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The Pathologization of Excitement ©2011 Romesh Senewiratne (MD)

In this era of mass-media advertising and Hollywood Blockbusters, the term ‘excitement’ is popularly used in a positive way. We are exhorted to watch the newest exciting movie, buy an exciting new (or old) house or car, and travel to exotic, exciting destinations where we get to enjoy exciting foods, wines and entertainments. People, especially young people, delight in exciting music. Advertisements for the newest technological toys, and even the drabbest of political figures, stress how exciting the future will be if we consumers make the right choice. People like feeling excited, and advertisers have long known this. But the word excitement has a dark history when it comes to medical use of the term, and even today excitement is measured as a sign of mental illness according to psychological rating scales which continue to pathologise this enjoyable emotion. The physiology of excitement has been studied scientifically using a range of methods over the past century. The thousands of published studies about excitement, though, interpret the word excitement in different ways – a few mean positive emotions, many more infer negative emotions (including rage and terror), while some physiologists and psychologists assume ‘excitement’ to mean sexual excitement in addition to fear and anger. Much neurobiological use of the term ‘excitement’ through the twentieth century was unrelated to emotion as such. Neuroscientists wrote about their observations of ‘exciting’ nerves or localised areas of the brain with electrodes, in mice and men. Passing an electric current directly into the brain, sufficient to cause nerve cells to fire electrical pulses of their own, and observing motor, sensory and physiological responses (such as blood pressure, heart rate and sweating) was a mainstay of experimental neuroscience throughout the twentieth century. During this time the popularity of passing large electrical currents through the whole brain (sufficient to cause convulsions) promoted as a treatment for ‘manic excitement’ as well as ‘depression’ and ‘schizophrenia’ rose and fell. The physiology and biochemistry, and the neural circuits involved in rage and terror (and their milder forms, anger and fear) have been researched intensively by universities around the world since before the First World War,

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with major injections of funding into the study of rage, terror and other ‘nervous excitements’ during the Second World War and Cold War. The principle means of study, including experiments that established many enduring doctrines in medical and physiological science (including some factual ones), involved creating these emotions deliberately in cats, dogs, monkeys and apes. In a misguided line of inquiry spearheaded by Harvard University’s Professor Walter Cannon and his junior associate Philip Bard during and after the First World War (1914-1918), bigger and bigger chunks of the brains of cats were removed, while continuing to provoke the animals in increasingly cruel but meticulously calculated ways. Bard, who is credited with formulating, with his mentor, the Cannon-Bard theory of emotion, proudly described, in his 1942 paper Neural Mechanisms in Emotional and Sexual Behavior how he had been able to keep ‘decerebrate’ cats alive for several months. These were cats in which the entire cerebral hemispheres had been surgically removed:

“Recently M.B.Macht and I have been able to maintain for long periods of time, i.e., up to periods of over 3 months, decerebrate animals in which the remaining parts of the central nervous system are: spinal cord, medulla, cerebellum, and various portions of the mid-brain.” (Bard, 1942)

To the surprise of the mutilators, not much brain needed to be left behind for cats to continue to show rage when they are subjected to threat or pain. Thinking this could not be ‘real’ emotion, Cannon, Bard and the many thousands of researchers who embarked on further mutilations of cats and, later, monkeys, apes and humans, termed the hissing, back-arching, tooth-baring behaviour they provoked in these poor cats ‘sham rage’.

The physiology of excitement

During the First World War, the ironically named Professor Cannon coined the phrase ‘flight or fight’ to describe activity of the sympathetic nervous system, while the parasympathetic nervous system was responsible for ‘rest and digest’. The first of these phrases, more so than the second, caught on, and became a core doctrine of neurophysiology. Schoolchildren learn about ‘fight or flight’, and the phrase is commonly bandied about in the media. The reasons Walter Cannon’s phrases have seen such popularity is because, for

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one thing, they have catchy rhymes and describe the relationship between the two branches of the autonomic nervous system reasonably well. Activity in the sympathetic nervous system stimulates the heart, raises blood pressure and heart rate and contractility, diverts blood to the muscles and brain and away from the digestive tract, dilates the small airways in the lungs (allowing more oxygen to enter the blood) while the pupil of the eye dilates, allowing more light into the eye. These are clearly adaptations to danger and characteristic physiological responses to fear (flight) and anger (fight). A serious limitation of this model is that activity of the sympathetic nervous system (SNS) and the catecholamine neurotransmitter molecules it synthesises and releases have essential functions that have little to do with anger or fear and less to do with fighting or running away. This function might reasonably be described as ‘activation’, meaning both physical and mental activation. Of course the parasympathetic nervous system is also involved in activation – of the salivary and other digestive glands, of the involuntary muscles in the lungs and elsewhere, and the neurotransmitter released from its synapses, acetyl choline, is one of several (usually) stimulatory transmitters. Having said that, the sympathetic nervous system plays a more obvious role in mental excitement and preparation of the muscles for action. Walter Cannon spent his working life at Harvard University, doing research at the Department of Physiology from 1900 till his retirement in 1942 (during the Second World War). His position as Professor and Chairman of the Department of Physiology at Harvard Medical School (since 1906) helped make his phrases ‘fight or flight’ and ‘rest and digest’ famous around the world, but it is less often taught to medical students as to what the nature of his research was. What his techniques were, what animals he experimented on, or how and why he conducted the particular experiments he performed. The title of the book in which he coined the phrase ‘fight and flight’ gives a good idea of where Cannon’s interests lay, in terms of human and animal emotions: Pain, Hunger, Fear and Rage: An Account of Recent Researches into the Function of Emotional Excitement. It is clear that what the eminent physiology professor meant by ‘emotional excitement’ is not what the advertisers are trying to induce with their slick photos of new cars, elegant perfume bottles, exotically-named confectionaries and travel destinations. He was not talking about the excitement of love or of new discoveries or insights.

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No, Walter Cannon, seen in this portrait, had a grim view of what it means to be excited – the unpleasant emotions of pain, hunger, fear and rage. Professor Cannon studied thirst, as well. An example of his style of research was his investigation of the Dry Mouth Hypothesis he had put forward – that people get thirsty because their mouths get dry and not because they are not getting enough hydration (in real life people do get dry mouths when they are dehydrated, though there are other reasons). To investigate his hypothesis, Cannon slit the throats of experimental dogs and inserted a tube that collected the water they drank before it got to the stomach. The physiology professor reported that these dogs drank the same amount of water as ‘control’ dogs that had not been mutilated in this way. Thus Cannon proved his own hypothesis at the Harvard University School of Medicine, at least to his own satisfaction. The ‘Cannon-Bard Theory of Emotion’, was developed at Harvard as an alternative to the counter-intuitive ‘James-Lange theory’, which had dominated American psychological doctrine about emotions since it was proposed by the famously neurotic philosopher and psychologist William James (1842-1910) in the 1880s. When, in 1900, Walter Cannon was first employed in a junior position at Harvard’s department of physiology, William James had been an icon of the university for many years – credited by his many admirers as the Father of American Psychology. James had argued, based on introspection of his own emotions, that our ‘natural way of thinking’ that the emotion precedes the bodily expression of that emotion is incorrect. In his analysis the emotion followed the bodily changes mediated by the autonomic nervous system. Rather than running away after seeing a bear and feeling afraid, according to the James-Lange theory, we feel afraid because we run away. Likewise we feel sad because we cry, rather than the intuitive idea that we cry because we feel the emotion of sadness. As it turns out, recent neurophysiological studies much more sophisticated than Cannon’s mutilations of dogs and cats have shown manifold flaws in both the James-Lange and Cannon-Bard hypotheses. These studies have also exposed problems with the influential model of the anatomist James Papez (1883-1958) which had become a core doctrine in late twentieth-century neuroscience.

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The Papez Circuit, usually taught as synonymous with the ‘Limbic System’ was declared, in textbooks and other medical literature to be ‘the neural substrate of emotions’ or, less pretentiously, the ‘emotional circuits’ of the brain. Not surprisingly, given his modus operandi, the ring of structures in the core of the brain Papez identified in his 1937 paper A Proposed Mechanism of Emotion tells us more about the spread of rabies in the brains of cats than what moves us when we gaze in delight at a beautiful sunset or the eyes of someone we love. James Papez adopted Walter Cannon’s general approach to the scientific study of the emotions, with some hideous innovations of his own. At Cornell University in Ithaca, New York, he mapped out what he regarded as the emotional circuit in mammalian brains by injecting the deadly virus rabies into

the brains of cats. Papez was careful about his technique, but typically insensitive to the suffering of animals. He injected the virus specifically into the hippocampus, deep within the temporal lobes. He then carefully observed the effects of the deadly virus on the cats by ‘sacrificing’ them at critical times on their journey towards paralysis and death, and looking for the presence of ‘Negri Bodies’ in the brains of the killed cats. These are pigmented pathological abnormalities that are characteristic of

rabies infection in the brain.

The problem is, what has been researched as ‘excitement’ has usually meant those emotions that stimulate the ‘fight or flight’ response in animals – fear and anger, their intense forms, terror and rage and chronic states, anxiety and aggression. Little attention has been paid to the more positive aspects of excitement and related mental processes (including emotions). When such enjoyable emotional states develop, the thinking and behaviour of the ‘affected person’ fulfils textbook criteria for diagnosis of mental illness – specifically the serious ‘psychotic disorder’ known as ‘mania’ and the ‘less serious’, non-psychotic mental state termed ‘hypomania’ . Despite abundant evidence to the contrary from cognitive neuroscience (let alone commonsense) it is maintained by the more hardline members of the

James Papez

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psychiatry profession that hypomania inevitably leads to mania if ‘untreated’. Treatment, in this instance, means drug treatment with the toxic drug lithium and/or equally toxic dopamine-blocking and serotonin-blocking drugs (so-called ‘antipsychotics’). Meanwhile, the advertisers continue to promote excitement as a desirable mental state, ignorant of the fact that their excited consumers may end up in mental hospitals being ‘treated’ for this positive mental state. REFERENCES: Bard, P. (1942) Neural Mechanisms in Emotional and Sexual Behavior. Psychosomatic Medicine, volume 4, pp171-172 Cannon, W. (1915) Pain, Hunger, Fear and Rage: An account of recent researches into the Function of Emotional Excitement. D. Appleton and Company: USA James, W. (1884) What is an Emotion? Mind, volume 9, no. 34, pp188-205 Papez, J. (1937) A Proposed Mechanism of Emotion. Archives of Neurology and Psychiatry, volume 38, no.4, pp725-743