Aphantasia?

We are a culture of categorists. Slotists. Namists. It is a society of Nomino, ergo sum. It’s as if we can sleep more securely knowing we have named and categorized everything we have seen that day –no matter how bizarre, no matter how unimportant. No matter, even, how mistaken the belief that by so doing, we have added something of substance to the world at large. I suppose what concerns me, though, is when to stop the naming? How finely do we divide the gradations before asking if we are really labelling something different?

And, does the act of naming something reify it –make it a real thing, in other words? Or does it merely select it from an otherwise amorphous background where it existed all along? Or, to identify yet another permutation, is it more like taking a shape, say, from a Rorschach ink blot and privileging one interpretation as gospel?

We are all different in many ways –some, interestingly so, others not as noticeably until pointed out by otherwise underemployed taxonomists. I accept this, but still question whether each variation from a norm is deserving of a separate name. Might we put ourselves in greater danger of muddying the water the more we stir it? Losing what we could previously identify in its depths? And for what? Are there really ‘more things in heaven and earth, Horatio, than are dreamt of in your philosophy? as Hamlet might have asked – More things requiring unique and quirky names?

So, what provoked this mini Jeremiad? Well, I suppose I am as much to blame as the taxonomists in my relentless search for novelty. As I poked and prodded my way through –what else?- the BBC News app, I came across an article on Aphantasia. http://www.bbc.com/news/health-34039054 At first, I wondered if it was a reminiscence about that Disney film which was set to classical music. I was about to scroll past it, but the ‘Ph’ spelling aroused my etymological curiosity.

It turns out that Aphantasia is a neologism that borrows from both Greek and Latin roots: a –meaning ‘without’, and phantasia –meaning ‘image’, or even ‘a making visible’. It refers to the inability to produce a voluntary mental image of something when it is not actually present. So remembering a mental picture of a face might be a problem for someone with aphantasia, although they would still be able to remember non-visible facts about the face –things that stood out, perhaps, like a large nose or a patch over an eye… Attributes, not images.

It may well be a spectrum of loss, however, as Professor Zeman, at the University of Exeter, points out in his study: ‘..the majority of participants described involuntary imagery. This could occur during wakefulness, usually in the form of ‘flashes’ (10/21) and/or during dreams.’ http://medicine.exeter.ac.uk/media/universityofexeter/medicalschool/research/neuroscience/docs/theeyesmind/Lives_without_imagery.pdf  I find this interesting; their capacity to form the internal visual memories is not lost apparently –more the ability to retrieve them at will.

But the very acknowledgement –and naming– of this edge of the normative Bell curve set the neuroscientists scurrying to find its other perimeter and they found it: hyperphantasia –perhaps more easily described as hyper-imagination. I have less faith in this category as a distinct entity, though –I would suspect it wanders terribly close to the edge of more classically defined psychopathology, as in the outer border of bipolar disease, for example, or the imaginative excesses often found in schizophrenia.

So, what has this study purported to identify? Boundaries. After all, up to a certain point, we classify difference as merely a variation from the mean –a quirk of behaviour. A nuance, not an epiphany. And yet boundaries are slippery and once determined, are heavily scented with unintended consequences. As the BBC article pointed out, ‘One person who took part in a study into aphantasia said he had started to feel “isolated” and “alone” after discovering that other people could see images in their heads.’ After all, a boundary had obviously not existed until it had been defined, and then, sadly, the person found that he was on the wrong side of it. What is normal and unremarkable to one, is alien, or at least unexpected for another.

But all of us are on one side or another of some line, aren’t we? Our very uniqueness requires it. It is something to celebrate, something to admire. And yet, not to appear unduly Cassandroid, there are dangers in names –in difference– unless Society learns to honour the mosaic. Cherish it for the montage it weaves into our cultural fabric. Accept the ever changing clothes despite any unwanted flesh it may expose.

I may sound like I’m against the free and unexpurgated pursuit of scientific curiosity -I’m not. Against the inductive method of interrogating nature -again, I’m not. Nor am I content to drift with the tide, happy to land wherever wind and water direct. But curiosity is a watchful cat that lurks in our shadows with hungry eyes and eager claws. It needs to be fed and nurtured constantly, but sometimes carefully. Respectfully.

Pregnancy Stress

Curiosity is a curse sometimes. It strikes in the most unusual circumstances and often with little warning. Some little thing will set it off and bang, you’re hooked. I’m an obstetrician, so procreative issues are constantly surfacing in my life. Environmental stressors and reproductive failure also seem to be de rigeur in the social media nowadays so there’s no escaping it. The worry may have started with animal data -animals are the easiest to study so we often look at what evidence they provide and then extrapolate. I’m thinking of those dark mysterious star-filled nights at summer camp when there is howling in the distance, and everybody huddles together with questions.

And worst of all are those important things that don’t have ready answers, or the answers have different explanations each time you look for them. Different causes. The secondary sex ratio has always been that type of enigma for me: why isn’t the ratio exactly 1:1 in humans? Well, first of all, some definitions. The primary sex ratio is the ratio between the sexes at fertilization, and the secondary sex ratio is their ratio at birth. There’s even a tertiary ratio -the sex difference in mature organisms.

In the past, the gender ratio at conception was unknowable, so the only useful ratio was the one at birth -and that seemed to favour males (1.1 males for every 1.0 female). So did that mean that male sperm somehow outswam the female ones or damaged them on the way to the egg? Did it speak to the quality of the gametes or merely suggest that to balance tertiary sex ratios (the ratio in sexually mature organisms, remember) more males were needed because, unlike females, they were less able to make it through childhood..? Until recently, as I mentioned, there was no way to measure the primary sex ratio, so it remained a mystery. Now it seems there is, and, surprise surprise, there would appear to be an equality of sexes -at conception at least: http://www.pnas.org/content/112/16/E2102.full.pdf  This fascinating study tracks gendered mortality during development in the uterus. There is a theory (the Trivers-Willard hypothesis) which posits that more males are born in a favourable environment and more females in an unfavourable one because just one sex will be better at ultimate reproduction under those differing conditions.

So what conditions might effect the secondary sex ratio? Well, amongst other things, there is some evidence that major stressors may influence it. Large disasters have certainly been implicated -earthquakes, for example: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881738/  And then, of course, there were the changes in secondary sex ratio immediately after the 9/11 World Trade Center attack in 2001… One explanation that has been offered to explain how this could occur is that males typically attain a critical fetal weight earlier than do females (the average weight of newborn males, for example, is ∼100 g greater than females) and this might exert a higher metabolic demand on mothers. So, depending on the gestational age and the extent of the stress, the mothers may be able to abort the male fetuses, but maintain the less physiologically demanding female ones. In other words, evolution would seem to have selected for those females that can regulate the sex of their offspring… Really?

That explanation seems rather contrived to me. Exactly how would the mother accomplish this feticide? And avoiding direct maternal involvement by referring it back to changes in placental function merely pushes the question back another layer. Of course, some have tried other approaches -for example citing the epigenetic environment (factors influencing the functionality of genes): http://humrep.oxfordjournals.org/content/20/9/2662.full But even when I force myself through the commentator’s words, the explanation still seems a little strained.

And yet, statistically, there does seem to be reason to believe that something is happening that relates to stress.

Of course pregnancy itself is a stress -levels of stress hormones increase as pregnancy unfolds: (http://www.jogc.ca/abstracts/full/201505_Editorial_1.pdf) -although, as the editorialist explains, ‘as a pregnant woman approaches term, environmental stress has less effect in triggering the usual response in the hypothalamic-pituitary-adrenal axis, and she becomes less responsive to the effects of stress’. Uhmm… So, pick your answer from a hat?

Well, in the rubble of destroyed answers and ever blossoming questions, what are we left with? Is there something special about violence that triggers it? Or does any stress threaten the ratio? And what constitutes a stress anyway? All imponderables, I suppose, but at least a recent article in the JOGC (Journal of Obstetrics and Gynaecology of Canada) brings it closer to home: http://www.jogc.ca/abstracts/full/201505_WomensHealth_1.pdf  And in an ‘Only in Canada, eh?’ fashion it demonstrates that we, too, can participate in the secondary sex ratio debate -on our own terms, of course. I mean, who would have thought that our two referenda on Quebec secession from Canada could provoke such a response? I’m almost proud that it did –it shows how involved we are in our country. How much it matters. And how we don’t need earthquakes, either.

And maybe the slight increase in female births that the worries about the referenda caused says something about our growing appreciation of women in Canadian society as well… I live in hope. But you gotta love this stuff, eh?