Neuroanthropology, Applied Research, and Developing Interventions

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I am about to get the final version of a special issue on “Neuroanthropology and Its Applications” to the publisher. That special issue, as well new things I have read over the past few weeks, have prompted some thoughts on how neuroanthropology can put together a framework for developing programs and interventions.

I outline some interesting neuroscience research that can inform the specifics of applied neuroanthropology, then examine how to draw on anthropology to expand our sense of how we approach applied work, and finally circle back to an applied program that implicitly uses an anthropological approach while drawing on neuroscience and behavioral health research for inspiration in working with troubled teens.

Neuroscience and Applied Neuroanthropology

I am particularly intrigued by new types of interventions using memory retrieval and exercise, and how these approaches offer ways to couple ideas of plasticity and learning with the structuring of environments and activities for people.

For example, recent work pairs memory recall and extinction training to help attenuate memories of drug cues in addicts, and thus lower craving (news article here, Science paper here). Pairing watching a video of drug use activity and repeated exposures to conditioned cues to lower reactivity lead to significant reductions in craving up to 180 days later. One of the keys was the timing of the pairing – too far apart, and the same intervention outcomes were not achieved.

Work published in PLoS One last year (paper here, news here) shows how exercise lead to reductions in marijuana use and in cravings during the study period. Study participants did not want to stop using marijuana, but nonetheless, running on a treadmill cut craving and marijuana use up to 50% over the two week study period.

The combination of a structured environment (the study), a specific activity (exercise or memory recall), and targeted techniques (extinction training) is one that makes sense to me for a broad range of neuroanthropology-inspired approaches to intervention. I’d also add that the intention and interpretation that participants bring to what they do also matters. In the case of exercise, it is more than just physiological arousal leading to neural plasticity; there is a strong case for the joy and framing of exercise to make a difference in the effects achieved.

This approach to intervention and policy is one that recognizes context, behavior, and meaning as equally important components alongside more targeted techniques that fields like psychology, psychiatry, and neuroscience have developed. We know from previous work with mental illness that in general, a pharmacological treatment and a psychotherapy treatment work better together than either one on its own.

This approach pushes that formula one step further, recognizing the anthropological dynamics of applied work and the ways we can achieve targeted effects both matter. On the targeted effects side, I definitely think it’s interesting to think of novel ways that we can create biological effects besides pill popping. As the Science article puts it, “The memory retrieval-extinction procedure is a promising nonpharmacological method for decreasing drug craving and relapse during abstinence.”

Nonpharmacological methods for change are good. As Peter Martin, one of the authors of the exercise and marijuana study: “Exercise can really change the way the brain works and the way the brain responds to the world around us. And this is vital to health and has implications for all of medicine.”

Yet what still needs development is the anthropological side of intervention. What does change look like in the real world, outside of hospitals and clinics and treatment programs? I fear that unless we further develop how anthropology works to make a difference, then the established ways – extinction training, cognitive behavioral therapy, and so forth – will remain predominant, and remain tied to an approach to change that highlights professionalization and institutionally-driven approaches. And for people who can’t access high-level professionals or are vulnerable to institutional power, not much will change. I’d rather get the tools of change further out into the real world if possible.

On Anthropology and Change

Anthropologists are good at grasping other people’s point of views. We are good at examining meaning and intention, and how those relate to other aspects of people’s lives, such as their social relationships, their cultural heritage, and their socioeconomic position.

This point about the anthropological perspective, and how it might relate to applied work, was clarified by Tanya Luhrmann’s recent New York Times op-ed, Do as I Do, Not as I Say, where she examines the divisions between democrats and republications, as typified by liberals and evangelicals.

Luhrmann has just published her new book When God Talks Back: Understanding the American Evangelical Relationship with God, based on long-term ethnographic research. She gets where evangelicals are coming from.

If you want to understand how evangelicals conceive of their political life, you need to understand how they think about God. I am an anthropologist, and for the last 10 years I have been doing research on charismatic evangelical spirituality — the kind of Christianity in which people expect to have a personal relationship with God.

Luhrmann then pushes that analysis:

When secular liberals vote, they think about the outcome of a political choice. They think about consequences. Secular liberals want to create the social conditions that allow everyday people, behaving the way ordinary people behave, to have fewer bad outcomes.

When evangelicals vote, they think more immediately about what kind of person they are trying to become — what humans could and should be, rather than who they are. … This perspective emphasizes developing individual virtue from within — not changing social conditions from without.

The question then becomes how to match communication with grasping how a certain group understands the world. As Luhrmann puts it, “If Democrats want to reach more evangelical voters, they should use a political language that evangelicals can hear.”

And what motivates evangelicals in thinking about politics and change?

They should talk about the kind of people we are aiming to be and about the transformational journey that any choice will take us on. They should talk about how we can grow in compassion and care. They could talk about the way their policy interventions will allow those who receive them to become better people and how those of us who support them will better ourselves as we reach out in love. They could describe health care reform as a response to suffering, not as a solution to an economic problem.

Grasping the other’s point of view can lead to policy recommendations. I am also interested in how it can become a part of an applied approach, one that can help inform anthropology’s more “everyman” engagement rather than proceed down the credentialed, professionally-delivered route.

An Example of Neuroanthropology in Action

A recent article at the site ACEs Too High describes a new approach to student discipline developed at Lincoln High School in Washington State, which had lead to a dramatic drop in the number of suspensions, expulsions, and referrals there. This approach – basically listening to the hard-knock students who create many of the worst discipline problems – is derived from research on neuroscience and human development, in particularly understanding the effects that stress and trauma can have on childhood development.

The article goes over the creation of this approach in considerable detail, including how John Medina, author of Brain Rules, and research on Adverse Childhood Experiences, helped provide the intellectual background for how this Walla Walla high school now deals with discipline issues.

What I want to focus on here is the applied side. Natalie Turner, who works at Washington State’s Area Health Education Center, developed core principles for how to engage with kids who had difficult childhoods, are often involved in gang and other delinquent activities, and can lack parental involvement and stable home circumstances.

There are just two simple rules, says Turner.

Rule No. 1: Take nothing a raging kid says personally. Really. Act like a duck: let the words roll off your back like drops of water.

Rule No. 2: Don’t mirror the kid’s behavior. Take a deep breath. Wait for the storm to pass, and then ask something along the lines of: “Are you okay? Did something happen to you that’s bothering you? Do you want to talk about it?”

It’s not that a kid gets off the hook for bad behavior. “There have to be consequences,” explains Turner. Replace punishment, which doesn’t work, with a system to give kids tools so that they can learn how to recognize their reaction to stress and to control it. “We need to teach the kids how to do something differently if we want to see a different response.”

Kids need adults they can count on, who they know will not hurt them, and who are there to help them learn these new skills, Turner tells the Lincoln High staff. If it’s not happening at home, it had better happen at school. Otherwise that teen doesn’t have much of a chance at life.

Jim Sporleder, Lincoln High’s principal, contrasts the new approach to student discipline with the old approach.

With the Old Approach to Student Discipline, this is how it went down:

A student blows up at a teacher, drops the F-bomb. The usual approach at Lincoln – and, safe to say, at most high schools in this country – is automatic suspension. Instead, Sporleder sits the kid down and says quietly:

“Wow. Are you OK? This doesn’t sound like you. What’s going on?” He gets even more specific: “You really looked stressed. On a scale of 1-10, where are you with your anger?”

The kid was ready. Ready, man! For an anger blast to his face….”How could you do that?” “What’s wrong with you?”…and for the big boot out of school. But he was NOT ready for kindness. The armor-plated defenses melt like ice under a blowtorch and the words pour out: “My dad’s an alcoholic. He’s promised me things my whole life and never keeps those promises.” The waterfall of words that go deep into his home life, which is no piece of breeze, end with this sentence: “I shouldn’t have blown up at the teacher.”

Whoa.

And then he goes back to the teacher and apologizes. Without prompting from Sporleder.

“The kid still got a consequence,” explains Sporleder – but he wasn’t sent home, a place where there wasn’t anyone who cares much about what he does or doesn’t do. He went to ISS — in-school suspension, a quiet, comforting room where he can talk about anything with the attending teacher, catch up on his homework, or just sit and think about how maybe he could do things differently next time.

For me, three things stand out about the approach that Lincoln High takes: (1) Listening to others, (2) Grasping where students come from, and (3) Asking what is going to create change, rather than enforce social structure or institutional power.

All three things are deeply anthropological, and provide a way for us to think seriously about what anthropology can do as an applied discipline. They provide ways we might think about operationalizing an understanding of people, social context, and meaning and couple that with the sort of targeted methods described in the first section of this post.

The lengthy article, Lincoln High School in Walla Walla, WA, tries new approach to school discipline — suspensions drop 85%, also points to a video that outlines this new paradigm for discipline. Both the article and the video capture the inherent interdisciplinary approach used (including the innovative Lincoln High Health Center), and also represent well the different social actors – including the students – in this work.

Neuroanthropology and Interventions

Some basic lessons from this range of work that can inform applied neuroanthropology:

-Draw on innovative research and thinking about how to develop interventions, and match those with an anthropological paradigm that focuses on how local environments and people’s behavior can impact the brain

-In developing policy and applied programs, use anthropology’s strengths in grasping the other’s point of view and understanding where people are coming from

-Use listening and social communication in a proactive way, coupled with an interdisciplinary approach that can address people’s varied needs and desires, as we develop targeted interventions and applied programs

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