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>> WISER: I wanted to tell you first how I approach the course which is the reverse,
exactly in opposite order of textbooks, although I'm probably too late because I've seen one
textbook coming out that is actually in that order. In any case, and what I want to talk
to you about is why I do it this way as well as tell you, share with you things I share
with the students about pain and touch. Probably that's all we'll have time to do, either interesting
empirical finding or interesting twist or interesting angles, that sort of thing. And
I would very much like to be interrupted. [Laughs]
Truly, it's not much fun to just talk at people, so please, anytime you need a clarification
or comments or whatever, it's more than welcome. So before I start though, I'm going to be
out of order with one of my slides. And one thing I do with the students as well as prospective
students here when I talk to them is I ask them at the beginning of the course if you
had to lose one of your senses so you can keep all the others, which one would you lose
and why? And if you had to keep only one, which one would you keep and why? And if you're
not too bashful, I think I'd love your reaction to that. There is no right or wrong answer
although I have my prejudices, [laughs] okay.
>> WORKSHOP PARTICIPANT: I think I would like to say I would have to keep vision.
>> WISER: And which one would you lose if you had to?
>> WORKSHOP PARTICIPANT: Taste.
>> WISER: Taste, okay.
>> WORKSHOP PARTICIPANT: I'd lose taste and keep touch.
>> WISER: Keep touch, okay.
>> WORKSHOP PARTICIPANT: I would lose smell.
>> WISER: You would lose smell?
>> WORKSHOP PARTICIPANT: Because when I go into like [unclear] stores, I get nauseous.
[Laughter]
>> WISER: My son does too. Yeah, there are lots of smell ... and which one would you
>> WORKSHOP PARTICIPANT: I'll keep sight.
>> WISER: You'll keep sight. We don't have time for everyone, but let me do this, if
you kept one, who would vote for sight?
Who would vote for hearing?
Who would vote for touch?
Who would vote ... what's left ... taste?
Smell? And pain is a sense.
So vision has it, right?
All right, so we'll see what develops in the next hour and whether by any chance you change
your mind. I'm not saying you have to. I'm really not.
Sorry for the small letters here. So basically this is what I start with; this is what I
end with. And the reason is that it's very hard to motivate vision. In other words, if
you take a class on September first, whatever, and you say, "We are going to understand how
vision works." On average, the students will look at you and say, "What do you mean? You
just need light and light make things visible. Yeah, light hits your retina and that's how
you really know the apple is there, but, big deal." Or, "Okay, fine we're going to learn
how the retina works."
Now, what I try to teach is that, well, that there is a deep problem to solve with vision,
that no ... yes, you need light to see but to say light make things visible is really
not saying very much. How does it? And I try to, over the course of vision, to say that
light is both, yes, the carrier, what excites your retina. I am not denying that, obviously,
but also it is the carrier of information about objects. When the light hits the apple,
some of the wavelengths get selected and it hits your retina in a certain angle and it
makes patches on the retina of a certain size, blah, blah, blah. But the fact is that there
are no apples in your mind or your brain or anything like that.
So vision is really a construction process by which your brain processes a lot of information
from your retina in lots of different ways and then somehow puts it together and you
experience an apple. But in between - and then I go philosophical a little bit, not
too much because not many students stick to it - we don't really know what's out there.
You see it as an apple. And a student made my day one day saying, "Yes, and my philosophy
professor [unclear] here says, what apple? [Laughs]
So she got it. But it's very hard to start a class that way, of course that way, because
it's a complicated idea, that you construct an understanding out of the data that your
retina provides and it ends up being experienced as an apple.
On the other hand, pain is not hard to motivate in several ways. First, it's very interesting.
Emotionally, students will either be horrified or interested or both by the different gory
details I present about pain or not too much. So there is an intrinsic emotional interest,
but it's also much simpler because unlike ... of course, there is an apple there so
you see it as long as there's light. Most of us do not live in pain, so pain is an abnormal
event. Therefore, there's something to explain because everything that doesn't work according
to normal requires an explanation. So automatically if I say let's understand pain, that makes
a lot more sense to students as an enterprise. Also, unlike the apple you perceive the apple
as the thing out there as you should because if the caveman hadn't seen the tigers out
there and had said the tigers are a construction of my mind, blah, blah, blah, we wouldn't
be here, right? [Laughs]
So it's very important we see the apple is out there and that we perceive it automatically
and don't think about how it happened. It's also important we take our finger away from
the stove, the finger, but that's taken care of as well. But basically pain is an inner
... you know the pain is not in the knife, right? The pain is in you.
So you experience it inside instead of outside, so that's much more compatible with understanding
the role of the brain and the nervous system which is also part of you. And then as I said,
it's an abnormal event, so you can say how does the knife, which doesn't have pain in
it, whereas the apple is [unclear] so the knife is not painful. How do you go from cutting
your skin to a painful experience? I'll talk a little bit more about that after covering
the philosophy of the course.
So what that allows me to do is introduce a sort of meta vocabulary in terms of transduction,
neurotransmission, processing, receptors, pathways, all of those things within a context
which is not too overwhelming. It allows me to do a lot about the role of the brain because
not everybody perceives pain the same way. There are cultural effects so there are lots
of systems interacting with each other so I can have a foray into ... not construction,
pain is pain, but certainly the way that it's mediated by a lot of factors in an understandable
way, and then you can slowly generalize to other things.
That's what I said, [laughs] more or less.
So this is the essence of what I teach in the pain, so I spend a lot of time on pain. If you look
at textbooks, there are two pages on pain and the half of the textbook is on vision.
And I spent a third of the semester ... well, not quite, on pain and touch.
So the knife cuts my skin, it causes intense skin deformation. I can talk about the external
energies, mechanical energy in this case, that causes electric activity in my skin receptors.
There's transduction, signals go along pathways towards my cortex. There are neural transmissions,
and I'm experiencing pain. So this is what I call the sensation perception lens, meaning
that's a way ... and I tell students there are other ways to study perception, obviously,
than by talking about the brain but that's the approach I take.
So it's a lens through which you analyze and systematize perceptual experiences.
And then it can be generalized. I mean, not the next day, but it's the same words but it's applied
to vision. I mean, almost the same words, right, and so the goal is that they see the
relationship between the two. That doesn't make vision ... vision is more complicated
than pain; there is no doubt [laughs]. But at least it makes ... the issues are a little
more transparent. Any questions, comments so far?
So touch is next because as for pain, you have to ... I mean, something acts on you
with touch, or you act on something to touch something; whereas, with vision, it's like
you sit there and you see, right? So there is something in common between touch and pain.
And then it's a little more complex because there are several kinds of receptors. By the
way, I never have time to know how the students particularly feel but I absolutely love the
biomechanical, the engineering aspect of skin receptors. It's one of the ... I'm enthusiastic
about many things. [Laughs]
I just think that the way those things work is absolutely mind-blowing. And then, of course,
in this case, the texture of something, et cetera, it's out there unlike there is an
outside stimulus but that's what in my work on science teaching I call the stepping stones.
So it's a way towards understanding vision in this case that's not as complicated to
master, but helps you get there more easily than if you had done it. So it's a learning
progression, if you wish.
Then I go to test taste and smell which also have outside stimuli that have to travel to
your nose or be on your tongue, et cetera. And then I use what I showed you in the previous
slide: before, during, and after each sense. I say, okay, let's review the lens, what's
different, what's the same. Hopefully, over the semester, it makes the perception lens
more meaningful.
So in other words once we reach vision, hopefully the students at least understand there's something
to explain and have perhaps a little bit of a framework to do it. So catching student's
... yes?
>> WORKSHOP PARTICIPANT: [Unclear] I problematize, you mean turning this into an analytic procedure?
>> WISER: Okay, good. Thank you for catching me on this. It's a jargon word from learning
science. It means making it a problem, making it something that's worth thinking about and
doing problem solving and finding a solution about it. In other words, it is not the case
that there is nothing to explain about vision other than the light hits it and reaches your
eye. It means turning into a real inquiry topic worth spending your time on. Does that
make sense?
>> WORKSHOP PARTICIPANT: Yes.
>> WISER: Thank you. Yeah, it's as I said a jargon word. So catching the student's interest.
Why do we feel pain? That allows me to introduce the evolutionary argument that is a theme
then when the student knows "why" can mean many things and we have to keep things straight.
But there is a why in the sense of evolution; there is a why in terms of how the receptors
work. There are lots of different why's, but that's an important one. What would life be
without pain? I'll get to that.
We talk about pain relief which is interesting because they're familiar with that. They also
know somebody with fibromyalgia or intractable pain of other kinds and we can talk about
that. And then we talk about cultural effects, which is interesting as well. Basically then,
I present different pathways and say, look, it explains a lot of things. It explains why
you take Tylenol rather than aspirin for headaches, but you take Aleve rather than something else
for muscle pain, whatever. I know it when I teach it. Why people did lobotomies long
ago and what's carpal tunnel syndrome? I'll show you, we relate that to simple, well,
to me simple, to them horrifying pathways diagrams.
But basically I try to say I'm not making you suffer for the sake of it, but there is
a reason to learn these pathways because they explain things, and then we can play problem
solving. Like if somebody had pain here, what could you do to help this person? Or given
the diagrams that I showed you, how do you think hypnosis works to relieve pain and stuff
like that? So it allows them to do some problem solving instead of just memorizing all those
very arcane words.
Okay, this I'm going to go quickly on because I have the feeling you know this. So I also
try to make it interesting to them like why you shouldn't turn your iPod so loud and,
of course, take drugs, and then relate it to all sorts of things about real life, different
... so all this is in your handouts. Is it okay if I just move on? All right.
Consumer marketing, why is it they have no green lights over the lettuce and yellow lights
over the pepper. Of course in the course of the course, we talk about hearing aids and
cochlear implants and the surgery. I try to have somebody actually who had a cochlear
implant to try to explain what the experience was, which I highly recommend, if you know
somebody who is willing. Because it's not what people think and it's really worth hearing
from somebody who had an implant what the experience is like.
>> WORKSHOP PARTICIPANT: There's a great little video that you can show that shows a little
girl who had a cochlear implant at age two and how she hears sound for the very first
time and her expression is [unclear].
>> WISER: Yes, that's right. That's right.
>> WORKSHOP PARTICIPANT: It's perfect, perfect for that.
>> WISER: That's right. But then what adults will tell you, even those who are very happy
with their implant is that it's very unsettling when you first have it because you hear clicks
you don't hear, especially if you had hearing before and you know what it was like to hear
music or speech. It's nothing like that. So you have to re-educate yourself, to translate
those clicks - that's what I've been told - into sounds. So I think it's well worth
anything that it seems to me in high school that makes students aware of all the worlds.
Either social ones or perceptual ones or motor ones I find very important.
And then there is, should you have any intellectual curiosity? You know, what do infants perceive?
Why do we see in black and white at night, et cetera? And then, I try to balance because
of course individual styles ... some metaphysics. Will we ever know the external world? Know
the tree in the forest, of course, although they know that one. Do the senses tell the
truth? If a Martian had eyes and a Martian brain, what would the Martian coming to earth
see?
This one is interesting. Would a person blind from birth who recovers her sight, what do
they see? And I have actually one of my mentors when I was a graduate student in [unclear]
has studied that sort of thing for a long time, first with babies because now it's caught
early and therefore a cataract can be operated on, I think, around four months or something
like that. But in the old days, in the old days when I was young there was no, I don't
think, such detection. It was not until ... people were not operated in their cataract until
late, but by then there is the sensitive critical period. So your brain atrophies is not the
word, but the visual cortex loses a lot of its ability. Light hits your retina, but as
an adult there's not a whole lot, it depends.
Some people have been incredibly depressed after cataract removal because it's nothing
like what they hoped for and they are essentially at least legally blind. They see light colors
but ... and so it comes and in a way life was simpler given how little ... I'm telling
you, I'm not making a judgment. I'm just reporting some of the things I've read. Okay, so with
babies they're still malleable enough, I mean their brain, then that problem doesn't occur
and with visual experience they develop completely normally. But then now there are those doctors
who go help people in less privileged countries where there are cataracts still in adults
or older children, et cetera. And so they are relieving that and at the same doing research
in young people of different ages to see how much they recover, et cetera. So that's, for
example, something I would include in my readings next time. That should be interesting.
And so they also say why is it that it's very easy to tell which of the two sets of black
dots has more dots, but if you're like me, you have to count the blue. You can't do it
with the blue ones. You have to count. So that's particularly perceptual. I don't teach
about that. I teach about I think cognitive development, but we have two systems that
rats have and a lot of other animals. One, to keep track of a small number of things
and that's how their mother keeps track of ... there is quack and lack and knack and
if they're all there. [Laughs]
But then there is this which is a process through what's called the magnitude estimation
system which is a way ... it doesn't tell you it's the same, it tells you whether there
is more or not. If they are enough more on one side than the other and babies, it has
to be twice as many, but they show you they know and then adults it's about 25 percent.
There is a difference of one so that's why I would think that you didn't immediately
know.
Anyway, there's lots of very interesting things. So developing counting among other things
consists through the words involving counting linking these two things to each other to
get the sense of number. That's part of my research, but that's not what I teach.
Then I say why do we have sensory and perceptual systems? How do we differ from plants? Why
do plants don't have vision? [Laughs] And that can create interesting classroom discussions
[laughter] because, as you know probably, different people have very different ideas
about plants, right?
It's not just entertaining; I think it's interesting. I don't think that students necessarily have
thought about why do we have a nervous system and plants don't or at least not much of one.
That is related to the fact we move and they don't. That's an important fact, and that's
not necessarily something that taught in biology, I think.
So I want to now go back to pain. Do you have any questions about the teaching of sensory
perception in general or my course in general before I go into specific topics?
>> WORKSHOP PARTICIPANT: Do you connect these sorts of problems into brain areas?
>> WISER: Yes. That's going to come, yeah. I try not to overwhelm them with it and I
don't ... no, the test is not about the names. And with my pain diagram you're going to see
soon, basically on the exam I have an unlabeled diagram because I don't want them to memorize
it for the sake ... but yes. No, actually a very important part of it is to show the
role of the brain as an interpreter. Yes, absolutely.
So I'm not going to go through this. You know what pain is for.
One thing that I find interesting is that when you hurt yourself, your body releases
histamines to maintain and increase the pain, maybe you all know this, so that you will
pay more attention to it. And then what's also interesting is that the nerve signals,
talking about more of the nervous system, are very different for the pain that maintains
you now in one place and taking care of it versus the immediate reaction. It's a totally
different mechanism with extremely different speed of neural transmission.
Can I go on at this pace? So this one, you don't have to read all this but basically
it's about recent work in neurology. It's relevant to how we learn to avoid painful
stimuli. Basically, you have originally neurons that respond to intense stimuli, and then
you have others that encode dangerous visual stimuli and then when you touch the fire or
cut yourself with a knife or whatever, I'm simplifying the least to say the two neurons
connect and remain connected so next time you see a knife, or the needle at the doctor
[laughs] you will have a warning signal. And you also feel it about others, if you're not
a psychopath. Meaning when you see the needle approach somebody else's arm, the same neurons
are going to get into play. That's how you feel empathy. I mean, that's one of the mechanisms
for empathy. So it's a little bit like mirror neurons but it's not.
>> WORKSHOP PARTICIPANT: Yeah, speaking of mirror neurons --
>> WISER: Yeah, it is. I'm sorry.
>> WORKSHOP PARTICIPANT: That isn't the mirror neurons.
>> WISER: No. Those are not mirror neurons. They are visual neurons and then pain ... I
don't like to call them this way because it looks like they are really different. I mean,
some neurons have spectacles [sounds like] and others ... so the one in the pain system,
I mean, they are in the temporal lobe, but they are neurons that originally react only
if you get hurt. And then there are neurons originally that reacts to visual stimuli and
then they get connected. They're designed to be connected obviously. Now they both fire
at the same time when you see without feeling the pain, and that's the basis of a warning
signal.
>> WORKSHOP PARTICIPANT: So is that evidence of learning?
>> WISER: Yes, that's definitely evidence of learning, oh yeah. It's also evidence of
predisposition. I don't know how much we want to go into the nature/nurture, but certainly
the learning wouldn't take place if there was not something that predispose those neurons.
It's not any neuron randomly that connects so not every neuron, when you look at the
fire, lots of neurons activated while you look at it, not all of them are even potentially
connecting to your pain neuron. So there is I would say genetically predisposed potential
connection about which I know nothing, but that means that given the right experience,
the connection will be made. I love the question because it's a tough topic for young students,
but it's a 100 percent nature and 100 percent nurture. But it's not necessarily obvious
but that's certainly my mantra. Yes.
>> WORKSHOP PARTICIPANT: The last one means that not only is the person being pricked ...
>> WISER: Yeah, but has to look at it.
>> WORKSHOP PARTICIPANT: ... but observers with the same brain neurons are active, you
can see this in a CAT scan, for example [unclear] the example of it. So the act of observing
triggers exactly the same sort of brain activity as ...
>> WISER: As the act, yes. So in that sense it's a bit like in spirit like motor neurons
where, you know, at first you have to act to activate them and then you just have to
think about acting or just the verb. I don't know if you know this, that when you listen
to sentences, the verbs like jumping, let's see, when you hear jumping, it activates the
neurons, the motor neurons that are involved in jumping. That's another thing I love. [Laughs]
>> WORKSHOP PARTICIPANT: That's why visualization ...
>> WISER: I'll get to you in one second.
>> WORKSHOP PARTICIPANT: That's why visualization exercise ...
>> WISER: Exactly. That's right. That's why it's not an idle ... absolutely. Yeah, and
also it solves a lot of stuff in language and language development. Where does meaning
come from? And I'm not saying that's the answer, but it's part of it. Yes, finally.
>> WORKSHOP PARTICIPANT: [Unclear] the person who observes the person getting the injection
has to have experienced this though.
>> WISER: Yes. There are no obvious questions ...
>> WORKSHOP PARTICIPANT: [Unclear] for the first time, I get the first shot ...
>> WISER: Right, but from then on [laughs] you know that about your pets and children
>> WORKSHOP PARTICIPANT: So let's see how it may help the children out [unclear].
>> WISER: Not mine.
>> WORKSHOP PARTICIPANT: The connection then between empathy and perception of pain, it
seems that that would be a very interesting place.
>> WISER: I think so. Yes, absolutely.
>> WORKSHOP PARTICIPANT: The non-empathetic feel the pain less or less profoundly or in
>> WISER: I don't know. It's a fabulous question, and I don't know the answer. But if you measured
the ... of course then there is the culture. It's complicated because the simple hypothesis
would be that people who have a high threshold should be less empathetic. And there is a
sense in which people say, "Oh come on, it doesn't hurt." Yes. So in that sense I think
it might be true, but then there is the culture playing that may develop empathy or they'll
make you a tough guy, then it gets complicated. But it's a great question to research at least.
>> WORKSHOP PARTICIPANT: What if, let's say a diagnosed sociopath has a perfectly normal
response like this, so what intervenes to make them less sensitive?
>> WISER: We don't know, right. I don't know. But that's also a great question. I don't
know if they have ...
>> WORKSHOP PARTICIPANT: What's the disconnect?
>> WISER: Yeah. You're right, so maybe the disconnect is right there already and maybe
it's much higher up, absolutely.
>> WORKSHOP PARTICIPANT: So if you've experienced one kind of pain before such as getting an
injection, because we now have connected these visual neurons to these neurons that are connected
with pain, will the next injection hurt even more?
>> WISER: It does but that's separate because from what I've just said, no ... oh, because
you mean now your pain neuron - interesting - is receiving input both from ... and the
vision ...
>> WORKSHOP PARTICIPANT: Yes.
>> WISER: Wow. You see, we could set up a whole lab. I don't know. But there is something
that may or may not be related, that the experience of pain tends to ... there is a phenomenon
that has a name that you don't habituate to pain. On the contrary, it's like allergies,
it gets worse. I'm sorry, I don't remember enough. But those are great questions. And
you would need a pretty precise, I think, neurophysiological recording to see that pain
neuron is fired. And I think working on pain is tricky both ethically and ... do you want
to do it? No. Let's see who ... yeah.
>> WORKSHOP PARTICIPANT: Is there like a generalized response to pain? So I'm thinking of social
learning that comes with these things. So even if you've never been stung by a bee,
you see other people freak out. So if you've experienced one kind of pain, when you think
about a pain that you've never had before, does it activate the pain neurons?
>> WISER: I would think not, but that's a speculation. And here is my personal take
on it. I'm the queen of this dungeon, so I'll try to keep this short. But I was last week
at the fantastic monologue by somebody named Mike Daisey.
>> WORKSHOP PARTICIPANT: Yeah, with the Apple.
>> WISER: Yeah, exactly. And I mean I had seen Spalding Gray before but he is absolutely
phenomenal in my view. And this monologue was about a lot of things including narrative
and making the point. I don't know if he studied psychology or not but that they all know,
almost know of all memory. My story has a point related to this. I like to announce
that [unclear].
And that's what Proust was trying to do in the Remembrance of Things Past. Every time
you remember something, you remember it a bit differently. You change it and then in
fact they've shown, I don't have it here, but neurologically there are new connections
being made when you remember something. So what you store again, when you store to be
remembered later, is not what you got out. And Proust was hoping to get to the bottom
of this. Well, apparently it can be done.
And Daisey was talking about everything in his narrative and Nancy Noswell [phonetic],
John Brunner [phonetic] and the idea that we are narrative beings. We make sense through
narratives. I'm very sympathetic to that. So he said think about what you remember.
Try to think of a trip that you really enjoyed and something that struck you.
I know the first time I saw Venice, I was lucky enough to be on a really crummy but
whatever boat that came through one of those canals and stopped in front of San Marco.
It was an experience. Do I feel it? No. I'm telling you the story because I've told it
a lot, too much probably, but I don't really remember the experience. No. Those of you
women who had children, do you remember the pain of childbirth? No. When it starts again
with your second child, you say, oh my god, I remember this. But in between you can't
call it up. So that's what Daisey was trying to say. There are no ... you cannot evoke.
I'm making a strong statement, but I certainly have not been able to sit in a chair and put
myself in a state of pain, not any more that I can evoke somebody's face in all the details,
no. That's what memory people can do, but do you see what I mean? So that was a long,
long answer that I think was relevant to your question, that I don't think one can evoke
those raw sensations. Not anymore. You can evoke red. You know what red looks like. It's
all through language, right? I'm not saying you should agree with me obviously.
>> WORKSHOP PARTICIPANT: [Unclear]
>> WORKSHOP PARTICIPANT: But when you say you can't evoke the senses, I noticed when
you said Venice, your face lit up. Yet, when you said Trollenberg [phonetic] [laughter]
your facial structure and your body posture were so different.
>> WISER: Yeah, but it could be ... here, we're probably going too far on my own tangent,
but I think it can be through language. That's why when you read novels, I don't know if
you do, but you sometimes cry or laugh. So I'm not saying you can't have emotions. I'm
talking about the really raw experience. Or try to imagine a bell. Can you really hear
it? Now some people are better than others for sure, but I guess I'm very language filtered.
>> WORKSHOP PARTICIPANT: [Unclear] for a while you can bring out grief in the same ...
>> WISER: The sense of grief ...
>> WORKSHOP PARTICIPANT: ... that you felt it initially.
>> WISER: But that's very cognitive. I mean it has physical, but it's not just physical
>> WORKSHOP PARTICIPANT: Or the memory of the experience of grief. When I think about
someone, when I think about my dad, I feel that sense of loss again. I don't remember
the feeling of I got the phone call that he was gone.
>> WISER: Right. You can tell it. I mean, you remember in the way we mean we remember,
but you can't relive it.
>> WORKSHOP PARTICIPANT: I know I don't ever want to relive it, that's usual. But I certainly
still feel that sense of loss, the same way that I still feel that sense of joy from the
first time they put my son in my arms. It's like the best moment in my life bar none.
>> WORKSHOP PARTICIPANT: Uh-huh, you summed it up when you said the sense of joy.
>> WISER: Well, that's the question, right?
>> WORKSHOP PARTICIPANT: I'm still happy with that memory or that ...
>> WISER: That's different, right? The memory makes you happy. That doesn't mean you ... I'm
being a bit hard, but it doesn't mean you are evoking your happiness from back then.
>> WORKSHOP PARTICIPANT: I'm trying to create the arguments that my students will create
and they will create it.
>> WISER: And they matter, yeah. If you had lived with my son, you would have a long experience
to go through. [Laughs]
>> WORKSHOP PARTICIPANT: If we think about ... when you're getting an injection using
needles [unclear]. The nurse says you're going to feel a pinch, the visualization technique.
Does that excite the areas in the brain ...
>> WISER: Well, that was the question before.
>> WORKSHOP PARTICIPANT: ... that make us think it's going to be a pinch. If she had
said it's going to be a needle stick, all right, or a skin puncture ...
>> WISER: Would it be different?
>> WORKSHOP PARTICIPANT: Are you fooling the brain into thinking that, oh, well ...
>> WISER: You expect a pinch. Do you think that's why they say pinch? I always thought
it's because ... what's the right word?
>> WORKSHOP PARTICIPANT: I wonder if they're [unclear].
>> WISER: That's very interesting.
>> WORKSHOP PARTICIPANT: [Unclear]
>> WORKSHOP PARTICIPANT: ... tickle.
>> WISER: A tickle, right.
>> WORKSHOP PARTICIPANT: The doctors and nurses to a child used to say, you know, it's just
a little bee sting.
>> WISER: A little bee sting. [Laughter] Yeah, right.
Now, I move to the next presentation.
So what if we didn't feel pain? Now you probably have the answer, et cetera, but your students
might not. The first reaction might be, "I don't know." Have you asked them?
That would be fantastic.
Do they say that?
>> WORKSHOP PARTICIPANT: Oh yeah.
>> WISER: So I won't go ... do you know about leprosy?
So that's something I talk about.
Talking about brain areas, I tend to relate the areas of the brain not related to pain
and then when we move to touch I contrast it, et cetera.
Yes?
>> WORKSHOP PARTICIPANT: What are the self-reports of people with the ‘a' symbol for pain?
What kind of things do they say?
>> WISER: Well, I haven't interviewed them.
>> WORKSHOP PARTICIPANT: Do they say, on a scale of 1 to 10, that was an 8.
>> WISER: They just don't feel it.
>> WORKSHOP PARTICIPANT: Because they can give it up. I'm asking I guess, can they give
it a label and say, yeah, that was an 8. How do you feel about the 8? I didn't care. Is
that what it is?
>> WISER: No, no. I think it's like asking a blind person what they think color is. They
feel touch, right? But I think that if you really don't have it, and there are conditions
where you just don't have it, and then I don't think it would make any sense. And of course,
as you know, it's a horrible thing.
>> WORKSHOP PARTICIPANT: ... of a girl who doesn't feel any pain that's been interviewed
and you can find out [unclear].
>> WISER: Oh, really?
>> WORKSHOP PARTICIPANT: They talk about how dangerous it is ...
>> WISER: It is horribly dangerous.
>> WORKSHOP PARTICIPANT: And pain is super important that [unclear] realize that.
>> WISER: That's right. And in fact this is an old one, but Missy [phonetic] who died
early and it's about ... and again, students are not necessarily aware of, but even not
turning in your sleep. I mean, the reason you turn in your sleep and that's good for
you is because it's painful to be in the same position. So you end up with lots of skeletal
problems, of course, burns.
What I read is that individuals without pain die young because it's just too hard to keep
one's self alive.
Culture, that's always a hit. This is where you can ask me to stop because not everybody
likes to hear. So there is a ceremony in a particular region of India where men will
put hooks through their back - I haven't seen it, I talk about it as if I did - and will
report not experiencing pain, although they do know in regular life.
>> WORKSHOP PARTICIPANT: You really want to show them something that maybe it's a small
one-minute clip. Remember the old movie, all of us in here that are experienced in pain,
A Man Called Horse, where he becomes a part of the tribe. And they put the hooks in his
>> WISER: That's right.
>> WORKSHOP PARTICIPANT: It's called the Sun Dance, right?
>> WORKSHOP PARTICIPANT: ... chest. I guess and he pulls it back, pulls it back. It's
a part of manhood. It's perfect.
>> WISER: That's right. That's exactly the same thing. You're right.
>> WORKSHOP PARTICIPANT: But it's only a minute. They show a little tiny minute of it. A Man
Called Horse, who was the guy in it?
>> WORKSHOP PARTICIPANT: Richard Harris.
>> WORKSHOP PARTICIPANT: Richard Harris.
>> WORKSHOP PARTICIPANT: [Unclear]
>> WORKSHOP PARTICIPANT: Fantastic. And then he becomes part of the tribe. That's a manhood
>> WORKSHOP PARTICIPANT: Warrior initiation.
>> WORKSHOP PARTICIPANT: ... warrior initiation, yes.
>> WISER: Very nice. Good idea. And then this is just how, you know, culture is not just
words. And I'm not saying ... no, not everybody but on average in a certain culture, people
have a higher pain threshold than others. There are also gender differences in our culture
and elsewhere.
So here's something you can do. It has a name called the cold pressure effect and I never
understood why there was the word pressure in it. But anyway, you hold your hand in very
cold water for five seconds and you rate how cold it is and how unpleasant it is. And then
you can do it with hot water or you can keep with the ice water. And you do it for 10 seconds
and you rate how unpleasant it is. And then you ask students before they do it to predict
how the sensation of cold and the unpleasantness are going to change with the amount of time.
So what's your prediction? Do you understand what I'm saying? So are they going to increase
both in the same way or ...?
>> WORKSHOP PARTICIPANT: It will become less the longer you ...
>> WISER: I'm sorry?
>> WORKSHOP PARTICIPANT: It will become less painful the longer your hand is in there.
>> WISER: That's different.
That's habituation.
I don't know if it happens within seconds actually.
I think it takes a long time before ... so let's assume there is no habituation. Yes.
>> WORKSHOP PARTICIPANT: I think the hot water is going to be give them a much higher [unclear]
response.
>> WISER: Yeah, that's right. The hot water is going to be steeper. How about how cold
versus how unpleasant about the ice water 5 seconds, 10 seconds, 15 seconds?
>> WORKSHOP PARTICIPANT: I think the ice water is going to be, for me, I would assume it
would be much more unpleasant.
>> WISER: Right. But how ... okay, sorry.
>> WORKSHOP PARTICIPANT: Greater intensity.
>> WISER: Yes. So let's say five seconds you rate the coldness of five, and the unpleasantness
of five. Ten seconds, you're going to rate the coldness of six or seven. Where will the
unpleasant be with respect to that? That's what I'm trying to ask.
>> WORKSHOP PARTICIPANT: It will increase.
>> WISER: But as much or less than the sense of cold?
>> WORKSHOP PARTICIPANT: You've got two things going like this and they'll either stay like
this or is one going to go ...
>> WISER: Right. That's what I'm trying ... thank you. I often need translators. So what do
you think?
>> WORKSHOP PARTICIPANT: We need the visual.
>> WISER: Yeah, you need the visual.
>> WORKSHOP PARTICIPANT: But there's a learned behavior at play here too. I know that if
I put my hand in the very hot water, it's going to hurt me. It's got to hurt; it's going
>> WISER: Yeah, if it's too hot.
>> WORKSHOP PARTICIPANT: When I take it out it's going to continue to hurt, but I know
>> WISER: Oh, you wouldn't do it with that hot water.
>> WORKSHOP PARTICIPANT: ... ice cold water, when I take my hand out, my hand will return
to its normal temperature much faster. There will be no long-term effect.
>> WISER: That's true.
>> WORKSHOP PARTICIPANT: Five seconds in boiling water versus five seconds ...
>> WISER: No, I didn't say boiling. These are classroom experiences, so hot tub temperature.
So you're avoiding the question. [Laughs]
So in other words what I'm trying to ask is will the unpleasantness go faster with time
than the sense of cold?
>> WORKSHOP PARTICIPANT: I think it will.
>> WISER: It will. Yeah, it does.
>> WORKSHOP PARTICIPANT: Because you don't habituate in that ...
>> WISER: Because you don't habituate and the unpleasantness goes faster than the coldness,
which shows that's one very basic way in which to show that pain is a sense of its own and
not just the perception of intense stimuli, which is basically I think what's accepted
now. When I was a grad student it was still a question.
What causes pain that you know?
Again, going back to the good old days where women were told that menstrual cramps were
just in their heads, my answer to that, of course it's in your head, where would it be?
When you cut your finger, it's also in your head. I mean there's the cut on your finger,
but the pain is not in your finger. So of course ... okay, so that's one thing, but
now people understand the nature of it. It has to do with, again, hormones related to
histamine, et cetera. So not only now we know it's real, right, because there's a chemical
explanation.
I also talk about neuropathic pain, meaning pain that has outlived its purpose and what
can and sometimes cannot be done about it.
Referred pain is interesting. You know the feeling heart attacks in your elbow? No? Left
arm or something. And the explanation, does everybody know? Then I just move on.
>> WORKSHOP PARTICIPANT: What's the explanation?
>> WISER: The explanation that I read is that embryologically the nerves that signal pain
coming from your heart and your arm are linked. And so whether the signal comes from your
arm or from your heart, your brain doesn't know, so to speak.
>> WORKSHOP PARTICIPANT: So they link somewhere together on the neural pathway to the brain.
>> WISER: Yes, that's right and then because we are more familiar with pain on our left
arm than in our heart that's how we experience it, right?
>> WORKSHOP PARTICIPANT: Are you going to talk about acupuncture?
>> WISER: Yes. I do. In fact, let's see. Let me show you. This is a simplified version
of my pain pathways, and there you go - acupuncture.
So this the pain detector in your skin and it goes to the spinal cord, and then it goes
to various brain areas. One is the PAG. I should have looked that up, the periaqueductal
gray, something like that, and then the association cortex, the limbic system that you know, et
cetera. And then the question is how do you explain pain neurologically this way? And
you can understand a lot. So for example, imagine being at the dentist. What does Novocain
do? Do you know?
>> WORKSHOP PARTICIPANT: Blocks the [unclear]
>> WISER: Yes, it blocks here, right. So it changes the electrical conductivity of your
nerve and it prevents ... so it's very early in the system so the pain signal doesn't even
reach the spinal cord. Whereas, when you go under as they say for surgery, that's of course
at the upper level.
Then aspirin and stuff act on inflammation at the locus of where you hurt. I'm not going
to do it all, but then acetaminophen ...
>> WORKSHOP PARTICIPANT: Acetaminophen.
>> WISER: Thank you [laughs]. I usually call it by its brand name. It's easier but then
I'm forgetting that one too. So it also acts in the spinal cord, et cetera. So you can
explain, for example, why when you hit your finger or your toe, you rub it and that really
helps. That's called the Gate Theory of Pain and you know that. And then here the PAG in
the midbrain has a huge role in lots of pain-related phenomenon.
There are different hypotheses about acupuncture, but one of them is that it stimulates activity
in the midbrain. Okay, so this is a non-labeled one. One thing the students have to do is
put arrows on it. Do the messages go down or up? So the PAG goes down when it's active
and it blocks activity here so it blocks the pain. I mean, not totally, et cetera, but
it inhibits activity here so then the pain message doesn't make it up. So that's the
theory about acupuncture. It stimulates the activity of an area of the midbrain, which
then sends activity down to the spinal cord, which takes care of the pain signals to a
greater or lesser degree.
Similarly that's where endorphins are generated so the run is high. I'm telling you like the
gospel that's what I read and there's good scientific evidence for it whether it's foolproof.
Probably, there will be lots of changes. You know this, right? That's where opiates act
as well, and they act on the same receptors as endorphins. That's also where self-produced
analgesia is, which is this little electrical device. When you have intractable pain, again
I hear, you can have a little electrical like a pacemaker, at least that's what I imagine,
except it stimulates your midbrain. It gives little bursts of electrical activity in your
midbrain which then does its thing like acupuncture, if you wish. Am I making sense?
>>VOICES: Uh-huh.
>> WISER: And then hypnosis is higher up. The association cortex can, of course, send
signal back and that's why that takes care of cultural influences, learning cognitive
effects and stuff. That has to come from a higher arch [sounds like] obviously, et cetera,
et cetera.
So anxiety, on the other hand, excites the limbic system, which excites the neurons in
the spinal cord. And then fibromyalgia has a lot to do ... I mean, there are lots of
different theories also about different unwanted signals are generated when they shouldn't.
Then I talk about the phantom limb pain. Why does it hurt? There are also different explanations
for that, but essentially the idea is that the nerves are still alive and therefore send
signals to your brain although they don't originate from where they used to originate.
That's one thing I use to try to teach students that, as I put it, you are at the mercy of
your brain. What that means is that whatever the reality is, all you have is the activity
in your brain. If the activity in your brain says my hand hurts, your hand hurts. The fact
there is no hand there is irrelevant. Your hand hurts, right?
That's not necessarily something they think about on a regular basis. I'm not saying about
amputation, but in general is that whatever ... that's where my little speech on drugs
come in. If you mess up your brain, it might be forever, and then that's your reality.
You can't choose to see things or hear things the way you used to because your brain is
not just your eyes and your skin and your ears, it's also all the parts of your brain
that participate in perception and that shape - we're back to that - that shape your perception's
experience. If you mess that up, it will change your perception in the same way as putting
colored glasses, whatever. You see the point. They don't listen, but I believe that very
deeply. Stress also acts at the midbrain level. And then I gave you a bunch of things to read
should you want to know more.
Now, I have a third part about touch, but I am not going to do it all. I would like
to ask you, is that okay? Questions about pain? We can always talk later. So why do
you need touch? And then I'll show you the slide.
>> WORKSHOP PARTICIPANT: To develop your brain.
>> WISER: To develop your brain. That's a little vague. [Laughs]
>> WORKSHOP PARTICIPANT: I guess immediately about them like Harlow and monkey studies.
[Unclear] like no touch then not the same.
>> WISER: So it's at least socially, extremely important.
>> WORKSHOP PARTICIPANT: Beware of [unclear].
>> WISER: Sorry, I skipped you. Yes. Absolutely, that's really important and it's not necessarily
something students will tell you. >> WORKSHOP PARTICIPANT: Related to what you
were saying, it's just part of the feedback that we used to ...
>> WISER: Okay. Anything else? Yes.
>> WORKSHOP PARTICIPANT: About phantom limbs.
>> WISER: Yes, that's right.
>> WORKSHOP PARTICIPANT: There's TEDTalks on YouTube about phantom limbs and a guy who
has severe nerve damage in his existing arm to the point where he asked it to be amputated.
The arm was cut off and he has the same phantom pain which hurts like, okay, I can't cut his
arm off because it's already gone. He's got agonizing pain which won't respond to stuff.
So eventually he works at a mirror box in which he has a mirror image of the existing
normal arm. He has to work the normal arm so it looks like both limbs are now operating
normally without pain, and cures it.
>> WORKSHOP PARTICIPANT: Vision over ...
>> WISER: Wow.
>> WORKSHOP PARTICIPANT: You have to see this.
>> WORKSHOP PARTICIPANT: ... there's no feedback anymore. [Unclear]
>> WISER: Now there is. I wonder if one could cure tinnitus the same way because tinnitus
is also things taking over where they shouldn't. In fact, I hear mine a lot more in quiet settings
than when there are other ... and it's not because it covers it. It's because if there
are noises, real ones, [laughs] it stimulates the auditory system, and then the spurious
ones don't. The neurons are busy responding to real things. So I think there is a similarity.
Yeah. He is one of the pioneer about somatosensory systems and ...
>> WORKSHOP PARTICIPANT: Who's that?
>> WISER: It's Ramachandran. He's in California I think.
Okay, what else with touch, anything else? Socially, yes.
>> WORKSHOP PARTICIPANT: I don't know if I missed this, but I just keep thinking of Harry
Harlow and the attachment and [unclear].
>> WISER: Yeah.
>> WORKSHOP PARTICIPANT: Sexuality.
>> WISER: Yes. Right. That's what I delicately put as social attachment. [Laughs] Yes, absolutely,
from babies to teenagers to ... yeah, absolutely. No. One can venture in it. In fact, the textbook
I use, they try to imagine sex without touch. I don't know if you can say that. At college
you can, but I don't know if you can say that in high school. Can you?
Well, students often think about the social aspect and rarely ... not necessarily bring
up all the role of touch in motor behavior and try to button your shirt without touch.
What I try to explain is when you are very cold and you can't button or unzip or whatever,
it's not because your motor neurons are not working, it's because your sensory neurons
are not working.
Anyway, so it's crucial to any movement. So I make a big deal out of that.
Sorry, I have to turn this on now. There we go.
First of all that's how you swat flies or whatever that land on your arm even when you
don't see them. You're very sensitive and that's building reflex for good reasons.
Information about objects, try to imagine picking up a tennis ball versus a crystal
glass. Even if you look at it and think about the role of touch in doing both successfully,
so what specifically ... it's probably obvious but no, the lecture on this ... what kind
of information do your hands give your brain essentially so that you successfully pick
up the crystal glass without breaking it and the tennis ball, whatever? What do you think
is relevant?
>> WORKSHOP PARTICIPANT: The weight.
>> WISER: The weight, exactly. So one thing is you will lift, you adjust to weight so
you lift properly. And in fact there is ... I don't think it's on YouTube, it's probably
way too old. But there is a very cute thing with babies where let's say, one-year-old
and you give them something to lift repeatedly. It's really an experiment about Piagetian
conservation. It's a bar and they lift it and you can see they get used to it. And now
they don't go ... whatever. And then you fold the bar into two, so now it looks half the
size. The young babies pick it up and they're, "Ow," whatever. They expected a different
weight. So how do we know the weight of something without putting it on the scale obviously?
>> WORKSHOP PARTICIPANT: We make assumptions [unclear].
>> WISER: There is learning absolutely which is why it was a trick tennis ball, whatever,
but it's more than that.
>> WORKSHOP PARTICIPANT: Isn't it the pressure that it exerted back from it?
>> WISER: That's part of it, but certainly and that's why there is the size-weight illusion
because more compact things ...
>> WORKSHOP PARTICIPANT: ... with water in this, it's pushing down on my hand more than
a [unclear].
>> WISER: Yes, right. But there is more to it than that. You're right, it's very important.
>> WORKSHOP PARTICIPANT: It's visual. I mean, that's a huge thing.
>> WISER: It's not so huge.
>> WORKSHOP PARTICIPANT: I don't know. I'm looking at an empty water bottle and I know
it's going to be light than a full one and I know it's going to ...
>> WISER: But if I blindfolded you, you would still very successfully lift both.
I considered doing it and then I said ... [laughter].
Female: I might feel a little awkward at first if I'm blindfolded not quite knowing what
to expect.
>> WISER: Yes, at the very first but ...
>> WORKSHOP PARTICIPANT: After the first millisecond.
>> WORKSHOP PARTICIPANT: The minute you touch it, like you pick up your cup. If my cup is
empty, the minute I pick it up I sense a lot of things about it. Right now it's full and
it feels and I sense something so totally different about it in my space, in my body,
the whole sense of ... I don't know what the word is. So there's like five or six things
that have to be going on for me to do this.
>> WISER: Look, she's holding it like this, right? And I'm not proving you wrong. You're
absolutely right. So what else? What is telling her that the cup is of a certain weight?
>> WORKSHOP PARTICIPANT: The pressure that you have to put against it, to hold it.
>> WISER: So there is slipperiness. So you have skin detectors that tell you how slippery
things are, I mean, how slippage is ...
>> WORKSHOP PARTICIPANT: How solid it is as opposed to ...
>> WISER: Yes, right. So some detectors, some sort of detectors measure how much is pulling
down, and then you adjust. Other detectors will tell you how it reacts to ... no, but
that's not the end of the story, right, because the detectors are not ... they don't have
any brain, so what is it with the tennis ball versus ... sorry, I've been ignoring you.
>> WORKSHOP PARTICIPANT: I'm thinking of a beer stein and a wine glass and you're blindfolded,
identical texture. So you're sensing a glass, but you'd be able to tell something about
this by, well, how much force it takes to displace them in space and to move them around.
So if I'm using the same identical pressure against both glass objects, then I can feel
the wine glass tipping and sliding versus the beer stein is in same place with the same
amount of pressure.
>> WISER: So physics is there, too, but let's talk. So let's say pushing is probably not
a good idea to do it fully, so you're pushing them both, right?
>> WORKSHOP PARTICIPANT: Plenty of space.
>> WISER: Yeah, plenty of space and blah, blah, blah, and you're blindfolded. What information
goes to the brain to tell you about that one is more massive than the other?
>> WORKSHOP PARTICIPANT: You're feeling, shape, quantity, texture. When we say the word feeling
or touching it's so much more ...
>> WISER: Right, but my question is ... what I try the students to do is to go beyond that.
Yes, we feel all that. How? What is the information that goes to your brain so that you experience
texture? It's like the apple doesn't go to your brain. Texture doesn't go to your brain
either. It's something else, so what is the intermediary? Do you see what I mean? So what
kind of information is it that allows you to perceive texture or how resistant the two
glasses are or whatever else? I mean, it's a bit different explanation but the general
idea is the same.
>> WORKSHOP PARTICIPANT: Are you just looking for the fact that it's a neurochemical event?
>> WISER: Oh no. Yeah. You see too many why's. So what I should have said is when you do
this to a tennis ball versus a baseball, or you push two things of different masses, whatever,
your sensors, your touch receptors are responding to something in the same way. I mean, not
in the same way but now the retina receptors respond to light, so that's all they do. They
are responding to something. And then the nerve signals that come from your touch receptors
are exactly the same nerve signals as the ones in your optic nerve. I mean, not at the
same time, but if you look at the nerve signal, you don't know whether it's about touch or
sight or anything, it's just a nerve signal.
So what makes you see versus feel is where in your brain it goes but that's a separate
issue. So what is it that they're encoding with say information processing people? What
information do those nerve signals carry? They're just little ... no, not even. They're
all different patterns. So what is it from the outside that is encoding in the nerve
signals about holding something?
>> WORKSHOP PARTICIPANT: It's all pressure-related.
>> WISER: It's pressure-related, yes.
>> WORKSHOP PARTICIPANT: I was thinking like pressure and touch and all, but then it's
going back to the experiences that as you learned this, every time you learn different
>> WISER: Well, you see I don't disagree. Experience is usually important. The thing
is, as clumsy as they are, babies do the same thing. So there is again a part that's not
learned. You have to learn in order to look at something and know how to handle it more.
First of all, and let me ... I want to get to the Pride and a Daily Marathon, because
everybody has ... it's terribly written but it's terribly informative. It's about a young
man who doesn't have touch.
That's for you and the vision. So he sees perfectly well. He could not do anything of
the things that we have talked about and he knows. He lived for 20 years with touch but
he keeps waiting things. He cannot do anything at first, but it's really ... I'm getting
ahead of myself. So what is it that touch, you know, pressure ... okay.
>> WORKSHOP PARTICIPANT: [Unclear]
>> WORKSHOP PARTICIPANT: I think what you're driving at is it's many different types of
textures ...
>> WISER: But texture is the percept. The question is what's the mediator? Assuming
you're not counting the texture is really there, right?
>> WORKSHOP PARTICIPANT: It's not an illusion.
>> WISER: It's not an illusion. And then you rub, you know how in stores ... I don't know
if men do it too. When you ... you're always feeling clothes, right, so corduroy versus
blah, blah, blah.
>> WORKSHOP PARTICIPANT: You mean sensory neurons?
>> WISER: I'm sorry.
>> WORKSHOP PARTICIPANT: Are you looking for sensory neurons?
>> WISER: No. I'm looking for what kind of information ... okay, let me try again and
then I'll get to Pride and a Daily Marathon because I'm just dragging you into this. [Laughter]
I often tell the students if you have to build a robot and I do that with cognitive development
too. In fact there is a famous paper called "How to Build a Baby." So, that's the idea.
How would you build your robot, not that he or she has the experience of ... that's metaphysics,
but that it holds ... there is such a problem with robots actually, right, so they don't
crush what they hold. So what information does the robot have to be sensitive to in
order to hold the glass, throw the ball or whatever?
>> WORKSHOP PARTICIPANT: How does Superman know not to break the wine glass that he's
holding?
>> WISER: Why Superman?
>> WORKSHOP PARTICIPANT: He's the man of steel. He crushes ...
>> WISER: True, presumably he had the same sort of sensory system we do, right?
>> WORKSHOP PARTICIPANT: It's resistance.
>> WISER: It's resistance, okay. It's as simple as that in a way. I'm well aware I didn't
ask my questions properly, but certainly I don't think it's necessarily obvious because
like with the apple, it's there. The texture is there. The glass, of course the glass is
slippery so it slips. Well, the question is how do you know it's slippery and everything
is spatial, temporal patterns of pressure. That's all touch is. So this immense world
of being able to walk, being able to hold, to button, to hold the baby, blah, blah, blah
is only patterned information about how pressure changes, how much of it there is and how it
changes in time.
>> WORKSHOP PARTICIPANT: It's all the relative amount of pressure against the skin surface,
and therefore, the receptors fire and ...
>> WISER: Exactly and that's all they do. Now there are four kinds, and they are not
sensitive to the same patterns of pressure - that's what I'm in love with but we won't
have time -and how combined, that's your touch world which is huge. It's all time, space-dependent
patterns of pressure. I find, again, that absolutely fascinating.
Anyway, thank you for your patience. So let me get to Ian.
So you have all of that. So the person in purple at the back there, I'm sorry I don't
know your name.
>> WORKSHOP PARTICIPANT: [Unclear]
>> WISER: That student, that's okay. To go back to your two glasses, when you push - action
and reaction - the thing is pushing back on you. And your sensory receptors, your touch
receptors just say how much pressure there is on them. I know you can do it. But the
students don't necessarily focus on the objects. They see on the action of the objects on them
and that's what is sometimes tough to carry.
So Pride and a Daily Marathon, I'm just going to give you a little taste of it. It was written
by either the therapist or the neurologist of this young man who one day literally woke
up without the sense of touch. He could feel temperature. He could feel pain and his muscles
were ... I mean, the muscles were intact but then the question was how to move them. And
it happened because of a viral infection that destroyed his touch fibers essentially. You
don't come back from that. And so the book is about both the neurophysiology aspect of
it, but also his experience. And I don't know about you but I knew I needed it for walking
[sounds like] et cetera, but until you read that, I think you'll realize how deep it goes,
how much you need touch in a sense.
So he is in his bed, he wakes up and he tries to sit up. He can't. So he tries to remember
how one sits up, and he thinks somehow that tensing his stomach muscles has something
to do with it. As we know sit ups have something to do with it. Nothing. He has the same brain
he had the day before but he cannot do it. And then he realizes it has to do with gravitational
thing. That he has to bend his head forward to sort of bring his ... it doesn't really
matter the specific. So he has to reinvent the simplest of motions. And I want to go
back to the first comment that ... what's his name? Yeah, you, sorry, I cannot call
by names because I don't know your name. So the first thing you said very early on is
we need touch to move, did you say?
>> WORKSHOP PARTICIPANT: Just to be aware of our movements.
>> WISER: Yeah, to be aware of our movements. And that's something that I don't think is
that much known is that without touch you cannot decide. Even when you look at your
arm, you cannot decide to move from here to there because in order for your brain to do
the command to move from here to there, your brain has to know where your arm is, not visually,
touch-wise. And so without touch, your brain is missing that information, and therefore,
cannot generate any controlled movement.
>> WORKSHOP PARTICIPANT: That's Ian Waterman's case.
>> WISER: Yes.
>> WORKSHOP PARTICIPANT: Actually, if you search for him online and there's a bunch
of [unclear]. You can watch him on video clips and things. You will see he had done an interesting
documentary on him that you can watch little clips of it, but in this case he like retrained
himself ... it was all through sight. He had to do it and if you shut off the lights and
they talked about ...
>> WISER: He fell.
>> WORKSHOP PARTICIPANT: ... power went out, he just collapses to the ground.
>> WISER: Think of it, if you have no sensation ...
>> WORKSHOP PARTICIPANT: That's because he no longer knows where his body parts are in
relation to each one of those.
>> WISER: And sometimes his arms would fling out because the brain ... it's not that the
brain doesn't give random, as you know, commands but no, totally. And so he did retrain himself
through sight. He literally crawled and then walked and as soon as it's dark ... I think
of driving because he got back to driving. Now imagine not having proprioception and
the car next to you moved. How do you know it's the other car or you?
>> WORKSHOP PARTICIPANT: No. You have that illusion of moving.
>> WISER: Yeah, that's the trained sort of illusion. I mean, the courage, it's fascinating
but it's also ... I mean, not everyone can do that. Other people who have that condition
chose to stay in a wheelchair. I mean, it's just too hard. And he lived ... did he die?
>> WORKSHOP PARTICIPANT: [Unclear] I don't know.
>> WISER: And then he ended up even building stone walls and trying to have a normal life.
But just a description of what it means to sit up or to hold an apple. And then he becomes
a clerk in a company. And talking about the crystal glass, he has to distribute sheets
of paper to different offices. How much pressure do I put not to crush this paper but still
not have the papers and on and on and on. I think that really brings home even at the
different level the importance of touch. Yeah, his name is Ian Waterman.
So I'll stop here. Thank you so much for your interest and I'd be glad to answer questions.
[Clapping]