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Daniel Amen is a scientist who does research in scanning the brain, and he also writes popular psychology books that have play up the importance of brain science to living well. In Sex and the Brain he unsuccessfully tries to make the case that knowing about brain science would improve most people's sex lives. What he in fact delivers is a pretty standard popular psychology of sex book with a bunch of facts or speculative theories about the role of the brain thrown in. The advice is humdrum and vague, and in fact the most interesting thing about the book is the challenge for the reader in sorting through Amen's ploys.
The book is divided into 12 lessons with titles such as "Look Closely: Brain Imaging Secrets to Enhance Your Love Life," and "The 'Oh God' Factor: Sex as a Religious Experience," Amen has a breezy writing style and most chapters feel like they were written in a day or two. There is a 10 page section of further reading, but there are no notes to the text, so it is just about impossible to work out which papers are relevant to which claims. There are quite a few lists and duplications of material from elsewhere, including a transcript of Amen's appearance on The View, and this makes the book feel padded out. After a while you may find yourself muttering 'yada yada yada' and flipping a few pages.
The first chapter spells out some of the health benefits of a good sex life: a longer life, less illness, greater immunity, better sleep, migraine relief, less depression, and weight loss are all there. The second chapter talks about the different parts of the brain and how they are relevant to your sex life. He writes about the pre frontal cortex (PFC), the anterior cingulated gyrus (ACG), the deep limbic system, the basal gangia, and the temporal lobes. The third chapter talks about brain chemistry such as the sex hormones, pheromones, and neurotransmitters. The fourth chapter discusses sex and gender differences. And so it goes.
Let's focus on the fifth chapter on brain imagine. He gives us six secrets. The first is that there is more to love than most people think -- i.e., the brain. He gives us a nice quote:
Frankly, I know of no marital therapy system or school of thought that seriously looks at the brain function of couples who struggle. But I wonder who you can develop paradigms and "schools of thought" about how couples function (or don't function) without taking into account the organ that drives their behavior, namely the brain. (90)
As a true believer in brain science, Amen believes that the brain is essential to understanding sexuality. Maybe he right that in the future when we have a sexual problem, the doctor will routinely order a brain scan. But the chances are that this will just be an expensive and unnecessary procedure that only tells us what an experienced psychologist could have said with no knowledge of neuroscience at all. Consider the couple he describes for secret 2, that whenever there is a sexual or relationship trouble, think about the brain. Amen was treating a couple who he found to be difficult people. The woman held long grudges against her husband. The husband would be very verbally nasty to his wife. He scanned their brains, and found that the wife had increased activity in her ACG, the brain's "gear shifter." People with overactive ACGs tend to get stuck in their thinking, and to hold grudges. The husband showed low activity in his PFC, which Amen took to be a sign of ADHD. So he put the wife an Prozac and the husband on Ritalin, and they became much happier. He never explains how this helped, how long they were on the medications, but just that they were still happy together 15 years later. So we have very little idea what did the work of helping. It's more like a story of faith healing. He worshipped at the altar of the brain and the couple was healed. The medications of course may have had an effect, but it doesn't take a brain scan to see if someone is unhappy, and it may simply have been that taking the antidepressant may have made the woman happier and easier to live with.
There are cases where doing a brain scan will help: in secret 3, he points out that something completely unexpected may be causing trouble, and gives the case of a man who worked in a furniture factory who was breathing in fumes. This was causing brain damage revealed by a scan, and was making him very difficult to live with. The scan identified the problem: the brain damage was permanent, but once identified as a medical problem, it was easier for the wife to cope with the behavior and for them both to plan around it and modify it. However, these kinds of cases are going to be rare.
The much more common sort of scenario will be such as those in secret 4, which recommends thinking about scanning potential partners or taking their brain science history. Amen mentions one case where a woman had a girlfriend who was disorganized and was prone to starting fights. Her brain scan revealed that she had low activity in her PFC, which might have been ADHD. He says this allowed the boyfriend "to make a more informed decision about what he wanted to do with the relationship." (97). But what new information did the boyfriend learn? Before the scan he knew she was disorganized, and after the scan he knew that she had a brain condition associated with disorganization. He could have known that without a brain scan being done. In such cases, there is in fact no new useful information gained. Maybe when we have better ability to manipulate brain processes, it will be helpful to do a scan so we are more able to do something about it. Right now, we have a range of possible treatments for traits such as being disorganized and argumentative, and doing a brain scan isn't going to help much, if at all.
I suspect that what is really going on is that having a brain scan changes a partner's perception of the person, making them see the problem as medical or organic rather than just psychological. But this is just a confusion. Seeing the condition on a brain scan makes it no more real or medical. At most it just shows the brain-correlate of the condition, and does not determine whether it is normal or abnormal, or even what the cause of the problem is. The condition of the brain shown by the scan may be an effect of something else. Amen's confident style gives the impression that scientists have uncovered the basics of brain science and can tell what is going on in a person, but that's at the least a controversial view.
At a time when health care costs are going up and college and university psychology departments are under pressure to buy brain scanning machines so that they can do research on brain functions, the issues raised by Amen and other enthusiasts of brain science are of crucial importance. Should those in charge of deciding the policies of health insurance companies and higher education be diverting funds to more brain scanning? Does it have the potential to solve the problems of psychology and can it lead to new cures of people's problems? Personally I do not want my health insurance company to be authorizing people with ordinary sexual problems to be getting expensive brain scans, because it would nearly always be a needless cost. I also do not like it when psychology departments decide to invest in a brain scanning machine rather than hire a new faculty member. While it is good for brain science to be investigating psychological and psychiatric problems, enthusiasts like Amen not only fail to convince me that it should be the high priority that they do, but in fact I become more convinced that it will be a long time before it can deliver what they promise.
NB: Sex on the Brain was republished in 2009 under the title The Brain in Love.
© 2010 Christian Perring
Christian Perring, Associate Professor of Philosophy, Dowling College, New York.