Neuropsychology, psychopathology, and neuroscience: The Death of Dualism Inés Monguió PhD

American College of Forensic San Diego, 2016 , psychopathology, and neuroscience: The Death of Dualism

Jurors, judges, you and I when asked to form an opinion regarding a criminal act, likely will contemplate the following: • “Was it him, or was it his circumstances? Was it him, or was it his brain? But what most people do not understand, despite the fact that naturalisc philosophers and sciensts have been saying it for centuries, is that there is no ‘him’ independent of these other things. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

(Or, to be a bit more accommodang to the supernaturally inclined, there is no ‘him’ independent of these things that shows any sign of affecng anything in the physical world, including his behavior.)” “Dualism fits naturally with libertarianism [i.e., belief in free will] because a disnct from the body is precisely the sort of non-physical source of free will that libertarianism requires. “ (Greene and Cohen, 2004) Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

Explaining the Mind-Body Issue • Dualism: The belief that there are two separate and disnct substances that make up a human being: mind and body. – – Chrisan doctrine & much of Western Civilizaon – Descartes res extensa (measurable) and res cogitans (non-physical, non-dimensional) Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Res cogitans was the “” of pre- Enlightenment thinkers. So it was for Descartes. • In the 20th Century the stuff of res cogitans somemes is referred to as “”. • Physicalism: Consciousness as an epiphenomenon of brain • Modern Trialism (Karl Popper, John Eccles) The “Hard” queson is always “HOW”?

Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• HOW does the immaterial, non-dimensional, non-measurable “soul”, “psyche”, “mind”, res cogitan cause physical changes in the physical reality that is the brain? HOW does it cause behavior? Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

“Any mind to brain communicaon has to be compable with the natural laws, in parcular with the principle of conservaon. Making the brain do things, like messing with synapses, takes work that the soul would have to perform and that has to be accounted for.“ (Koch, C. (2012), page 151) Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Integrated informaon theory (IIT) in the late 20th and current 21st Century (Francis Crick, Giulio Tononi, Chirstof Koff). • Consciousness (Φ) exists in all and every system that possesses informaon that it integrates, and that creates new informaon of its own. The more informaon, the higher the Φ. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• In our chosen specialty of we are asked to evaluate “fuzzy concepts” such as movaon, intent, understanding, appreciaon of consequences, veracity, prognosis of recidivism, psychopathology, extenuang circumstances, and so on. • Dualism seems to be at the root of many opinions and recommendaons I have read in reports by colleagues in forensic psychology. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

Definions of Psychology - The scienfic study of the human mind and its funcons, especially those affecng behavior in a given context. - The mental and emoonal factors governing a situaon or acvity. (Note the implicit dualism in the definion) Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

Definion of psychopathology • The scienfic study of mental disorders in order to understand their genec, biological, psychological, and social cause, course and treatment. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

Definion of Neuropsychology -The study of the relaonship between behavior, emoon, and cognion on the one hand, and brain funcon on the other. - A science concerned with the integraon of psychological observaons on behavior and the mind with neurological observaons on the brain and nervous system

Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

Definion of Forensic Psychology - As defined by the American Psychological Associaon, is the applicaon of clinical speciales to the legal arena - The applicaon of clinical speciales to legal instuons and people who come into contact with the law ( Cronin, p. 5). - The applicaon of psychology to legal maers in a court of law. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Much press given to the neurosciences in the past 15 -20 years. • The Decade of the Brain was a designaon for 1990-1999 by U.S. president George H. W. Bush as part of a larger effort involving the Library of Congress and the Naonal Instute of Mental Health of the Naonal Instutes of Health "to enhance public awareness of the benefits to be derived from brain research". Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

Definion of Neuroscience - The interdisciplinary scienfic study of the nervous system. It involves biology, chemistry, engineering, computer science, linguiscs, mathemacs, medicine (in cluding neurology), genecs, , physics, and psychology.

Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

“The growing role of neurosciensts in court means that neurosciensts should be aware of important differences between the scienfic and legal fields, and, especially, how scienfic facts can be easily misunderstood by non-sciensts, including judges and jurors.” (Jones et al., 2013)

ISSUE: Is a judge or jury able to define a “normal” brain? Since the brain causes all behavior, can any behavior be excused? How about NO behavior can be excused? Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Mr. Weinstein, 1992, killed his wife and then threw her out the window from their Manhaan apartment to make it look like suicide. A subarachnoid tumor was found in his brain. The prosecuon so feared the informaon going to the jury that Mr. Weinstein was allowed to plea to manslaughter. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Science aims to discover facts through inducve and deducve means that increase our collecve knowledge of reality. • The law aims to pursue the ends of society’s values — with respect to orderly, producve and just behavior. • Judge and jurors must always decide within a system of uncertainty. The more dire the consequences of their decision, the more that uncertainty must be reduced.

Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• As expert witnesses in psychology or neuropsychology we must be constantly on the alert to – 1) Idenfy our own propensity to separate “psyche” from “soma” in the evaluaon and in our conclusions – 2) Educate lawyers, invesgators, judges and juries in considering factors important at the me of clarifying/concrezing “fuzzy concepts” Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Assess the individual in all spheres of funconing and of influence received • Consider all possible condions that must be ruled out, and thoroughly assess (personally or via well-coached invesgators) • Insist on having access to all medical, school, and employment records available • Always queson your first impression by forcing yourself to come up with alternave explanaons for a symptoms or behavior Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

Known areas of the brain are involved in • Appreciaon of reward and punishment • Ascribing emoonal valence to external events • Emoonal responsiveness and aggression • Decision making • Reasoning • And many/all behaviors associated with lawful and unlawful behavior

Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Since all and any behavior has correlates in the brain, and the behavior of the brain correlated with external and internal behavior of the periphery, then it follows that at the me of assessing criminal behavior the psychologist must consider physical condions that may present with psychological or neuropsychological symptoms and condions. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• “Physical” illnesses/condions with neuropsychological or psychological correlated symptoms: ! Migraines ! Porphyria ! Chronic Fague Syndrome ! Fibromyalgia ! Chronic Lyme Disease ! Hypoglycemia ! Hypothyroidism Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• “Physical” illnesses/condions with neuropsychological or psychological correlated symptoms, (cont.) ! Systemic Lupus ! Gulf War Syndrome and other chemical injuries ! Acute thiamine (vitamin B6) deficiency ! Mulple sclerosis ! Alzheimer’s disease and Pick’s disease, early ! Hunngton’s chorea, early ! Cushing’s syndrome Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• “Physical” illnesses/condions with neuropsychological or psychological correlated symptoms, (cont.) ! Paral seizures ! Accumulaon of toxins from severe liver or kidney disease ! Disturbances in electrolytes ( toolow sodium or too high calcium) ! Intoxicaon with heavy metals (lead, mercury, manganese) ! Exposure to pescides ! Menopausal and premenstrual syndromes ! Inhaled anesthesia

Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Because psychological condions are known to affect cognion as well as emoons, and therefore the brain’s behavior, a forensic psychologist must look for the presence or absence of these condions at the me of formulang an opinion regarding premeditaon, intent, and extenuang circumstances. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

Psychological condions with physical correlates/consequences • Depression • Anxiety disorders (a variety of them) • PTSD • Dissociave disorders (possibly excluding Conversion Disorder, but definitely including DID.

Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

REFERENCES • Ardila A, Sanchez E. (1988) Neuropsychologic symptoms in the migraine syndrome. Cephalalgia , 8, 67-70.

• Botvinick, M.M. , Braver, T.S., Barch, D.M., Carter, C.S., Cohen, J. D. (2001). Conflict monitoring and cognive control. Psychological review, 108, 624-652.

• Cavedini, P. (2009) Decisional processes in obsessive-compulsive spectrum disorders • From neuropsychology to clinical implicaons . hps://www.researchgate.net/publicaon/ 222525293_A_Neuropsychological_Study_of_Dissociaon_in_Corcal_and_Subco rcal_Funconing_in_Obsessive-Compulsive_Disorder_by_Tower_of_Hanoi_Task. Accessed September 22, 2015, 8:09 PM.

• Eccles, J.C. (1994) How the Self Controls its Brain, Berlin: Springer-Verlag Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Fales CL, Barch DM, Rundle MM, Mintun MA, Snyder AZ, Cohen JD, Mathews J, Sheline YI. (2008) Altered emoonal interference processing in affecve and cognive-control brain circuitry in major depression. Biol Psychiatry, 63, 377-384.

• Ferenci , P., Lockwood A., Mullen K, Tarter R., Weissenborn K., Blei A.T. (2002) Hepac encephalopathy–definion, nomenclature, diagnosis, and quanficaon: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, Hepatology , 35: 716-721.

• Jones, O. D. ,Wagner, A. D., Faigman, D. L. and Raichle, M. E. (2013) Neurosciensts in Court 14 Nature Reviews Neuroscience 730 (2013); Vanderbilt Public Law Research Paper No. 14-17. Available at SSRN: hp://ssrn.com/abstract=2432469

• Greene J. and Cohen, J.(2004) Neuroscience and law changes nothing and everything. Phil. Trans. R. Soc. Lond. B, 359, 1775–1785 Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Greene, J. D., Fiery A. C., Stewart, L.E., Lowenberg, K., Nystrom, L. E., and Cohen, J.D. (2009) Pushing moral buons: The interacon between personal force and intenon in moral judgment. Cognion 111, 364-371. hp://nrs.harvard.edu/urn-3:HUL.InstRepos:4264763. Accessed August 13, 2015 3:55:04 PM EST

• Hanning, C.D. (2005) Post-operave cognive dysfuncons. Brish Journal of Anaesthesia 95, 82–87.

• Harris, L.T., McClure, S.M., van den Boss, W., Cohen, J.D., and Fiske, S.T. (2007) Regions of the MPFC differenally tuned to social and nonsocial affecve evaluaon. Cognive, Affecve, & , 7, 309-316

• Koch, C (2012) Consciousness: Confessions of a romanc reduconist. Cambridge, MA: MIT Press. Neuropsychology, psychopathology, and neuroscience: The Death of Dualism

• Loewenstein, G. Rick, S. and Jonathan D. Cohen, J.D. (2008) Neuroeconomics. Annual Rev. Psychol, 59, 647–672.

• Miller, E.K. and Cohen, J.D. (2001)An integrave theory of prefrontal cortex funcon. Annu. Rev. Neurosci. 24, 167–202

• Tononi, G and Koch, C (2015) Consciousness: Here there and everywhere? hp://rstb.royalsocietypublishing.org/content/370/1668/20140167