Brain-imaging and neurorealism: what does it mean to "feel something" in your brain?

Ben "Bad Science" Goldacre dissects the reporting of an experiment purporting to show a neurological basis for low libido in women's brains. Goldacre points out that the alternative to believing in a neurological basis for how you feel is to believe that you can feel something without having something happen in your brain.

Interestingly, this odd interpretation is far from new: in fact it's part of a whole series of recurring themes in popular misinterpretations of neuroscience, first described formally in a paper from Nature Reviews Neuroscience called "fMRI in the public eye". To examine how fMRI brain imaging research was depicted in mainstream media, they conducted a systematic search for every news story about it over a 12 year period, and then conducted content analysis to identify any recurring themes.

The first theme they identified was the idea that a brain imaging experiment "can make a phenomenon uncritically real, objective or effective in the eyes of the public". They described this phenomenon as "neuro-realism", and the idea is best explained through their examples, which mirror these new claims about libido perfectly.

So an article in the Washington Post takes a view on pain, and whether the subjective experience of it is enough: "patients have long reported that acupuncture helps relieve their pain, but scientists don't know why. Could it be an illusion?" They have an answer. "Now brain imaging technology has indicated that the perception of pain relief is accurate."

Another says that brain imaging "provides visual proof that acupuncture alleviates pain". The reality, of course, is much simpler: for your own personal experience of pain, which is all that matters, if you say that your pain is relieved, then your pain is relieved (and I wish good luck to any doctor who tells his patient their pain has gone, when it hasn't, just because some magical scan says it has).

Neuro-realism

• [Billegible]

  Doctors will happily tell you you’re not really having pain if their scans say it’s so. Friend of mine had pain so bad they could barely walk some days, and when nothing showed up on the magic scans they got a shrug and “If you still think it hurts then I can give you a referral to a psychiatrist.”

• [zootboing]

  Something few people cotton onto is that we don’t HAVE enough data to tell a person who’s in chronic pain that “You’re not in pain”. Why? Well, we don’t have a damn baseline scan from when they WEREN’T in pain, and we just don’t have enough data of healthy normal brains to know what a scan of a “normal brain, not in pain” looks like.
  (As a pre- “NOW that Big Pharma can make money off of it, we’ll treat your pain like it’s real” era fibromyalgia patient, I got treated like a delusional moron by enough MD’s to be a bit stroppy on the topic of “our machine doesn’t SAY you’re in pain, so you’re not!” So many MD’s are such poor scientists, it’s not even funny.)

  As for the libido thing- Heinlein had it HALF right when he stated, “Rub her feet”. What he should have added was “Start doing the dishes and take over chores until she sleeps 8 hours a night.”

  Most women with kids are so sleep-deprived that putting them in any libido study is like trying to figure out why bataan death march victims didn’t show any interest in ball room dancing.

• [Anonymous]

  Just because acupuncture or some other treatment isn’t an illusion doesn’t mean it isn’t a placebo. Placebo does not mean “no effect” – it means no effect statistically different from a placebo. Just sayin’.

• [Anonymous]

  *sigh*

  As if libido is a permanent and measurable thing. I guarantee that everyone’s libido is different a few minutes post-climax than at other times.

  fMRI purporting to measure transient states based on single individual snapshots proves nothing. It would be better to have multiple measures of a single individual.

  What interests me the most is post-stroke patients who have relearned walking or talking after losing it. This database would illustrate the flexibility of the brain as well as the insanity of ‘locating’ certain functions.

  Medicine suffers from its own arrogance — from plastic surgeons thinking they are psychiatrists, to researchers interpreting psychology as physiology.

  People are complex and frustratingly unquantifiable.

• [Ugly Canuck]

  Thinking about this question, my brain began to hurt, so I went to the brain specialist…

  http://www.youtube.com/watch?v=ydXW-JW3VTs

  …but it did not help much – however, an idea for an Hallowe’en costume did occur to me during my visit.

• [Michael Smith]

  When my son had his finger worked on by the doctor I distracted him with little stories. Got him thinking and he forgot about what the doctor was doing. I suppose the pain was still there but his stress was gone until he caught on and stopped listening to me.

  When I have seizures in my temporal lobe I can feel all kinds of things. Sometimes emotions which don’t have words to describe them. At other times drastic distortions of normal perception.

  I suppose pain relief means that you turn the volume down. If our imaging system agrees that the volume has been turned down then it is looking at the signal after the volume control. Something is being turned down. The observer is everywhere in the brain so it doesn’t make sense to draw a line at the point where the volume control takes effect.

• [Mark Dow]

  “… arrogance [of] researchers interpreting psychology as physiology”

  fMRI measures physiological response, indirectly through blood oxygenation and blood volume changes. This type of research most often interprets physiology as a response to psychology (stimuli, perception and behavior).

  Psychology and physiology are related, in a variety of ways that make interpretation of cause and effect difficult. Wouldn’t it be nice to know a lot about how pain (the percept), behavior (often a person’s reporting of pain), the body’s response to pain are related?

  fMRI provides a crude localization, smeared through time, of the brain’s activity during the experience of pain, in individuals as well as averages over groups. Only the largest effects are currently accessible — there are certainly effects throughout the brain, but some parts are more relevant to pain than other parts. This is great news for researchers and those who suffer from pain. We don’t know the answers, but we have solid clues not available only a decade ago.

  • [Hools Verne]

    Your nuanced view that physiology and psychology are interlinked in a complex manner is missing from the view in popular science, and even among some neuroscientists, that physiology determines psychology.

• [Anonymous]

  If you want to see some real cool candy brains go to think geek’s web site

• [Hools Verne]

  And what physiology can reliably tell us about phenomenology remains to be seen.