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BRAIN
A JOURNAL OF NEUROLOGY

BOOK REVIEW
The neuroscience of love, mysticism and poetry
Ill teach you differences! says Kent to the rascal Oswald in King Lear. And neuroscientists attempting to make correlations between love and the brain would do well to heed Kents lesson. For, there is a tendency in such enquiries to seek, and to nd, localized common denominators as if the seat of love were an organ like the kidney and passion no more than a wayward hormone. But here, at the outset, is another kind of difference. Not so long ago, in conversation at the Salk Institute with neuroscientist Prof. Terry Sejnowski, I asked what difference the discipline had made to his view of human nature? Neuroscience teaches he replied, that much of our behaviour normally viewed as the result of manifestation of individual responsibility, is hidden and determined. In consequence, he had become less judgmental of his fellows. To what extent then is love hidden and determined in the recesses of the brain and CNS? The impetus to explain the neuroscience of affections, sexuality, romantic love and its associated emotions has grown apace in recent years, resulting in a fascinating, although at times obtuse and ever-expanding literature. It would be true to say that the value of many of the research conclusions remains questionable. It was at the Salk for example, that Prof. Simon le Vey had been working in the 1990s on the difference between the homosexual and the heterosexual brain revealing, in his view, the importance of the similarity of hypothalamic structure in homosexual attraction. Elsewhere, researchers have been working on correlations between falling in love and phenylethylamine (PEA); while others have studied the density of peptide binding sites in the formation of emotional attachment. A central problem in these enquiries has involved a secure denition of that much used and abused word love itself. Some hilariously reductive characterizations have emerged, as for example: love is a cognitive-affective state characterized by intrusive and obsessive fantasizing concerning reciprocity of the loving feeling by the object of affection. The inescapable problem about love, however, remains as the issue raised, yet hardly settled, by Prof. Sejnowski. Is the human mind and body a kind of secret chemical factory that determines our behaviour, or do we have a measure of control over our chemicals, especially when it comes to human relationships? The question, in relation to love, is hardly new. The story of Tristram and Iseult, which nds its origins in early Celtic myth, has at its heart a passionate love affair prompted by a magic potion which

POETS ON PROZAC: MENTAL ILLNESS, TREATMENT AND THE CREATIVE PROCESS Edited by Richard M. Berlin Baltimore: Johns Hopkins Price: 14.50/$21.95 (Hard cover) ISBN: 978-0-8018-8839-7

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SPLENDOURS AND MISERIES OF THE BRAIN: LOVE, CREATIVITY AND THE QUEST FOR HUMAN HAPPINESS By Semir Zeki Hoboken: Wiley-Blackwell Price: 16.99 (Paperback) ISBN: 9781405185578

neither of the lovers can withstand. Early Medieval versions of the poem made much of the dilemma that arises when people engage in illicit sexual behaviour, while their capacity to behave freely has been suspended. The idea of romantic love as something that assails its victims from withouta form of infection, possession and poison even (deriving, of course, from the word potion) was as familiar in the folk literature of the rst millennium as it is in popular culture today. Queen Iseult sighs in her chamber for Tristram whom she so much desires, writes Gottfried von

Received and Accepted June 3, 2009 The Author (2009). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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Book Review desire later. But these differences, he insists, are trivial compared with the more enduring concept of love celebrated in poetry and art. That concept, he declares, can be summarized in one word, unity. It is the desire of lovers to be unied with one another, to become one. In support of his universalized unity-in-love contention, Zeki cites a circuit of literary, religious and philosophical texts, including Plato, Philo, the Upanishads, Virgil, Dante and Rimbaud. But can this unity idea form a basis for a neurobiological correlate for love? Love, he concedes, is of course a complex emotion that includes and cannot be easily separated from other impulses. He goes on to make the crucial, albeit modestly grandiloquent, qualication: there is a general neurological axiom (which I atter myself to have been the source of, although it is likely that many others have had similar thoughts) that if you can tell the difference it is because different brain areas, or cells, are involved. This, one assumes, takes care of such differences as depression and sadness. Nevertheless, holding in mind his belief in love as unity, Zeki comes to the salient point: neural structures that correlate with romantic love in all its complexity are very distinctive even if they share brain areas with other, closely linked, emotional states. He identies these areas as in the cortex (the medial insula, anterior cingulate and hippocampus) and the subcortex (parts of the striatum and probably also the nucleus accumbens), which together constitute core regions of the reward system. The thinking behind this is that love creates feelings of exhilaration and euphoria, of a happiness that is often unbearable and certainly indescribable. The areas that are activated in response to such feelings, he asserts, are largely co-extensive with those brain regions that contain high concentrations of dopamine, a neuro-modulator associated with reward, desire, addiction and euphoric states. What is more: like oxytocin and vasopressin, dopamine is released by the hypothalamus, a structure located deep in the brain and functioning as a link between the nervous and endocrine systems. The hypothalamus and pituitary gland are also involved as well as discharges of blood especially during orgasm in both sexes. We learn, moreover, of the importance of frontal, parietal and middle temporal cortex as well as a large nucleus located at the apex of the temporal lobe, known as the amygdala. Nor does Zeki neglect the decrease in activity, or inactivation of certain cortical zones in sexual performance. For example: the amygdala is known to be engaged during fearful situations and its de-activation, when subjects view pictures of their partners as well as during human male ejaculation, implies a lessening of fear. One cannot help wondering as to quite how scientic these onanistic experiments are, not to mention what they have to do, ultimately, with the focus of Zekis enquirylove. Other experiments reveal that the all-engaging passion of romantic love is mirrored by a suspension of judgement or a relaxation of judgemental criteria by which we assess other people, which is a function of the frontal cortex. Granted that there may be at least remote correlations between these localized natural chemicals and some forms of erotic behaviour, how would they play out in relation to sacred love? Zeki, citing Dante and Bernard of Clairvaux, argues that there is ample evidence to show that loveas a desire to be wholly united with the love objectis as common in the realms of religious

Strassburg in his 12th century rendering of the story. She can think of nothing else in her heart save loving Tristram. She has no other wish or love, nor any other hope. And Tristram, of course, is equally obsessed. Other early versions offer mutually contradictory descriptions of the power and longevity of the love potion. One declares that its effects last for the entire lives of the lovers; another insists that it wears-off after 3 years, leaving the lovers free to exercise their responsibility for continuing their affair, or ending it. Out of the proliferating stories, legends and mythologies of love come well established denitions and differences. C. S. Lewis celebrated literary history, Allegory of Love (1936) traced the early Western ideals of romantic love from the 13th century poem Roman de la Rose, with its notion of a knights choice of a single love object, as in the choice of a single rose in a garden of beautiful blooms. Lewis goes on to explore the difference between sacred and profane love: the Christian love of agape, with its self-sacricial, non-judgemental ideal of universal respect, as opposed to the erotic romantic ideal of exclusive, self-interested possession. Yet, understandings of love and relationships alter with the wheel of history. How different Prof. Terry Eagletons secular version of agape, severed from its religious origins, as the capacity to allow others to ourish, expounded in his book The Meaning of Life (2007). How different again, from the romantic tradition traced by Lewis, is the version of romantic love promoted by sociologist Prof. Anthony Giddens. In his notable essay Transformation of Intimacy (1993), he argues that modern notions of romantic love stem from the kinds of novels that became popular in the 18th and 19th centuries, eventually shaping the romantic themes of 20th century movies and TV soaps. These narratives, he maintains, brought external pressures to bear on the formation and maintenance of love bonds. With the breakdown of religion, however, feminism and the availability of contraception and easy divorce, romantic lovehe maintains has been shaped increasingly and narrowly by the emotions of the two people concerned. In the familiar parlance of the post-modern sociologist, Giddens asserts that lovers today behave as aneurs, their commitment lasting as long as the feelings or the rewards. Hence commitment, Giddens notes, becomes a scarce virtue, yet we have gained by what he calls the democratization of love. Such a viewlove as a serendipitous individual emotion, uncomplicated by social, familial, imaginative, religious or cultural forcesmay well make life simpler for neuroscientists seeking simple correlates by rounding up the usual hormonal suspects. Yet for one highly cultural and literary scientist, the task of dening love and its probable brain correlates are by no means uncomplicated, reductive tasks. Semir Zekis courageous and carefully considered book Splendours and Miseries of the Brain starts out by accepting the existence of a repertoire of differences between notions of love. He grants that we have an inherited concept of what love should be, as well as an acquired one that might be different from the former. He concedes, moreover, that the troubadour concept of love is perhaps a little different from that prevalent in Elizabethan England. It is obvious, he goes on, that the sort of person that one might want, love at one stage in ones life, might be different from the sort of person one may

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Book Review experience as it is in romantic love. He maintains, moreover, that there are even coincidences between mystical states and sexual orgasm, using as his exemplar not only the writings of Teresa of Avila but Berninis notorious statue in RomeThe Ecstasy of Saint Teresa, the great saint looking for all the world as if she is in an erotic delirium. Zekis book is wide in its sympathies and sources, and it deserves attention as part of a fascinating enquiry set to continue for many years to come. Where it suffers, in my view, is in the failure to teach differences in elds where he betrays less insight perhaps than in his chosen scientic expertise. Apart from the fact that the Ecstasy is a pure Bernini fantasy, the case he makes on the basis of the writings of Bernard and Teresa illustrates these difculties. In the realms of mystical theology, the kinds of contemplative prayer experienced by these two prolic writers have been long recognized as exceptional rather than the norm he assumes. In fact, there are whole libraries of ascetical and mystical theology counselling precisely against the orid ways of prayer practiced by the sublimated eroticism of a Teresa and John of the cross who routinely employed profane love metaphors to explicate the ineffable and the sublime. This brings me to a general weakness pervading neurobiological explanations of complex human behaviour: namely, a failure to address the nature and power of imagination as the fundamental impetus of human relationships. Does the imagination reside and reign in the brain, or does it reside, as Wittgenstein argued on the surface of our faces, in the light of our eyes, in the resonance of our voices lipsin other words, in the world in which we live and have our being? As John Henry Newman puts it: The heart is commonly reached . . . through the imagination, by means of direct impressions, by the testimony of facts and events, by history, by description. Persons inuence us, voices melt us, looks subdue us, deeds iname us. The chemistry, then, is subsidiary to imagination as the molecules of paint on canvas are subsidiary to a painting. The neglect of imagination in any discussion of powerful human emotions, such as love, is as much a failure in the realms of the humanities as it is within psychology and neurobiology. Under the inuence of literary theory, of the kind expounded by Jacques Derrida, emanating from France in the early 1970s, the death of the imagination was condently announced as a new form of enlightenment in which the author became no more than a series of multiple drafts. The rich critical commentaries on imaginative literature and the faculties of imagination, running from the 18th century down to I.A. Richards and Frank Kermode in the 1960s, were discarded in the mania for critical deconstruction. By the 1980s, neuroscientically informed philosophers-of-mind, such as Prof. Dan Dennett, were following the lead of the literary theorists, the neuroscientists and articial intelligence specialists in localizing, mechanizing and explaining the mindbrain relationshipnot least consciousness. Hence, Stephen Pinkers latest book on metaphor and the imagination, The Stuff of Thought, could traverse 500 pages without quoting a single poet, save Shakespeare ironically, or critic of imagination of the past 200 years. What is the need of aesthetics when the mindbrain works like a computer? What is the need of mystical theology when one can localize and identify ecstasies, sacred and

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profane, with the release of neurotransmitter substances? Which leads us to a matter of increasing interest in the question of pharmaceutical enhancements and procurable emotionsa modern day version perhaps of the Tristram and Iseult story. An example of Zekis neglect of wider differences in mystical experiences is illustrated by a correspondence from the 1950s between the American writer on mystical prayer, Thomas Merton, and Aldous Huxley who believed that mystical states could be procured by drugs such as mescaline. Conversely, Merton held that authentic states of love and mysticism cannot be procured for one very profound reason: What I would call a supernatural and mystical experience . . . has in its very essence some note of a direct spiritual contact of two liberties, a kind of ash or spark which ignites an intuiton . . . plus something much more which I can only describe as personal, in which God is known not as an object or as Him up there or Him in everything nor as the All but as the Biblical expression I AM, or simply AM . . . this is not the kind of intuition that smacks of anything procurable because it is a presence of a Person and depends on the liberty of that Person. This is a far cry from Zekis sense of love, sacred or profane, as a loss or annihilation of self in unity with the love object. It is about the preservation of personal integrity in a loving relationship, and an act of choice on the part of both independent parties. The unprocurable aspect of mystical experience, and indeed love, is perhaps less relevant to Zekis scheme of things than to a curious collection of autobiographical essays on treatments for mental illness and the creative process, titled Poets on Prozac (edited by Richard M. Berlin). The 16 poets featured here hardly amount to an organized thesis on the topic, but the contributors are united in their insistence that being traumatized, depressed or psychoactive, is emphatically no aid to artistic creativity. So if treatment is on offer, take it! There are two problems with this kind of exercise. The rst is to do with the importance of life experience in artistic achievement, including experience of darkness. Should the traumas of life out of which great literature has emerged be medicalized as suitable for treatment; or regarded as a natural and necessary condition of the work? Dostoyevsky suffered the loss of both parents (it is believed that his father was murdered) and in his thirties he spent 5 years in prison, including several months on death row, and 4 years as a convict in a labour camp. He was an epileptic, a state of mental health not helped by being subjected to a mock execution, facing a ring squad from which he was reprieved at the last moment. Clearly, there is a profound link between his great novels and his experience. It is widely accepted, moreover, that the form of epilepsy he suffered aided an extraordinary capacity for making imaginative connections. Whether his writing would have beneted from psychotropic medicine or anti-depressants is perhaps unknown and unknowable; but it seems doubtful. The poet informants of this collection, however, all regard themselves as somehow recovering, medically, from experiences they would rather have not endured. Jesse Milne, for example,

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Book Review of verbal excess. Still there was that obsessive drive for perfection with each additional revision. I suppose Eppolita is right; up to a point good poetry is economical. As Aristotle puts it, the right words in the right place. Yet surely one would not describe a poem like Paradise Lost as thinmore like a wide and endless stair carpet. But the real question is whether Eppolitas poetry is any good, and I have to confess that I rather liked it if for no other reason than it was indeed extremely, thinly, brief. One supposes that it is possible that a depressive person might decline treatment in the belief that it would ruin their writing talent. But those who have suffered serious depression consistently conrm that any treatment promising relief is better than none. My late friend, Prof. Stuart Sutherland, author of Breakdown, used to say that, offered the choice between cancer and depression, he would take the cancer. The contributors to this collection generally concur. And while many of them confess to having taken drugs or alcohol in the past, they see their medication, and talk-therapy as a means of achieving a state of mood and health approximating normality. And that teaches us the difference between taking Prozac for therapy, and taking Prozac as a means of procuring literary talent. John Cornwell Jesus College, Cambridge Advance Access publication September 8, 2009

reports her sense of guilt as a bad Baptist kid, her shame over a failed rst marriage, her resort to alcohol abuse with more concomitant guilt, followed, nally by this: I feel guilty for taking Prozac, which seems to be helping but feels like cheating. What is important in this dreary catalogue is that being lifted from depression through talk-therapy and an ever popular selective serotonin re-uptake inhibitor has enabled her to write. I began seeing a therapist last spring. And in May, at a writing residency in Wyoming, the darkness began to lift. One can only hope that her depression stays lifted and that she keeps writing. But is there not a difference between writing as therapy and writing as art? Again, the issue of imagination arises. Dostoyevskys novels were not so much a kind of therapy for his various traumas, as the exercise of a unique, dynamic imagination, creating a world with its own internal, artistic integrity. One of the strangest, and most original, contributions to the collection is by Caterina Eppolita, a recovering anorexic, who manages to see poetry itself as a form of medicalized syndrome: Poetic form is an anorexic form of writing. Literally, poetry is the thinnest form of writing. Poetry is so thin that by its very denition it cannot t across the page. So instead of restricting calories, I was restricting words. Instead of controlling what was left on my plate, I was controlling what was left on the page. Instead of spending hours trying to rid myself of extra food, I was spending hours ddling with words trying to rid myself

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