neu·ral sub·strate
͝
/ˈn(y)oorəl
ˈsəbˌstrāt/
noun
1. Psychology defenses are there for a reason; do not remove a defense if you cannot
re-establish it within the hour.
2. Your goal is to help your patient attain her goals. Your personal biases and judgment
are irrelevant and should not enter the room.
3.
4.
A
part
of
the
nervous
system
that
underlies
Transference/countertransference are real and can be used to enhance therapeutic progress.
a specific behavior or psychological state.
Sexual attraction may occur between women and men, men and men, women and women—
the only time it needs to be explicitly addressed is if it interferes with the therapy. This is not
simply sexual tension—it may include active fantasizing.
5. Maintain contact info of a clinical psychologist or psychiatrist on hand; if a patient expresses
suicidal ideation, it is your responsibility to ensure their safety.
Optimal sexual function requires that an organism can:
1. Identify attractive others in the environment
2. Orienting attention to potential mate
3. Detect sensory information about incentive value
4. Motor engagement to physically approach (and return!)
Optimal sexual function requires that an organism can:
1. Identify attractive others in the environment
2. Orienting attention to potential mate
3. Detect sensory information about incentive value
4. Motor engagement to physically approach (and return!)
See, smell, taste, move
TRPV-IR nerve ending
(vulvar lamina propria, mus musculus)
phre·nol·o·gy
/ freˈnäləjē /
noun
The detailed study of the shape
and size of the cranium
as a supposed indication
of character and mental abilities.
Planning
Die Hard 6
phre·nol·o·gy
/ freˈnäləjē /
Mancations
Daily
Cialis
Planning
Die Hard 6
Peanut
Bad
Decisions Butter
noun
Pokemon
The detailed study of the shape
and size of the cranium
as a supposed indication
of character and mental abilities.
Reward
Expectations
Human Connectome Project’s New Brain Map
Planning
Die Hard 6
The Resting Brain
Posterior
Anterior
Medial
Lateral
What kind of network is the brain?
What kind of network is the brain?
What kind of network is the brain?
The Last Horror Film (1982)
Kris Kristofferson
Les cent et une nuits de Simon Cinéma (1995)
Al di là delle nuvole (1995)
Marcello
Mastroianni
John Malkovich
Joyful Noise (2012)
Queens Logic (1991)
Queen Latifah
Sleepers (1996)
Beauty Shop (2005)
KEVIN BACON
Robert De Niro
Do we have “sexual” brain networks?
This is adaptive—
preferentially orients us to threats,
facilitates action/escape, etc
as well as rewards.
Pain Specific
Giandomenico
Iannetti
Pain Specific
Giandomenico
Iannetti
Touch Specific
Physical Contact
Specific
Auditory Specific
Common to
All Conditions
Visual Specific
Can the body detect threat before it contacts the body?
The position of body in space modulates perception of pain.
Pain perception
increases as
threats approach.
Bucchari et al., 2016
The position of body in space modulates perception of pain.
Pain perception
increases as
threats approach.
Bucchari et al., 2016
Peri-personal space determines perceived pain intensity
Sensitive to: Approaching threats, rules of gravity, and the importance of the head
Bucchari et al., 2016
Hard-Blink Reflex
Blink responses were recorded when the shocked hand was 4-60 cm from Drake’s face.
40-60 cm
20 cm
Increased blink response
at 20 cm in those with
high anxiety.
4 cm
Defensive
Peripersonal
Space
Our internal states are, in part,
defined by the space we inhabit.
The perceived boundaries of our bodies
—which define internal / external—
can change.
Ex. “Body Matrix” (Moseley, Gallace, & Spense, 2012)
By sharing peri-personal space with lovers,
they may impact perception of body boundaries.
How do we know this is sexually relevant?
Intranasal oxytocin……
Intimate
•
18” (45 cm)
Friend Zone
48” (120 cm)
Social
140” (360 cm)
•
Facilitates female approach behavior
to male confederates (double-blind RCT).
Mediates physical distance from an
attractive female confederate in
monogamous but not single men.
Vaginismus: Existence of a peri-pelvic space?
+
=
Perceived threat is positively correlated with EMG vaginal activity
in women with and without vaginismus.
(Van der Velde & Everaerd, 2001)
Anxiety mediates altered subcortical circuitry in men with UCPPSsex
Greater communication* between fronto-limbic and temporal regions.
*measured as link-count functional connectivity
Farmer et al., In Preparation
Men and women with bladder pain syndrome/interstitial cystitis
show symptom-related changes in axonal microstructure
Corticospinal Tract
Anterior Thalamic Radiation
Farmer et al., 2015
Take home messages
•
Internal perception is dependent on the body’s position in space,
•
Measure of fitness? An astute nervous system is evolutionarily adaptive
•
Anxiety can amplify peri-personal defensive space and reorganize brain
networks in men with ejaculation-related pain
•
An underappreciated dimension of sexuality to assess and target
neu·ral sub·strate
͝
/ˈn(y)oorəl
ˈsəbˌstrāt/
noun
The surface or material on or from which
an organism lives, grows, or obtains
its nourishment.
[email protected]
@Farmer_MindBody
Methods
Modality: resting state fMRI scans
1.
Functional connectivity defined in 2 ways:
(a) Pearson correlation between two regions’
BOLD time courses (standard); and
(b) Voxel-wise link count (# of significant inter-regional correlations, where r > 0.3),
for 10% most connected regions (e.g., 10% connection density)
-Note this method controls for known site differences in resting state fMRI
by extracting an equal # of data points from each brain that relative to
2.
Two-way ANOVA: Main effects for gender, sex-related pain (+/-) & their interaction;
3.
Significant regions were examined individually and within spatially-defined
neural networks (frontolimic, sensorimotor, temporo-occipital)
4.
Hub disruption was examined in relation to UCPPS-specific networks
36
Two measures of neuroplasticity: function and structure
Function
Structure
-assessed via fMRI
-assessed via T1-weighted
anatomical scanning
AND
diffusion tensor imaging
-extracted in relation to
a task (e.g., pain rating)
OR
as correspondence of
activity in two regions
(e.g., resting state)
-short-term plasticity
vulnerable to change
-tissue types segmented
based on magnetic
properties
-used to infer loss/gain
of function based on
anatomical abnormalities
-longer-term plasticity