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1.+escamilla2018 BrainActivation During WAE
1.+escamilla2018 BrainActivation During WAE
Michael Escamilla,
Hugo Sandoval, Vince Calhoun and Marisol Ramirez, El Paso, Texas
Abstract: C.G. Jung’s theory of psychological complexes lies at the root of analytical
psychology theory and practice. Functional magnetic resonance imaging (fMRI)
provides a powerful tool to validate the theory of complexes and eludicate the
neuropsychologic mechanisms underlying the unconscious activation of significant
memories. In this study, using fMRI, we identify two brain circuits which are activated
in response to complex triggering words. Circuit one involves brain regions involved in
episodic memory and somatic (body) responses and the experience of uncertainty. A
second circuit involves episodic memory, emotion, visual and language association,
and semiotic meaning. Specific brain regions include the right prefrontal cortex, SMA
cortex, left temporal cortex, and the caudate and cingulate. These brain circuits may
be thought of as the biological form in which complexes are experienced. Implications
for analytic psychology practice and theory are discussed.
Introduction
Carl Jung, analytical psychology and the word association test
From 1903 to 1906, Carl Jung and his associates at the Burghölzli psychiatric
clinic in Switzerland conducted a number of important experiments to
identify how subjects responded spontaneously to a list of words. Jung edited
a book summarizing these experiments in 1906 in which he and his mentor,
Eugen Bleuler, elucidated a theory of unconscious complexes which could be
triggered by specific words. Which words triggered these unconscious
‘complexes’ were unique to each person (Jung & Riklin, 1919). Jung defined
what he meant by complexes at various stages in his career:
Jung’s notion of complexes thus links together a whole network of words, ideas,
emotions, and biological responses, and he proposed that these complexes
operate in an autonomous or semi-autonomous way, that is, apart from
conscious intention. With the advent of functional brain imaging, we now have
the opportunity to test whether these unconscious reactions can be observed in
the brain. Furthermore, if complexes can indeed be visualized in the brain, we
can gain further knowledge about the neurologic components and brain regions
which are the biologic carriers of emotional/associational complexes.
The word association test (WAT) was originally developed by psychologists
who studied human mental processes by mapping associations when a person
was presented a word (Shamdasani 2003). Early psychologists who used
versions of the WAT included Francis Galton and the ‘father’ of experimental
psychology, Wilhelm Wundt. At the time Jung and his colleagues began to do
WAT experiments at the Burghölzli, the test had been used by various
psychology and psychiatry researchers in Germany and elsewhere. Franz
Riklin, a psychiatrist who worked with Jung on the WAT experiments at the
Burghölzli, had previously studied how to conduct the WAT with psychiatric
colleagues in Germany. The original motivation for the WAT experiments in
these German clinics and at the Burghölzli was to see whether patterns of
association could distinguish different types of patients and thereby facilitate
diagnoses of different psychiatric conditions.
Of the WAT experimental findings published by Jung and colleagues, perhaps
the most important was the first article written by Jung and Riklin focusing on
a control sample of persons without serious mental illness (Jung and Riklin
1919). Their sample consisted of 38 adults, both male and female, and was
composed of psychiatric staff (doctors, nurses, attendants) and family members.
486 Escamilla, Sandoval, Calhoun & Ramirez
Jung and Riklin noted that certain words seemed to cause an emotional reaction
(delay in responding, physiological manifestations) and proposed that upon
hearing the prompt word, an unconscious net of associations and feelings was
set off. As Jung further developed his theory of complexes, he would eventually
consider that everybody had complexes and that these were important building
blocks of each person’s unconscious topology. In later developments of Jung’s
psychological theories, he would also postulate that archetypes (basic, inherited
patterns of experiencing life through particular psychological mechanisms) are,
at the species level, general forms in which an individual is primed to experience
individual complexes. As such, Jung’s entire analytical psychology project,
which he initially considered defining as ‘complex psychology’, depended in
large part on his findings from the WAT studies and his interpretation that
certain words could trigger unconscious psychological reactions.
Methods
Subjects were undergraduate or graduate students taking psychology classes
at a university in west Texas. Inclusion criteria included being in good
general health, having no history of a neurological disorder, no current use
of any psychotropic medications, a requirement that their first language
was English, and no history of claustrophobia (note: claustrophobia
prevents subjects from comfortably undergoing the process of imaging of
the head). A total of twenty participants, 10 males (ages 21-29, mean = 26)
and 10 females (ages 21-29, mean = 25), were able to complete the study
procedures. In order to assess whether the subjects had any current or past
psychiatric conditions, each subject completed an interview with a research
assistant who administered the MINI-plus (Sheehan et al. 1998). The
MINI-plus results were reviewed by a psychiatrist who used DSM-IV
criteria to diagnose any current or past psychiatric disorders. Fifty percent
488 Escamilla, Sandoval, Calhoun & Ramirez
(n=10) of the subjects had no present or past Axis I disorder and the other
fifty percent (n=10) had a history of one or more Axis I disorder. Two
subjects had a history of major depression, but neither was currently
experiencing an episode. Five subjects had a history of alcohol or substance
abuse/dependence, and four of these met criteria for current abuse/
dependence. The following diagnoses occurred only one time each out of
the twenty subjects: Anxiety Disorder Not Otherwise Specified, Social
Phobia, Agoraphobia, and Specific Phobia. All subjects provided informed
consent and the project was approved by the Institutional Review Board of
Texas Tech University Health Science Center in El Paso.
Brain imaging
Subjects underwent scanning using BOLD fMRI (blood oxygenation level
dependent functional magnetic resonance imaging). The first ten subjects
were scanned using a Siemens Magnetom Espree 1.5 Tesla MRI unit. The
subsequent ten subjects were scanned using a Siemens Skyra 3.0 Tesla MRI
unit. Scanning was done within 5 days of the administration of the WAT.
Although we originally planned to play audio tapes of the ‘complex’ and
neutral words for each subject while they were in the MRI machine, we
encountered difficulty in subjects’ ability to hear words while in the scanner.
We therefore presented words to each subject via a computer screen. This
manner of delivering the words to subjects while they were in the MRI
scanner was similar to the manner of delivery used by Petchkovsky et al.
(2011) in their study.
Each subject went through an fMRI session which included two nine minute
blocks of time, one in which they were exposed to complex words (i.e. the five
words from the WAT which had elicited the most complex indicators for that
particular person) and another block in which they were exposed to neutral
words (five of the words from the WAT that had scores of 0 complex
indicators for that person). Subjects were asked to read the word and think of
the first word that came to mind. From one person to the next, the order of
the blocks (complex word session and neutral word session) was reversed so
that half of the subjects completed the complex word session first and half
completed the neutral word session first. The order of the particular words
during each block of time (his/her complex words during the complex session,
and his/her neutral words during the neutral session) was randomized using
Eprime. Each block of time consisted of twelve partitions of time – six
partitions with no task (no stimuli presented) alternating with six task
partitions (words were presented and the subject was asked to associate to
them). Each partition lasted for 45 seconds for a total of nine minutes per block.
To deliver the images and capture blood flow readings, an echo planar
imaging sequence was used. One hundred and eighty volumes were tracked
per session with the following parameters: FOV= 240 mm, Voxel size=
3.8x3.8x5 mm, slice thickness= 5 mm, anterior-posterior phase encoding
direction, interleaved acquisition, echo time (TE) 40 ms, repeat time (TR)
3000 ms, flip angle 90 degrees.
490 Escamilla, Sandoval, Calhoun & Ramirez
Data analysis
We analyzed differences in brain activation during the partitions of time during
which subjects were presented with neutral words compared to partitions when
there was no task (neutral vs. no-task) for all twenty subjects. We also
compared differences in brain activation of all subjects combined during
presentation of complex words compared to no task (complex vs. no-task)
and finally, we compared activation during blocks of time when complex
words were presented to blocks of time when neutral words were presented
(complex vs. neutral). Two types of statistical analysis were done:
Results
We first looked at which brain networks were activated when a subject
responded to the WAT test in the scanner. To do this we looked at which
brain circuits were activated when the subjects were responding to the task
(with either neutral or complex words) in comparison to when they were at
rest (no task). The GIFT analysis identified 50 brain networks and of these 25
networks showed very strong activation or de-activation (T value > than 5.0
or less than -5.0) when the subjects were performing the WAT in the scanner.
These networks include a multitude of brain regions including the frontal
gyrus, precentral gyrus, cingulate gyrus, precuneus, superior and inferior
parietal lobes, middle and superior temporal and occipital gyri, lingual gyrus,
parahippocampal gyrus, insula, fusiform gyrus, angular gyrus, supramarginal
gyrus and cerebellum.
With regard to detecting brain networks or circuits that showed preferential
activation when the person was responding to complex words versus when
they were responding to neutral words, only one network (Circuit 1,
component 27) showed significant differences (p < 0.05), and a second
network (Circuit 2, component 40) approached significance (p=0.07). Table 1
summarizes these two networks and figures 1 and 2 show visual
representations of the brain regions preferentially activated when a person is
responding to complex words (versus neutral words).
Table 1. Main networks activated by task: Complex Words minus Neutral Words
Brain regions
activated (+) or Brodmann
Component # P value T value deactivated (-) Areas
Circuit 1 0.0328 2.3 (+): Paracentral, 4,5,6,7,8
superior and
middle frontal,
postcentral,
precentral
(-): medial frontal,
precuneus
Circuit 2 0.0725 1.9 (+): caudate, superior 21,22,38,39,42
temporal, middle
temporal, inferior
temporal, sub-gyral,
inferior frontal
(-): cingulate,
thalamus,
extra-nuclear
492 Escamilla, Sandoval, Calhoun & Ramirez
Discussion
The experiments and results in this paper offer an independent confirmation
that the human brain responds differently to words which generate complexes
(unconscious reactions, as measured in the word association test) from the
way it does to neutral words (words which do not generate complexes). Our
findings offer a window into defining at a neuro-psychological level what
happens in the brain when complexes are triggered in an individual. The
study suggests that particular brain mechanisms underlie these complexes. In
addition, the study also shows that brain reactions to complex generating
words can be seen if measured within a few days of identifying the complex
words using the standard Word Association Test. Lastly, given that there has
been one previous study using functional brain imaging to identify the neural
substrates involved in the activation of complexes, we can compare results
with that previous study by Petchkovsky et al. (2011, 2013).
What circuits of the brain are activated when complexes are triggered?
This question is best answered by comparing (the analyses which subtract) the
activation level of the brain while responding to neutral words from the
activation levels when responding to complex words. In general, our data
showed that these differences were much more subtle than the differences
between responding to the WAT compared to doing no task. The GIFT
analysis showed one significant circuit (p< 0.05) and one suggestive circuit
Brain activation patterns 495
contiguous) and operating as a unit that links somatic and body movement with
episodic memory and action in response to specific memories. The somatic
nature of this circuit corresponds to Jung’s idea that:
Whenever there is a high tonus it is just as if that particular complex had a body of its
own, as if it were localized in my body to a certain extent, and that makes it unwieldy,
because something that irritates my body cannot be easily pushed away because it has
its roots in my body …
(Jung, 1935, para. 148)
particular regions (SPM analyses). Our SPM results might also reflect greater
heterogeneity of the sample (as sample sizes increase, so does heterogeneity)
or, finally, may be an artifact of combining images from 1.5 and 3.0 tesla
scanners.
Taken together, both our study (GIFT analyses) and the study by Petchkovsky
et al. (using SPM analyses) have shown distinct brain circuits or regions
activated by complex triggering words. We can therefore affirm with some
confidence that both studies implicate the right prefrontal and SMA (B6), left
temporal (B22), caudate and cingulate as brain regions activated when a
complex is triggered in the WAT.
Our Circuit 1 overlaps most directly with what Squire and Dede call
nondeclarative simple classical conditioning, a skeletal response pathway with
the involvement of frontal cortex which moderates the tendency to freeze
movement versus the tendency to flee. Our Circuit 2 shows overlap with what
Squire and Dede define as nondeclarative procedural learning (skills and
habits) which primarily involves the caudate, and a simple classical
conditioning, emotional pathway which involves connections between the
amygdala, cingulate and hippocampus. The use of medial temporal cortex in
Circuit 2 also taps into the declarative (conscious) memory through its
activation of the temporal lobe.
In a fMRI study looking at the effect of emotional context on motor
responses, Mazzola, Gallese and colleagues (Mazzola et al. 2013) have shown
that emotional contexts can modulate the activity in the supplemental motor
area of the brain, which is part of Brodmann area 6 and a central component
500 Escamilla, Sandoval, Calhoun & Ramirez
of our Circuit 1 (memory, body, action). This area of the brain also contains the
mirroring network which Gallese and Carauna (2016) and others have pointed
to as a key entry point into triggering the unconscious somatic information and
subsequent cascade of cognitions we experience when reacting to others in
emotional contexts. Our data support the hypothesis of Wilkinson (2010) and
others that the body and brain contain a major component of information
related to complexes in this unconscious bodily pathway (Circuit 1) which
would ordinarily bypass verbal means of communication. Luckily this
information is still accessible to the therapist as the mirror system
(supplementary motor area) is part of this circuit, which provides the
possibility that this critical information can nevertheless be transmitted to the
attuned, empathic therapist who is able to mirror through unconscious bodily
mechanisms.
Interestingly, a study of MRI activation patterns done by Lanius et al. (2001)
looking at persons who had experienced sexual or motor vehicle accident
trauma showed, upon stimulation by scripts, decreased activation in the
thalamus, cingulate gyrus and medial frontal gyrus in the subjects who had
developed full PTSD. We also noted decreases in activation in these same
three regions when complexes were triggered by the WAT (medial frontal
gyrus in Circuit 1, and thalamus and cingulate gyri in Circuit 2). Lanius et al.
also suggest that decreased activation in these areas may be neurologically
correlated with experiences such as dissociation.
Donald Kalsched has postulated that the processing of trauma requires
what he calls ‘whole experience’, ‘… an integration of affect in the body,
images in the mind, and a component of meaning – how things make sense
in the world’ (2013, p. 8). Kalsched’s three components tap into regions
of the brain that are activated by complexes in our present study,
namely Circuit 1 (which directly engages the body and memory, Brodmann
areas 4-8) and Circuit 2 (which contains brain regions used in the assigning
of meaning (BA21) and also in visual memories (images in the mind, BA38)
(Table 3, Figures 3 and 4)).
The common thread in the two circuits is stimulation of the parts of the brain
involved in episodic memory. This highlights the importance of personal
experience (the personal unconscious) as the building block of complexes and
the psychological mind. As noted by Knox (2004) it is likely that the implicit,
internalized working models, the basis of complexes as understood in modern
analytical psychology, are primarily built on experiences of persons and
situations in the outer world. In other words, they are comprised of
memories, even if implicit, and are not therefore a priori or separate from real
world experience.
Based on our results in these experiments which pooled data from 20 different
persons, we can say that the brain circuits we see activated in the participants of
our study can be thought of as circuits common to human beings and that these
are probably inherited through the development of specialized brain regions
with specific connectivity. In this sense, these circuits may constitute the
biological form of what Jung would call archetypal experiences. The specific
episodic memories or words which activate these circuits are unique and
specific to each of the study subjects, their complexes. But the fact that these
complexes, regardless of their individual expression, will have a bodily
component, a language and symbol component, and an affective component,
and that they stimulate a feeling of uncertainty can be considered to be a hard
wired form which will orchestrate the psychological experience in a manner
that has universality.
As noted in Samuels (1986), one previous hypothesis has been that
archetypes reside in the sub-cortical limbic system. Our data suggests that the
biological form of an individual’s complexes is not limited to a single location
but that it rather involves circuits moving from cortex to limbic system and
the body itself. Perhaps the state of uncertainty (a shift from logical, directed
thinking) triggered as part of circuit 1 (Brodmann area 8, Table 3, Figure 3)
or the increase in attention that is part of circuit 2 (Brodmann area 39, Table 3,
Figure 4) can be considered part of the numinous state sometimes ascribed to
experiencing of archetypes and to the discomfort and anxiety when
experiencing complexes.
Finally, we can also hypothesize that these complexes (activated brain/body
circuits, related to specific memories) have a positive biological function for
the human species. Experiences which were particularly threatening or
pleasurable for a person, for instance in early or later life, if coded as
memories, would have potential survival value if, when some aspect of the
environment (sensory or linguistic) triggers the memory, the body prepares to
react (moving into an uncertain, but ready to act, mode) (circuit 1) and begins
to scan and assign meaning (semiotic) to the situation, driven by emotional
memory (circuit 2). In a practical manner, therapy (as well as art, journaling,
and other means of verbal and semiotic exploration) can access the experience
of complexes through circuit 2 and possibly lead to a refinement in the
utilization of information that comes upon us when a complex is activated.
504 Escamilla, Sandoval, Calhoun & Ramirez
Limitations
As in any study there are limitations which should be mentioned here. First, this
study utilizes combined data from multiple subjects and therefore gives a
composite view of which brain circuits and regions are activated when
complexes are triggered through words. There may be individual variations
which would be obscured in this combined approach. For instance, individual
differences might theoretically be seen in individuals who have different
diagnostic backgrounds. Our sample size was too small to explore this. As in
the Petchkovsky study, we were limited in needing to use visual written words
to deliver the stimuli for patients within the scanner, thus not directly testing
the effect of spoken words on the neurobiology of the individuals tested.
Finally, the sample size was still on the small side, and the finding for circuit 2
was statistically suggestive but not significant and should therefore be
interpreted with caution. Further testing with larger samples would be
necessary to be certain these two circuits are associated with responses to
complex triggering words. We are partly swayed in the interpretation of our
results by seeing similar brain regions highlighted in the two circuits reported
here and the brain regions previously reported on by Petchkovsky et al.
Further study and elucidation of the neuro-psychologic mechanisms operative
in these brain areas should help guide the development of both analytic
psychology theory and practice.
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Acknowledgements
We thank the persons who volunteered to participate in this study and to the
support of the Center of Excellence in Neuroscience at Texas Tech University
Health Science Center in El Paso. Drs. Mercedes Ramirez and Juan Zavala
assisted with best estimate diagnosis of the research subjects. We also are
grateful to the University Medical Center of El Paso for neuroimaging
resources and to Dr. Philip Bechtel, who assisted in ratings of the WAT and
contributed to the early stages of this research work.
TRANSLATIONS OF ABSTRACT
Mots clés: complexes, IRMf, imagerie cérébrale, le test d’association de mots, cortex
frontal, cortex temporal, archétypes
C.G. Jungs Theorie der psychologischen Komplexe bildet einen Basisbestandteil der
analytischen psychologischen Theorie und Praxis. Die funktionelle
Magnetresonanztomographie (fMRT) bietet ein leistungsfähiges Werkzeug um die
Komplextheorie zu validieren und die neuropsychologischen Mechanismen zu
identifizieren, die der unbewußten Aktivierung von bedeutungshaftigen Erinnerungen
zugrundeliegen. In dieser Studie identifizieren wir mit Hilfe der fMRT zwei
Gehirnschaltkreise, die in Reaktion auf komplexauslösende Worte aktiviert werden.
Der erste Schaltkreis umfaßt Hirnregionen, die an episodischem Gedächtnis und
somatischen (Körper-) Reaktionen beteiligt sind, sowie an der Erfahrung von
Unsicherheit. Eine zweiter Kreis schließt episodisches Gedächtnis, Emotion, visuelle
und sprachliche Assoziation und semiotische Bedeutung ein. Spezifische Hirnregionen
umfassen den rechten präfrontalen Kortex, den SMA-Kortex, den linken temporalen
Kortex sowie Nucleus caudatus und Gyrus cinguli. Diese Hirnschaltkreise können als
die biologische Form betrachtet werden, in der Komplexe erfahren werden.
Implikationen für die Praxis und Theorie der analytischen Psychologie werden diskutiert.
La teoria dei complessi di Jung si pone alle basi della psicologia analitica e della sua
pratica. La Risonanza Magnetica Funzionale (fMRI) offre uno strumento potente per
validare la teoria dei complessi e per chiarire i meccanismi neuropsicologici che
sottendono l’attivazione inconscia di memorie significative per mezzo di parole che
hanno una carica complessuale. Un primo circuito comprende regioni cerebrali
coinvolte nella memoria episodica e nelle risposte somatiche, e nell’esperienza
dell’incertezza. Un secondo circuito comprende la memoria episodica, le emozioni, le
associazioni visive e linguistiche, ed il significato semiotico. Specifiche regioni cerebrali
includono la corteccia prefrontale destra, l’Area Motoria Supplementare, la corteccia
temporale sinistra, il nucleo caudato ed il giro del cingolo. Questi circuiti cerebrali
508 Escamilla, Sandoval, Calhoun & Ramirez
possono essere visti come la forma biologica dell’esperienza dei complessi. Vengono qui
discusse le implicazioni per la pratica e per la teoria della psicologia analitica.
La teoría de los complejos psicológicos de C.G. Jung está en los fundamentos de la teoría
y práctica de la psicología analítica. La resonancia magnética funcional por imágenes
(fMRI) brinda un instrumento potente para validar la teoría de los complejos y
elucidar los mecanismos neuropsicológicos que subyacen a la activación inconsciente
de recuerdos significativos. En este estudio, utilizando fMRI, identificamos dos
circuitos cerebrales que son activados en respuesta a palabras complejas
desencadenantes. El circuito uno abarca regiones cerebrales involucradas en la
memoria episódica y en las respuestas somáticas (cuerpo) y en la experiencia de
incertidumbre. El segundo circuito envuelve la memoria episódica, la emoción, el área
de asociación visual y de lenguaje, y el sentido semiótico. Las regiones cerebrales
específicas incluyen la corteza derecha prefrontal, la corteza SMA, la corteza temporal
izquierda, el núcleo caudado y el giro cingulado. Estos circuitos cerebrales pueden
pensarse como las formas biológicas en las cuales los complejos son experimentados.
Se discute las implicancias para la teoría y práctica analítica.
与词语联想测试所激活的情结相关的脑激活模式:来自美国的一项新研究成果
荣格关于心理情结的理论,是分析心理学理论与实践的根基。功能性核磁共振成像
(fMRI)是一样有力的工具,用以验证情结理论,以及阐明重要记忆对无意识激活的神经
心理学机制。这篇研究, 通过fMRI, 识别出两个脑回路, 它们被激发情结的词汇所激活。
第一个回路包含的脑区涉及情景记忆和身体 (躯体)反应, 以及关于不确定体验的区域。
第二个回路涉及情景记忆, 情绪,视觉和言语联想,以及符号意义。还涉及特定的脑区,
包括右额叶, SMA皮层, 左颞叶, 以及尾核及扣带回。这些脑回路可以被看作是情结经验的
生理形式。文章讨论了这些发现对于分析心理学实践与理论的意义。