 01:13:52 --> 01:13:57 Right, he's just bad, and what we should do is catch him 1259 01:13:57 --> 01:14:00 and beat him and put him back to work. 1260 01:14:00 --> 01:14:05 Cartwright was an odd sort of liberal from the sound of it in 1261 01:14:05 --> 01:14:09 the sense that he said, no, no, no, no, no -- they're 1262 01:14:09 --> 01:14:11 not bad, they're sick. 1263 01:14:11 --> 01:14:16 Because after all, as he understood it, the proper place 1264 01:14:16 --> 01:14:21 for a slave for an African American was to be 1265 01:14:21 --> 01:14:22 a slave, right? 1266 01:14:22 --> 01:14:28 So if you wandered off, you weren't being a 1267 01:14:28 --> 01:14:29 healthy, normal slave. 1268 01:14:29 --> 01:14:33 You'd gone up here somewhere and you were being abnormal. 1269 01:14:33 --> 01:14:36 He also, by the way, had a lovely biological theory about 1270 01:14:36 --> 01:14:41 the cause of this, which was decarbonized blood. 1271 01:14:41 --> 01:14:44 I don't know, it sounds like it would do something bad to me. 1272 01:14:44 --> 01:14:48 1273 01:14:48 --> 01:14:50 And he had a treatment regimen. 1274 01:14:50 --> 01:14:53 Remember that the standard treatment for a slave who ran 1275 01:14:53 --> 01:14:59 away was catch him, beat him and put him back to work. 1276 01:14:59 --> 01:15:05 Cartwright said, when you catch him, what you need to do is 1277 01:15:05 --> 01:15:09 slap some oil in with a broad leather strap and 1278 01:15:09 --> 01:15:10 put him to work. 1279 01:15:10 --> 01:15:12 All right, so the treatment didn't sound all 1280 01:15:12 --> 01:15:13 that different. 1281 01:15:13 --> 01:15:20 In any case, it's a pretty clear case of a disorder 1282 01:15:20 --> 01:15:24 defined entirely by society. 1283 01:15:24 --> 01:15:26 There's not a -- I don't know, decarbonized 1284 01:15:26 --> 01:15:27 blood not withstanding. 1285 01:15:27 --> 01:15:31 There's not an organism there. 1286 01:15:31 --> 01:15:34 There's not -- well, you can think of the environment as 1287 01:15:34 --> 01:15:37 causing the slave to run away, but not in the sense 1288 01:15:37 --> 01:15:39 of causing a disorder. 1289 01:15:39 --> 01:15:43 We would consider this to be essentially a normal -- we'd be 1290 01:15:43 --> 01:15:45 with Thomas Szasz on that, that's a sane reaction to an 1291 01:15:45 --> 01:15:52 insane world, perhaps, to be a slave and to run away. 1292 01:15:52 --> 01:15:57 Now, you might argue that we don't do that anymore, but 1293 01:15:57 --> 01:16:02 if you were to, say, OK, what this is, is weight. 1294 01:16:02 --> 01:16:06 Let's make this normal distribution weight. 1295 01:16:06 --> 01:16:11 The Surgeon General is perfectly happy and all sorts 1296 01:16:11 --> 01:16:14 of outfits are perfectly happy to declare that if you're above 1297 01:16:14 --> 01:16:17 this level whatever it is, you're abnormal, 1298 01:16:17 --> 01:16:20 you're overweight. 1299 01:16:20 --> 01:16:24 And there are plenty of theories, folks psychological 1300 01:16:24 --> 01:16:28 and otherwise, that basically give a psychiatric spin to 1301 01:16:28 --> 01:16:30 what's going on there, right. 1302 01:16:30 --> 01:16:36 If you've heard theories of obesity being -- there are pop 1303 01:16:36 --> 01:16:39 theories that oh, they're overcompensating -- that 1304 01:16:39 --> 01:16:41 they're eating to substitute for the lack of love in their 1305 01:16:41 --> 01:16:46 life, or it's a lack of self-control, or it's because 1306 01:16:46 --> 01:16:50 they have gene for fatness. 1307 01:16:50 --> 01:16:52 All of this might be true at some level. 1308 01:16:52 --> 01:16:58 I'm not casting any doubt on the particular theory, 1309 01:16:58 --> 01:17:00 that's a separate topic. 1310 01:17:00 --> 01:17:03 But you gotta realize that what you're doing is taking an 1311 01:17:03 --> 01:17:07 essentially normal distribution with the exception of some very 1312 01:17:07 --> 01:17:11 few -- there are a small number of clear pathologies 1313 01:17:11 --> 01:17:12 of weight regulation. 1314 01:17:12 --> 01:17:15 Mostly what you're doing is taking one tail of the 1315 01:17:15 --> 01:17:18 distribution, declaring it to be abnormal, and putting 1316 01:17:18 --> 01:17:21 an explanation on it. 1317 01:17:21 --> 01:17:28 How you understand that is culturally dependent. 1318 01:17:28 --> 01:17:31 How we talk about obesity is in part defined by how 1319 01:17:31 --> 01:17:33 we talk about beauty. 1320 01:17:33 --> 01:17:38 In cultures where obesity is considered beautiful, you don't 1321 01:17:38 --> 01:17:42 get theories that say it's an abnormality, right? 1322 01:17:42 --> 01:17:47 So in some fashion we do this all the time. 1323 01:17:47 --> 01:17:51 1324 01:17:51 --> 01:17:55 In the remaining time, what I want to do, and then I'll loop 1325 01:17:55 --> 01:18:02 back to this point, is look on your handout on page three. 1326 01:18:02 --> 01:18:07 Let's do a little bit of armchair diagnosis here. 1327 01:18:07 --> 01:18:08 We don't have much time. 1328 01:18:08 --> 01:18:13 Quickly read these three vignettes and quickly decide 1329 01:18:13 --> 01:18:18 where they lie on the scale from fine to very weird. 1330 01:18:18 --> 01:18:22 I'm deliberately using very casual language there in order 1331 01:18:22 --> 01:18:26 to suggest that you not think deeply about whether or not 1332 01:18:26 --> 01:18:28 you're giving them a psychiatric diagnosis 1333 01:18:28 --> 01:18:30 here, I just want to know whether they're nuts. 1334 01:18:30 --> 01:18:36 1335 01:18:36 --> 01:18:37 We'll collect a little data. 1336 01:18:37 --> 01:18:39 How are we going to collect this data? 1337 01:18:39 --> 01:19:04 1338 01:19:04 --> 01:19:07 Don't cheat off your neighbors, please, and [? wavel ?] 1339 01:19:07 --> 01:19:08 in when you're done. 1340 01:19:08 --> 01:19:11 How many people are done? 1341 01:19:11 --> 01:19:11 Most people are done. 1342 01:19:11 --> 01:19:14 OK, good enough. 1343 01:19:14 --> 01:19:17 In the interest of getting some data relatively quickly, let's 1344 01:19:17 --> 01:19:30 group between -- let's do aluminum hat boy, Jim. 1345 01:19:30 --> 01:19:35 How many people gave him a sort of 1-3, he's fine? 1346 01:19:35 --> 01:19:38 4-7 he's a little weird. 1347 01:19:38 --> 01:19:41 I take it we got a lot of population-- All right. 1348 01:19:41 --> 01:19:45 1349 01:19:45 --> 01:19:46 So Jim's here. 1350 01:19:46 --> 01:19:49 1351 01:19:49 --> 01:19:52 How about Jack there at the bottom -- we'll 1352 01:19:52 --> 01:19:53 come back to Sam. 1353 01:19:53 --> 01:19:55 How many people thought Jack was in the 1-3 1354 01:19:55 --> 01:19:57 he's fine category? 1355 01:19:57 --> 01:20:00 1356 01:20:00 --> 01:20:00 A bunch of people. 1357 01:20:00 --> 01:20:04 How many people thought he's in the 4-7 category? 1358 01:20:04 --> 01:20:06 A bunch more people. 1359 01:20:06 --> 01:20:08 Let's give him some hash marks here so we can 1360 01:20:08 --> 01:20:11 tell the difference. 1361 01:20:11 --> 01:20:12 So this is -- what is his name? 1362 01:20:12 --> 01:20:13 Jack. 1363 01:20:13 --> 01:20:17 1364 01:20:17 --> 01:20:19 How many people thought he was very weird? 1365 01:20:19 --> 01:20:21 So only a very few. 1366 01:20:21 --> 01:20:25 So, you can, in fact -- so Jim is sort of the guy who came to 1367 01:20:25 --> 01:20:28 my lab all those years ago, and Jack can be found in Harvard 1368 01:20:28 --> 01:20:32 Square any time selling some far left newspaper and yelling 1369 01:20:32 --> 01:20:35 at you about the fact that we're all controlled by 1370 01:20:35 --> 01:20:38 something, and we just consider them to be sort of weird but 1371 01:20:38 --> 01:20:41 kind of -- this is in the realm of free speech. 1372 01:20:41 --> 01:20:44 All right, let's take a look at Sam. 1373 01:20:44 --> 01:20:49 How many people thought Sam's just fine? 1374 01:20:49 --> 01:20:50 OK. 1375 01:20:50 --> 01:20:53 How many thought Sam was just in the middle? 1376 01:20:53 --> 01:20:54 OK. 1377 01:20:54 --> 01:20:57 How many thought that Sam was pretty weird? 1378 01:20:57 --> 01:21:02 All right, so that looks-- I need some space here. 1379 01:21:02 --> 01:21:10 1380 01:21:10 --> 01:21:13 Well actually, lots of fines, a few less in the middles, 1381 01:21:13 --> 01:21:17 and almost as many weird. 1382 01:21:17 --> 01:21:19 Pretty wide distribution, right. 1383 01:21:19 --> 01:21:22 The other two are very heavily skewed. 1384 01:21:22 --> 01:21:26 Could somebody in the fine department 1385 01:21:26 --> 01:21:29 explain why he's fine? 1386 01:21:29 --> 01:21:30 Yes, find person. 1387 01:21:30 --> 01:21:33 AUDIENCE: I think he's weird, I just don't think he's disabled. 1388 01:21:33 --> 01:21:36 PROFESSOR: I need somebody who thinks he's fine, fine. 1389 01:21:36 --> 01:21:38 Yes. 1390 01:21:38 --> 01:21:39 Yes, you pink person. 1391 01:21:39 --> 01:21:42 1392 01:21:42 --> 01:21:45 AUDIENCE: He's just a stamp collector -- he sounds fine. 1393 01:21:45 --> 01:21:47 PROFESSOR: A stamp collector. 1394 01:21:47 --> 01:21:49 All right. 1395 01:21:49 --> 01:21:55 The trick here is there is a two-word variation between what 1396 01:21:55 --> 01:21:58 half of you have and what the other half of you have. 1397 01:21:58 --> 01:22:03 Let's see if that makes a difference. 1398 01:22:03 --> 01:22:06 The people who don't have the stamp collector one know the 1399 01:22:06 --> 01:22:13 difference, which is that one half of you have his major 1400 01:22:13 --> 01:22:17 passion is collecting stamps, and the other have his major 1401 01:22:17 --> 01:22:18 passion is collecting women's undergarments. 1402 01:22:18 --> 01:22:22 1403 01:22:22 --> 01:22:24 Right. 1404 01:22:24 --> 01:22:26 That is the only difference here. 1405 01:22:26 --> 01:22:27 Yes? 1406 01:22:27 --> 01:22:37 AUDIENCE: [INAUDIBLE] 1407 01:22:37 --> 01:22:39 PROFESSOR: You know, actually that's lovely because I 1408 01:22:39 --> 01:22:45 could probably expand the description. 1409 01:22:45 --> 01:22:49 If I said he used to write all of his relatives and asked them 1410 01:22:49 --> 01:22:54 to send him used stamps, nobody would think that was weird. 1411 01:22:54 --> 01:22:57 If I said he used to write to all his relatives and asked 1412 01:22:57 --> 01:23:02 them to send used underwear, that's really weird, right? 1413 01:23:02 --> 01:23:05 1414 01:23:05 --> 01:23:09 If I changed it a little more to say -- what is his name? 1415 01:23:09 --> 01:23:14 Sam was a shy, withdrawn man, the president of the Haines 1416 01:23:14 --> 01:23:19 underwear company and at the corporate headquarters he had 1417 01:23:19 --> 01:23:22 the big underwear exhibit or something, then he 1418 01:23:22 --> 01:23:24 becomes less weird. 1419 01:23:24 --> 01:23:29 Given the time, let me just reiterate the point that what 1420 01:23:29 --> 01:23:33 this is intended to illustrate is that the border between what 1421 01:23:33 --> 01:23:38 makes you weird and what makes you just a little 1422 01:23:38 --> 01:23:42 different is not clear. 1423 01:23:42 --> 01:23:44 It's not something that we can define nice and sharply. 1424 01:23:44 --> 01:23:47 See you Thursday. 1425 01:23:47 --> 01:23:47