Abstract
From news in the mainstream media announcing the latest functional magnetic resonance imaging (fMRI) findings about the inner workings of the brain, to scientific studies in academic journals, the brain has become central to the way we think about ourselves. Therefore, it is good news that two important books on the history and historiography of neuroscience have been published. Vidal and Ortega’s Being Brains is a genealogy of the brain as a source of personal identity in contemporary Western societies. The authors provide both an account and an explanation of what they perceive to be the undisciplined proliferation of a ‘brainhood ideology’, not just in the neurosciences and psychiatry but also in the humanities, in literature and in film. Casper and Gavrus’s The History of the Brain and Mind Sciences is an edited volume of nine stories about forgotten and hidden technologies and techniques, all of which could be read as autonomous pieces of scholarship on the history of neurology and psychiatry in Germany, France, Britain and North America. The contributors to the volume have the common goal of exposing the contingent and complex construction of neuroscientific knowledge. Both books attempt to counteract the dominance of a neuroscientific past in the historiography of the brain and mind sciences.
This dominance is perhaps reflected in the ubiquitous use of the prefix ‘neuro’. Some ‘neurohistorians’ seem to believe that the widespread brainhood creed is in fact a benign phenomenon (Rose and Abi-Rached, 2013). Indeed, some embrace it positively and believe that their historical research should strengthen it intellectually (see e.g. Smail, 2008). Furthermore, neurohistorians generally maintain that showing the contingent and ideological character of the neuroscientific narrative does not conflict with the will to empower it ‘from untapped potential’, and that, in fact, the historian of the brain and mind is compelled to accept ‘the shared responsibility in shaping the narrative by which a science legitimizes itself as a form of knowledge’ (Fuller, 2014: 104).
The authors of Being Brains and the contributors to The History of the Brain and Mind Sciences do not sympathize with such claims. They share a mistrust for what they perceive as a ‘brainhood ideology’ (Vidal and Ortega), which is informed by a fabricated ‘brain-centered neuroscientific past’ (Casper and Gavrus, pp. 108, 110). They also argue that some of the methods and goals of the human sciences are being affected by what they regard as the wider problematic repercussions of the overstatements of neuroscientific research: this generally tends to conceal and dissemble the contingent and fractured character of human existence, hence quashing the very condition of possibility of the human sciences. Moreover, authors and editors take the Foucauldian genealogical method in earnest. Their historiographical method, although articulated differently, is intended as a history of the present. They use history not only as a ‘diagnostic device’ for the impact of the brain and mind sciences as a cultural resource, but also as a tool to ‘disturb’ and ‘unsettle’ the ideology, without necessarily delegitimizing it as perhaps harsher critics would do (see e.g. Cooter, 2014; Hasler, 2009; Strasser, 2014). The authors collectively do not view the proliferation of the prefix ‘neuro-’ as a benign development and set out to demonstrate that the historian cannot be at once a sponsor of the neurosciences while simultaneously being critical of their claims.
In their book, Vidal and Ortega re-work and assemble ideas that they articulated previously over the last decade (e.g. Vidal, 2009). Drawing extensively on rich and substantial new research from the social history of medicine and health, as well as from cultural studies of medicine, the authors argue that the ‘cerebral subject’ has been brought about through ‘multiple processes of subjectivation’ (i.e. large scale mechanisms of identity creation and validation), many of which have little to do with neuroscientific research. They claim that many of these processes oppose each other, while sharing more or less the same neuroscientific justification. For example, social movements aligned with left-wing identity politics (such as the neurodiversity movement in autism) currently co-exist with neoliberal agendas behind ‘brain fitness’ (p. 51), ‘mindfulness’ (pp. 152–4) and other self-help businesses, fostered by ideas of personal responsibility and individual autonomy. Despite their overtly critical stance, the authors claim neither to be ‘against’ the neurosciences, nor to be ‘neuroskeptics’ (p. 4). Finally, the authors show that these co-existing and sometimes paradoxical forms of subjectivation around the ‘neuro-creed’ were portrayed and problematized in literature and film long before fMRIs and the ‘neuro’ prefix emerged, thereby revealing some of the non-scientific roots of the brainhood ideology. Vidal and Ortega conclude that the cerebral subject is not the outcome of scientific knowledge, but is in fact a concept that guides not only neuroscientific research but also, more recently (and perhaps alarmingly), some research in the humanities and social sciences. Their message is that the genealogy of brainhood corresponds more to a cultural history of the brain than to the history of the brain sciences as such.
Rose and Abi-Rachad (2013) have previously suggested that the brain gained more significance because it mobilized issues related to personal identity in the Western philosophical tradition. However, Vidal and Ortega would argue that this is a whiggish and presentist approach. According to them, it is not the case that the brain became better known in the course of the last 250 years, but rather what happened was that, at a certain point in nineteenth-century Europe, the self became definable by mental functions that were thought to be anatomically localizable in the brain. In Chapter 1 of the book, Vidal and Ortega examine how definitions of personhood have been historically contingent and subject to seemingly contradictory research programmes. For example, consider the contrasts between the paradigm of localization (the idea that certain regions of the brain have autonomous, fixed functions), and the concept of neuroplasticity (the idea that the brain can reorganize itself by forming new neural connections). Furthermore, they argue that non-scientific notions of personal identity have endured social processes of naturalization and biologization without them being necessarily brought down in their cultural significance. For example, as the authors indicate, in Japan the notion of ‘brain death’ is officially embraced as the decisive feature of human death, although studies have been consistently showing that most Japanese reject the idea that the mental faculties and the cognitive apparatus of a patient are the key to differentiate between him/her being alive or dead. Thus, the brainhood ideology may be ubiquitous but not hegemonic.
The authors also demonstrate a long-standing association between a brainhood ideology and unscrupulous business. As an example, Vidal and Ortega put forward an interesting comparison between commercial practices linked to phrenology in the nineteenth century and those linked to neuroscience today. Franz Gall (1758–1828) and Gaspar Spurzheim (1776–1832) made important contributions to the knowledge of the brain by developing innovative dissecting methods and by demonstrating that nerves stemmed from grey matter. However, these innovations were in no way empirically connected with phrenological localizations. Yet it was the promotion and advertisement of the latter that had a more direct impact outside medical circles. Indeed, the concepts of ‘brain fitness’ and phrenological self-help were legitimized in the early nineteenth century by medical practitioners. For instance, the Brighton clinician Arthur Wigan emphasized the virtues of exercising the brain in order to obtain equal pre-eminence of both hemispheres, further claiming that to do so was a sign of autonomy and personal responsibility. Lie detection tests performed a similar function in the early twentieth century. Today, ‘neuroascesis’ (brain programmes that foster self-discipline) are driven by similar marketing mechanisms disguised as scientific and medical knowledge. As Vidal and Ortega show, these and other commercial practices were reinforcing the cerebral subject some 150 years prior to the ‘decade of the brain’.
With the wide application of fMRI scans in the 1990s, the story was only enhanced with further pseudoscientific processes of subjectivation, which also had very little to do with empirical knowledge of the brain. The authors show that many studies conducted with these instruments frequently conflate correlation with cause. The neurodisciplines are often complicated by causality dilemmas; for example, we tend to think that since we cannot create culture without our brains, culture must be a product of our brains. Chapters 2 and 3 are filled with similar examples from neuroethics, cultural neuroscience, neuroaesthetics and the neuroimaging of mental illness. For Vidal and Ortega, the neurobiological level of analysis is therefore not always the most appropriate to account for human experience.
The use of neuroimaging in mental illness is, perhaps, particularly problematic. FMRI technology has made a modest impact on pre-surgical planning, treatment evaluation and clinical assessments. The technology has been widely applied in psychiatric research, but plays virtually no diagnostic role and has not influenced psychiatric care. Nonetheless, the biomodel for ‘cerebralizing distress’ has been harnessed by a wide range of research programmes, including brain plasticity and ‘multiple realizability’; epigenetic mechanisms as aetiological explanations for schizophrenia; and the understanding of biomarkers in terms of vulnerability, susceptibility and risk. FMRI technology ‘seems’ to serve them all. As the authors show, however, it is still unclear whether neuroimaging in depression, for example, demonstrates pathological brain processes responsible for causing that illness, or whether abnormal mechanisms develop as a result of the condition.
Vidal and Ortega embark on a large-scale analysis of the cerebral subject as a Foucauldian dispositif, that is to say, as a regulatory ensemble of cultural resources, which, as the authors show, has little to do with actual empirical knowledge. In the last chapter, the authors explore representations of the cerebral subject in fiction, extending their analysis of the ubiquitous character of the brainhood ideology.
Stephen Casper and Delia Gavrus’s The History of the Brain and Mind Sciences consists of nine chapters, plus coda. It is arranged chronologically, from the late eighteenth century to the late twentieth century, covering events in Britain, France, Germany and North America. The contributors are experts in the history of biomedicine, neurology or neuropsychiatry, and are interested in the social and cultural dimensions of neuroscience. The volume aims to show that what Vidal and Ortega claim to be the brainhood ideology is reinforced by a fictitious brain-centred neuroscientific past operating in historians of the brain and mind sciences today. The contributors of the volume also employ a Foucauldian approach to historicize the interface of centrality and marginality. While Being Brains is broad in scope, the authors in this edited volume focus on marginal stories about the emergence of neuroscientific disciplines. The chapters deal with a range of less visible ‘objects’, rhetorical technologies, non-traditional scientific spaces, cultural events, and technicians that have thus far been rendered invisible by medical discourse.
Vidal and Ortega endeavour to show how and why it is the case that the brainhood ideology is pervasive but not hegemonic, and that it is not easy to destabilize insofar as it co-exists with other practices and understandings that end up reinforcing it. In contrast, the contributors to The History of the Brain and Mind Sciences set out resolutely to destabilize grand narratives that support and further such ideology. They do so by decentralizing not just the human brain but also the human self. For instance, a grand narrative would perhaps highlight how Georges Cuvier (1769–1832) and Jean Pierre Flourens (1794–1867), with their claim that ‘animals were never free’, managed to counteract romanticism and moral therapy to further the classification of animals in confinement as a way to understand human intelligence. By contrast, Stephen Jacyna tells us how the keepers of the post-revolutionary Parisian Ménagerie had a powerful though invisible role in putting together the rhetorical device that was Cuvier’s and Flourens’ claim. Together with the Parisian Ménagerie, the 1951 Festival of Britain makes another good example of hidden, non-traditional spaces of brain and mind knowledge production. Stephen Casper explains that the people in charge of the exhibits at the ‘Dome of Discovery’ and the Science Museum intentionally hid from the public the techniques and technicians involved in psycho-technic illusions that allowed the exhibitions to display a simplistically materialist and physicalist understanding of the nervous system. In short, Jacyna and Casper argue that it is necessary to uncover such non-traditional spaces of knowledge production, rhetorical techniques and artefacts, for they are insufficiently examined in ‘grand narratives’.
Delia Gavrus puts together the story of one ‘invisible’ technician in particular. In her chapter, she argues that the work of Canadian-American neurosurgeon Wilder Panfield’s (1891–1976) laboratory technician, Eduard Dockrill, was in fact far from marginal. It was Dockrill, and not Panfield, who successfully applied Cajal’s staining method, thus obtaining visual images of interstitial cells. Moreover, Dockrill wrote a novel that was never published, but was preserved in Panfield’s archives. The novel allows us to see how pervasive marketing and commercialism were in neurology and neurosurgery a century ago. Positive narratives tend to neglect the contrasts there were between the world of the laboratory and the world outside. Dockrill’s novel exposes these tensions: on the one hand, there was the world of self-congratulatory medical men; on the other, there was the ‘real’ world, where homeless people suffering from neurological disorders would sell newspapers informing the public about the achievements of those very same medical men. Indeed, in neurosurgery, success could be attained by masking and marketing technical knowledge as neurological knowledge. For example, as Thomas Schlich reveals in his chapter, a neurosurgeon’s sense of authority in the operating theatre in the early twentieth century in Germany and the USA was actually based on techniques legitimized through resective and radical surgery and transplants conducted elsewhere in the body.
Some chapters of The History of the Brain and Mind Sciences show how the establishment of neurology as a medical specialty was contingent upon developments external to the field. Frank Stahnisch provides a fascinating example. He argues that longue-dureé narratives of forced German Jewish migration under the Third Reich tend to describe the phenomenon as a period of ‘brain-gain’ for the USA. However, Jewish psychiatrists and neurologists underwent a complex process of transfer and re-integration that was determined by what the émigrés possessed in their luggage when they first landed in North America. ‘Migrating objects’ such as books and brain slide collections demonstrated the professional identities of these doctors as much as their knowledge of the brain. Stahnisch thus emphasizes the important role that objects played in the production of knowledge of the brain. A similar perspective is furthered by Max Stadler, who provides the reader with a historical analysis of scientific and non-scientific objects in electrophysiology in the 1920s and 1930s.
Given the wide scope of the two books, some omissions are perhaps inevitable. There is no explicit discussion, for example, of the ethical issues related to commercial practices driven by neuroscience – yet Casper and Gavrus seem implicitly to be concerned about this. Furthermore, there is no discussion of the political dimensions of both large-scale and small-scale analyses undertaken in either of these books, which is something that a reader interested in a Foucault-inspired history of the present may have expected. Finally, neither book explicitly addresses the problems that neurohistory poses for the historiography of the neurosciences. In Casper and Gavrus’s volume, the term does not emerge at all, whereas in Vidal and Ortega’s, it appears only once in the Introduction.
Notwithstanding these minor misgivings, the two books reviewed here are major and welcome contributions to our understanding of the contingent and fragmented nature of neuroscientific knowledge. I am in no doubt that they will become a valuable resource for scholars working in the social and cultural history of medicine, and that they will help to refine our ways of conceptualizing the critical role of history in science, medicine and technology. While the rigour and depth of both volumes will make them too demanding for undergraduate students and those with an amateur interest in this subject, Chapters 8 and 9 in Casper and Gavrus’s text (by Justin Garson and Brian Casey, respectively) will be useful and original resources in Master’s modules on biological psychiatry in the second half of the twentieth century. ‘Cerebralizing Distress’, Chapter 3 in Vidal and Ortega’s text, would also be useful in advanced undergraduate modules on the philosophy of psychiatry, while Chapter 4, ‘Brains on Screen and Paper’, might serve those interested in the impact of neuroscience in popular culture.
Broadly, these books will challenge anyone interested in the history of neuroscience to ask important questions about the dominant discourse of neuroscience. As Stephen Casper puts it, ‘it is worth leaning the other way in order to see what we are leaning on’ (p. 197).