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Psychic Numbing

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Psychic numbing is the tendency for a society to withdraw its attention from both experiences that were traumatic as well as current issues that are perceived to be of great risk, but have low probability. [1] [2] [3] The term has evolved to include both societies as well as individuals. Current manifestations of individualist psychic numbing are found in victims of rape and people who suffer from post-traumatic stress disorder. [4] Due to this evolution of the phenomenon, psychic numbing has dual conceptualizations. One is more of a collectivist focused paradigm and the other concentrates on the individualist manifestation. It is also important to consider the neuroscience behind the phenomenon, which gives validation to the observable human behavior [5][6].

History

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The original concept of psychic numbing argued by Robert Jay Lifton was that it manifests itself collectively. This means that a society or a culture adapts this withdrawn attention outlook and collectively applies it to current issues [1]. Lifton believed this will be detrimental to mankind because it promotes a lack of awareness and connection to others. Recent applications of the concept have taken on a more individual representation in the form of post-traumatic stress disorder (PTSD), cancer patients and their religious values, and victims of mass genocide.

Robert Jay Lifton: Beyond Psychic Numbing: A Call to Awareness

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Lifton's 4 Focal Points:

  1. Hiroshima as a text for "psychic numbing"
  2. Nuclear Illusions
  3. What are nuclear weapons doing to us? (Nuclear fundamentalism)
  4. Hope for the future

Lifton's main area of focus was the Hiroshima bombing during WWII. He broke up his analysis of the bombing into psychological stages that spread at the societal level. Lifton's article, Beyond Psychic Numbing: A Call to Awareness[1] addressed a concern that was new at the time: nuclear warfare. He argued now that there is a single weapon in the world that can cause so much damage, humans need to be more alert and confront the images of nuclear power and an ever increasing nuclear actuality.[1][3] There is a societal understanding now that countries can create nuclear weapons, this lead to Lifton's coining of the term "nuclear fundamentalism." [1]That is the psychological affect that the nuclear weapons have on humans without them even being used. It is evident that Lifton took a very proactive stance on how to decrease the power that psychic numbing has on a society.

Lifton also addressed the concept of nuclear illusions and their perceived affect on the well-being of mankind. Examples of illusions are:

  • Radiation - the chemical aftermath of the atomic bomb
  • Foreknowledge - being able to predict the future considering new scientific discoveries and tests regarding nuclear warfare and power
  • Preparation - elaborate evacuation plans and what to do in the event of nuclear war

All these are argued by Lifton to be beneficial at times, however rather inadequate for helping people feel better about the ubiquity of nuclear weapons and potential warfare. There needs to be a sense of control [4][1][3][2] and personal responsibility in order for people to overcome psychic numbing.

Lifton's final argument regarding hope for the future is that society must take action. He uses Vietnam veterans as a reference point.[1][4] He has worked with them before and noticed partial changes, while he agrees this is good, society must adapt an awareness that aims to teach and educate as opposed to avoid and withdraw from the potential threats to survival. [1][3][4]

Neuroscience

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Psychic numbing has been associated with PTSD because they share the same attributes of withdrawal and behavioral changes when presented with a stimuli that triggers a reminder of the traumatic event or with a very intense neutral stimuli [5] . The observable emotional response is not enough to understand the concept of psychic numbing. Therefore, neuroscience and the biological activity that occurs within the brain is employed to give people a better understanding of the thought process of individuals who engage in psychic numbing.

Phan, et al. (2003) conducted a study that focused on the habituation of the rostral anterior cingulate cortex (rACC). The rACC is part of the limbic system, which is responsible for emotional processing. It is hypothesized that the rACC determines the, "correct allocation of attention based resources to emotionally aversive stimuli."[7]. This means it may play an active role in identifying important behavioral responses necessary to comprehend the consequences of the aversive stimuli. The limbic system also includes areas that are important for memory consolidation. The relationship between all the areas in the limbic system is an area of interest for psychic numbing because it encapsulates two factors that contribute to the phenomenon: emotions and memory. [7]. This study is also a good paradigm for the understanding of psychic numbing because it considers sustained aversive material and how the brain reacts in a habitual manner in an effort to remove the underlying emotional content. [5] [6] [7]

Phan, et al. (2003) study consisted of eight participants and two conditions. One group had aversive pictures and the other had neutral and blank pictures. The activation of the limbic system and rACC were measured using an fMRI and measured areas of the brain with oxygenated blood. The flow of oxygenated blood is considered to be the variable that activates separate areas of the brain. The results found that there was a significant activation of the hippocampus, amygdala, and rACC during the first presentation of both aversive pictures as well as blank and neutral pictures. However, during the second administration of the same pictures there was no activation of the hippocampus, amygdala, and rACC. These findings suggest that habituation to repeated exposure of the same aversive stimuli over time results in a lack of response.[7] This type of response on an observable human behavior level can be seen in the Taiwanese study discussed later [6]. It follows the same idea that aversive stimuli lose their emotional magnitude over time due to habituation. This suggests that psychic numbing can also be influenced by situational and environmental factors as well.

Neuropsychophysiology

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The response of organisms under stress starts with the release of neurohormones such as norepinephrine, epinephrine and cortisol.[5] Cortisol helps regulate the stress response via the negative feedback loop. The release of these hormones triggers an increase in glucose and immune function. In the short term there is a rapid and observable stress response such as increased heart rate, blood pressure, respiratory rate, and even skin conductance [5]. Peter Lang, PhD. created the idea of "associative networks"(see: [5], which are activated when a person is subjected to specific situations that trigger the relationship between the emotionally charged memories of the traumatic event and the observable autonomic responses [5][8] . In the long term, this leads to desensitization due to hyperarousal. This long term exposure to a stressful stimuli may be the motivating factor behind the phenomenon of psychic numbing.

Stress can also be considered a brain-body reaction due to external or internal cues [8] this can include the environment as well as memory. The areas of the brain that communicate with one another are the prefrontal cortex, amygdala, hippocampus, nucleus accumbens, and the hypothalamus. Through a series of feedback processes, the release of specific neurotransmitters as well as neuromodulators occurs. [8][5]

File:RACC activation.jpg
rACC activation

Norepinephrine (NE) is released by the Locus coeruleus, it is then transferred to the limbic system where much of the memory consolidation and fight or flight responses are facilitated.

Adrenocorticotropin (ACTH) is released from the anterior pituitary, which triggers the release of glucocorticoids from the adrenals. The chronic exposure to stress affects organisms that deal with daily activities and it also interferes with one's coping mechanisms.

There has also been investigations into the HPA axis as its response to environmental challenges and stimuli[9] . Once the HPA axis is activated, it triggers an increase in glucocorticoids. Once these hormones cross the blood-brain barrier, they interact with other neurotransmitters and change the brain's chemistry as well as structure. [8] The HPA axis, when subjected to psychopharmacological intervention can also help regulate the release of ACTH as well as cortisol. This allows for a lowered level of anxiety, coping ability, and most importantly - a sense of control [9]. This access to perceived control over potential threats and coping responses can be seen in HPA axis activation.

Phan, et al. (2003) study helps complement this information by providing accurate diagrams of the areas of the brain that are activated during initial perception of aversive stimuli as well as the repetitive exposure. [7] The process of habituation is important to consider because it is a prevalent variable in the phenomenon of psychic numbing. The constant exposure a society or individual has to a prolonged and sustained aversive stimuli, the emotional magnitude that the stimuli has decreases greatly over time to where it becomes unnoticeable to those who have been surrounded by it for a long period of time. This type of response is seen in Vietnam veterans and rape victims who suffer from PTSD [5] [4].

Additionally, Decety, et al. (2010) supported Phan, et al (2003) in the analysis of the rACC. This study describes the importance of the rACC and the cingulate cortex for comprehension and the feeling of a painful stimulus [6]. A pin and a Q-tip were used to simulate aversive and non-aversive stimuli, respectfully. There were two populations, one was a control group, and the other was 15 physicians. The results showed that the physicians responses to both the aversive and non-aversive stimuli were indistinguishable. Figures of areas of the control group's brains showed activation in the rACC, and the physician's brains did not, suggesting there was already habituation. This concept is described in further detail under Individualist.

Conceptualizations

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File:Figure of psychophysical numbing.jpg
Two figures that show the value of saving lives.

The original view of psychic numbing dealt with human extinction and the mass response to potentially life threatening scenarios. Lifton argued the worry for these events was low and therefore generated an equally low probability of occurrence point of view [1]. This repeated exposure makes man numb to the possibility that an event of that nature can occur. However, when asked to recall the probability that mass extinction will occur, people have a tendency to think counter-intuitively and rate the probability as high when it is in fact low and behaviorally respond opposite to his or her rating [3].

Additionally, much of the individualist view comes from studying the behavioral traits of people who suffer from PTSD. Focus groups, clinical cases, as well as religion play a crucial role in one's ability to cope with the stress of traumatic stimuli [4] Many studies have been conducted that address the value of these therapeutic interventions as well as their efficacy. There is a strong connection to depersonalization, emotional numbing, as well as dissociation from one's identity. This shows the shift of psychic numbing from a collectivist view to an individualistic view.

Collectivist

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Robert Jay Lifton spearheaded the psychic numbing movement and his concentration was on a much larger scale. Psychic numbing is about the way a culture or society withdraws from issues that would otherwise be too overwhelming for the human mind to comprehend. In this respect, psychic numbing is a societal reaction to impending doom, chaos, and ultimately mankind's extinction[1]. Lifton's analyses were adapted and modified by people to fit psychopathological models and shifted its focus from the collectivist view to a more individualistic representation later on.

Paul Slovic, a prominent psychologist in the realm of risk maintains the original interpretation posited by Lifton. Slovic's article, Psychic Numbing and Mass Atrocity returns to the collectivist model and most notably confronts the value of saving a human's life. The figures to the right denote both arguments for the hypothesized value of saving a human's life as well as the true value of saving a human's life established through Slovic's empirical research. [1] [3] Slovic introduced the concept of psychophysical numbing, which is the diminished sensitivity to the value of life and an inability to appreciate loss [3]. Essentially, the proportion of lives saved is more important than the number of lives saved [3]. One of Slovic's arguments for this outcome is that people suffer from innumeracy and cannot comprehend the emotional connotation associated with large numbers. The threshold, as stated by Slovic, where people cannot comprehend the emotional magnitude of the loss of life is two, as shown in the figure. [3]

File:Value of saving a life in regards to the number of lives being saved.jpg
The true value of saving human lives

Slovic also points to Weber's law, which states the difference between two stimuli is proportional to the magnitude of the stimuli. Additionally, Weber's law focuses on the just-noticeable difference between the two stimuli. Slovic addressed Weber's law from a different context - he considered the magnitude and value of a human life. Slovic took Weber's law and incorporated Prospect theory, which is decision making based on potential gains and losses, not the actual final outcome. Slovic found that when Prospect Theory and Weber's law are analyzed in regards to human life, the value of saving human lives is greater for a smaller tragedy than for a larger one [3]. This can potentially be referred back to innumeracy and people's inability to comprehend and emotionally relate to numbers.

These are all considered collectivist views of psychic numbing because they encapsulate a general theory of mind held by the majority of citizens in a society. Additionally, these views remain consistent with the original concept of which collective avoidance and attention withdrawal becomes the active state of mind in regards to potential threats of mass extinction[1] [3]. Also, both authors employ a set of ideas and concepts that can be used to prevent further psychic numbing as well as empower education and a more global and realistic understanding of the potential consequences if this type of attention withdrawal continues.

Individualist

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Psychic numbing, as it shifts away from the collectivist view, is a common characteristic of people who suffer from PTSD. A general definition of psychic numbing is a diminished response to the external world [10]. There are three elements that attribute to psychic numbing

  1. Loss of interest in activity
  2. detachment from others
  3. restricted range of affect [10]

These are all behavioral traits which can be observed. In a more general theme, there are argued to be two mechanisms that relate to psychic numbing

  1. Avoidance of the trauma related stimuli [11]
  2. Numbing causes an automatic response due to continuous hyperarousal [10]

These two mechanisms promote the inability to engage emotionally with a traumatic memory (acceptance), thus impairing the process of recovery [10] [12]

Susan Gill bridges the disciplines of social psychology and neuropsychology in her analysis of psychic numbing by explaining that there are notable behavioral changes, the most typical trait is being zombie-like and in a "dead-zone"[13]. This "dead-zone" is a complete dissociation and deviation from the person's typical behavior and completely removed from his or her's surrounding environment. Susan Gill, a senior supervisor at the Psychoanalytic Institute provided two characteristics of the "dead-zone."

  • The relationship between being overwhelmed and completely shutting down.
The state of being overwhelmed is different than complete shut-down. Overwhelmed responses follow moderate to prolonged stressful states and result in an active effort to regain control [13] whereas complete shut-down is due to sustained stress, resulting in flat-affect and complete loss of control both physically and psychologically. This further supports the importance of control, both perceived and actual, a victim of psychic numbing must have in order to prevent further deterioration.
  • The neurochemical states associated with dissociative behavior are not metabolized, that is they become perpetual and frozen in time, which causes the deviation from normal behavior.
The very anatomy of the brain can be manipulated under extreme cases of psychic numbing. The neurochemical reactions fail to metabolize and result in lack of synaptic connections and neuronal firing with no dendritic connections. There is also a loop of the same information that fails to connect with other areas of the brain, which results in the inability to get out of the "dead-zone" [13][5][10]

Religion is also considered to be an internalized coping mechanism. The role of religious values in coping with life-threatening illnesses is another individualistic trait that people use to cope with the behavioral side-effects associated with the diseases [14]. Depersonalization is a very prominent behavioral trait associated with cancer patients. Findings show that people with cancer cope no worse than non-cancer patients [14] [11]. Cancer patients tend to blunt his or her experiences as a means of handling a painful reality. Avoidance and denial are typical tendencies of psychic numbing[11]. Cancer patients also report a self-distancing mechanism, and take on a third person perspective as a means of dealing with the life-threatening disease. [14] It is argued that putting one's life within a framework of religion is a very important part of the coping process. This religious framework helps the patients understand that some things are out of one's control. As discussed earlier, a lack of control over one's stressful stimuli generates a degree of psychic numbing. However, by putting his or her's life threatening disease within a religious framework takes the mystery out of the disease and adds a sense of control [14]. As discussed earlier, the perceived sense of control as well as actual control are important contributors to adequately coping with psychic numbing.[14][11][9]

As described earlier, research on psychic numbing has suggested that people who become desensitized to suffering may be more adept in dealing with an upsetting or dangerous situation.

In a 2010 study, Taiwanese and American researchers recorded brain-wave readings from participants as the researchers observed body parts pricked with a pin, or dabbed with a Q-tip. Half of the subjects were physicians and the other half was a control group. The control group showed clear differences in his or her reactions to the pin-prick in comparison to the Q-tip. The physicians, who previously had experience managing sickness and pain, did not. The authors of the study theorized that the physicians unconsciously numbed their reaction to the pain of the pin-prick due to his or her profession. This may be a beneficial result because physicians need to block out the pain response and use more cognitive resources necessary for being of assistance in a time of need [6]. This further suggests the individual differences people have in regards to psychic numbing and the deviation away from more tragic accounts of rape and PTSD. This type of desensitization is not independent of the participant's lives, instead it is a result of years of experience woven into his or her daily lives, resulting in a numbed response.

References

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  1. ^ a b c d e f g h i j k l Lifton, Robert Jay (October 1982). "Beyond psychic numbing: a call to awareness". American Journal of Orthopsychiatrics. 52 (4).{{cite journal}}: CS1 maint: date and year (link)
  2. ^ a b Gregory, Robert J. (Fall 2003). "Venturing past psychic numbing: facing the issues". Journal for the Psychoanalysis of Culture and Society. 8 (2).{{cite journal}}: CS1 maint: date and year (link)
  3. ^ a b c d e f g h i j k Slovic, Paul (August 2011). "Psychic numbing and mass atrocity". New York University School of Law: 1–17. Retrieved 19 March 2012. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: date and year (link)
  4. ^ a b c d e f Rozynko, Vitali; Dondershine, Harvey E. (Spring 1991). "Trauma focus group therapy for vietnam veterans with ptsd". Psychotherapy. 28 (1): 157–161. doi:10.1037/0033-3204.28.1.157.{{cite journal}}: CS1 maint: date and year (link)
  5. ^ a b c d e f g h i j van der Kolk, Bessel (1994). "The body keeps the score: memory and the evolving psychology of post traumatic stress". Trauma Information Pages: 1–21.
  6. ^ a b c d e Decety, Jean; Yang, Chia-Yan; Cheng, Yawei (1 May 2010). "Physicians down-regulate their pain empathy response: An event-related brain potential study" (PDF). NeuroImage. 50 (4): 1676–1682. doi:10.1016/j.neuroimage.2010.01.025. PMID 20080194.
  7. ^ a b c d e Luan Phan, K.; Liberzon, Israel; Welsh, Robert C.; Britton, Jennifer C.; Taylor, Stephan F. (2003). "Habituation of rostral anterior cingulate cortex to repeated emotionally salient pictures". Neuropsychopharmacology. 28 (7): 1344–1350. doi:10.1038/sj.npp.1300186. PMID 12784119.{{cite journal}}: CS1 maint: date and year (link)
  8. ^ a b c d Mora, Francisco; Segovia, Gregorio; Del Arco, Alberto; De Blas, Marta; Garrido, Pedro (2012). "Stress, neurotransmitters, corticosterone and body-brain integration". Brain Research. 1476: 71–85. doi:10.1016/j.brainres.2011.12.049. PMID 22285436.{{cite journal}}: CS1 maint: date and year (link)
  9. ^ a b c Abelson, James L.; Khan, Samir; Liberzon, Israel; Erickson, Thane M.; Young, Elizabeth A. (2008). "Effects of perceived control and cognitive coping on endocrine stress responses to pharmacological activation". Biological Psychiatry. 64 (8): 701–707. doi:10.1016/j.biopsych.2008.05.007. PMC 2579765. PMID 18571624. {{cite journal}}: Check date values in: |year= / |date= mismatch (help)
  10. ^ a b c d e Feeny, Norah C.; Zoellner, Lori A.; Fitzgibbons, Lee A.; Foa, Edna B. (2000). "Exploring the roles of emotional numbing, depression, and dissociation in ptsd". Journal of Traumatic Stress. 13 (3): 489–497. doi:10.1023/A:1007789409330. PMID 10948488.{{cite journal}}: CS1 maint: date and year (link)
  11. ^ a b c d Solomon, Zahava; Arad, Rivka; Mikulincer, Mario (1991). "Monitoring and blunting: implications for combat-related post-traumatic stress disorder". Journal of Traumatic Stress. 4 (2): 209–221. doi:10.1002/jts.2490040205.{{cite journal}}: CS1 maint: date and year (link)
  12. ^ Hicks, David (2001). "Learning about global issues: why most educators only make things worse". Environmental Education Research. 7 (4): 413–425. doi:10.1080 /1350462012008128 7 (inactive 2023-08-02). {{cite journal}}: Check |doi= value (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)CS1 maint: DOI inactive as of August 2023 (link)
  13. ^ a b c Gill, Susan (2010). "The therapist as a psychobiological regulator: dissociation, affect attunement, and clinical process". Clin Soc Work J. 38 (3): 260–268. doi:10.1007/s10615-009-0213-5.
  14. ^ a b c d e Acklin, Marvin W.; Brown, Earl C.; Mauger, Paul A. (1983). "The role of religious values in coping with cancer". Journal of Religion and Health. 22 (4): 322–333. doi:10.1007/BF02279928. PMID 24306829.{{cite journal}}: CS1 maint: date and year (link)