by Kelly LikosM. Cameron Hay comparatively discusses Sasak medical cultures and American medical cultures in Chapter 5: Memory and Medicine. The questions studied through out the comparative study revolves around the connection between medical assumptions and the active use of memory. Additionally, Hay attempts to argue three points within the chapter: that memory and medicine must work together within contexts, that these interactions must take place within the sociocultural locations of the world, and that we must strive to stop separating biological sciences from the social sciences.
Hay references Budson & Price (2005) and Squire (2004), who describe memory as “a collection process embedded within or, more accurately, catalyzed by specific brain structures”. Four brain structures are thought to be vital to the memorization of medical traditions. Hay goes in depth to define episodic, semantic, procedural, and working memory. Particularly episodic and semantic memory are described as “explicit and declarative”. Hay believes that there is a relationship between environmental influences and the biocultural style of learning. Hay hopes to show this through the comparative look at Sask medical education and American medical education. The Sasak ethnic group commonly lives on the Island of Lombok, which is known for it’s abundance of small hamlets and poor health. Jampi is the exclusive set of medical concepts used by a majority of Sasak people. Biomedicine is not believed by the Sasak to be a form healing. Therefore, many do not seek help from a clinic unless they have already attempted jampi treatments. Jampi is passed down verbatim through family lines. It is believed that if more people than necessary know jampi, it leads to a weakening of the healing properties. To contrast the Sasak, who rely solely on a set of memories to provide medical treatment, Hay dives into the set of knowledge composed into American medical traditions. Hay notes the common assumptions of American medical education: competent medical practice is scientifically based, scientific knowledge is wrong and can always be improved, and that scientific knowledge should be integrated into one’s already existent knowledge. Schemas are a common and encouraged tool when attempting to memorize many different forms of information. Schemas allow for new knowledge to be assimilated efficiently into categories and allow for selective forgetting that has the ability to be independent from hippocampal stimulation. Interestingly, Hay speaks extensively on the role of the hippocampus. The hippocampus facilitates memory consolidation and memory plasticity. Recalling information that has been placed into categorical schemas requires plasticity to facilitate the movement between varying schemas. In relation, the amygdala is responsible for “mediating both biological and emotional stress by focusing on various brain structures to gather memories in order to resolve the stressor”. In American medical traditions, anxiety is associated with not being able to recall information, or in this case, a particular unfamiliar illness. Sasak healers utilizing jampi use schemas that have primarily social reinforcement and must be precisely associated with symptom cues. In contrast, American healers work primarily with core knowledge which can be integrated into other aspects of medical care. American healers must retain the ability to change information in their minds as new knowledge is gained. Through the different ways the Sasak healers and American healers encode medical knowledge, we began to see the larger problem of knowing what information to utilize at what time. This is troubling when healers must actively take in information concerning symptoms and associate them with particular illness. Memory plasticity is a necessity. Hay’s chapter provides a detailed and fascinating learning contradiction between two strikingly diverse cultures. The formation of schemas and the ability to move between them permits for a beautiful insight into the ever-changing knowledge surrounding neuroplasticity. More profound differential examples, like the Sasak, would allow for an even greater understanding of memory and how it shapes cultural traditions. This is a particularly interesting case study under the field of neuroanthropology. Memories and traditions, paired with neurological function allow for potentially great window into new neuroanthropolgical knowledge. Lende, Daniel H.; Downey, Greg (2012-08-24). The Encultured Brain: An Introduction to Neuroanthropology (141-167). The MIT Press.
18 Comments
Larry Monocello
2/23/2016 06:23:59 pm
While I appreciate the attempts to explicate the phenomena of memory and humor from a neurological perspective, I will say that I think both articles fall flat. That's not to say that the chapters were poorly written, badly researched, or uninteresting. On the contrary, they are well-reasoned chapters that present very interesting and useful information. I don't even disagree with their assumptions. My main problem is this: I fail to see what makes either of these studies "neuroanthropological." Sure, they incorporate a discussion of the brain; however, as these articles are presented, the discussion of the problem's relationship to brain function is more of an afterthought than an integral part of the research. Instead of the brain being the subject of discussion, it comes in as more of a "X is stressful. We know that stress affects the health of humans. Humans are biocultural beings, in the interplay of biology and behavior. Therefore, this stress affects their biology, of which the brain is part, which affects behavior. Therefore, this is neuroanthropology." It's an uncontroversial proposition, but not a conclusion by any means.
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Larry Monocello
4/26/2016 05:08:38 pm
I will say that I am still left unconvinced about the "neuro" in most of these studies. I think my position has been misrepresented as an assertion that every neuroanthropological study requires brain imaging data. Not all neuroscience deals in brain images, and neither should that be expected in a field whose strength really lies in ethnography. That being said, "neuro" needs to be more than an afterthought, which was largely the case in most of the studies we read.
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Edward Quinn
2/23/2016 07:26:00 pm
This chapter by M. Cameron Hay was a good example of what I think neuroanthropology should be: an approach to human variation grounded in ethnography, with a thoughtful consideration of the enculturation of the nervous system. The chapter might have been improved by presentation of original neurological data, but I also don’t think it’s reasonable or necessary for every neuroanthropological study to present brain imaging data. Hay spent two years in Lombok and has expertise in cognition, which makes for a powerful combination in the comparative approach taken in this chapter. What I really like about this chapter is that cognition is seriously situated in cultural context, while a series of conjectures about possible differences in neurological processing between Sasak healers and American clinicians are backed up by knowledge of actual cognitive processes. Hay delves into possible differences between these two types of healers in memory on a neurological scale of analysis. This is refreshing to me because there is an entire vocabulary in cognitive anthropology devoted to describing thought (e.g., “cultural models,” “prototypes,” “schemas,” “scripts,” etc.) which does not require a basic understanding of neuroscience. Through such nonbiological language, one could be an expert in human cognition without knowing what an action potential is, and that has always seemed strange to me. I appreciate the fact that Hay delves into carefully considered cultural differences in cognition while maintaining scientific credibility.
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Edward Quinn (2nd Response)
4/28/2016 07:20:11 pm
While I still feel like this is a good example of a neuroanthropological study, I also recognize the limitations here. The primary limitation of the field seems to be in the methodology. As Dr. DeCaro said in class, we can think about the brain analytically, but we don't have the methods to observe "brains in the wild." Until we do, studies like the one done by Hay will have to suffice for this new field. One would hope that someday neuroanthropology will be able to move beyond conjectures about what might be happening in the brain and how it might connect to some culturally mediated process, but this will have to wait until methodological developments are made.
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Catherine Manson
2/24/2016 09:50:40 am
I found this chapter incredibly interesting and well written. Cameron Hay's article on the memory that is used by healers in separate, and very different, cultures was argued very well. What I appreciated most in this article was the explanation of the 4 types of memory, and how they were each described to be used by the Sasak and American medical cultures. This was extremely helpful to my understanding of the article, in that I was able to fully grasp what and how each type of memory differed from each other and why the medical cultures may use different memories in order to diagnose or treat a patient. Hay states that the American physician may use episodic, semantic, and procedural memories, as well as working memories, and that the Sasak Healer would use episodic and working memories. I also found the idea that the environments of the healers could effect the learning styles and how they process the symptoms and information given to them by the patient interesting.
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Catherine Manson
4/27/2016 09:58:29 am
After reading the article by Dr. Lynn I as interested in learning more about HBERG and how it is implemented in cross-disciplinary settings to combine research for a more whole end product. I discovered that many of my class mates are involved in HBERG and do research with Dr. Lynn. I find this resource for research to be an incredible opportunity of students at the undergrad level, because they get to work with academics of many levels and disciplines to research studies of anthropology.
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Jake Aronoff
2/24/2016 09:59:52 am
I must say I agree mostly with Larry, but first I will list what I liked about the article.
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Jake Aronoff (2nd Post)
3/1/2016 05:51:22 pm
I think Edward makes a very interesting point in suggesting that not every neuroanthropological study requires brain imaging data. I am on the fence regarding this issue. On the one hand, as Edward mentions, this will not be practical or reasonable to every research question. However, on the other hand, brain imaging is largely, if not entirely, what neuroscience deals with. Therefore, if a study does not incorporate brain imaging, can it be called neuroanthropological? Perhaps, brain imaging is not necessary. Though if this is the case, I think it becomes a necessity to foster communication between anthropologists and neuroscientists so that neuroscientists can comment on the speculations made by anthropologists regarding the relevance of their ethnographic findings to the nervous system. This would also allow anthropologists to provide more input on cultural neuroscience research, something Seligman & Brown highlight as important.
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Olivia Davis
2/24/2016 10:02:33 am
I really enjoyed this chapter by M. Cameron Hay because it provided a clear and concise model for a neuroanthropological study that has equal parts ethnography and neurology. His comparison of the American and Sasak medical traditions and their use of memory cognition was interesting because it showcased the way that the same neuroanthropological research question could apply to both traditions and still procure accurate and relevant results. Something that I also considered while reading this chapter is that the comparison of two or more traditions with regards to one concept (memory) is basically the main factor that makes this study neuroanthropological. I think that if one were to consider only one of these traditions and the memory cognition involved in its retention, the ethnographic and neurological dualism would be lost. I wonder if neuroanthropology will be a majorly comparative field in future research?
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Olivia Davis
3/2/2016 08:22:25 am
I still think that this was my favorite chapter to read in the book so far. One thing that I recall from the passage that I didn't write about in my first post is that of the encoding process for both the Sasak and American doctors/healers-- one has only one encoding episode and the other has multiple. There is something to be said for the sanctity and protection of the 'jampi' as the Sasak call it.
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Molly Jaworski
2/24/2016 10:04:30 am
After reading this chapter I found myself having more questions than answers. I felt like there was a disconnect with each of these studies as it pertains to Neuroanthropology. What I mean to say is that without the comparison of American Medicine and Jampi medicine I feel like the subject matter would lose the aspect of Neuroanthropology. American medicine has a firm grasp on the biological and psychological (memory) aspects where as Jampi has a strong cultural embodiment as well as memory. In comparison It makes for an interesting neuroanthropological study however it could hold more value if each individual medicine was explored neuroanthropologically first, before comparing the two.
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Molly Jaworski
3/2/2016 07:56:42 am
After rereading I still find myself with more questions than answers. I wish that this article had developed a neuroanthropological approach to each type of medicine before comparing the two. I felt a disconnect with the subject at hand.
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McCallie L. Smith III (Trip)
2/24/2016 10:19:41 am
I found Hay's chapter, Memory and Medicine, very thought provoking and well rounded. I am split, I can agree with both parties here (those who find it nuroanthropological and those who find it lacking more nuroanthropological aspects).
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McCallie Smith III (Trip)
3/2/2016 09:51:40 am
After returning to and reviewing my review, I am still split on if this was truly nuroanthropological or not. However, now i am leaning more toward it being nuroanthropological in nature. It may not be in the "purest" form of nuroanthropology, but i am leaning toward it being considered a nuroanthropological study. I fell this should be the case because this study is very similar to the study involving the human equilibrium and balance. That study was, or at least in my opinion, nuroanthropological in nature, and because they are some what related i believe this study should be more nuroathropological than not. It is not as steeped in neurological or anthropological aspects to the same level as the other study, but similar enough and containing elements of anthropology and neurology to be considered as nuroanthropology.
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April Irwin
2/24/2016 10:56:27 am
Through its comparison of Sasak and American medical traditions, Hay’s (2012) chapter brought to mind a few things that I’ve been thinking about lately in relation to empowerment of participants and positivism as a framework for neuroscience as a “hard science.” In my qualitative research course, we have been examining critical ethnography as a methodology and, of course, I’ve been thinking about how this relates to the research I’m interested in. One of the ideals that I really admire in critical ethnography is that it seeks to empower the participants rather than overpower them by looking in on the culture from an outsider’s perspective. As researchers, we tend to take practices and traditions from other cultures, put their experiences into our mindset, and then frame it against what we know as “normal.” The language of this article countered that practice very nicely. In comparing the two traditions, one which is very familiar to the intended audience and one that may not be so familiar, Hay portrays each as equally important while framing it around neurological information about memory. For me, this demonstrates a researcher’s ability to successfully empower participants and describe their traditions while also describing them in terms of what we know about how the brain works.
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Michelle Bird 2nd Post
3/2/2016 10:23:32 am
April’s post was interesting to me, because I’ve had personal experiences being “overpowered” by a medical professional's expectations of what my illness “means” or “is”, which has resulted in the overlooking of some symptoms and excessive focus on others (for example, when I was first diagnosed, the cardiologist I saw insisted I be placed on a beta-blocker to reduce tachycardia, but neglected to realize that the tachycardia is a reaction my body has to constantly falling blood pressure, and lowering my heart rate increased my incidence of fainting ten-fold; he judged my symptoms by his personal standards, and didn’t quite listen to what I was telling him was happening, and we exist within the same general American culture – I can’t imagine some of the difficulties people with values and beliefs different from those they are sharing their ideas with must encounter). I’ve discovered that a large part of science relies on the willingness of individuals to participate in research projects and encountering judgment from stereotyping or another snap decision can be very hurtful, and result in diminished participation. I think the content of this week’s lecture reiterates the importance of understanding differences among humans and their methods of transferring knowledge, as opposed to classifying and judging their value.
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Issac
4/12/2016 01:49:40 pm
While reading the beginning of this chapter and seeing the importance of memory in medical assumptions and treatment , I began to ask myself what would happen when the practicioner came across an illness he or she did not recognize. The part of the chapter titled, " unfamiliar illness", attempted to answer this question but did not satisfy my curiosity. While I agree with the previous comments that this chapter could have been strengthened with more ties to neuroscience, this section seemed to lack in ethnography. It explains very well the role of the hippocampus which is activated by episodic memory compared to semantic recelection which activates more the left hemisphere. The point of this was to say that physicians are still seeking for memories even when faced with unfamiliar problems, which did not seem to further the reading very much.
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Michelle Bird
4/13/2016 10:21:01 am
One of the things I found most interesting in this chapter was the discussion of the role of anxiety on memory. As Americans, we tend to view anxiety as a hindrance, even going so far as to medicate those who have an extreme form of it on the basis that it hinders their daily life. I think that this stigma on it is one of the main reasons why it becomes so out-of-control for Americans - anxiety is an uncomfortable feeling, but being taught that it's wrong somehow intensifies the effect it has, and eventually the person is ashamed of how they feel and run from it rather than exploring why the feelings are there to begin with. In a medical context, anxiety is associated with not knowing - a feeling which, in the United States, a patient never wants to hear a doctor say, especially if they are unfamiliar with the symptoms as well. Personally, however, I would rather have a doctor tell me they are unfamiliar with my condition and aren't comfortable treating me than making a misdiagnosis in an attempt to save their own pride and avoid that sort of social shame. My quality of life means more to me than someone else's pride. In contrast, the Sasak culture doesn't seem to have any real stigma against anxiety, and it can help them with memory plasticity. The more personal nature of Sasak healing has quite a bit to do with this, I'm sure, but I did find it intriguing that they have so much confidence in choosing the correct jampi even in unfamiliar situations, and use anxiety as a helping mechanism. Whether this phenomena is a blessing or a curse is all determined by the person experiencing it.
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AuthorThis blog is group authored by Dr. DeCaro and the students in his ANT 474/574: Neuroanthropology. Archives
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