Changing your mind

Emory's strategic initiative in Neuroscience, Human Nature, and Society brings a campus of thinkers together to explore the mysteries of the brain.

When it happens, patients feel a change immediately in the operating room. What they previously had described as a debilitating sense of being pressed down in a confined space suddenly lifts. Now they describe themselves as rising up and walking through an open door.

That's when Emory neurologist Helen Mayberg knows that she has found the right spot. Continuing to talk with the patient, she simultaneously works with neurosurgeon Robert Gross to ensure the electric implant is secured deep within the patient's exposed brain. This pioneering surgical intervention, however, is only the first step in a fascinating story of recovery and discovery that may revolutionize how we think about the mind. Its ambitious scope illustrates the courageous range of Emory's strategic initiative in Neuroscience, Human Nature, and Society.

'Forward' not 'down': Listening to what the brain tells itself

"Essentially patients need to learn how to use their new brain," Mayberg says of her post-op patients. Yes, she says, for some patients suffering from severe depression that has proven resistant to other treatments, Deep Brain Stimulation (DBS) can "open the door." But patients still need to get up and go through that door -- and do it again and again when they feel the door closing. In other words, patients recovering from prolonged severe depression need to relearn everyday coping skills. Mental time travel is one such coping skill. During a really bad day, most of us can tell ourselves: "Get through it; tomorrow's another day." Healthy people take for granted the capacity to talk oneself forward in time. Part of the cruelty of depression is that it robs a person of the motivational metaphor of time travel.

Attention to metaphors is not incidental in this experimental work. The metaphors, which Mayberg's patients use to describe their steps towards recovery, are themselves instructional. They help patients and researchers alike to characterize the difference between depressed and neutral states of mind.

Prior to DBS treatment, patients tend to describe their states of mind with vertical metaphors, such as being pulled downwards. Post-treatment patients tend to use lateral metaphors such as going through a door. Graduate student Perry Guevera noted this language pattern while working in Mayberg's lab. The significance of this observation is particularly interesting because of who made it: Guevera is a graduate student in Renaissance English literature.

Why was an English grad student working in the neurology lab? The answer to that, we'll see, says a lot about the multidisciplinary reach of Emory's neuroscience strategic initiative. "Neuroscience at Emory is extraordinarily diverse, very strong, and cuts across many of the academic and clinical domains of the institution," notes Lanny Liebeskind, the strategic plan's theme leader for Exploring New Frontiers in Science and Technology and Samuel Candler Dobbs Professor of Chemistry. "One of the hallmarks of the initiative was to nurture this diversity while also fostering collaboration."

Team science

In 2005 Emory's strategic plan boldly identified neuroscience as the "next frontier of great science." Crucially, the plan envisioned that advances on this frontier wouldn't only come from the natural sciences. Rather, the neuroscience and society initiative recognized that understanding the brain required multidisciplinary teams of clinicians and researchers spanning the health and natural sciences as well as the social sciences, humanities, and the arts.

"Team science offers the best chance for advancement," says Stuart Zola, a former leader of the neuroscience initiative. "No individual can solve the kinds of challenges we face in neuroscience. The task is too complex. Progress will come from researchers learning to work together."

Easier said than done, Zola hastens to note. Everything from graduate training to faculty promotion tends towards specialization. How to combine the benefits of that rigor with opportunities for sustained interdisciplinary collaboration is an enormous institutional challenge. It's one, however, that Zola and his colleagues in the strategic initiative met head on.

Examples have transformed the campus. The name of the Psychology and Interdisciplinary Sciences Building says it all. The School of Medicine has brought together the departments of Psychiatry and Neurology under the same roof to advance patient-centered care and team science. New multidisciplinary teams have sprung up, such as the Emory Sleep Center and the Healthy Brain Initiative. Emory College of Arts and Sciences has advanced interdisciplinary work through the Center for Mind, Brain, and Culture, as well as other initiatives. The Center for Ethics has developed a leading program in neuroscience and ethics.

Recognition has come from the highest levels as well as society at large. Larry Young, director of the Center for Translational Social Neuroscience, was elected to the American Academy of Arts and Sciences in 2014. The same year, Mahlon DeLong, the pioneer of DBS in the treatment of Parkinson's disease, simultaneously received two of the most prestigious awards in the natural sciences: the Lasker Award and the Breakthrough Prize. The media, too, has picked up on Emory neuroscience. Tune into Charlie Rose to hear Mayberg discussing her work, or 60 Minutes to hear psychology professor Gregory Berns, the pioneer of neuroeconomics, explaining his research on the canine brain of man's best friend.

Cultural salience

The social implications of the rapid advance in neuroscience are profound. For this reason, in 2009 Barack Obama asked Emory President James Wagner to serve as vice chair of the President's Bioethics Commission. With his fellow vice chair, University of Pennsylvania President Amy Gutman, Wagner and their team completed in 2014 the first of a two-part set of policy recommendations for neuroscience research and education, Gray Matters: Integrative Approaches for Neuroscience Ethics and Society (the second part will be completed in the fall of 2015). In their report, Wagner and Gutman called for integrating ethics into every aspect of neuroscience research. They also called for wider public education and special attention to the cultural context and history of brain research. Referencing DBS, for instance, Wagner and Gutman wrote, "much as the field of genetics has had to contend with the history of eugenics, advances in psychosurgery, such as DBS, must contend with the widespread cultural salience of a controversial past."

Part of that controversy includes past practices such as lobotomy. It also includes a more general point: consideration of how history and culture inform our understanding of the brain and shape our mental experience. For example, the vertical and horizontal metaphors of Mayberg's pre- and post-op patients aren't just the products of an electrical stimulus; they're culturally conditioned. In different cultures or historical periods, these metaphors for depression and health might be construed differently.

Recognizing this, we can appreciate the logic that brought a scholar of Renaissance literature into a neurology lab. As Guevara notes, "One aspect of Renaissance literature that is most relevant today is the attention to emotional corporeality: the materiality of emotions registering as bodily states." Significantly, Mayberg herself, despite a very different disciplinary trajectory, recounts her career interests in analogous terms. Her path led from psychiatry to neurology because she wanted bodily data about the mind. That a 21st-century neurologist and a student of Renaissance literature should find common interest in the corporeality of emotion isn't surprising. What's extraordinary, however, is the institutional openness at Emory that brought them together through the neuroscience strategic initiative.

An open mind

Such openness to multidisciplinary collaborations between neuroscience and other disciplines is occurring across Emory. Guevara learned of the opportunity that led him to Mayberg's lab from Deboleena Roy, associate professor of Women's, Gender, and Sexuality Studies (WGSS) and Neuroscience and Behavioral Biology. Roy, who works at the intersections of neuroscience, ethics, the politics of difference, and feminist theory, is a leader in helping to make neuroscience more multidisciplinary and innovative, including the development of research agendas open to human difference and complexity. To better understand the mind in its cultural and biological dimensions, Roy recommends that researchers in the natural sciences get more exposure to the critical modes of humanistic inquiry. And she wants humanists, such as Guevara, to get advanced training in lab science.

Similarly, Roy's WGSS colleague Elizabeth Wilson is advancing a critique of biomedical treatments of depression in her new book, Gut Feminism. In the English department, Laura Otis partners with neurologist Krish Sathian to explore cognitive styles and sensory perception, including how understanding of metaphors references corresponding sensory and motor perceptions in the brain. Otis also teaches a course on the history of neuroscience with Paul Lennard, founding director of the Neuroscience and Behavioral Biology department in ECAS. Her English department colleague, Benjamin Reiss, has collaborated with neurologist David Rye on interdisciplinary approaches to understanding sleep. Reiss is publishing a cultural history exploring how sleep became a subject of medical attention and pervasive worry in modern industrial society.

This list of multidisciplinary intersections could go on -- and no doubt will continue expanding as result of the stimulus and support provided by the neuroscience and society strategic initiative.