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Last updated: Thu, Sep 12, 2024
Our ancestors, not so many years ago, honored us with the scientific name Homo sapiens. "Homo" means "man" or "human," and "sapiens" refers to thinking or perhaps wisdom. Our confidence in our own judgements and understandings is expressed in the name we use for ourselves. Neuroscientific inquiries, beginning in the 1990s, have suggested that the common image of man as rational, perceptive, and self-regulating needs to be tempered.
Cognitive psychologists have identified many strange quirks in our behavior, things that Star Trek's Spock would disdain. We're vulnerable to optical illusions. Eyewitness testimony is less reliable than the confidence of witnesses would suggest. People prefer the letters in their own names. When asked to quickly decide which of two letters they prefer, they choose letters from their own names. We especially like our first and last initials, and this extends as far as selecting spouses. Married couples share the same last initials far more frequently than chance would predict. The same preference is seen with the numbers in our birthdates. The effect for letters has been found in all the languages in which it has been tested, and occurs in people from age eight to university.1
(My wife and I share the first two letters of our last names.)
Our thinking is quirky, and neuroscience has thrown into question the supremacy of our conscious control. Are we in control of our own actions? The answer is neither yes nor no, but something more complex. “…it is often easy to imagine that decisions arise in consciousness and are carried out by orders emanating from the system [of consciousness].“2
Around 1990 it was shown that a plan to act forms more than half a second before the plan becomes conscious. Once we are consciously aware of such a plan, we have a window of another half second in which to accept or reject the unconsciously-prepared plan.3 This finding is in contrast to the customary model, that we develop a conscious intent to act, and elaborate a plan beginning with that intent. To say that cognition occurs unconsciously is not the same as to say that it's not rational, but it does say that we don't have awareness of how and why the plan was chosen. The conscious mind "is much more observer of action than initiator."4
The finding of unconscious planning and preparation highlights two important features of human cognition. First, conscious awareness (attention or "thinking") is a scarce resource. Second, our brains have to deal not only with data processing, but also with time. In an earlier section (The Basic Anatomy and Physiology of Pain) I described the different transmission speeds of A-delta and C neurons, which lead to "fast pain" and "slow pain." Our brains have to produce the impression that fast and slow pains from an insult are connected, despite the different time lags. They also have to plan in the background, unconsciously, to allow us to take action quickly.
Those 1990 findings were based on electroencephalograms (EEGs), that give very precise readings of time but only rough readings of brain locations. Subsequent studies have used functional MRI (fMRI), which gives only rough readings of time but can identify activity in smaller areas and deeper in the brain. One such study of conscious decision-making estimated that ten seconds may elapse between the first brain activity that initiates a decision process, and consciousness of the plan.5
Although much of the planning for action occurs unconsciously, we have up to a second to veto the plan, and we can veto it up to one-tenth of a second before our action starts. In that sense, the concept of "free will" co-exists with these findings (at least in being able to veto bad plans), and we are able to learn from experience, whether the learning occurs consciously or unconsciously.6
Perception has also turned out to be more complex than it might seem. We perceive our own action plans after some delay, and the same applies to our sensory perceptions. A sensory signal from the big toe traveling over the fastest transmission lines can reach the brain in 20 milliseconds (.02 second). It takes half a second (.50 second), however, for it register consciously.7
More serious (in terms of our self-image as "Homo sapiens") is that our attention is selective. There are things that are virtually impossible to ignore, including certain intense and unexpected pains, but in non-stress situations we attend to a few things and ignore most. Our attention can be applied selectively, for example, by noticing things that confirm our beliefs. This seems to happen, again, subconsciously.
One series of experiments that demonstrated unconscious selective attention presented subjects with ambiguous stimuli that could be interpreted in either of two ways. One set of stimuli showed characters that could either be numerals or letters, for example, B or 13. Another set showed pictures that could be a farm animal or a marine animal, for example, a seal or a horse. The subjects' eye movements were tracked.
Groups of subjects had been "primed" to prefer one or the other of the two categories by being fed rewarding food in association with one or the other category prior to the experimental observations. These subjects showed a reliable tendency to prefer items in the category for which they had been rewarded, even though the stimuli were displayed for only four-tenths of a second, just long enough to enter conscious awareness. Their first look in sixty percent of trials was in the direction in which they expected to see a stimulus of the preferred category. The conclusion is that attention of the visual system can be influenced unconsciously by rather mundane experience.8
Now take yourself out of the psych lab and walk out onto the gridiron. You're a defensive football player. Based on what you've just read, you can't imagine how you could possibly defend against an offensive play, given how much unconscious processing is needed, and how much time it all takes. The answer is training and coaching. You have a repertoire of "moves" that you've been practicing for years. They are almost automatic. You've learned what you should watch for and what not to be distracted by. Your coaches watch you and "coach you up" when you deviate. Plus, your coaches make sure that your responsibilities are clear and limited. I'd venture to say that most advanced skills have these elements: practice, attention, and teaching or imitation. Their offensive coordinator is busy designing plays that will confound your expectations. Such is the intellectual nature of this sport.
Neuroscientific research has revealed mental mechanisms that are involved in some of our higher mental functions and foibles. For example, one group of researchers targeted magnetic stimulation to their subjects' anterior prefrontal cortex (aPFC), one area in the front of the cortex, that is regarded as the seat of higher reasoning powers. This sort of magnetic stimulation blocks or degrades the functioning of the modules that it affects.
The experimenters devised a situation in which the subject felt responsible for a faux social crime, stealing money from a room. Suppression of the aPFC improved the subjects' ability to lie. The suppressed subjects lied more quickly and were more relaxed as they did so. They also appeared to feel less moral conflict while lying. They lied more often when lying was relevant, and lied less often when irrelevant. We apparently have a brain module that regulates our ease in deceiving. This should raise questions that traditional theories of the mind would not raise.9
We have the ability to intentionally forget. This ability seems to reside in the dorsolateral prefrontal cortex of DLPFC, which is a near neighbor the aPFC. We sometimes will ourselves to block out memories that are unwanted, and can achieve some success. In the psychology lab, subjects first strongly memorize random sequences of letters and/or digits, and then are asked to forget the sequences. When they do this, the DLPFC is activated, and suppresses activity in the hippocampus, a part of the middle or limbic brain that is involved in solidifying memories. The DLPFC affects a lot of different areas of the brain, and is involved in vetoing behavioral plans, that is, suppressing behavior that would otherwise occur. It is a plausible theory that the ability to intentionally forget has developed recently, and that the DLPFC took up that function because it is similar to its other functions.10
It's also plausible to speculate that the unconscious planning and conscious vetoing of action plans could be the source of the intuition that "the devil made me do it."
What does all this have to do with pain understandings? Our own actions, as well as those of our friends, relatives, co-workers, and healthcare providers, aren't typically thought out and carefully selected. They are based on beliefs and memories that developed over our lifetimes. Our experiences have been shaped by our selective attention. Much of our decision-making is done unconsciously. There is not a large mass of smart tissue inside our skulls, but a collection of rather specialized processing modules with limited interconnectivity. It is part of a picture of human intelligence that is more complex and more limited than the moniker "sapiens" implies.