Exceptionalism

Exceptionalism

I am writing a book about disruptive science. This is science that overturns how we think about the world. Such scientists as Galileo, Newton, Einstein, Freud, Tesla, and many others. I am researching this to understand why there is a lack of disruptive science nowadays. We seem to have career scientists who do not disrupt science but affirm it. This is not how science progresses. Science progresses through ‘revolutions’ that turn what we believe upside down. The book focuses on similarities between these scientists. As a psychologist, I am interested not just in their personality but also in the conditions that allowed them to be disruptive. Interestingly, for example, most of these scientists were accused of plagiarism early on. Most had influential friends, and most spent time in obscurity and isolation. With this frame of thought, I was trying to explain what is happening politically here in the US and, it seems, across Europe, too. We are going through disruptive politics. But unlike science, which only seems to move forward, politics is more of a pendulum confined by human desires. The pendulum swings right and, after some time, returns to center and swings left. Right now, we have swung out to the right as much as we have ever done. I speak with a lot of this administration’s supporters, as most are older adults. They want things to be more stable and more consistent They are afraid of ambiguity: transgender, gay, foreigners, disabled, poor, homeless. Their view of the world, where the US is the paramount of virtue, does not fit with having these “types” of people. There is also a strong belief in exceptionalism. That we are uniquely different. I find exceptionalism in every country. I was brought up on a small island of Malta. We had no resources, could hardly feed ourselves throughout history, and it was one of the poorest places on earth. We had a coin, a ‘habba,’ that was the lowest denomination in the world (‘Habba’ a third of a farthing-farthing a quarter of a penny-penny one-twelfth of a shilling, shilling one-twentieth of a pound). Despite this poverty, I was brought up to believe we are special. Everyone believes this about their country growing up. The difference is when you impose this view on others, either by enslaving them or declaring war on them, then you create an injustice. In the US, we are now again imposing war on ‘others.’ It seems we exported this to other countries and waged war on the poor. However, there is another angle to this conflict, both at home and abroad. The inequity also affects those who are doing well. There is a feeling that they do not deserve their condition, they have not earned it. This feeling makes them more protective of what they have, an unsettling feeling that it can all be taken away. This is the new conservatism we are seeing. People are so unsettled that they feel they must protect themselves from others, even if they are doing well.

Money and Science

Galileo sold telescopes; Einstein sold patents for a refrigerator (among other patents), Edison commercialized many of his 1,000 patents, Tesla sold many appliances and inventions to the public, while Watt improved and sold steam engines. In fact, science is expensive, but science is not only about money, but it seems like it is. 

Science as it relates to old people is all about geriatrics, about their health. The biggest worry is, of course, dementia. In the United States, dementia receives the third most funding money, after heart problems and cancer. After more than five decades of this funding, there are the traditional medications that were supposed to slow the disease. These Acetylcholinesterase Inhibitors are ineffective. Although they seem to reduce death, they do not improve behavior. In the last few years, a new class of anti-amyloid drugs was introduced that clean the disease (amyloid) from the brain. Two main drugs are now approved by the Food and Drug Administration (FDA) for dementia: donanemab (Kisunla) and lecanemab-irmb (Leqembi). A third anti-amyloid drug, aducanumab (Aduhelm), was fast-tracked for approval in 2021, but Biogen, the drugmaker, took it off the market in early 2024, possibly to reduce the risk of liability. In all these injectable drugs, there is a serious risk of brain bleeds that have caused death in the past. Statistically, these drugs make little positive changes, but money has a way of interfering with science. What is surprising is that non-drug therapies have much better improvement and yet receive little research funding. These non-drug alternatives also have the advantage of not causing your brain to bleed.

Brainfitness, from Posit Science, is the oldest and most established of such programs in the US. However, Japan has its own homegrown and established programs. One of these is a computer-based program developed by Namco Bandai and tested by Dr. Kawashima, known for his Nintendo DS games Brain Age: Train Your Brain in Minutes a Day! and Brain Age 2: More Training in Minutes a Day! Japan sold 3.3 million already. The other with more than 20 years of legacy, is NeU Corporation. They fused the science of Tohoku University’s Institute of Development, Aging and Cancer, with the “portable brain measurement technology” of Hitachi’s High Technology Division. All of these are effective, and although they cost a little bit of money, it is an investment in the future. Science does not have to be free, only affordable.

Sarcopenia

There is an “Obesity paradox” among older Americans. This describes the unexpected finding that slightly overweight older people with a particular disease have better outcomes than their normal-weight or underweight peers.  Overweight is measured by a formula called the Body Mass Index (BMI), which measures height, weight, and age. A recent review in 2023 by Moustapha Dramé confirmed this observation that being a little overweight for older adults is beneficial. Even though obese people are more vulnerable to diseases, including an increased risk of infections, cancer, and heart disease. However, once you get a disease, having greater functional reserves might come in use. But there is a more interesting story to tell rather than simply weight.

BMI is not a good way to measure healthy body weight, especially for older adults. Once you reach 30 years of age, muscle begins to reduce. By the time we reach 70, we may have only half the muscle we had in our 20s. This is not only a function of age but a function of poor nutrition, inactivity, and a general difficulty in building muscle. Women’s menopause might also make things worse. Physicians call this Sarcopenia, the common tendency to lose muscle mass due to aging, but it does not have to be like this.

Loss of muscle mass is a serious threat to health.  It contributes to disability and frailty. In addition, studies show that there may be an association between sarcopenia and rheumatoid arthritis, falls, and even dementia. Building muscle in older age is difficult but possible. A person can only build muscle through resistance training, not just walking. We can use our own body weight (e.g., by doing push-ups and squats) and lifting household items such as soup cans. One of the few areas that is easy to change is diet. Older adults don't eat enough protein. 

Rei Otsuka and his colleagues have shown that greater protein intake improved muscle mass for men but not for women, which might have to do with menopause and the role of estrogen (especially estradiol). Women have it worse, since the loss of estradiol increases fat, decreases bone density, as well as muscle mass and muscle strength. All of these factors significantly contribute to the development of a condition termed “sarcopenic obesity.” It is that much harder for women to retain their muscles. But diet and exercise still seem to help, and increasing protein intake seems to help.

Keisuke Sakurai and his team compared a high-carbohydrate (HC) diet mainly composed of cereal against a protein-balanced (PB) diet with high intake of legumes, vegetables, seafood, meat, and eggs. Cognitive function was significantly higher in the PB group than in the HC group in a Japanese group. 

What is good for muscles is also good for the brain. A healthy body means a balanced diet and staying as active as you can.  Addressing sarcopenia might also prevent falling. Improving balance and flexibility by strengthening core muscles (chest, back, belly, hips, glutes, and thighs) and careful stretching can help prevent falls, a major cause of disability and death. Avoiding falls can be as simple as wearing stable shoes and having well-lit paths, to maintaining strength and flexibility. However active you are, don’t use ladders and perform other risky actions.

Sleep

We are only aware when we are conscious, and the obverse is also true, that we are unaware of our unconscious life. As a result of this skewed perception, we assume that we are primarily conscious beings. But this fallacy is the result of conscious bias. This self-awareness is what is known as the “hard problem.” First introduced by David Chalmers, the hard problem is why and how we have consciousness. This contrasts with the “easy problems” of explaining the ability to discriminate, integrate information, report mental states, focus attention, and problems of cognition in general, since we will eventually specify a mechanism that can perform these functions. But the problem of experiencing consciousness is distinct from these questions and will persist. Although consciousness is a hard question, we might learn about what it means by defining the unconscious in our daily lives.

One of the longest period of unconsciousness is sleep. Most animals sleep. Birds, mammals, and reptiles have some form of daily sleep varying from around 3 hours in a horse to over 20 hours in the pocket mouse. This variation can be due to conserving energy, reflecting predation risks and energy conservation (Elgar, Pagel & Harvey, 1988). Since lack of sleep is detrimental to health, it is therefore assumed that sleep is a necessary and adaptive feature. In a review of the literature that looked at the global practice of changing the clock by an hour to accommodate seasonal changes in sunlight, Till Roenneberg and his colleagues reported that the first days after summer time change results in an increase in general accidents and visits to the emergency room increase (Ferrazzi et al., 2018),  incidence of myocardial infarctions (Manfredini et al., 2018), ischemic stroke (Sipilä et al., 2016), the risk of in vitro fertilized mothers losing their babies (Liu et al., 2017), and suffering from negative mood changes (Monk & Aplin, 1980). Interference in our sleep patterns have serious harmful effects.

With humans there is also the need for sleep to consolidate our isomorphic representation and therefore our memories. All theories of sleep involve some aspect that involves memory consolidation. Everything that we have experienced for that day is assimilated with our general model of the world (Bucci & Grasso, 2017). Since sleep-deprived humans and animals perform poorly in learning tasks when compared to individuals that are well rested, there is some evidence for the function of sleep and dreaming as a consolidation of memory (Smith, 1995). Dreaming has also been functionally linked with amygdala growth providing some biological evidence that sleep and dreaming are involved with memory processing (Capellini  et al, 2009). This is especially true for humans as we spend almost one-third of our life sleeping, and a good portion of that time is spent dreaming (Bucci & Grasso, 2017).

Continually evolving theories all support the idea that sleeping and dreaming contribute to memory consolidation. But this consolidation is not simply through rote repetition until memorization takes hold, but it is a much more complex development of scaffolding. Building different scenarios where our experiences becomes integrated together until it forms a virtual edifice that eventually morphs  into one overall model of the world.  Humans use sleep and dreaming to test the integrity of this  scaffolding, a model built on real experiences, by conjecturing different scenarios. Our isomorphic model of the world becomes predictive. In sleep, while dreaming, we replay and predict different scenarios on the basis of our past experiences. The consolidation of memory is one artifact of this intricate process of learning.

There are many theories of the neural explanation of dreaming. Each of these theories provide one part of the puzzle that contribute to an understanding of how we consolidate our experiences into a model of the world, our isomorphic representation. These theories, that will be explained later, include: activation-synthesis hypothesis (ASH; Hobson & Mc Carley, 1977); reciprocal-interaction model (RIM; Vogel, 1978); hippocampo-neocortical dialogue (Buzsáki, 1996); Activation level, Input source and Information-processing Mode (AIM; Hobson et al. 2000); neuropsychoanalytic model (Solms, 2000); cognitive-functional approaches (Domhoff 2001); Reverse Learning theory (Crick and Mitchison 1983); Synaptic Pruning hypothesis/ Synaptic Homoeostasis hypotheses (SHY; Tononi & Cirelli 2014); memory consolidation (Stickgold et al. 2001; Perogamvros and Schwartz 2012); Threat Simulation theory (Revonsuo 2000; Valli & Revonsuo 2009); Social Simulation theory (Revonsuo et al. 2015); and, neurocognitive theory (Domhoff, 2011). 

All these theories contribute to a part of the story of how we develop our model of the world. ASH posits that dreams automatically synthesizes experiences by comparing information generated in specific brain stem circuits with information stored in memory. There is an exchange across the brain to merge different types of information. Reciprocal Interaction Model (RIM) proposes that waking and Rapid Eye Movement (REM) sleep are at opposite extremes of a state continuum with Non-Rapid Eye Movement (NREM) sleep intermediate between them. Suggesting that processing continues while sleeping at different dream cycles. The hippocampo-neocortical dialogue posits a transfer of data from neocortex to hippocampus in active awake, and consolidation of information within the hippocampus along with its transfer back to the neocortex for longer-term storage during quiet waking and NREM. In the AIM theory we see again this exchange across different processes with a two-stage hypothesis of sleep enhancement of plasticity with Rapid Eye Movement sleep (REM) at one end of this continuum and Non-Rapid Eye Movement sleep (NREM) at the other end that allow a two-stage process of memory consolidation. In AIM the excitation of the neurons determine the level of processing (Activation level) while the level of input into the system can be high when awake or low when sleeping and there is little external input (Input source) and the type of neuronal activity shift from noradrenergic and serotonergic activity when awake to aminergic activity with NREM (Information-processing Mode). Again, we see this processing of information during dreaming that is both qualitatively and quantitatively different. An interesting developing was with the neuropsychoanalytic model since it argues that what happens in sleep reflects what happens in conscious life. By applying neurobiological knowledge this model places disorders of dreaming as equal to other higher mental functions such as the aphasias, apraxias, and agnosias that are associated with specific localization (focal) cerebral pathology. Disorders of dreaming are part of the continuum of neural processing.  In contrast, the Threat Simulation Theory predicts that dreams contain more frequent and more severe threats than waking life does, and because these threats are realistic, they elicit defensive response. Dreams are a way of teaching us about threat in the environment the options we have at our disposal to deal with them. While Social Simulation theory proposed that we enact dreams that simulate social situation that we have experienced. Dreaming is a rehearsal for waking social perceptions and interactions, and therefore has adaptive value. Antti Revonsuo recently developed these Threat and Social stimulation further into the “world-simulation” (Revonsuo, Tuominen & Valli, 2015),  that require an “obvious avatar” (Dresler, 2015). World simulation is another term for isomorphic representation and is as close as we get to a theory of dreaming that supports an isomorphic explanation. Waking consciousness and dreaming are manifestations of the same natural biological phenomenon in the brain. The theory stipulates that there are three mechanisms; downward-, backward- and upward-looking that refers to excitation of the brain, the focus on past experiences and the influence that our dreams have on our conscious cognition. While an intensified form of mind-wandering that makes use of embodied simulation, primarily to enact the dreamer's major conceptions and personal concerns, is a byproduct of human cognitive developments important in waking life. The difference is that the neurocognitive model argues that dreaming has no adaptive value (Domhoff, 2018). Since there is evidence that dreaming can be largely or completely absent without any obvious ill effects (e.g., Pagel, 2003) it therefore is not an adaptive feature of our life. Despite variation in emphasis and approaches, there is an incredible consistency in these theories. While not discounting the importance of nuanced criticism—the process that will eventually refine these theories—there are overwhelming consistencies in all of these theories that require recognition, especially since this convergence promotes an obvious convergence.

As can be seen, all these theories of dreaming suggest that we are revisiting our model of the world. The embodied nature of dreams represent our real-life experiences in a virtual world that correspond to waking life. For example the content of dreams reflects our engagement in the word with the following activities: Movement (66%), Verbal (62%), Physical (61%), Sight/visual (44%), Location (29%), Cognitive (18%), Expressive (12%), and Auditory (7%) (Domhoff & Schneider, 2018). Dreams are mainly reported to involve social simulation (94%) and very rarely are dreams exclusively just about the dreamer (4%) (Domhoff & Schneider, 2018). Most of the processing in dreams related to negative elements, as we would expect since the squeaky wheel gets the most attention. Aggressions, misfortunes, failures, and negative emotions accounted for 80% of men's dreams and 77% of women's dreams. In contrast, 53% of dreams for both men and women had at least one of several positive elements, including friendly interactions, good fortune, success, and positive emotions (Domhoff, 2007). Dreams are about the world around us, one that we have experienced when interacting in the world. These dreams are enactment for consolidation of our model of the world that results in a consolidation of our memories, streamline learned material that integrates new experiences into our predictive model. We act upon this process in virtual reality, “dreams are weakly functionally embodied states” (Windt 2015, p. 383). As Bucci & Grasso (2017) have proposed, dreaming is not only a way of running scenarios so that we can predict the future—using the theory of Predictive Processing (Clark 2013)—it also allows for synaptic organization and restore energetic equilibrium (homoeostasis) in the brain (SHY (Tononi & Cirelli 2014). Even in dream however, the brain is designed to narrate, to tell a story. For example, when there is the introduction of external sensation while sleeping (a blood pressure cuff fitted above the knee) people incorporate the pressure into their dream as a story, however bizarre that story might get (Sauvageau et al, 1998). The model of the world we develop is a temporal and spatial story, based on a time and a place, an embodiment.

Eventually even sleep and dream research leads to the study of consciousness. The integrated information theory, one attempt at explaining consciousness (Oizumi et al. 2014; Tononi et al. 2016) falls short of descriptive potential. The theory starts by identifying the properties of conscious experience as five “axioms” and are based on properties of the physical world “postulates”. These axioms are more general rules that are assumed to exist and difficult to substantiate empirically. However, the theory argues that learning and sleep is where these axioms are modified to reflect postulates. Why this process is best done while sleeping under dreams is not explained. The hard question of why we have consciousness, and why sleep is so important remains impenetrable to our feeble attempts.

References

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Manfredini, R., Fabbian, F., De Giorgi, A., Zucchi, B., Cappadona, R., Signani, F., et al. (2018). Daylight saving time and myocardial infarction: should we be worried? a review of the evidence. Eur. Rev. Med. Pharmacol. Sci. 22, 750–755. doi: 10.26355/eurrev_201802_14306

Ferrazzi, E., Romualdi, C., Ocello, M., Frighetto, G., Turco, M., Vigolo, S., et al. (2018). Changes in accident & emergency visits and return visits in relation to the enforcement of daylight saving time and photoperiod. J. Biol. Rhythms 33, 555–564. doi: 10.1177/0748730418791097

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I Shrunk

 I shrunk. I went to get my annual physical check-up, and I came out 6 centimeters shorter than I thought I was going in. From 188 cm to 182cc! I might lose another 6 centimeters if I am lucky enough to continue to age. It’s mainly in my torso, as what has shrunk is the soft tissue in between my vertebrae in my spine. There are 33 of them, all stacked one on top of the other. In humans, the 24 upper vertebrae are separated by discs that allow movement, while the 9 lower vertebrae are fused. Usually, these discs shrink because of osteoporosis, but in my case, it is pure aging. The discs lose some of their moisture and shrink as we age. We become drier. A human embryo is about 90 percent water, a newborn child about 80 percent, a mature adult about 70 percent, and an older adult about 60 percent water, while those between 70-80 years of age are only 50 percent water. I wonder what water percentage a 100-year-old would have.

Driving home from the clinic, as I was thinking how lucky I am to be able to enjoy aging, despite shrinking, I remembered the Aristotelian view of aging. I use this example with my students. Aristotle defined aging as a natural, inevitable process of becoming cold and dry, characterizing it as a "natural disease" and the gradual extinction of innate heat. He believed life requires warmth and moisture, but over time, the body’s "innate heat" diminishes due to the consumption of "radical moisture" or fuel. If you believe that you get old because you are drying out and losing heat, then the therapy that would reverse this is a sauna. Which is why hot baths were so popular in the gymnasiums during Roman times. They believed that this method of moisturizing rejuvenated the lost moisture and heat. 

Romans followed a ritualized sequence: beginning in the tepidarium (warm room), moving to the caldarium (hot, steamy room), using the laconicum (hottest dry room), and finishing in the frigidarium (cold plunge). Recent studies have supported these beliefs. In a 2017 study on a Finnish male population, Tanjaniina Laukkanen and his colleagues reported that moderate to high frequency of sauna bathing was associated with lowered risks of dementia and Alzheimer's disease. In a review, the same researcher reported that saunas are linked to several health benefits. These include a reduction in the risk of heart diseases such as high blood pressure, cardiovascular disease, and pulmonary diseases, as well as less arthritis, headache, and flu. Maybe Aristotle was onto something when he identified water as the giver of life. But as we get older, we do not feel as thirsty as we did when younger and therefore drink less. This results in less water around our cells and points to an increased risk for dehydration. 

Japanese culture is also centered around the bath, more so than just cleanliness. So, we expect to see this advantage reflected in life expectancy. Finnish life expectancy at around 81-82 is less than Japan’s 84-85. Although moisture might be a contributing factor to long life, there are other things that promote long life. While we all ponder this, remember that we are still shrinking, and although some might also experience reduced spinal mobility because of this dryness, it does not have to restrict mobility. There are things we can do to remain active, stay hydrated, and enjoy our shrinking lives.