In this article, Neitzke argues that the higher prevalence of diagnosis of depression in women  cross-culturally is the result of the biomedical framework’s removal of a patient from her social surroundings. She argues that this removal obscures the fact that a diagnosis is often made without consideration of the fact that women live in “a patriarchal system of gender as it interacts with a social, political, and economic order…limits or altogether preventing the examination of social and economic mechanisms in the causal pathways of mental disorders” (60). She argues that the DSM-III’s definition of depression mapped to “feminine” behaviors and characteristics, and, circularly, depression became “identified with women, as primarily a disease of women” (62). Statistics, showing that women suffered from depression more often than men, “objectively” legitimated the category. Further, the mechanistic analogies used by biomedicine, and therefore the assumptions biomedical researchers and practitioners come to espouse as reality, served to “bracket-out gender and other social influences” (63), denying them the ability to attribute their “disorder” to anything other than their biology.

One of the many strengths of this article is the author’s attention to ethnographic work on depression. Referencing anthropologists work on depression cross-culturally, she shows that the experience of depression is culturally constructed. She explains how, in some cultures that valorize instead of marginalize the depressed (e.g., Gaines and Farmer’s (1986) work on the Visible Saints of France), outcomes and experience are different. She argues that the biomedical/psychiatric model of depression is disempowering to women for that very reason: the culture around depression is hostile, and yet the culture is not considered in the model, erasing a very real factor from consideration. As a result, she calls for a truly biopsychosocial model of depression to address this flaw.

Importantly, Neitzke notes that her criticism of the biomedical psychiatric model of depression as erasing the consideration of gender can also be extended to considering the erasure of sexuality and race/ethnicity. This made me consider a couple of questions that I would like to leave up for discussion:

Over the course of the semester—aside from our discussion of poverty—we haven’t spent much time discussing the experience of marginalized groups (sexual and racial minorities, women, etc.). Critically considering the topics of past discussions, how do you think that the utilization of a feminist or racially-sensitive lens would affect our interpretations of what we have read thus far? 

Is a feminist/racial/queer neuroanthropology necessary? Is it even possible? What would it look like? 


Neitzke, Alex B. 2016. "An Illness of Power: Gender and the Social Causes of Depression."  Culture Medicine and Psychiatry 40 (1):59-73. doi: 10.1007/s11013-015-9466-3.

​            In this study, Kohrt et al. (2015) examined gene-environment interactions in relation to phenotypic expressions of depression and PTSD as well as a biological marker in the form of cortisol awakening responses. This study is unique in that it examines a specific gene-environment interaction in an unconventional setting: Nepal. The authors note that while there has been increased attention in global mental health, studies have focused mostly on populations in high income countries and of European descent. Thus, the authors intended to examine whether previously reported relations between specific genetic profiles, childhood maltreatment, and adult expressions of depression and PTSD were also present in a population outside of a high income country and not of European descent.
 
            The gene of interest to the researchers was FKBP5. Previous studies have examined alleles of this gene, and found interactions with child abuse and later life risk for depression as well as PTSD. Thus, the researchers wanted to see if this interaction could also be observed in a population conventionally not studied. Along with examining depression and PTSD, they also measured cortisol awakening responses. Cortisol awakening responses were measured because of the role FKBP5 has in the stress response as well as the fact that depression and PTSD are stress-related. The stress response relies on the hypothalamic-pituitary-adrenal (HPA) axis, and its functioning can be altered by FKBP5. Certain alleles of FKBP5 can do this by enhancing the gene’s expression. This results in a decreased efficiency of negative HPA feedback (the brain knowing when to turn off the stress response), which prolongs HPA activation after exposure to a stressor. Cortisol, a steroid hormone, is the end product of the HPA axis, being produced by the adrenal gland. Thus, the cortisol awakening responses served as biological markers for the functioning of the HPA axis that can be altered by different alleles of FKBP5.
           
            The researchers found an interaction of a specific genotype with childhood maltreatment and depression, but not PTSD. The genotype found to have the highest risk for developing PTSD in the presence of child abuse in a previous study was associated with the most severe depressive symptoms. Also observed in individuals with this genotype were opposite cortisol awakening responses depending on presence of childhood maltreatment. For individuals with this genotype who experienced childhood maltreatment, their cortisol levels dropped from the time of waking to thirty minutes later, whereas the opposite occurred in individuals with this same genotype who did not experience childhood maltreatment. For these individuals, cortisol levels rose from the time of waking to thirty minutes later. The researchers posit that individuals with this genotype may be more sensitive to early environmental conditions, and are more likely to experience epigenetic changes in the expression of FKBP5 (a genetic-epigenetic interaction) that alters the functioning of the HPA, an alteration that persists into adulthood. Thus, the researchers entertain the possibility that individuals with this particular genotype who experienced prolonged childhood maltreatment, and therefore prolonged elevations of cortisol, have negative cortisol awakening responses and hypocortisolism (low cortisol levels) as adults.
 
            The potential explanation proposed for why this study replicated previous findings on the interaction of genotype, childhood maltreatment, and depression but not PTSD was the cultural meaning associated with depression and PTSD in different parts of the world. In American and European populations, PTSD is less stigmatized than depression. However, in South Asia, where this study took place, PTSD is more stigmatized than depression. Thus, due to cultural differences regarding PTSD, there might have been under-reporting. The researchers also rely on the cultural context to explain why cortisol awakening responses had the most statistically significant gene-environment interaction effect. However, while cultural variation may influence self-reports of mental health, it must also be noted that measures of cortisol are not always perfect indicators of mental health. For example, approximately half of individuals with major depression have elevated cortisol levels (Sapolsky 2004). Therefore, there is not a single cortisol profile for depression, and this may be part of the explanation for why cortisol awakening responses had a more statistically significant gene-environment interaction effect than depression in this study.
 
            The researchers note some limitations as well as implications of their study. They note that the small number of individuals with the genotype that they observed such a strong gene-environment interaction with limits generalizability of their findings. They also note that individuals with this particular genotype who also experienced childhood maltreatment reported waking times approximately thirty minutes later than other participants. Therefore, they suggest further study on cortisol awakening response differences and different wake times. One implication of the study the researchers note is the importance of culturally and contextually diverse samples in order to avoid gene-environment associations being generalized based on samples of populations in high income countries of European descent. Another important implication the researchers note is the prevention of childhood maltreatment, as even in this setting of high exposure to political violence child abuse still had a significant effect on adult mental health and HPA regulation.
 
References:
 
Kohrt, Brandon A., Carol M. Worthman, Kerry J. Ressler, Kristina B. Mercer, Nawaraj Upadhaya, Suraj Koirala, Mahendra K. Nepal, Vidya Dev Sharma, and Elisabeth B. Binder. "Cross-cultural gene− environment interactions in depression, post-traumatic stress disorder, and the cortisol awakening response: FKBP5 polymorphisms and childhood trauma in South Asia: GxE interactions in South Asia." International Review of Psychiatry 27, no. 3 (2015): 180-196.
 
Sapolsky, Robert M. Why zebras don't get ulcers: The acclaimed guide to stress, stress-related diseases, and coping-now revised and updated. Macmillan, 2004.

​Neuroanthropology recognizes the brain’s plasticity (rather than conceptualizing it as a hard-wired instrument) and that cultures help construct both cross-cultural and intra-cultural neural diversity.  Different knowledge traditions and environments can lead to variation in brain patterning across cultures, while differential “forms of expertise, difficult social circumstances, social divisions such as those of race, gender, and socioecological conditions can all work to shape neural patterns” (p. 392) of individuals within cultures.
 
Neuroanthropology focuses on neurocultural processes. “Processes are operation, components, or factors that shape the overall flow, development, or outcome of a phenomenon.  As opposed to a simple cause-and-effect model, processes are considered formative rather than determinative” (p. 395).  Finley, in her chapter about PTSD, for example, looked at the processes of stress, horror, dislocation, and grief. She did not, however, treat these processes as isolated determiners of PTSD, but argues that these processes, steered along by cultural mediators, interact to form the “inherently integrative dimensions of neurocultural processes”  (p 395) that shape the experience of PTSD.
 
An emphasis on neurocultural processes also steers us away from essentialised views of vulnerability.  For example, studies that highlight neurological differences between men and women or the increasing evidence that shows that poverty poisons the brain can essentialize gender, or poverty, as inherent vulnerabilities, “rather than focusing on neurocultural processes that explain how that happens,”  “confronting entrenched patterns of socialization,“ or challenging “the inequalities that set up the poisoning in the first place” (p. 398). Thus, the notions of “neuroanthropological vulnerabilities” created by “neurocultural processes” illustrate how neuroanthropology can contribute to social analysis and applied interventions.
 
This move away from essentialism, which is foundational to modern anthropology, is evident in other fields  - such as neuroscience,  psychology, linguistics, and philosophy, as well.  The rest of the chapter highlights how a neuroanthropolological perspective can contribute to other fields.
 
Psychological research has often tended to look for “universal mechanism located within the mind” (p. 402) and “has never considered either neuroplasticity or culture as foundational operating principles for the mind” (p. 403). In fact, “culture and environment were elements to be controlled and excluded in experimental designs” (p. 403).  Bringing in a neuroanthropological perspective means “recognizing that psychological processes generally do not happen in laboratories to subjects, but to individuals with biographies and biases, in situations shot through with power shaped by negotiations [or interactions] and overshadowed by significance” (p.404).
 
However, it’s not just psychologists who show tendencies toward essentialism (treating the mind as the same everywhere). Anthropological research on different cultures can fall pray to cultural essentialism – or the view that cultures are timeless, bounded, homogenous units. Where (human) nature is assumed to be universal, ‘culture,’ from a popular perspective, implies ‘whatever makes one different.’ Essentialized cultural differences have been used to justify the subordination of one cultural group to another and enforce assimilation or even genocide. (p. 406).
Even when addressing questions of “difference” within cultural groups, social scientists may essentialize categories of differences, such as those between men and women or different racial or ethnic groups. Yet, “what it means to be a member of a racial or ethnic group or a man or a woman [or what it means to have a disability], is not simply an exemplar of a category, but is itself liable to shifting meaning and impact across our lives and context” (p. 405).
When differences between cultures or categories are subjected to essentialists notions, “interventions” to aid a vulnerable group (or get rid of a deviant group) may do more harm than good.
 
“But neuroanthropology can disrupt these folk models” (p.407) by highlighting neurocultural pathways and processes and the interactions between the brain, the environment, culture, and learning – in other words by presenting the encultured brain.

Chapter 11 of Lende and Downy’s book, The Encultured Brain, is a case study that was conducted by Rachel S. Brezis that deals with the general topics of autism, religious practice and beliefs, and agency. However, speaking more directly to the specifics of her study, Brezis hones in on the theory of mind, which she describes as “our ability to understand others’ thoughts and intentions”(Brezis 292). She refffrences a hypothesis proposed by another scholar, Jesse Bering, as a framework if sorts to set up her research. Bering’s hypotheses suggests that individuals who have autism would not posses Theory of Mind, or is incapable of understanding not only other individual’s thoughts and intentions, and thus individuals with autism would develop a mechanical, or impersonal way of understanding the universe (Brezis 292). She also uses Bering’s hypothesis as grounds to open on of her research questions: “Given autistic persons’ difficulty in inferring with others’ thoughts, would they be capable of conceiving of the world as directed by a spiritual agent?” (Brezis 292).
 
Brezis approached this question by conducting ethnographic research on individuals who have autism, and focusing on the religious aspects of their life. The research she conducted was “focused on individuals with high-functioning autism and Asperger’s syndrome, who have spared language abilities and normal to above normal intelligence, along side their social and communicative difficulties” (Brezis 293). She goes and introduces several paradigms of the causes of behavioral defects of autism, and they are “impairment of theory of mind”,  “weak central cohearence”, and “pervasive difficuilty in engaging in pretend play and symbolic, non-literal communications” (Brezis 293-4).  Also, Brezis introduces an emerging theory of autism that connects several of the paradigms that currently exist “to a central deficit in self-understanding” (Brezis 294).
 
The theory of mind aspect perpetuates a fair amount throughout the rest of the chapter. This is probably because it is the paradigm that Bering (2002) uses to make predictions that individuals having autism  “would not search for an intentional agent to give meaning to events in the world”, Brezis’s application and main focus on theory of mind in her research helps to refute the previous notions provided by Bering (2002).
 
The notion of theory of mind, and the other paradigms presented by Bering (2002) would present a great deal of difficulties to an individual who has autism, and one of those difficulties might be religion and religious development. As Brezis points out a main aspect of religious development theory is the idea of the individuals personal “relationship with the divine is modeled after social relation ships”, and as previously mentioned, this process could be disrupted in an individual who has autism. Due to these notions Bering (2002) makes predictions that individuals with autism my have ritualistic behavior, but would lack the “existential search for meaning, or the religious belief in God” (Brezis 296). Brezis extends past the predictions of Bering, and conducts ethnographic first person accounts of religious belief in individuals in autism. 
 
The religious background she chooses to us for her research was Judaism. She decided on Judaism because “of its special emphasis on the behavioral performance of 613 biblical commandments and their deviations, alongside its lack of a specific credo” (Brezis 296). She had a total of sixteen participants in the study four of which were female, and the rest male all participants were between the ages of 9 to 26. “Participants were recruited through local support groups for parents of autistic children in and around Jerusalem”, and their degree of religious practice varied from “ultra-orthodox to secular” (Brezis 297).  She conducted all the interviews in Hebrew, and three participants interviews, out of the original sixteen, had to be excluded form the study. The interviews she conducted were between one hour to one hour and half hours. She opened with questions regarding the degree of religious practice, such as keeping kosher, Shabbat, and holidays they and their parents keep, and then she slowly worked into more “personal questions of belief and the nature of their personal relationship with God” (Brezis 298).
 
The results of her research were full of diversity and rich with information that is worthy of further inquiry.  There are several excerpts that Brezis includes in the chapter from her interviews that point to a use of religious and cultural scripts and “scaffolding of personal identity, but also refute Bering’s (2002) predictions that “autistic persons would fail to develop agentive views of God” (Brezis 306). Brezis was in fact able to show, through her interviews, “that autistic persons can hold an agentive view of God as directing events in the World, and a minority can even engage in an amore personal exchange with God” (Brezis 306).
 
This chapter is a striking one in the essence that there is a wealth of potential for future research that can be conducted and the copious amounts beneficial aspects that said research could produce, and this chapter was just scratch on the surface.  There should be, and hopefully already is more and current research being conducted surrounding the ideas proposed in this chapter. There is not much from this study that can be ultimately conclusive other than what was mentioned in the previous paragraph. However, the study is able to add new narrative to the continuing debate surrounding the role theory of mind has on the neuropsychological foundations of religious belief. Also, adding new narrative to autism studies in anthropology. An ethnographic anthropological approach has the ability to capture, or attempts to capture, the natural occurrence of things as the happen in nature, and in this case how individuals with autism navigate their various strengths and weaknesses as they occur naturally instead laboratory setting that’s can be isolating and commonly focuses on just one or two aspect here and there.
 
Works Cited
           
Lende, Daniel H., and Greg Downey. "Chapter 11 Autism as a Case for Neuroanthropology: Delineating the Role of Theory of Mind in Religious Development." The Encultured Brain: An Introduction to Neuroanthropology. Cambridge, MA: MIT, 2012. 292-314. Print.

People with autism spectrum disorder (ASD) have difficulty with face-to-face social interactions, and this can have negative consequences for overall well-being. Social networking sites (SNS) offer a platform for interaction that is more comfortable for people with ASD, and has the potential to enhance both online and offline relationships. Mazurek (2013) investigates patterns of social media use among people with ASD and tests for relationships with friendships (quality and quantity) and loneliness.
 
In a sample of 108 adults diagnosed with ASD, Mazurek (2013) finds that about 80% of the participants use SNS, mostly for purposes of social connection (rather than business, entertainment, etc). Mazurek (2013) finds that those who use SNS are more likely to have close friends, and that ASD adults who use SNS specifically for social connection have closer friendships. Interestingly, the use of SNS was not related to feelings of loneliness. Instead, the quality and quantity of offline friendships was associated with loneliness. Greater numbers and quality of offline friendships were negatively associated with loneliness. Surprisingly, SNS use was not related to offline friendship. This finding runs counter to the notion that SNS have a positive effect on social engagement (in real life).
 
A number of limitations are discussed by the author, including online recruitment, which may have biased the sample towards greater numbers of SNS users. The data are cross-sectional, and causality cannot be determined. Also, the gender of the sample was evenly split, which is not an accurate reflection of the ASD population. There are roughly four men with ASD for every woman with ASD. Despite the limitations, there is a lot of value in this study. This is a first look at social media use in adults with ASD. From a basic science point of view, it is illuminating to understand the use of SNS and their effects in typically developing people and in people with ASD. Though Mazurek (2013) did not use a control group, she does compare her findings to literature on social media in the broader population, and it appears that the patterns of social media use in the broader population hold in this sample of people with ASD. Another reason this study is important is that it has potential clinical relevance. Given the high levels of engagement with computers by people with ASD, it may be a tempting platform for intervention. This study suggests that any positive effects of SNS on the social lives of people with ASD will work through effects on offline social networks.
 
ASD interventions would benefit greatly from the type of ethnographic work that Brezis (2012) presents in her chapter. If we subscribe to the idea that a lack of self-understanding is central to ASD, it means that any intervention should be evaluated in terms of its ability to improve self-understanding and self-expression. Social media sites seem like perfect mediums to facilitate such activities, and may be an important testing ground for Brezis' (2012) suggestion that people with ASD might benefit from scaffolding (or outright appropriation of narratives) in self-expression. Social media provides a myriad of tools for self-expression, and it would be interesting to see if these help people with ASD to build an understanding of themselves that enables better social interaction and communication.
 
References
 
Mazurek, M. O. (2013). Social media use among adults with autism spectrum disorders. Computers in Human Behavior, 29, 1709-1714.
 
Brezis, R. (2012). Autism as a Case for Neuroanthropology: Delineating the Role of Theory of Mind in Religious Development. In Lende, D. H & Downey, G. Eds. The Encultured Brain: An Introduction to Neuroanthropology. (pp. 291-314). Cambridge, Massachusetts: MIT Press.

Daniel Lende focuses chapter thirteen on addiction and how it relates to neuroanthropology. An addiction is defined as having cravings, desires and urges but addiction can also lead to very extreme measures causing problematic situations for both the individual as well as members of their immediate friend and family circles. Lende hones in on the very core of addiction; compulsive desires and the repetitive use of drug habits.

Lende’s purpose of this chapter is to begin to understand how addiction effects an individual’s neurological process within their own cultural niche. Compulsive involvement not only leads to destructiveness but it also is directly “defined by the neurocultural dynamics of desire and habit” (Pg. 340).Lende takes an ethnographical approach as he noted that addiction is sought out to be a problem that is associated with involvement. Addiction is often thought about as feeding one’s pleasure but as Lende continues his research on addictions he finds this not to be as accurate.
Addiction cannot be summed up in a simple definition as it is very complex in its own right. Addiction does not only affect a certain area of the brain but travels through the brain’s neural  circuit disrupting motions, memories and choices of individuals which in turn creates a social complexity. Addiction changes the way that individuals perceive themselves and how their actions mirror their thoughts.  Addiction runs a certain path starting with the “basal parts of the brain” that regulate body activation, continues “through the limbic circuits” that control emotions and process information that is within our cultural environments finally reaching its destination at the “frontal cortices that perform higher-order cognition and control” (Pg.342).

Substance abuse interferes with many aspects in life including abandonment of family and social obligations such as jobs that were in fact very prominent before substance abuse began to take a toll. Families are constantly being ripped apart all because of an addiction. Substance abuse alters ones capability to make informed decisions that allow individuals to control their behavior.

Incentive Salience is defined by Robinson and Berridge as being distinguishable, it encompasses declarative goals and has explicit expectations of future outcomes which in turn are controlled by the cortical circuits of the brain. Incentive salience is used to describe an urge for something that is later turned into a sudden realization that they need to fulfill their desires at that very instance. Incentive salience is not the sole component of addiction but it does in fact play a big role.  It is important to note that salience drives addictions that turn into repetitive addiction behaviors. Salience cues a form of motivation and is rewarded when the action is complete as the body is content for a moment in time.

Lende’s study takes place in Colombia where he works with adolescents and tries to understand their motives behind their addiction. Many adolescents feel that their family is against their every move so they turn to drugs as an outlet. This outlet allows them to associate with others who feel the very same way and it creates a bond of acceptance. When the individual feels they are accepted they long to feel that way again and are very anxious for the next appointed time. Once addicted that is all they can think about. Their motives get them through the day with the idea that they will reward themselves with a chosen substance. Addictions allow individuals to feel in control of their environments even when they are not. Salience causes one to seek out a place where one feels important for who they are.

Addictions are habits that become routine. Habits like addictions are caused by internal motivations. They are goal oriented with a short term future. Addiction behaviors are linked to the ventral and dorsal striatum. Once the researchers began to understand the linkage between the ventral and dorsal striatum it highlighted the actions that the brain performs again and again. One must place themselves in the thought processes of an addict to fully understand the motives and drives behind doing so.

Part of the ethnographic research ties back in the idea of having brains in the wild as conducting such an experiment in the laboratory would change the outcome of the data. The drug addicts need to be in their own environments for proper documentation. The results of this study portray that “social interaction among young users were actually one of the main motivators and rewards for people with deep involvement in that setting” (Pg. 355).
 I find this article very interesting but very relatable simultaneously. Involvement is a key factor when trying to find one’s place within a given group. A key factor of involvement is being with like-minded individuals who have the same aspirations in life. Coming from a high school with several drug addicts this particular article stood out and made me question whether or not I made these individuals feel as if they were valued.  Should I have included them more?
​
In one of the other readings last week about PTSD it talked about preventing it before it ever happened. Is there a way to reach out to young kids letting them know they are not alone and that there are other alternatives besides drugs which they can turn to? 

In an effort to enhance our understanding of what the interdisciplinarity of neuroanthropology looks like in practice, I present this article by Khalighinejad and Haggard (2015) about transcranial direct-current stimulation (tDCS) and how it may assist or impeded how the brain handles sense of agency. For a quick primer about tDCS please visit this page by The John Hopkins University. Although it is not a neuroimaging method, tDCS is common for understanding the role a neural network may play in various neurological processes. In this case, the authors seek to further the research that pertains to the neural correlates of sense of agency, which has shown activation in the angular gyrus (AG) and the dorsolateral prefrontal cortex (DLPFC) during agency tasks. The authors target intentional binding as a way to measure a person’s sense of agency and they use this concept in several experiments. They describe intentional binding as, “the perceived time of voluntary actions and their sensory consequences [that] are attracted towards each other” (Khalighinejad & Haggard, 2015, p. 94). This binding of intentions differs from direct agency tasks which typically measures feelings of agency by asking participants to judge if their actions caused a specific sensory event. However, the authors advocate for intentional binding as the measurement because it is not seen in involuntary movements.

Each of the three experiments involved an image of a clock with a hand that begins rotating when the participant presses the enter key. They are asked to watch the center of the clock and then press a certain button with one of their index fingers (the finger that they used depends on the experiment). When they pressed the button, the clock hand stopped and they had to make a time judgement, which changed according to each condition and experiment. In some conditions, an audio tone placed before the clock hand was stopped, but in other conditions, the tone was played when a button was pressed. Before the clock-task, each participant had a 25-minute session with tDCS and the setup of the anodal (increases neuron excitability) and cathodal (decreases neuron excitability) electrodes changed according to the aim of the experiment.

The experimental design for this paper was extremely detailed, which is really wonderful if you’re attempting to replicate it. However, I want to explain that the electrodes were set-up according to fMRI studies with sense of agency with the goal of understanding how sense of agency may be distributed across the frontal (where the DLPFC is) and parietal (the location of the AG) lobes as well as how sense of agency is distributed across the hemispheres. Placing the electrodes at these places allows us to determine whether the AG or DLPFC have a large role in sense of agency.

I have presented the experimental conditions under which people were asked to demonstrate sense of agency, which may have positive implications on how we talk about it in neuroanthropology because knowing how things are being measured in labs may allow us to elaborate on those procedures and compare those to events in people’s real lives where they exhibit sense of agency. Now I will present the major findings from these experiments because that’s where the discussion usually begins. Also, what I’m appreciating about the authors that we’ve read thus far is their ability to take these findings and apply them to the concepts that they are studying.

Compared to the sham conditions where there was actually no stimulation, anodal stimulation of the left AG significantly reduced the likelihood that the audio tone was bound to keypress. This aligns with other studies that suggests that, “the AG processes mismatches in action outcomes” (Khalighinejad & Haggard, 2015, p. 100).  The cathodal results from all three experiments supported that this type of stimulation tends to have weak effects on cognitive tasks. Their main conclusion is that this study provides a half-step forward and that more research will have to be done in order to make any definite conclusions. My big takeaway from this article is that both this experimental data and the theoretical discussions are needed in order to really move things forward.
​
Reference: Khalighinejad, N., & Haggard, P. (2015). Modulating human sense of agency with non-invasive brain stimulation. Cortex, 69, 93–103. http://doi.org/10.1016/j.cortex.2015.04.015

            In his article, Stromberg argues that young adults who take up smoking might not be in total control of their actions. He argues that this might be true even when the young adult is not a habitual smoker and is generally believed to be in control of themselves by American society. Instead of viewing addiction as the product of a wrong, but freely made, choice, Stromberg theorizes that mechanisms which evolved in humans to facilitate social coordination and activity create the sense of lapse in agency which, he argues, is at the core of why people start becoming habitual users of tobacco and possibly other drugs. By viewing addiction neither as the exclusive domain of clinical psychology nor as the result purely of free choice, Stromberg uses evolutionary models and anthropological theory to explain the large population of habitual smokers on college campuses.
            Stromberg begins his argument by discussing the delicate nature of the word “agency.” The word has been used in various contexts throughout history. Stromberg settles on using the phrase “sense of agency” which is defined as the feeling of being in control of one’s own actions and one is ultimately responsible for one’s own actions. The presence of other humans, each with their own sense of agency, creates the need to be able to anticipate the plans and actions of others in order to navigate the complex social lives of humans. One way the human brain handles this complexity, according to Stromberg, is the phenomenon of joint attention where a person can simultaneously attend to someone and the object that someone is attending to. Stromberg then argues that the increased capacity for group projects in humans led to more flexible social structures that necessitated a subjective sense of a lapse of agency in order to control the more complex social structures.
            Stromberg continues his argument by discussing the American sense of agency. He argues that the idea that people are not entirely in control of their actions poses a threat to American assumptions of individual responsibility and achievement. As a result, lapses in agency are often regulated to the realm of politics and psychopathology by Americans. However, even with the presence of a strong, autonomous sense of self in America, there does exist lapses in agency in American culture that can either be described as positive (being lost in a good book) or negative (drug addiction and other severe pathologies). These lapses are often the source of confusion in American society as to what causes them.
            Stromberg’s core argument rests on the data he and his team collected on young adult cigarette smokers in college. He argues that some of the activities his sample reported performing when they first started to smoke were similar to the ritualistic activities Durkheim reported in his The Elementary Forms of Religious Life. Stromberg argues that the excitement caused by large and energetic social gatherings combined with imitating other smokers and the emotional arousal generated by the whole context constitute what Durkheim called a “collective effervescence” whereby the act of smoking is associated with the excitement and positive feelings of the surrounding social context in a manner similar to religious rituals. According to this model, the act of smoking becomes associated with the feelings of the wider social context. According to Stromberg, these thoughts and feelings are powerful enough to overpower a smoker’s sense of agency creating a situation where they feel that they are unable to control their actions.
            Stromberg describes this collective effervescence in three parts. First, many of the young adult smokers he had interviewed reported that they started smoking habitually at parties which were characterized by high-energy interactions between friends. Second, interviewees reported a sense that when someone started smoking they felt they needed to as well. Third, large and energetic social gatherings, like parties, tend to arouse states of emotion that do not usually arise in an individual and are often interpreted as coming from beyond one’s body. These factors can act to weaken an individual’s sense of agency and may lead to lapses in agency.
            Stromberg’s argument may seem controversial, especially in America, for the same reasons he described in his article. As a society that is in many ways built on the ideas of personal responsibility and achievement, the idea that many of the actions people take may not be freely chosen is confusing at best and disturbing at worst. Stromberg argues that the social context young smokers find themselves in can lead to them being “swept up” into the social activities and lose their sense of agency amid the excitement and emotion of the gathering. Furthermore, in a manner described by Durkheim, smokers come to associate the act of smoking to the increased arousal that surrounded their smoking.  
            While I would have liked to see more recent data and there is an issue in generalizing the findings of a study which used a sample of college students broadly to describe all Americans, I found the study interesting and in need of further elaboration. Specifically, I am interested if similar effects exist for other drugs such as alcohol. I find the discussion of contextual reasons why people may start becoming habitual smokers far more enticing than the ongoing deterministic/free-will philosophical debates that often frame theories of addiction. I think that this look at the psychological processes which underlie much of our social interactions is a promising avenue for future research in addiction and dependency.