Neuroanthropology: evolution and emotional embodiment

The Meaning and Experience of Patients Undergoing Rectal High-Dose-Rate Brachytherapy

BACKGROUND

High-dose-rate (HDR) brachytherapy is a precise form of radiation therapy that targets cancerous tumors by directly applying the radiation source at the site or directly next to the tumor. Patients often experience but underreport pain and anxiety related to cancer treatments. At present, there is no research available concerning the pervasiveness and intensity of patients' pain and anxiety during rectal brachytherapy.

OBJECTIVE

The aim of this study was to examine patients' thoughts, emotions, coping strategies, physical sensations, and needs during rectal HDR brachytherapy treatment.

METHODS

Twenty-five patients with rectal cancer were interviewed using a semi-structured qualitative interview following the completion of their brachytherapy treatment delivered at a Montreal-based hospital in Quebec, Canada.

RESULTS

The experiences of pain and discomfort varied greatly between patients and were linked to the meaning patients attributed to the treatment itself, sense of time, the body's lithotomic position, insertion of the treatment applicator, and the patients' sense of agency and empowerment during the procedure. Patients drew upon a variety of internal and external resources to help them cope with discomfort.

CONCLUSION

Staff need to know about the variation in the physical and emotional experiences of patients undergoing this treatment.

IMPLICATIONS FOR PRACTICE

Clinical teams can tailor their procedural behavior (eg, using certain language, psychosocial interventions) according to patients' needs to increase patients' comfort and ultimately improve their experience of HDR rectal brachytherapy.

Memory and self-neuroscientific landscapes

Relations between memory and the self are framed from a number of perspectives-developmental aspects, forms of memory, interrelations between memory and the brain, and interactions between the environment and memory. The self is seen as dividable into more rudimentary and more advanced aspects. Special emphasis is laid on memory systems and within them on episodic autobiographical memory which is seen as a pure human form of memory that is dependent on a proper ontogenetic development and shaped by the social environment, including culture. Self and episodic autobiographical memory are seen as interlocked in their development and later manifestation. Aside from content-based aspects of memory, time-based aspects are seen along two lines-the division between short-term and long-term memory and anterograde-future-oriented-and retrograde-past-oriented memory. The state dependency of episodic autobiographical is stressed and implications of it-for example, with respect to the occurrence of false memories and forensic aspects-are outlined. For the brain level, structural networks for encoding, consolidation, storage, and retrieval are discussed both by referring to patient data and to data obtained in normal participants with functional brain imaging methods. It is elaborated why descriptions from patients with functional or dissociative amnesia are particularly apt to demonstrate the facets in which memory, self, and personal temporality are interwoven.

Affective infrastructures: toward a cultural neuropsychology of sport

Recently there has been a turn toward considerations of embodiment, cognition, and context in sport studies. Many researchers have argued that the traditional focus on clinical psychology and performance enhancement within the discipline is incomplete, and now emphasize the importance of athletes’ social and familial contexts in a research paradigm that examines interconnections between movement, cognition, emotion, and the social and cultural context in which movement takes place. While it is important that the sport studies focus is being expanded to consider these interactions, I will argue that this model is still incomplete in that it is missing a fundamental variable – that of our evolutionary neurobiological roots. I will use the work of affective neuroscientists Jaak Panksepp and Stephen Porges to show that because sport so clearly activates neural systems that function at both proximate and ultimate levels of causation, it can be seen to serve fundamental needs for affective balance. A neurobiology of affect shows how the evolution of the mammalian autonomic nervous system has resulted in neurophysiological substrates for affective processes and stress responses, and has wide-ranging implications for sport studies in terms of suggesting what forms of coaching might be the most effective in what context. I propose the term cultural neuropsychology of sport as a descriptor for a model that examines the relationships between neurophysiological substrates and athletes’ social and familial contexts in terms of how these variables facilitate or fail to facilitate athletes’ neuroceptions of safety, which in turn have a direct impact on their performance. A cultural neuropsychological model of sport might thereby be seen to elaborate a relationship between proximate and ultimate mechanisms in concretely applied ways.

Amygdala in action: relaying biological and social significance to autobiographical memory

The human amygdala is strongly embedded in numerous other structures of the limbic system, but is also a hub for a multitude of other brain regions it is connected with. Its major involvement in various kinds of integrative sensory and emotional functions makes it a cornerstone for self-relevant biological and social appraisals of the environment and consequently also for the processing of autobiographical events. Given its contribution to the integration of emotion, perception and cognition (including memory for past autobiographical events) the amygdala also forges the establishment and maintenance of an integrated self. Damage or disturbances of amygdalar connectivity may therefore lead to disconnection syndromes, in which the synchronous processing of affective and cognitive aspects of memory is impaired. We will provide support for this thesis by reviewing data from patients with a rare experiment of nature - Urbach-Wiethe disease - as well as other conditions associated with amygdala abnormalities. With respect to memory processing, we propose that the amygdala's role is to charge cues so that mnemonic events of a specific emotional significance can be successfully searched within the appropriate neural nets and re-activated.