By Natalia Zdorovtsova
This is a transcript of a talk I gave for Luminomelia, a multi-disciplinary philosophy society based at the University of Cambridge, on the 7th of October 2022. You can find out more about Luminomelia, and get updates about its upcoming events, through the society's Facebook page: https://www.facebook.com/cambridgeluminomelia
It's worth noting that avoided citing specific papers throughout this talk. However, the topics I covered here each have a wide and accessible literature that you can look into yourself, if you wish. As always, I'm happy to talk about my work in this area, my ideas, and also my motivations for writing this. So, without further ado...
Developmental cognitive neuroscience is a field that focuses on three things.
Development refers to processes of change across the human lifespan, though a lot of scientists tend to look at times of rapid change, like childhood and adolescence. Cognition refers to a variety of different mental processes, like memory, emotion, and abstract thought. It can also mean general cognitive ability, or intelligence. Neuroscience is the study of the brain, but actually, this field encapsulates a lot of different things. If we want to know how the nervous system works, we can look at molecules, genes, cells, diseases, white and grey matter structure, activity, networks, computational models, electrophysiological dynamics, and more. We can also study how nervous systems work in other creatures, which we call model organisms. So basically, developmental cognitive neuroscience—the field I do my research in—wants to find out how links between cognition and the brain change within individuals across time. We also want to understand how differences emerge between people.
Developmental differences can be understood in terms many different modalities: genes, neurobiology, cognition, behaviour, and even sociology. Knowing that change happens across all of these levels as a person progresses through life means that there’s a lot to study. Additionally—and most importantly—interactions happen between each of these modalities, so they can’t really be studied as causally-separate levels. Genes can influence the body’s development, but signals that the sensory organs receive from the outside world can also literally change your brain and genetic code. Although we often view biological phenomena through a lens of set-in-stone determinism, or as ‘blueprints,' this characterisation of the arrow of causality is somewhat misleading. In the realm of developmental change, flux is the rule, rather than the exception, and everything seems to influence everything else.
I’ve noticed that popular media tends to place a ton of importance on the brain, relative to other potentially meaningful things. Before I get into the meatier parts of this talk, I want to discuss why this might be the case, because the current discourse surrounding this issue makes me somewhat uneasy. It’s not difficult to find articles, even from reputable journalistic sources, that claim that there is something inevitable about what goes on beneath the skull. Take, for instance, the example of depression. A lot of you will have heard the phrase that it’s a “chemical imbalance.” And there’s often a lot of stress on the word chemical. According to this narrative, someone’s brain spontaneously produces the wrong stuff, or not enough of the right stuff, and then they feel sad all the time. The cure to a chemical problem, then, is a chemical solution: take this pill, and your brain will make serotonin again. Oh, and you might have to exercise too—not because of the enjoyable and empowering phenomenology of exercise, but because it gives you endorphins, which are the right chemicals.
But wait, hang on a minute—billions upon billions of pounds, many decades, and thousands of research careers have been spent trying to fix brain chemicals in depression. SSRI-based medications do induce chemical changes, and definitely help some people’s symptoms—but overall, improvements only occur at chance level, and they come with a wide range of unpredictable side effects.
The problem might lie within our interpretation of the direction of causality in this situation. It’s not that there’s some kind of metaphysical cause to depression, or that it’s more useful to think about it as an injury to the soul. I firmly believe that we can still remain naturalists about the causes for these phenomena—it’s just that we need to widen the scope of material observation.
Studies consistently show that depression medications, on their own, aren’t enough to treat depression. They just give a person the initial push they might need to begin recovering. It turns out that recovery is a very effortful process indeed—you need to muster up the mental energy required to fight your habits with every fibre of your being, even if it makes you feel exhausted, uncomfortable, and occasionally defeated. You need to talk to people, come to terms with the profoundly unlikeable parts of your personality, engage in physically and mentally-effortful activities, and believe in your ability to change. Unfortunately, depressed people struggle with precisely these things, which is what makes recovery hard. This is what leads some people to regard their depression as a lifelong, pervasive condition that they simply have to manage with the right chemical cocktail. But medications, like SSRIs, only make the first steps of a challenging recovery process less painful to initiate.
What I’m describing, when I say ‘recovery,’ is a change over time. Recovering from depression is like a self-initiated, agentic, intentional process of development. Crucially, I think, dominoes need to be toppled in multiple realms: a person might be medicated, but the changes actually happen because they interact with the outside world in a better way.
This is the thesis of my talk today: the development of the mind happens ‘out there’, in a dynamic exchange between the agent and the environment. This position stands in contrast to more reductive conceptions of the mind, which claim that the mind ‘comes from’ the brain by some magical process of ‘emergence.’ No: my argument is that the mind is not something that comes from the brain, but rather, that ‘the mind’ is what we call the interaction between an agent—with all of the mechanisms that drive it to sustain itself—and the outside world.
In other words, the brain is responsible for keeping the score. If you scan someone’s brain, what you’re actually seeing is the aftermath of a lifetime of embodied interactions. These interactions can be partially attributed to measurable phenomena—things in the genes and the environment—but also stochastic factors that are neither uniquely genetic nor macroscopic. In this sense, the operations and characteristics of the mind can be tied in some way to the brain, but really, we invented the term ‘mind’ as a useful abstraction. This abstraction allows us to categorise different types of thinking, describe our subjective experiences, and ground our study of neurological phenomena in a language game that makes intuitive sense.
The reason I think this is a better framing is because it frees us from a reliance on a unidirectional arrow of causality. The ‘shape’ of developmental change is a dance between all levels of observation. It’s not a chicken-and-egg problem, and it’s not the case that we ‘start off’ with genes that drive all other processes, even though they are an important thing to study. Things are changing at all levels, all the time, and our subjective experiences of selfhood are just along for the ride. I don’t know where these experiences ‘come from,’ but to me, the hard problem of consciousness seems like an ill-posed question. So let’s move on to something more practical.
A lot of research has shown that autistic people have anxiety at much, much higher rates than average. And already, you’re probably asking yourself why. Some of you may be thinking that whatever genes are involved in autism might also independently drive the emergence of the anxiety disorder phenotype. Others might be thinking about what autistic people might be anxious about, and what about their thinking could result in this discomfort. A few of you might also have considered that the world is cruel to people who are different, and that experiencing challenges throughout one’s life can lead one to be hypervigilant, untrusting, and afraid of certain consequences.
These are all valid viewpoints, and I want to stress that we need to consider all of these levels of observation, at once, in order to get the full picture of how the development of anxiety in autistic people occurs. Genetic studies can shed light on some fine-grained biological mechanisms that underpin developmental differences. By the end of this talk, I do not want you to walk away with the sense that studying the genome tells us nothing of value—rather, I want to stress that life is characterised by interactive processes, and limiting our view of these interactions is myopic on all fronts.
However, a lot of scientific studies choose to fixate on exclusively the genetic, or neurological, side of things. If you look up ‘genetic co-morbidity between anxiety and autism,’ you’ll get a vast range of studies which show you that genes commonly shared amongst autistic people are also common to those with anxiety disorders. The take-home message that these genetic attributes cause anxiety in autistic people, and it's often framed in a rather deterministic way. Anxiety is just part of being autistic—it’s in your genes! And look, we have all of these ground-truth, ‘biologically-objective,’ causally-fundamental measurements to prove it.
But knowing what we know about the interactions between genes, brain, cognition, behaviour, and the environment, this is not an adequate picture. Although objective measurements of biological phenomena make many of us feel good inside, the environment is just as present in a person’s life as the genome. Unfortunately, there are so many different factors ‘out there’ that they can be hard to measure, and the environment is often disregarded as a ‘soft science’ topic of interest. I think this is silly—the environment is really there! It’s real and material! It’s scaled up, and much noisier to try to measure, but it’s the very thing to which we adapt across the lifespan. Development is an active communion with the outside world, not a passive reading-off from a genetic blueprint. Similarly, psychiatric conditions aren’t as genetically-innate as many people have been led to think, and treating them as such does not improve treatment outcomes.
Here's a quote from Thomas Insel, the former director of the National Institutes for Mental Health, that might give you a sense of how this type of reductionism has negatively impacted both science and society:
“I spent thirteen years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists, at pretty large costs—I think $20 billion—I don’t think we moved the needle in reducing suicide, reducing hospitalisations, [or] improving recovery for the tens and millions of people who have mental illness.”
This paints a very bleak picture indeed. If we’re doing this type of science in order to help people, we should be looking to other relevant factors that could be driving mental health problems across the population.
Returning to autism and anxiety, it may be more pragmatic to look at how the environment could lead a person to develop certain symptoms. Hypothetically-speaking, changing someone’s genes is costly, dangerous, complicated, and ethically questionable in the case of altering personalities. Changing the world is similarly costly and risky, but we have much more practical insight and knowledge about what tends to work and what doesn’t. There are many clear paths to making our shared social environment safer and more accommodating for autistic people. Towards the end of this talk, I’ll speak more on policy changes that might help make this happen. But right now, I want to give you an account that illustrates why I think the mind develops ‘out there.'
If you know anything about autism, you’ll know that people with these traits seem to interact with the world in a different way from ‘typically-developing’ individuals. A lot of autistic characteristics occur in families, so I think a lot of the variance here can be explained by the genome—there’s not an outside intervention that can make a person ‘not autistic’, because it’s something that characterises a very strong and robust biologically-driven developmental trajectory. But anxiety is not so well-explained by genes, even in autism, and past research shows that it doesn’t characterise a developmental trajectory or lifelong way of being. Anxiety is more of an ‘out there’ thing than autism, even though autism is an ‘in here’ condition with high anxiety rates across the population.
Okay, so imagine you start off life interacting in a pretty different way with your environment. Maybe you’re really sensitive to bright lights and sounds, and as a baby, you cry all the time, because that’s a normal way for a baby to express their discomfort. Perhaps you also have some difficulty with looking at people’s faces, because they contain a lot of overwhelming information that you have trouble processing. So, when you cry, your parents might not know what’s wrong, and might think you’re a fussy baby. And then you grow up into a fussy toddler, and by that point, your body has already registered that the world is a scary place, full of bright lights and sounds, and confusing social interactions.
When you go to school, things get worse—not only is the environment intense, but you have trouble connecting with the people around you, and you might experience bullying. At this point, you have a few options. You might become really good at suppressing your emotions and needs in order to please other people, which is sometimes referred to as “masking," because you put on the “mask” of being more neurotypical. This is a high-vigilance behaviour, because you’re worried about what would happen if the mask slipped, or if people ostracised you for being different. Alternatively, you might just face the bullying as you are, which can interfere with your learning, social relationships, and wellbeing.
By the time you’re a teenager, you have unbearable anxiety, because the world around you has always been an extremely stressful one—not because you’re the problem, but because you’ve always had to navigate an environment that’s tailored to people who can handle a lot of sensory information, who can socialise in a very specific way, and who can seek support from friends when troubles arise. Sure, as an autistic person, maybe you have some ‘genetic precursors’ for anxiety. But genes don’t cause anxiety in autistic people—the causal relationship is much more complicated and reciprocal. In this case, it’s also clear that the interaction between an individual and their environment—especially a very stressful environment—is what makes them develop an anxiety disorder. Simply focusing on genes or neurology can severely limit our understanding of this type of developmental phenomenon to easily-measurable biological characteristics, when thinking of the mind in terms of the outside world would make far more sense.
As I said before, I’d like to propose a shift in thinking about how we actually view the mind in the first place. When we study mental phenomena, and consider the properties of the mind, we shouldn’t focus exclusively on biological processes in the brain or genome. It’s definitely tempting to, but remember, the brain is not necessarily the causal ‘source’ of the mind, and cannot be considered a sufficient cause for mental phenomena. To me, thinking in this way makes little sense in the context of dynamic processes of developmental change. I don’t believe that it’s useful to think of a person as a brain in a jar—we’re embodied, externalised, and in constant interaction with our world, which we access and influence in a multitude of different ways.
We don’t need to become dualists, either. The mind is a useful abstraction, since it allows us to talk about all levels of observation at once—both internal and external. Once again, I should note that there is a great deal of non-trivial, and profoundly consequential, correspondence between neurological and mental phenomena. But the mind is not a literal, physical thing that is localised to a particular place. Rather, it’s something that can describe the feeling of perceiving, thinking about, and interacting with the outside world. Development is the temporal extension of this perception-action loop. By studying brain development, we’re placing priority on the dynamics of agent-environment interactions, and trying to find out how these dynamics might correspond to gradual neurological change.
Everyone’s internal and external states differ from one another, which is why we get different trajectories of development over time. To have a similar-looking trajectory to someone else, you don’t necessarily need to have a similar genetic or experiential profile, though it may help. My point is that the interactions that go on between the individual and outside world are so intricate and complex that experiential heterogeneity is inevitable, and not always predictable. Many different paths can lead to the same observed outcome, and shared features across the genome, brain, and so on can nonetheless lead to different outcomes. This is a really useful fact to consider if you want to think about mental and developmental conditions. The emergence of ‘different minds’ only means anything in the context of the environment.
If we’re abandoning the old way of thinking about multi-level causes and effects in development, then maybe we ought to consider a new set of questions. Instead of asking, ‘what genes cause mental phenotypes?’, we could ask ‘how does an individual’s interaction with the environment result in their phenotype?’. This allows us to consider lived experiences, societal structures, and meaningful ways of helping people who might be struggling. Often, the most effective thing is to target the environment first, because people can sometimes identify what about their world is making things challenging. For instance, an anxious autistic person could probably tell you that would benefit from sensory accommodations and social understanding. Autistic anxiety is a way of dealing with environmental stressors—in an ancestral environment, high vigilance protected us from all kinds of threats, so it’s only natural to experience chronic anxiety after experiencing a chronically threatening environment. This is not a flaw—but an adaptive feature—of our biology, and its manifestation depends on the outside world. Why pathologise this natural response to a threatening world and ascribe its causality to genes, when instead we could listen, understand, and help people who are struggling?
Understanding development in terms of the ‘outside’ gives us the ability to act and change society for the better. Where the scope of what we think we can do to help can be limited by genetic reductionism, opening the doors to complex models of development allows us to understand things in context. A lot of negative mental health outcomes we see in children with neurodevelopmental conditions aren’t genetically predetermined. It may not even be the case that these children are ‘predisposed’ to them, or more sensitive than average to stressful environments. Rather, research has shown that people with these conditions face a wide variety of hindrances to their flourishing that we can prevent.
So, what do we do? There are many ways of addressing problems with the ‘outside’ that we create, but I think that children’s basic needs always need to be addressed first. In classical psychology, there’s something called Maslow’s Hierarchy of Needs, which forms a pyramid of different physiological and emotional things that people require from their environments. The theory goes that unless the most basic layers are established, personal flourishing and healthy development simply can’t happen, because the absence of these things places a huge amount of stress on the body. The foundational tiers of Maslow’s hierarchy of needs are physiological requirements, like safety, shelter, good-quality sleep, and a diet that is both calorically adequate and nutritious. Right above safety needs are emotional and community belonging needs.
All of these things are incredibly important, and hundreds of studies have shown that they are, indeed, requirements for wellbeing. It is not merely a suggestion that a person should sleep enough and eat healthily, or have plenty of direct emotional support from loved ones. If you don’t have these things, first and foremost, it will take a massive toll on your body. And if you’re in an early stage of life, where a lot of developmental change is occurring, deficits in these areas will have lifelong effects. Counter to popular belief, children are not as ‘resilient’ to these forms of trauma as we’d perhaps like to think. Rather, the body registers these experiences as the norm, and develops accordingly.
Therefore, even if a child has specific learning, sensory, and social needs, the first question we need to be asking is whether they have a safe and stable home, enough food to eat, and adequate access to healthcare. Unfortunately, many children, even in industrialised countries like the UK, don’t have those things. In 2020, 322 Conservative MPs voted against extending free school meals to children in state-funded education. This means that potentially millions of school-aged children, including those with additional neurodevelopmental difficulties, struggle to have a stable, consistent, healthy diet that can support development. Meanwhile, in my line of work, I often come across politicians who wax poetic about the need for inclusivity and for specific classroom accommodations to help those with, say, dyslexia. I always think, that’s very nice, coming from someone who went to an expensive boarding school. Why not feed these kids first?
An autistic child whose basic physical needs aren’t being met won’t benefit very much from fancy, targeted classroom interventions. On the other hand, an autistic child from a better-off background, at a private school, might be receiving interventions on top of having their basic needs met. They might even flourish so well that they end up in a place like Cambridge, because they received a great deal of encouragement in a safe, abundant environment. We should not be surprised that a child with a neurodevelopmental condition who faces a difficult environment experiences significantly worse outcomes, where material deprivation and a lack of specific accommodations interact with one another over time.
Creating good environments, and changing the outside world to facilitate healthy development, needs to happen in stages. Physical states of deprivation and danger do the most harm, so they need to be addressed first, for every child. Then, more specific policies can be rolled out, which will help children overcome further challenges in school. I really think that we can do better by neurodivergent people, but targeted policy changes need to start with the basics. One recommendation would be to provide all children with free school meals, establish good and low-cost afterschool programmes, and offer families support with childcare, which would include investing a lot into infrastructure that supports communities. This infrastructure, ideally, would also make it more straightforward for people to find work and provide for their families. When we empower people to do this great task of caring for others, through their labour and perseverance, the benefits reach everyone.
Fostering good developmental outcomes means tackling the environment, rather than trying to alter the specific biological attributes that an individual child may or may not have. We don’t need to be fatalistic about genetic determinism, or treat poor outcomes as inevitable in the case of children who are developing differently. We can mitigate poor outcomes, even in those who have been dealt a more challenging hand from birth.
Once we see the mind as something that is realised out in the world, instead of something that is generated from within, we can feel empowered to change the world for the better. Treating poverty, reducing traumatic life events, and altering the way that we interact with neurodivergent people is far more effective, and more sensible, than placing all the focus on neurological and genetic differences.
I hope that this talk has given you a bit of insight into my thinking on the links between embodiment, extended mind theories, and developmental cognitive neuroscience. I’m excited to hear your thoughts! Thanks.
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