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The Pathologization of Excitement

2011 Romesh Senewiratne (MD)

In this era of mass-media advertising and Hollywood Blockbusters, the term

excitement is popularly used in a positive way. We are exhorted to watch the
newest exciting movie, buy an exciting new (or old) house or car, and travel to
exotic, exciting destinations where we get to enjoy exciting foods, wines and
entertainments. People, especially young people, delight in exciting music.
Advertisements for the newest technological toys, and even the drabbest of
political figures, stress how exciting the future will be if we consumers make
the right choice. People like feeling excited, and advertisers have long known
this.
But the word excitement has a dark history when it comes to medical use of
the term, and even today excitement is measured as a sign of mental illness
according to psychological rating scales which continue to pathologise this
enjoyable emotion.
The physiology of excitement has been studied scientifically using a range of
methods over the past century. The thousands of published studies about
excitement, though, interpret the word excitement in different ways a few
mean positive emotions, many more infer negative emotions (including rage
and terror), while some physiologists and psychologists assume excitement to
mean sexual excitement in addition to fear and anger. Much neurobiological
use of the term excitement through the twentieth century was unrelated to
emotion as such. Neuroscientists wrote about their observations of exciting
nerves or localised areas of the brain with electrodes, in mice and men. Passing
an electric current directly into the brain, sufficient to cause nerve cells to fire
electrical pulses of their own, and observing motor, sensory and physiological
responses (such as blood pressure, heart rate and sweating) was a mainstay of
experimental neuroscience throughout the twentieth century. During this time
the popularity of passing large electrical currents through the whole brain
(sufficient to cause convulsions) promoted as a treatment for manic
excitement as well as depression and schizophrenia rose and fell.
The physiology and biochemistry, and the neural circuits involved in rage and
terror (and their milder forms, anger and fear) have been researched
intensively by universities around the world since before the First World War,

with major injections of funding into the study of rage, terror and other
nervous excitements during the Second World War and Cold War. The
principle means of study, including experiments that established many
enduring doctrines in medical and physiological science (including some factual
ones), involved creating these emotions deliberately in cats, dogs, monkeys
and apes. In a misguided line of inquiry spearheaded by Harvard Universitys
Professor Walter Cannon and his junior associate Philip Bard during and after
the First World War (1914-1918), bigger and bigger chunks of the brains of cats
were removed, while continuing to provoke the animals in increasingly cruel
but meticulously calculated ways.
Bard, who is credited with formulating, with his mentor, the Cannon-Bard
theory of emotion, proudly described, in his 1942 paper Neural Mechanisms in
Emotional and Sexual Behavior how he had been able to keep decerebrate
cats alive for several months. These were cats in which the entire cerebral
hemispheres had been surgically removed:
Recently M.B.Macht and I have been able to maintain for long periods
of time, i.e., up to periods of over 3 months, decerebrate animals in
which the remaining parts of the central nervous system are: spinal cord,
medulla, cerebellum, and various portions of the mid-brain. (Bard,
1942)
To the surprise of the mutilators, not much brain needed to be left behind for
cats to continue to show rage when they are subjected to threat or pain.
Thinking this could not be real emotion, Cannon, Bard and the many
thousands of researchers who embarked on further mutilations of cats and,
later, monkeys, apes and humans, termed the hissing, back-arching, toothbaring behaviour they provoked in these poor cats sham rage.

The physiology of excitement

During the First World War, the ironically named Professor Cannon coined the
phrase flight or fight to describe activity of the sympathetic nervous system,
while the parasympathetic nervous system was responsible for rest and
digest. The first of these phrases, more so than the second, caught on, and
became a core doctrine of neurophysiology. Schoolchildren learn about fight
or flight, and the phrase is commonly bandied about in the media.
The reasons Walter Cannons phrases have seen such popularity is because, for

one thing, they have catchy rhymes and describe the relationship between the
two branches of the autonomic nervous system reasonably well. Activity in the
sympathetic nervous system stimulates the heart, raises blood pressure and
heart rate and contractility, diverts blood to the muscles and brain and away
from the digestive tract, dilates the small airways in the lungs (allowing more
oxygen to enter the blood) while the pupil of the eye dilates, allowing more
light into the eye. These are clearly adaptations to danger and characteristic
physiological responses to fear (flight) and anger (fight).
A serious limitation of this model is that activity of the sympathetic nervous
system (SNS) and the catecholamine neurotransmitter molecules it synthesises
and releases have essential functions that have little to do with anger or fear
and less to do with fighting or running away. This function might reasonably be
described as activation, meaning both physical and mental activation.

Of course the parasympathetic nervous system is also involved in activation

of the salivary and other digestive glands, of the involuntary muscles in the
lungs and elsewhere, and the neurotransmitter released from its synapses,
acetyl choline, is one of several (usually) stimulatory transmitters. Having said
that, the sympathetic nervous system plays a more obvious role in mental
excitement and preparation of the muscles for action.
Walter Cannon spent his working life at Harvard University, doing research at
the Department of Physiology from 1900 till his retirement in 1942 (during the
Second World War). His position as Professor and Chairman of the Department
of Physiology at Harvard Medical School (since 1906) helped make his phrases
fight or flight and rest and digest famous around the world, but it is less
often taught to medical students as to what the nature of his research was.
What his techniques were, what animals he experimented on, or how and why
he conducted the particular experiments he performed.
The title of the book in which he coined the phrase fight and flight gives a
good idea of where Cannons interests lay, in terms of human and animal
emotions: Pain, Hunger, Fear and Rage: An Account of Recent Researches into
the Function of Emotional Excitement. It is clear that what the eminent
physiology professor meant by emotional excitement is not what the
advertisers are trying to induce with their slick photos of new cars, elegant
perfume bottles, exotically-named confectionaries and travel destinations. He
was not talking about the excitement of love or of new discoveries or insights.

No, Walter Cannon, seen in this portrait, had a grim

view of what it means to be excited the unpleasant
emotions of pain, hunger, fear and rage.

Professor Cannon studied thirst, as well. An example of

his style of research was his investigation of the Dry
Mouth Hypothesis he had put forward that people
get thirsty because their mouths get dry and not
because they are not getting enough hydration (in real
life people do get dry mouths when they are dehydrated, though there are
other reasons). To investigate his hypothesis, Cannon slit the throats of
experimental dogs and inserted a tube that collected the water they drank
before it got to the stomach. The physiology professor reported that these
dogs drank the same amount of water as control dogs that had not been
mutilated in this way. Thus Cannon proved his own hypothesis at the Harvard
University School of Medicine, at least to his own satisfaction.
The Cannon-Bard Theory of Emotion, was developed at Harvard as an
alternative to the counter-intuitive James-Lange theory, which had
dominated American psychological doctrine about emotions since it was
proposed by the famously neurotic philosopher and psychologist William
James (1842-1910) in the 1880s. When, in 1900, Walter Cannon was first
employed in a junior position at Harvards department of physiology, William
James had been an icon of the university for many years credited by his many
admirers as the Father of American Psychology. James had argued, based on
introspection of his own emotions, that our natural way of thinking that the
emotion precedes the bodily expression of that emotion is incorrect. In his
analysis the emotion followed the bodily changes mediated by the autonomic
nervous system. Rather than running away after seeing a bear and feeling
afraid, according to the James-Lange theory, we feel afraid because we run
away. Likewise we feel sad because we cry, rather than the intuitive idea that
we cry because we feel the emotion of sadness.
As it turns out, recent neurophysiological studies much more sophisticated
than Cannons mutilations of dogs and cats have shown manifold flaws in both
the James-Lange and Cannon-Bard hypotheses. These studies have also
exposed problems with the influential model of the anatomist James Papez
(1883-1958) which had become a core doctrine in late twentieth-century
neuroscience.

The Papez Circuit, usually taught as synonymous with the Limbic System was
declared, in textbooks and other medical literature to be the neural substrate
of emotions or, less pretentiously, the emotional circuits of the brain. Not
surprisingly, given his modus operandi, the ring of structures in the core of the
brain Papez identified in his 1937 paper A Proposed Mechanism of Emotion
tells us more about the spread of rabies in the brains of cats than what moves
us when we gaze in delight at a beautiful sunset or the eyes of someone we
love.
James Papez adopted Walter Cannons general approach to the scientific study
of the emotions, with some hideous innovations of his own. At Cornell
University in Ithaca, New York, he mapped out what he regarded as the
emotional circuit in mammalian brains by injecting the deadly virus rabies into
the brains of cats.
Papez was careful about his technique, but typically
insensitive to the suffering of animals. He injected the
virus specifically into the hippocampus, deep within the
temporal lobes. He then carefully observed the effects of
the deadly virus on the cats by sacrificing them at
critical times on their journey towards paralysis and
death, and looking for the presence of Negri Bodies in
the brains of the killed cats. These are pigmented
James Papez
pathological abnormalities that are characteristic of
rabies infection in the brain.

The problem is, what has been researched as excitement has usually meant
those emotions that stimulate the fight or flight response in animals fear
and anger, their intense forms, terror and rage and chronic states, anxiety and
aggression. Little attention has been paid to the more positive aspects of
excitement and related mental processes (including emotions). When such
enjoyable emotional states develop, the thinking and behaviour of the
affected person fulfils textbook criteria for diagnosis of mental illness
specifically the serious psychotic disorder known as mania and the less
serious, non-psychotic mental state termed hypomania . Despite abundant
evidence to the contrary from cognitive neuroscience (let alone
commonsense) it is maintained by the more hardline members of the

psychiatry profession that hypomania inevitably leads to mania if untreated.

Treatment, in this instance, means drug treatment with the toxic drug lithium
and/or equally toxic dopamine-blocking and serotonin-blocking drugs (socalled antipsychotics).
Meanwhile, the advertisers continue to promote excitement as a desirable
mental state, ignorant of the fact that their excited consumers may end up in
mental hospitals being treated for this positive mental state.

REFERENCES:
Bard, P. (1942) Neural Mechanisms in Emotional and Sexual Behavior.
Psychosomatic Medicine, volume 4, pp171-172
Cannon, W. (1915) Pain, Hunger, Fear and Rage: An account of recent
researches into the Function of Emotional Excitement. D. Appleton and
Company: USA
James, W. (1884) What is an Emotion? Mind, volume 9, no. 34, pp188-205
Papez, J. (1937) A Proposed Mechanism of Emotion. Archives of Neurology and
Psychiatry, volume 38, no.4, pp725-743