A study done on the “anatomically distinct dopamine release during anticipation and experience of peak emotion to music” by a team of researchers in Montreal delves into the neurological basis of musical appreciation in humans. The study used brain scans in order to assess the affect music has on dopamine release throughout the reward network. However, what is most pertinent to our furtherment of neuroanthropology is how their findings can be utilized to understand the neurophysiological aspects of the cultural importance of music and dancing.

The study took ten people who regularly received “chills to instrumental music” and ran an fMRI combined with a ligand-based Positron Emission tomography (PET) scan while they listened to music. The results showed not surprisingly that music causes a release of dopamine in the dorsal and ventral striatum which have long been correlated in all pleasurable experiences from sex to recreational drug use to food consumption. What was interesting was the timing of certain responses. Prior to the climax of the music there was an increase in activity in the caudate nucleus. They argue that this is the brain priming itself for the arrival of the favorite portion. This anticipatory phase is initiated by temporal clues that a potential pleasurable sequence could be imminent. The same way seeing pictures of food when hungry causes people’s mouths to water in anticipation of the reward to come. Musicians have unknowingly utilized this response in order to manipulate emotional responses in listeners for centuries by disrupting the anticipated conclusion to certain sequences. This is why predictable repetitive songs “get old” so fast as the brain quickly adapts to predictable rewards the same way extreme sports enthusiasts have to constantly find new things to try or the exponential increase of addiction. Once you’ve done the same thing a couple times, the brain adapts to the predictable reward and requires something more or different for the same pleasurable response. However, the caudate nucleus is also connected to the sensory, motor and associated networks in the brain. Dopamine is also released during the emotional reaction caused by the actual desired sequence which constitutes the normal “liking” phase of the reward network. Even though dopamine is released during both of these phases, the researchers believe they travel through different sub circuits of the striatum which could cause different effects throughout the brain and body.

Past research has shown that listening to music causes an increase heart rate, blood pressure and a redirection of blood flow to the legs. The cerebellum which is very influential in all forms of movement, especially fine motor control, has an increase in activity as well. All of these activated systems and the ones discussed in this study have direct connections in influence on the sensory, motor and associated networks in the brain. Deeper research into the effects other than dopamine release music has on these systems could shed light on why humans dance. It is easy to jump to conclusion like increased blood flow to legs must be why people tap their feet while listening to music and the different effects of dopamine release throughout different phases of a song can explain why people dance differently throughout building and climax of songs. However, the affect music has on all these movement associated neurological systems must be taken into account. Most other species “dance” under a sexual context during mating, but humans can also dance for pure enjoyment unrelated to reproduction. Does the myriad of effects to systems of the brain that contribute to movement cause us to have the urge to dance? Did the benefits of dancing in a cultural setting cause us to associate music with reward or did both aspects evolve simultaneously?

​There is still a vast amount of research to be done on the true cause of the pleasurable experience music brings to people. It is generally assumed that humans evolved an acuteness for specific sequences of rhythms, tones, and sounds in the process of developing language and understanding not only what, but how things are being said. However, did this appreciation for unrelated melodies develop as an unexpected consequence of these language skills, or was the reason these auditory abilities evolve simultaneously due to the sociocultural effects and benefits of music and dancing? Was the ability to bond as a distinct culture through music and dance a sufficient enough selective pressure to cause this path of evolution?

I was hesitant to share this selection both because of its length and because it is a
narrative review of a topic that can seem out of left field. But as I was reading it, I felt it
provided strong neuroscientific grounding in the descriptions of Altered States of
Consciousness (ASC) and it did so in a very accessible way. This topic seemed
extremely relevant because it offers a unique window to study the human brain and its
functions through the different manifestations elicited by cultural practices such as
meditation, mindfulness, dance, yoga, starvation and diet, etc. To me, it is a direct study
of how different cultures and cultural practices have adapted brain capacities for different
purposes, especially ones relevant to group cohesion and healing.

The induction of ASC in shamanic practices is widespread in human cultures and
is perhaps as old as cultural practices themselves. Although it has been the subject of
interest of some anthropologists, it has been mainly ignored by psychology and
neuroscience. This is in spite of the fact that William James, the father of American
Psychology, had a strong interested in how consciousness changed during religious
experiences. Thus it seems that ASC are a core aspect of human behavior.

In this book chapter Mishara and Schwartz introduced Altered States of
Consciousness (ASC), a wide range of conscious experiences demarcated perhaps only
by how they differ from normal waking consciousness, and describe how they are used in
shamanic practices to induce healing effects mainly through the neurocircuitry of the
human social brain. The authors present the multiple problems with attempts to study
these phenomena that range from the methodological problems of how to study them
(many have only nonrandomized groups without a control), to the difficulty of making
sense of extremely subjective experiences (i.e. inner journey). While there might be an
impulse to dismiss shamanic practices as acting as a placebo, the authors state that the
enactment of the ritual is a mechanism exploited by practitioners to provide healing
effects by enhancing feelings of belonging to a community. Thus there is something to be
said for how prevalent such practices are across the world.

The authors also present evidence of change of patterns of brain activity during
hypnotic states that might coincide with the phenomenology of an ASC. Furthermore, the
authors argue that such an experience might contribute to healing by allowing the
experiencer to gain a new reflective perspective as if outside of him or herself. They also
describe that the use of narrative, especially that of death and re-birth, might serve as a
way to optimize reflective awareness. This last conclusion is taken to be the paradoxical
healing power of the ASC.

​I thought this article was relevant to the end of the semester because it offers a
perspective of what it would look like to have a more unified description of cultural
dependent aspects of psychology and nervous system variation while maintaining
grounding in neuroscience. I though it provided a rich depiction of a whole class of
phenomena not widely discussed but relevant to discussions of neuroanthropology.

This paper by Vogl et al. (2015) discusses neuroanthropological perspectives on music therapy. The authors illustrate how using research and behavioral observation of patients with disorders of consciousness has assisted in developing music therapy to assist in the well being of these patients. They also state that music therapy has been helpful both in neural and behavioral rehabilitation in patients with unresponsive wakefulness syndrome (UWS). The authors emphasize that neuroscience isn’t the only avenue for knowledge and cannot capture the meaning of music therapy for patients. This is where the neuroanthropology perspective comes into play to bridge the gap between research and therapeutic practices with an integrated, broad approach and interpretation of results. 

The authors discuss both the neuroanthropological and anthropological approaches to music therapy. The neuroanthropological approach is using neuroimaging techniques and multidisciplinary methods to conduct research with the patient and not on the patient. The anthropological approach is to engage the culture of the individual through sensual perception and experience of music to help regain mental and physical stability, which can vary from person to person. The authors share a quote from Simon Rattle (2004): “music is not just what it is, but is that what it means to the people” which I think embodies this type of approach to music therapy very well. 

The neuroanthropological perspective in music therapy research is discussed next. This section exemplifies this type of perspective by examining two cases of UWS. The researchers took positron emission tomography (PET) scans of two patient’s brains which showed that after 5 weeks of music therapy, brain activity had increased in 3 areas, frontal, hippocampus, and cerebellum. However, there were some slight differences in the numbers for these two patients. These differences can be exemplified by looking at the cultural differences in the individual patient. One patient had played in a band when he was younger, so the therapy took a more active and upbeat route while the second patient enjoyed singing folk songs, so the therapy took a more relaxing route. Each of these patients took a different route to therapy based on culture. In this way a neuroanthropological perspective of taking into consideration each of the patient’s cultural backgrounds assisted in making improvements in brain activity. 

​I thought this paper took into account both neurological research and anthropological methods very well. However, I would have liked to see a little more of the neuroimaging results explained. Overall, I think that the integration of neuroimaging techniques and the anthropological view of integration of culture into therapy is very important for the advancement of both music therapy and neuroanthropology. I believe that this paper shows a bright future for neuroanthropology by showcasing how neuroanthropology can be put into practice into field outside of pure research to have an impact, and possibly improve, the quality of care in therapy just by having a neuroanthropological viewpoint. 

My questions for the class are: 

1. What other areas of therapy could you see having a benefit from using a neuroanthropological perspective and approach?

2. Do you think it is appropriate for neuroanthropology to be used in therapy? Why or why not?

Stromberg was looking at the reasoning why “smart” college students were taking up smoking in such high numbers, when most smart people recognize the health issues associated with the practice. He considers this to be an example agency in that it’s not something that these people would typically participate in, but they find themselves doing it anyway. He found two main reasons why college students attributed their smoking. The first one is that majority of them see it as a social occasion. Smoking is often introduced in high excitement environments, like parties. This can lead to smoking being associated with these high excitement periods and more, leaving a positive impression. Another reason college kids pick up smoking has a historical backing as well. Smoking used to be done by men looking to establish elegance and climb the social ladder. Men who were able to handle their cigarettes in elegant ways were able to more effectively climb the social ladder. These ideals carried over and even today smoking is seen as a way to make someone look or feel cool. Testimonials from college kids showed that it even helped them feel like something they weren’t. It made them feel cooler or even “sexier” and that was worth participating for them.

​What I found confusing about this chapter is that, though Stromberg claimed multiple times that the mystery behind collective effervescence wasn’t so much of a mystery anymore due to our better understanding of the brain, I don't fully understand how exactly the neurology behind it all works. I don’t exactly see where he explains the processes in depth so that the reader can actually see how everything comes together. It’s almost like he makes the claim that it all fits and just expects you to trust him. It was a little confusing to me.

Peter Stromberg addresses cigarette smoking among young adults among American colleges and universities in chapter 12 of The Encultured Brain. Although smoking is ill-advised due to numerous medical reasons, Stromberg provides reasons as to why young adults pick up cigarettes in the first place. At the beginning of the chapter, the lapse in agency is a concept that refers “to the basic awareness that one us author of one’s own actions” (Stromberg, 316). Throughout the chapter, the lapse in agency among cigarette usage is explained further by different viewpoints: emotional arousal, pretend play, imitation, and rhythmic entrainment.

The chapter presents an ethnographical study from two universities to determine what factors attribute to early-phase tobacco use among first-year college students. Whether one comes from a family of smokers or non-smokers, cigarette usage appears to be most prevalent in social settings. One study shows that there is a higher correlation between attendance at social gatherings and cigarette usage (Stromberg, 323). Various substances are consumed at these types of social gatherings, and tobacco is often used in conjugation with alcohol, for example.

Imitation and rhythmic entrainment are factors that help explain the basis as to why cigarette usage occurs in these types of social gatherings among young adults. When others are seen smoking cigarettes at a party or other social gathering, the desire to imitate those individuals becomes heightened. The two central reasons behind imitation are due to the Western culture’s social history of smoking and the belief that “social history has imparted a certain kind of symbolic valence to cigarette smoking” (Stromberg, 324). Although the rates of tobacco use have declined, Stromberg argues that cigarettes still retain a strong association with the coolness factor and sexual desirability. In the case of imitation, cigarettes are used as a tool to blend in at social gatherings. Secondly, rhythmic entrainment is closely associated with imitation. In a broad sense, rhythmic entrainment is a way to follow the crowd. Rhythmic entrainment has an evolutionary basis to it, “mirror neuron systems evolved to facilitate more effective food acquisition among social primates” (Stromberg, 325). Aside from cigarette smoking, rhythmic entrainment can be seen when following dance movements to synchronize oneself to others when they follow the beat of a song. The desire for joint rhythmic activity is a “basic form of playful social cooperation” (Stromberg, 326).

Similar to imitation, the chapter delves into the idea of using cigarettes as a prop to promote pretend play. Pretend play involves the manipulation of an individual’s self-image to project a new identity that appears appealing to others in social settings. Intentional or not, pretend play and using cigarettes as a prop is caused by a lapse in agency. Collective effervescence is attributed to the “most important factor underlying the heightened sense of excitement people can feel in crowds is primitive emotional contagion” (Stromberg, 328). This emotional arousal leads to an autonomic nervous system response creating a heightened sense of arousal. Emotional arousal can lead to dissociation, especially when tobacco usage is combined with other psychoactive drugs including alcohol. In social gatherings like parties, dissociation elevates creating an amnesic effect that masks peripheral awareness.

​Stromberg’s chapter provides a better understanding of how cigarettes are used as a domain of entertainment in social gatherings among college students in America. Although his ethnographical and qualitative study examined freshmen college students at two universities, the explanations within the chapter explain the evolutionary factors on how tobacco products are consumed in social gatherings. Since cigarettes contain the psychoactive stimulant, nicotine, the lapse in agency is exacerbated by other drugs such as alcohol. Following the actions of those around us in social settings is highly prevalent. Although the rates of traditional smoking involving the combustion of tobacco have decreased, it would be interesting to see how electronic cigarettes have evolved among college campuses. It is not uncommon to see a student use a Juul on his or her way to class. Electronic cigarettes appear to be used not only in social gatherings but also in other settings. It would be interesting to learn more about the newer nicotine delivery systems and to study the origins that cause the lapse in agency.

In Chapter 13, Lende discusses the neuroanthropological view of drug addiction, emphasizing that addiction is the result of a complexity of intertwined biological and socio-cultural factors. Lende clarifies that his definition of addiction is the desire to use drugs and the repetition of drug use. In the past, American society has typically defined drug addiction either as a disease where a person is unable to make rational choices or as a moral failing due to the inability to resist pleasure. Lende argues instead that incentive salience, a biological phenomenon triggered by social factors, plays a major role in drug addiction. Incentive salience as it pertains to drug addiction means that an individual with an overly sensitive mesolimbic dopamine system wants drugs “too much.” This wanting isn’t a conscious decision, but rather a desire that operates subcortically and brings a sense of intense urgency; for example, in a typical sequence of events, a drug user decides they want to take drugs, and then they experience an increasing, emphatic urgency to obtain and take those drugs. Since incentive salience motivates the individual to do what they most want, this can vary greatly between people and even throughout the course of the day. The concept of incentive salience does help to explain certain patterns of drug addiction. For example, an adolescent who becomes addicted to drugs might be doing so because there are little to no rewards for working hard at school or spending time with his family (perhaps if the individual lives in a low-income area with an abusive family). The incentives offered by using, like belonging to a group of other users and experiencing an “escape” from daily life, motivate the incentive salience system, and the individual is increasingly drawn to engage in this rewarding activity. 

Drug addiction begins with an individual’s pursuit of pleasure and reward, but as time goes on and drug use is repeated and increased, its association with the brain changes. Neural activation by drugs moves from an individual’s ventral stratium to the dorsal stratium, where drug-seeking is then maintained and made into a habit. After this, the habit of drug use isn’t affected by reward as much, and a person is unable to make much of an evaluation of the consequences of his actions. Continual exposure to drugs makes habitual use easier and more likely, as does stress. 

​This chapter was at times difficult to read, mostly because I felt confused about how the different neurological concepts fit together. Although it seems clear that Lende is attempting to argue that environmental factors play a large role in drug addiction, I feel that he did not spend enough time discussing these factors. In particular, what cultural or social factors might lead a person to use drugs in the first place, and why might that person return to drugs over time, other than because of a neurological pull to do so? Overall, though, I thought Lende explained the concept of incentive salience and its connection to the attraction to repeated drug use well, and I certainly felt that I gained a better understanding of drug addiction by reading this chapter.

In Chapter 13 of The Encultured Brain, Daniel Lende discusses drug use and addiction and the importance of cultural contexts associated with those drug-related behaviors. Lende uses his ethnographic research on adolescents and drug use that he conducted in Colombia to demonstrate the complexities of addiction and habitual actions. The author begins this chapter by immediately separating Colombian views of drug usage and the United States’ views of drug usage. According to Lende, the people of Colombia view the use of drugs not as a problem of pleasure, rather problems of “social violations” and their actual nature of being (Lende pg. 339). In contrast, Americans view drug-related problems, such as addiction, as strictly medical related issues, such as disorders and diseases, or an absence of morality. Ironically, the United States’ incomplete view of addiction mostly stems from the Diagnostic and Statistical Manual, which provides criteria in order to diagnose substance abuse. This contrast between two different cultures that Lende presents sets up nicely a deeper discussion about ways to combine neuroscience with anthropology in order to more fully understand drug addictions in the context of culture and the human experience.

Lende presents a neuroanthropological theory of addiction containing two key components. One component of Lende’s theory includes a “compulsive desire for drugs” (Lende pg. 340). The second component of Lende’s proposed theory deals with the fact that drug use becomes habituated. Using drugs becomes an automatic behavior due to repeating actions over a period of time, which the author explains how this mechanism of shifting to automaticity occurs later on in the chapter. Lende’s integrative theory of addiction stresses the importance of not just neurobiological research, but also the inclusion of subjective aspects that can be a result of anthropological research.
​
Chapter 13 provides much evidence that discredits the outdated views of addiction. For example, Lende counters the idea that addiction does not involve a single chemical imbalance or a single network in the brain. Because the brain is highly connected, most networks within the brain are active during a multitude of events. The brain structures that we view as components of a remote neural circuit might be, in fact, key pieces to completely different neural circuits as well. This suggests that the idea of addiction is extremely complex and requires a more intricate understanding of not only the brain itself, but how human experiences shape it.

An important term used in Chapter 13 is “incentive salience”. Incentive salience is the process of deciding which cues or incentives for a potential reward are important enough to an individual in a certain context. As Robinson and Berridge (1993) point out, incentive salience plays a key role in addiction, and helps guide to the understanding that addiction is not simply a “problem of pleasure” (Lende pg. 343).  

Lende uses the idea of incentive salience with his research on adolescents and addiction in Colombia as a way to combine more of the specific anthropological aspects of addiction with the neurobiological side of addiction (i.e. “wanting phase,” “liking phase,” and “learning phase”). The potential mechanisms by which the reward system works are beyond the scope of this review, although they are detailed in Lende’s chapter. However, as mentioned above, “wanting”, “liking”, and “learning” are crucial in reward-based behaviors and incentive salience, as Lende finds, is what links those pieces together. Incentive salience is almost like the “glue” of those aspects regarding addiction. But what exactly is the “glue” of incentive salience? Lende explains how important a person’s complete cultural experience, which includes socioeconomic and environmental factors, is to their experience of incentive salience and thus addiction.

This chapter shows just how complex addiction really is. In order to get the most out of this chapter, Lende demands that every aspect of addiction be considered with context. Habits, for example, exist only through the light of context. The underlying goal of habits is to guide a person through a series of actions to achieve something based on a previous context (Lende pg. 352).
​
Lende concludes Chapter 13 with the term “chunking” and how intertwined it is with habitual behavior. Through learning, one is able to create a model, or an idea of what the best way to accomplish something would be, and once that model is in place, a transition to automaticity takes place. Specifically, a “cache” system, that contains inflexible sequences of actions that can be executed quickly, takes over and the learned behavior is engrained into a habit, and eventually an addiction is formed.
           
Questions:

1. Lende states that this “cache” system contains “inflexible information that is used to identify the right situation for the model and then mediates the automatic execution of a particular behavior sequence” (pg. 357). How inflexible is this information? When people are able to “break” habits, is the inflexible information still there or is that information more flexible now?
2. Regarding Lende’s work in Colombia, why do you think he specifically chose to research adolescents and addiction? How might his work differed if he chose to work with adults and addiction instead? 

​Non-human primates provide a useful model for studying the influence of genetic factors on alcohol consumption. The complex social structures, behaviors, and genetics of non-human primates parallel humans, and thus are fruitful models for research. Animal models are particularly useful for studying the interaction of genetics with social environments, and because of this they are critical to our understanding of neuroadaptive processes. 

The article provides a review of the utility of using non-human primates to study alcohol use in humans. Laboratory animals offer an easy way to model consumption, withdrawal, tolerance, dependence, sedative and reward effects, and neurobiological effects in a way that mirrors those in humans. Most notably, non-human primate models provide the opportunity to study genetic influences on alcohol consumption and alcohol-related phenotypes in a highly social animal model that is genetically close to humans.

Non-human primate models add to our understanding of inheritance vulnerability to alcohol use disorders in humans along multiple indices. First, non-human primates can be followed from birth or pre-birth, and alcohol exposure can be tightly controlled throughout development. Following humans in longitudinal research is difficult, and humans who are already alcohol-exposed, even prenatally, have neurochemical, physiological, and behavioral differences. Moreover, this ability to tightly control the experimental environments of laboratory animals enables the experimenter to reduce confounds and increase the power and sensitivity of genetic and neurobiological analyses. Because of this, animal models are ideal for studying gene by environment (GxE) interactions. 

Rhesus macaques demonstrate individual differences in alcohol response and temperament, and the relation of the these differences to genetic variants. Because these genetic variants are also present in humans these models are important to discussing GxE interactions. For example, rhesus macaques can be used to develop experimental models of early adversity, such as loss of a parent, as models of early adversity and their relationship to voluntary alcohol consumption.

Moreover, non-human primates are useful to modeling the behavioral and social effects of alcohol use disorders. Non-human primates are social animals that live in highly structured hierarchies with social norms and relationships. Non-human primates that continue to consume alcohol even though it disrupts social interactions provide a model of the disruption of interpersonal relationships that is characteristic of alcohol use disorders. Likewise, individual differences in temperament, and its relation to alcohol use disorders, can be explored via non-human primate models.

Still, there are limitations to using non-human primate models to understand alcohol use in humans. Animal models are unable to communicate subjective states, and this limits assessment of subjective differences in alcohol response. In addition, some animals have nervous systems that are much simpler than the human nervous system. On top of this, there are ethical issues when using non-human primates. Moreover, rodent lines offer controlled genetic diversity via selective breeding and transgenic/knockout lines—something that non-human primates cannot yet offer. Inbred primates are unavailable, and transgenic primates have not been successful. Further, rodent models are easier to breed, have large litters, are fairly inexpensive, and have accelerated developmental trajectories.

The authors conclude their review with a discussion of candidate genes influencing alcohol-related disorders. These polymorphisms, rh5-HTTLPR, MAOA-LPR, and OPRM1 C77G have been shown to influence alcohol consumption in rhesus macaques. Moreover, studies seeking to identify polymorphisms have pointed to variants in the coding and regulatory regions of multiple genes in rhesus macaques. These studies point to the need for further studies, using non-human primates, exploring genes influencing behavior or alcohol consumption and response. The authors then provide a brief discussion of genetic and environmental interactions. Non-human primates are particularly useful for the study of GxE interactions because their environments can be tightly controlled. 

1. Do you think that the benefits outweigh the limitations when using non-human primates in research?
2. How can non-human primates be used in a neuroanthropological study? How would you design a research study using these methods?

​Perhaps the best way to start with this chapter is recognizing the problems with defining and studying culture. The authors outline five reasons: culture is based on a weak social nature of “facts”, culture is often confused with established social-psychological ideas, intracultural diversity is not taken into account (homogenization), culture is defined at population level and not with respect to individuals, and methods for measuring culture at the population level have not been/ cannot be applied to individual level. 

The authors also provide a definition of culture via the Cognitive Theory of Culture as culture is defined as what an individual needs to know in order to function adequately in a particular society. From this definition, the idea of cultural consonance is developed where culture emphasizes the sharing of meaning and knowledge within social groups. Cultural consonance then is a twofold issue. First, it is when individuals incorporate populationally shared meanings into their lives that influence their beliefs and behaviors, and secondly, it is the degree to which these individuals recognize and use these population level cultural meanings. Though the idea of cultural consonance can be tricky to comprehend, the authors put it into perspective by connecting it to the other issues discussed in the chapter. Lower cultural consonance is associated with greater depression because living at the edge of social and cultural norms for a society is an inherently stressful experience. 

With these ideas in mind, the chapter moves on to discussing how depression is a result of cultural beliefs and behaviors intersecting with the genetic information that structures the neural net’s functioning. Additionally, cultural consonance and depression are affected by the gene variant encoding serotonin receptors. A preliminary study showed the AA variant of the serotonin receptor gene had more drastic changes in serotonin and thus depression levels depending on how an individual’s cultural consonance changed over a two-year period. The question is how exactly genetics and cultural consonance interact. The direction the research is going is to combine a model of how genes moderate the effects of cultural consonance with a model of how psychological factors mediate the effects of cultural consonance. The important distinction here is that a moderator changes the relationship between variables, whereas a mediator stands between a predictor and an outcome. Mediation hypothesis research looks at the causal relationship between cultural consonance, dysfunctional beliefs, and depression. 

The research presented is fascinating, but there are so many aspects, each with their own caveats that I am not sure I fully understand how the data collected could be analyzed in a way that could translate to treating depression. Additionally, consciousness is tied in during the discussion, but the differentiation between reflexive vs non-reflexive consciousness wasn’t entirely clear to me. I’m hoping that class discussion will highlight the connections that I am missing. 

In chapter 10 of The Encultured Brain, Erin P. Finley discusses post-traumatic stress disorder in male veterans from Iraq and Afghanistan. Finley take a more neuroanthropological approach, choosing to focus on cultural factors that influence the development of post-traumatic stress disorder.

What exactly PTSD is, how it develops from trauma, and how to diagnose and treat it are all topics hotly contested by experts. The “Authoritative understanding” of PTSD, as Finely refers to it on page 267, is that post-traumatic stress disease is a mental illness caused by the exposure to a traumatic event and that its symptoms are hyperarousal, reexperiencing, and avoidance / numbing. For an individual experiencing these symptoms to be clinically diagnosed with PTSD, their symptoms must prevent them from function normally. This “Authoritative understanding” provides a very rigid understanding of PTSD and suggests that exposure to a traumatic event solely dictates if an individual will develop PTSD. Finley takes a dramatically different multidisciplinary approach, drawing from anthropology, psychology, psychiatry, neuroscience and epidemiology to identify 6 variables that contribute to the development of PTSD: cultural environment, stress, horror, dislocation, grief, and cultural mediation. She combines these factors and their relationships with other another into one helpful figure, 10.1, on page 282. Ultimately these factors work together and influence each other to elicit a post-traumatic response. One advantage of Finley’s holistic model is that it opens more avenues for treatment (including things such as rituals and storytelling) rather than solely being limited to clinical intervention. Finley does not criticize the current diagnosis and treatment protocols used for PTSD. Instead, she acknowledges how many veterans have been helped using such protocols and uses her models to suggest that perhaps there is more to the story of PTSD and its treatment.

One thing that I appreciated about Finley’s chapter is that she admits that she is only telling half of the story. By purposefully interviewing male veterans about their experiences with PTSD, she misses the perspectives and experiences of female veterans because women perceive and interact with their environments in different ways them men and so will have different trauma responses. For the purpose of what Finley is trying to accomplish, this one-sided view is not an issue. She is trying to show that there is more to PTSD than trauma, not assert that those 6 variables are the absolute causes of PTSD.

Questions:

How would the inclusion of women into Finley’s study provide a more complete picture of the effects of the 6 variables mentioned in the chapter on the development of post-traumatic responses?

How did our culture get to the point where post-traumatic responses are viewed as negative and unacceptable? How would a more positive and de-stigmatized viewpoint of them change the process of healing?