Review | ‘The Body Keeps the Score’ offers uncertain…
O’Connor, who directs the Grief, Loss and Social Stress (GLASS) lab at the University of Arizona, was among the first to use functional magnetic resonance imaging (fMRI) brain scans to study grief. When her first study on the neuroanatomy of grief was published in the early 2000s, fMRI technology was only about a decade old and was seen as a revolutionary breakthrough in modern neuroscience — itself only a few decades older. The giant magnets of an fMRI machine detect the iron in oxygenated red blood cells; the resulting scans depict the changes in oxygenated blood flow that coincide with brain activity. This technology promised to show which parts of the brain “lit up” when a patient was performing a particular task, seemingly giving neuroscientists the ability to map the brain and chart where each particular emotion, thought or action originates.
“The Grieving Brain” represents O’Connor’s attempt to translate her fMRI-based research for a general audience. In this, it joins a genre that psychiatrist Bessel van der Kolk popularized with “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” (2014). In recent years, van der Kolk’s book, with its Matisse-bedecked cover, invaded social media, rendering it both a meme and a sleeper bestseller — it has stayed near the top of the New York Times paperback nonfiction list for 248 weeks, more than 4½ years. “The Body Keeps the Score” found an eager and sizable audience because it boiled down complex ideas about the physiological and behavioral effects of trauma — the visceral ways we feel mental pain, the lasting role of early adversity in the patterns we fall into as adults — into explanations that feel intuitively true. We have all felt our guts clench and pulses quicken in moments of fear or anguish; we have all questioned why we can’t control our emotional reactions.
I first picked up “The Grieving Brain” for the same reason that I read “The Body Keeps the Score” the year before: I wanted to understand how a series of firing neurons can suddenly leave me in tears when I get an unexpected reminder of my parents, who both died of cancer about 20 years ago, when I was a young teen. More than that, I wanted the objectivity and rationality of science to impose order on my grief.
Reading “The Body Keeps the Score,” I realized that my experience of losing my parents — while devastating and life-altering — wasn’t traumatic, exactly; at least not by van der Kolk’s definition, making me wonder why so many readers had slogged through its dense descriptions of brain activity. As science journalist Eleanor Cummins argued in the Atlantic, when researchers like van der Kolk talk about “trauma,” they mean something quite different than the everyday discomfort imposed by, say, the first year of the coronavirus pandemic. In the psychiatric world, ruled by the Diagnostic and Statistical Manual of Mental Disorders, trauma manifests in physical and emotional wounds from experiences like combat, or surviving horrific accidents or acts of violence.
My feelings around my parents’ deaths may not result from trauma, but they are definitely grief. As I read “The Grieving Brain,” I encountered descriptions that mirrored some of my emotions back to me: my anguish over not being able to locate my parents on this earthly plane, my yearning to be close to them. But I questioned why I had sought an “objective,” neurobiological stamp of approval on what I had already known about how and why humans suffer when we are bereaved: We long for our dead, we face the need to adapt to a world without them in it, we dwell on what our lives would be like if our dead had instead lived. Even O’Connor acknowledges early on that she does “not believe that a neuroscientific perspective on grief is any better than a sociological, a religious, or an anthropological one,” but she feels that “neuroscience is part of the conversation of our times.”
Our interest in talking about what’s going on inside our brains isn’t new, but received neuroscientific wisdom is now recirculating in new mediums, calcifying into consensus that we can’t stop parroting. Most Americans have poor scientific literacy — as the pandemic attests — and yet we cannot get enough of using the language of neuroscience to talk about our brains and seeking self-help solutions to what we think ails us neurologically.
Beyond “The Grieving Brain” and “The Body Keeps the Score,” publishing has cashed in on these desires in recent years with bestsellers such as psychiatrist Bruce D. Perry and Oprah Winfrey’s “What Happened to You? Conversations on Trauma, Resilience, and Healing,” biologist and neurologist Robert M. Sapolsky’s “Behave: The Biology of Humans at Our Best and Worst,” and clinical psychologist Lisa Feldman Barrett’s “How Emotions Are Made: The Secret Life of the Brain.” More such books are forthcoming: “Brain performance coach” Nicole Vignola — who has a bachelor’s degree in neuroscience and more than 300,000 people following her advice on Instagram — recently sold “Rewire: The Neuroscience of a Good Life” to Harper One and 12 other publishers worldwide. The book, pitched as a “toolkit for shifting deeply ingrained brain behavioral patterns,” is due out next spring.
The more I learned about how much some of these books overplay what neuroscience can currently tell us about the brain and human behavior, the more I thought that the self-helpification of a relatively young and incredibly complex field of scientific study is not so helpful after all. We keep consulting neuroscience — even when its findings are disproven or overblown — to explain the human condition, and often to validate what we want to believe or what we already know. Tracing all of our messy emotions, reactions and habits to the workings of electrical currents and neurochemicals lets us off the hook.
Humans have been trying to understand the brain since the time of Hippocrates; neuroscience is still in its toddlerhood. Western physicians didn’t even know what the brain looked like until the mid-16th century, when the Belgian anatomist Andreas Vesalius illustrated what he observed via autopsies and dissections in “De Humani Corporis Fabrica.” Vesalius’s empirical drawings finally unseated theories put forward in the second century that the brain was composed of four fluid-filled ventricles through which the “pneuma physicon,” or animal spirit, flowed.
It wasn’t until 1848, when a railroad construction foreman named Phineas Gage survived an accident in which an iron rod was driven through his head, that it was proved that different areas of the brain are responsible for different functions. That breakthrough initially seemed to back up some of the tenets of phrenology, a pseudoscience that studied bumps on the skull and offered “evidence” for racist ideas — namely, that characteristics such as benevolence were controlled by “organs,” or areas, of the brain.
As recently as the mid-20th century, doctors performed lobotomies on people deemed mentally ill, severing the connection between the thalamus and the frontal lobe. Neuroscientists like Walter Freeman, the biggest evangelist for the lobotomy in the United States, believed that psychosis was caused by endlessly circling thoughts and that cutting off the prefrontal cortex would break the circuit.
It’s worth remembering that as we advance in our understanding, what we know about the brain — such a key part of what makes us human — will inevitably be revised, refined and sometimes proved wrong. The imaging revolution, starting with the invention of the positron emission tomography (PET) scanner and the MRI in the 1970s, seemed to bring neuroscience out of the dark ages. But the fMRI scan, which is just over 30 years old, has already had episodes of comeuppance. In 2009, a neuroscientist put a dead salmon through an fMRI and detected activity in its dead brain, showing how easy it is to produce a false positive when sorting through the statistical noise of these scans. Beyond statistical dangers, there’s an even more fundamental problem of interpreting what fMRI scans depict. A scan can correctly identify the areas of a person’s brain that are receiving blood flow at a particular moment, but we can’t definitively say that activation of a brain region equals a particular emotional or cognitive state. An activated amygdala can be pointed to as proof of negative emotions like fear, stress or anxiety, but also positive ones, like happiness.
More recent reevaluation of fMRI scans taken while subjects are triggered to feel certain emotions — the kind that O’Connor and van der Kolk have deployed in their research and write about in their books — has further revealed their limitations. In 2020, Ahmad Hariri, a Duke University professor of psychology and neuroscience, led a team that conducted a reanalysis of 56 published academic studies based on fMRI analysis, and found that when an individual has their brain scanned in an fMRI, the results are not replicable on a second scan. You can have the same person conduct the same task while in an fMRI scanner a few months later and get a different readout of brain activation. While bad fMRI data will probably not lead to the same horrors as phrenology and lobotomies, it’s not hard to imagine how these scans could be manipulated to diagnose people with psychiatric illnesses they may not have, or to deny insurance coverage for treatments they need.
And yet books that tout the results of fMRI studies are still being marketed to everyday readers who aren’t up to date on issues of psychological science. These books propose that the findings of fMRI studies provide groundbreaking insight into human emotions and behaviors. These claims play into the motivations of everyone involved in the intersection of neuroscience and self-help, like the scientists who get to promote the real-world applicability of their work outside of the academy (and thus gain notoriety within it) and the publishers who are willing to shell out hefty advances for books that promise to meet readers’ endless appetite to understand why they feel bad — and promise solutions. At best, these books oversimplify and overstate the takeaways of neuroscientific research; at worst, they rehash neuroscientific ideas that are already outmoded.
In “The Grieving Brain,” O’Connor constantly hedges when writing about the status of knowledge in the field. Here she is on mirror neurons, brain cells that TikTok users can’t get enough of. She’s using them to explain how “neural machinery” helps us feel close to others, and later how our brains struggle when we cannot be close to our dead: “If you show a monkey that you are doing something with your hand — grasping a banana, for example — some of his same neurons will fire when he watches you grasp the banana as when he grasps the banana himself.” Immediately following this clunky explanation, she inserts a caveat that I had never seen issued in discussions of mirror neurons, which come up frequently to explain empathy: “Despite the widespread interest in mirror neurons, human neuroimaging does not have sufficiently high definition to detect individual mirror neurons in humans.”
In “The Body Keeps the Score,” van der Kolk writes about those same monkey experiments on mirror neurons, calling them “one of the truly sensational discoveries of modern neuroscience.” He obscures the distinction between monkeys and humans, though: “Numerous other experiments followed around the world, and it soon became clear that mirror neurons explained many previously unexplainable aspects of the mind, such as empathy, imitation, synchrony, and even the development of language.” This makes it sound like experiments on humans followed. Yes, we are closely related to the macaque monkeys used in these studies, but the connection between our evolutionary lines diverged 25 million years ago. Our brains are capable of more than monkey brains, and not just because they are bigger.
Beyond the hyperbole common when neuroscience crosses over into self-help is the popularization of theories that have already been disproved. “The Body Keeps the Score” takes the prize in this realm. Van der Kolk is totally credulous when it comes to researcher Stephen Porges’s ideas about the vagus nerve, a central component of the parasympathetic nervous system that controls basic bodily functions such as digestion and resting heart rate.
As van der Kolk sees it, Porges’s polyvagal theory explains why, when faced with danger, people respond in different ways. When we collapse or disengage in a dangerous situation, van der Kolk says, we’ve been taken over by the dorsal vagal complex, “an evolutionarily ancient part of the parasympathetic nervous system.” Except the dorsal vagal complex hasn’t actually been proved to exist in humans. Some of van der Kolk’s readers spread this theory further on Instagram carousels about trauma-informed parenting and breathing and stretching exercises to help you move from “freeze + disassociation states to calm and connection states.”
Perhaps unsurprisingly, van der Kolk also buys into the triune brain model, as do many therapists on social media. Maybe you’ve heard of it as your “lizard brain” or “reptilian brain” — the idea that humans have a primitive brain center that acts on instinct. The triune brain model, developed in the mid-20th century by neuroscientist Paul MacLean, has long been considered nonsense by most neuroscientists; the theory was first disproved back in the 1970s. Van der Kolk proposes that when we are pulled back into trauma, we behave like lizards. People still love this explanation — like mirror neurons, it’s all over TikTok.
Van der Kolk must be aware that his peers have long discredited the idea of the “reptilian brain,” but he continues to give it the sheen of scientific credibility in his work, perhaps because it speaks to something a large audience wants to hear: If some of our worst reactions stem from a primitive, animalistic part of our brains, we are not really responsible for them.
Neuroscientific self-help books scratch the same itch as labeling everything a trauma response, self-diagnosing ADHD and treating mental health diagnosis like a giant BuzzFeed quiz. They superimpose order on the messiness of emotions, telling us that looking inside the brain can explain why we feel so out of control. With neat answers come neat solutions, as though we can life-hack some of the hardest parts of being a person — grieving our loved ones, grappling with the long effects of trauma. But there is no remedy for the human condition, and implying that it’s all in our heads makes our pain seem like a glitch instead of a feature.
Kristen Martin is a cultural critic based in Philadelphia. Her debut narrative nonfiction book on American orphanhood is forthcoming from Bold Type Books.
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