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MIND-ALTERING MEDICINE Robert Julien, M.D., did not choose a typical 9-to-5 job. His profession involves paralyzing people, interfering with their memory formation, and numbing their senses—but only temporarily. Dr. Julien is an anesthesiologist, a medical doctor whose primary responsibility is to monitor a patient’s vital functions (for example, respiration and pulse) and manage pain before, during, and after surgery. With the help of powerful drugs that manipulate the nervous system, Dr. Julien has eased the pain and anxiety of over 30,000 patients undergoing procedures that otherwise could have been very unpleasant.

In ancient times, people may have sought pain relief by dipping their wounds in cold rivers and streams. They concocted mixtures of crushed roots, barks, herbs, fruits, and flowers to ease pain and induce sleep in surgical patients (Keys, 1945). Many of the plant chemicals discovered by these early peoples are still given to patients today, although in slightly different forms. Opium was used by the ancient Egyptians (El Ansary, Steigerwald, & Esser, 2003), and its chemical relatives are used by modern-day physicians and hospitals all over the world (for example, morphine for pain relief and codeine for cough suppression).

Nevertheless, it took many centuries for anesthesia to become a regular part of surgery. Before the mid-1800s, surgery was so painful that patients writhed and screamed on operating tables, sometimes held down by four or five people (Bynum, 2007). During the Mexican-American War, a band would play when Mexican soldiers had their limbs amputated so the men’s cries would not be heard by others (Aldrete, Marron, & Wright, 1984). The only anesthetic available may have been whiskey, wine, or a firm blow to the head that literally knocked the patient out. Fortunately, the science of anesthesia has come a long way. It is now possible to have a tooth extracted or a mole removed without a twinge of discomfort. A patient undergoing open heart surgery can lie peacefully as surgeons pry open his chest and poke around with their instruments, then leave the hospital with no memory of the actual operation. But anesthesia is a curious thing. Drugs used to ease pain and anxiety also influence sensations, perceptions, and one’s awareness of self and the environment: They can dramatically alter “conscious” experiences.

Note: Unless otherwise specified, quotations attributed to Dr. Robert Julien and Matt Utesch are personal communications.

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LO 1 Define consciousness.

Consciousness is a concept that can be difficult to pinpoint. Psychologist G. William Farthing offers a good starting point: Consciousness is “the subjective state of being currently aware of something either within oneself or outside of oneself” (1992, p. 6). Consciousness is best defined as the state of being aware of oneself, one’s thoughts, and/or the environment. According to this definition of subjective awareness, one can be asleep and still be aware (Farthing, 1992). Consider this example: You are dreaming about a siren blaring and you wake up to discover it is your alarm clock; you were clearly asleep but aware at the same time, as the sound registered in your brain. This ability to remain aware while asleep was especially useful for our primitive ancestors, who needed to be vigilant about dangers day and night.

Several years ago, Dr. Julien had a patient who didn’t want to have general anesthesia during her hysterectomy, an operation to remove the uterus. Anesthesiologists typically put patients “to sleep” for hysterectomies, but Dr. Julien agreed to honor the patient’s unusual request. He gave her a drug called Versed (midazolam) to help her relax, but not enough to knock her out. (Versed belongs to a class of calming drugs called depressants, which you will learn about later.) The woman seemed to be wide awake throughout the 2¹/₂-hour procedure, chatting with doctors and nurses and even requesting that certain music be played in the operating room (much to the dismay of the surgical team).

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At 11:00 P.M. that night, a nurse called Dr. Julien saying the patient was furious that he had used general anesthesia during the operation (which he had not done). The drug Dr. Julien had used to help the patient relax can also cause memory loss for events experienced while under its influence. Unable to remember the surgery, the patient logically assumed she had been given general anesthesia. “I went to the hospital at midnight to explain to the patient that I had honored her request and that she had been wide awake during the procedure but was unable to form memory proteins because the Versed had blocked their formation,” Dr. Julien explained. In other words, the Versed had interfered with the production of a protein needed for memory creation. “To this day, I’m not sure she ever accepted my explanation or forgave me for taking away any memory of the procedure” (Julien & DiCecco, 2010, p. 11).

Would you say Dr. Julien’s patient was conscious during the operation? If consciousness is a “subjective state of being currently aware” (Farthing, 1992, p. 6), then it would appear she was conscious during the surgery. She was alert and talking, yet her awareness of the event vanished within hours. Was this a problem with her consciousness or her memory? Although memory plays an important role in conscious processes, it is not equivalent to consciousness. The patient appeared to be “aware” during the procedure, but later had no memory of the event. As Dr. Julien explained to her, a failure occurred in the process involved in memory formation, perhaps in the encoding or storage of the event (Chapter 6).

Millions of Americans suffer from memory problems similar to that experienced by Dr. Julien’s patient. They are aware, alert, and able to have meaningful conversations, yet they cannot form new memories because they suffer from Alzheimer’s (Chapter 6) or another form of dementia. There are also people who cannot form memories because they are taking consciousness-altering drugs. In very rare cases, people taking certain types of prescription sleeping pills have been known to “sleep drive,” or get behind the wheel in a trancelike state (Dolder & Nelson, 2008; Southworth, Kortepeter, & Hughes, 2008; Zammit, 2009).

The field of psychology began with the study of consciousness. Wilhelm Wundt and his disciple Edward Titchener founded psychology as a science based on exploring consciousness and its contents. Another early psychologist, William James, regarded consciousness as a “stream” that provides a sense of day-to-day continuity (James, 1890/1983). Think about how this “river” of thoughts is constantly rushing through your head. An e-mail from an old friend appears in your inbox, jogging your memory of the birthday party she threw last month, and that reminds you that tomorrow is your mother’s birthday (better not forget that one), and you need to swing by the store to pick up a gift. You notice your shoe is untied, think about school starting tomorrow, and remember the utility bill sitting on the counter, all within a matter of seconds. Thoughts interweave and overtake each other like currents of flowing water; sometimes they are connected by topic, emotion, events, but other times they don’t seem to be connected by anything other than your stream of consciousness.

Although psychology started with the introspective study of consciousness, American psychologists John Watson, B. F. Skinner, and other behaviorists insisted that the science of psychology should restrict itself to the study of observable behaviors. This attitude persisted until the 1950s and 1960s, when psychology underwent a revolution of sorts. Researchers began to direct their focus back on the unseen mechanisms of the mind. Cognitive psychology, the scientific study of conscious processes such as thinking, problem solving, and language, emerged as a major subfield. Today, understanding consciousness is an important goal of psychology, and many believe science can be used to investigate its mysteries.

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Advanced technology for examining brain processes and functions has added to our growing knowledge of consciousness, but barriers to studying it remain. One is that consciousness is subjective, pertaining only to the individual who experiences it. Thus, it is impossible to objectively study another’s conscious experience (Blackmore, 2005; Farthing, 1992). To make matters more complicated, one’s consciousness changes from moment to moment. Right now you are concentrating on these words, but in a few seconds you might be thinking of something else or slip into light sleep. In spite of these challenges, researchers around the world are inching closer to understanding consciousness by studying it from many perspectives. Welcome to the world of consciousness and its many shades of gray.

There are many elements of conscious experience, including desire, thought, language, sensation, perception, knowledge of self, and of course memory, as conscious experiences usually involve the retrieval of memories. Simply stated, any cognitive process is potentially a part of your conscious experience. Let’s look at what this means, for example, when you go shopping on the Internet. Your ability to navigate from page to page hinges on your recognition of visual images (Is that the PayPal home page or my e-mail log-in?), language aptitude (for reading), and motor skills (for typing and clicking). While browsing products, you access various memories (which link you just clicked, the shoes you saw last week, and so on)—all of this is part of your consciousness, your stream of thought.

LO 2 Explain how automatic processing relates to consciousness.

AUTOMATIC PROCESSING In describing consciousness, psychologists often distinguish between cognitive processes that occur automatically (without effort, awareness, or control) and cognitive activity that requires us to focus our attention on specific sensory input (with effort and awareness, we choose what to attend to and where to direct our focus). Our sensory systems absorb an enormous amount of information, and the brain must sift through this data and determine what is important and needs immediate attention, what can be ignored, and what can be processed and stored for later use. This automatic processing allows information to be collected and saved (at least temporarily) with little or no conscious effort (McCarthy & Skowronski, 2011; Schmidt-Daffy, 2011). Without automatic processing, we would be overwhelmed with data. Just imagine having to manage your brain’s behind-the-scenes responsibilities (for example, keeping track of your heart rate or filtering unimportant noises) while taking a psychology midterm exam.

Automatic processing can also refer to the involuntary cognitive activity guiding some behaviors. We are seemingly able to behave and act without focusing our attention. Behaviors seem to occur without intentional awareness, and without getting in the way of our other activities (Hassin, Bargh, & Zimerman, 2009). Do you remember the last time you drove your car on a familiar route, daydreaming the entire time? Somehow you arrived at your destination without noticing much about your driving, the traffic, and so forth. Or have you ever been listening to music while cleaning the kitchen, and then realized you were almost finished without once being aware that you had scrubbed the countertop or mopped the floor? You were conscious enough to complete complex tasks, but not enough to realize that you were doing so.

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Although unconscious processes direct various behaviors, we can also make conscious decisions about where to focus our attention. While walking to class you might focus intently on a conversation you just had with your friend or an exam you will take in an hour. With this type of conscious activity, we deliberately channel or direct our attention.

LO 3 Describe how we narrow our focus through selective attention.

SELECTIVE ATTENTION Although we have access to a vast amount of information in our internal and external environments, we can only focus our attention on a small portion at one time. This narrow focus on specific stimuli is known as selective attention. Talking to someone in a crowded room, you are able to block out the chatter and noise around you and immerse yourself in the conversation. This efficient use of selective attention is known as the cocktail-party effect (Koch, Lawo, Fels, & Vorländer, 2011). Studies suggest selective attention can be influenced by emotions. Anger, for example, increases our ability to selectively attend to something or someone (Finucane, 2011). So too does repeated exposure to important stimuli (Brascamp, Blake, & Kristjánsson, 2011). We also get better at ignoring distractions as we age (Couperus, 2011).

This doesn’t mean other information goes undetected (remember we are constantly gathering data through automatic processing). Our tendency is to adapt to continuous input, and ignore the unimportant sensory stimuli that bombard us every moment. We are designed to pay attention to abrupt, unexpected changes in the environment, and to stimuli that are unfamiliar or especially strong (Bahrick & Newell, 2008; Daffner et al., 2007; Parmentier & Andrés, 2010). Imagine you are studying in a busy courtyard. You are aware the environment is bustling with activity, but you fail to pay attention to every person—until something changes (someone yells, for example). Then your attention might be directed to that novelty.

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INATTENTIONAL BLINDNESS Selective attention is great if you need to study for a psychology test while others are watching a movie, but it can also be dangerous. Suppose a friend sends you a hilarious text message while you are walking toward a busy intersection. Thinking about the text can momentarily steal your attention away from signs of danger, like a car turning right on red without stopping. While distracted by the text message, you might step into the intersection—without seeing the car turning in your path. This “looking without seeing” is referred to as inattentional blindness, and it can have serious consequences (Mack, 2003).

Ulric Neisser illustrated just how blind we can be to objects directly in our line of vision. In one of his studies, participants were instructed to watch a video of men passing a basketball from one person to another (Neisser, 1979; Neisser & Becklen, 1975). As the participants diligently followed the basketball with their eyes, counting each pass, a partially transparent woman holding an umbrella was superimposed walking across the basketball court. Only 21% of the participants even noticed the woman (Most et al., 2001; Simons, 2010); the others had been too fixated on counting the basketball passes to see her (Mack, 2003).

LEVELS OF CONSCIOUSNESS People often equate consciousness with being awake and alert, and unconsciousness with being passed out or comatose. But the distinction is not so clear, because there are different levels of conscious awareness including wakefulness, sleepiness, drug-induced states, dreaming, hypnotic states, and meditative states, to name but a few. One way to define these levels of consciousness is to determine how much control you have over your awareness. A high level of awareness might occur when you focus intensely on a task (using a sharp knife); a lower level might occur as you daydream, although you are able to snap out of it as needed. Sometimes we can identify an agent that causes a change in the level or state of consciousness. Psychologists typically delineate between waking consciousness and altered states of consciousness that may result from drugs, alcohol, or hypnosis—all topics covered in this chapter.

Wherever your attention is focused at this moment, that is your conscious experience—but there are times when attention essentially shuts down. What’s going on when we lie in bed motionless, lost in a peaceful slumber? Sleep, fascinating sleep, is the subject of our next section.

Question 1

Question 2

1. consciousness

2. automatic processing

3. depressants

4. encoding

Question 3