The next step

To summarize, then, according to Newberg and d’Aquili the following brain structures and phenomena are to be considered central to the generation of MSCs: the ANS, the limbic system (especially the hypothalamus), the PFC and PSPL, the hypothalamic “spillover” and the phenomenon of (functional) deafferentation.

On this basis, if one is to evaluate and/or develop the speculation that MSCs are evolutionary byproducts of sexual response and, specifically, orgasm, one might proceed by asking – is there any evidence that the neural substrate of orgasm overlaps with the described substrate for MSCs. Also, it would be useful to look into other neurocognitive analyses of MSCs in order to establish with more confidence the validity of Newberg and d’Aquili’s results.

With the foregoing functioning as a background context and a frame of reference – this is precisely what will be done in the next four chapters.

94 Newberg 2001, 504.

CHAPTER V. MSCs AND ORGASM:

AUTONOMIC LEVEL INTERSECTIONS

A. TOWARDS AN INTEGRATED APPROACH

§ 1. Defining orgasm

The current understanding of what happens in the brain when people have orgasms seems to largely be in a similar state to that in the research into the neural correlates of MSCs. There is a lot of debate and nothing is “for sure”.

Analogously to the research situation in the field of MSCs, the bits and pieces of data originate in studies using often incomparable techniques and fragments of theory are sometimes incompatible with each other.

Similarly, again, to research into MSCs the main difficulty lies not with the data themselves but with how to interpret them. Luckily, however, Francesco Bianchi-Demicheli and Stephanie Ortigue have recently published a well-documented overview of the current positions,¹ putting the existing results in a badly needed perspective. Although their metastudy mostly concentrates on the female orgasm, the parallel findings for males are also reported to be set against the findings on females.

Bianchi-Demicheli and Ortigue assert that while the origin and function of the female orgasm remains controversial, the current models of sexual function acknowledge a combined role of central (spinal and cerebral) and peripheral processes during the orgasm experience. However, they state, the cerebral “side of the equation” has not been extensively investigated and important gaps in knowledge remain. They thus set their goal at reviewing the clinical and experi-mental findings on the cortico-subcortical pathways associated with orgasm and at defining the specific brain areas that sustain the assumed higher-order representation of orgasm.² Such an approach is perfectly suited for my purposes in this volume. And, as will become clear below, it does reveal several important “meeting points” between MSCs and orgasm.

Before going further into Bianchi-Demicheli and Ortigue’s and other analyses, though, it is necessary to define what is meant by orgasm. At first glance, it might seem to be a term that is unambigous enough without any further explanation. Not so. It is becoming increasingly clear that having or-gasms does not fundamentally depend on genital stimulation. In a sense, geni-talia are “merely tools” – orgasm “happens” in the brain, not in the genigeni-talia. As early as in 1960 John Money offered evidence for what he termed to be phan-tom orgasms – experiences of sexual climax without any genital involvement at

1 Bianchi-Demicheli, Francesco, Ortigue, Stephanie. Toward an Understanding of the Cerebral Substrates of Woman’s Orgasm. – Neuropsychologia, Vol. 45, Issue 12, 2007, 2645–2659.

2 Bianchi-Demicheli & Ortigue 2007, 2645.

all (he worked with patients who had spinal cord injury and no genital sen-sation).³

More recently, Barry Komisaruk and Beverly Whipple have measured blood pressure, heart rate and pupil diameter in women who claimed that they could produce orgasm without mechanically stimulating any part of their body.

Indeed, in those women, there were significant increases in, e.g., systolic blood pressure (from a resting level of around 126 mmHg to around 210 mmHg at

“orgasm”), heart rate and pain thresholds (a characteristic feature of orgasm) when the women generated what they claimed were “thought orgasms”. Quite surprisingly, these increases were well comparable with those observed in women who experienced orgasms in the laboratory via genital self-stimulation.

From these considerations, Komisaruk and Whipple arrive at positing the whole of human body as a potentially erotic organ: there can be back-of-the-neck orgasms, palm-of-the-hand orgasms etc.⁴ They conclude, “Just as pain is not restricted to any one part of the body, neither is pleasure.”⁵

The problem is that if one accepts the “merely tools” or “it is all in your mind” approach suggested by the data of the above type, then it becomes almost impossible to unambiguously define what an orgasm is. If one cannot employ markers such as ejaculation (in males) or involuntary rhythmical contractions of the circumvaginal muscles (in females) as “crutches” for a definition, then orgasm becomes a hazy, experiential term very much like ‘love’ and ‘happi-ness’: everybody talks about it but no-one really knows how to define it.

Bianchi-Demicheli and Ortigue, too, recognize the problem, saying that a major issue in defining orgasm is the discrepancy between subjective descriptions and objective physiological signs, forcing most researchers to describe only the observed physical changes.⁶

To get around this problem, Bianchi-Demicheli and Ortigue adopt an elegant definition by Cindy Meston and colleagues: (female) orgasm is a variable tran-sient peak sensation of intense pleasure, creating an altered state of conscious-ness, usually accompanied by involuntary, rhythmic contractions of the pelvic striated circumvaginal musculature, often with concomitant uterine and anal contractions and myotonia that resolves the sexually-induced vasocongestion, usually with an induction of well-being and contentment.⁷

3 Money, John. Phantom Orgasm in the Dreams of Paraplegic Men and Women. – Archives of General Psychiatry, Vol. 3, No. 4, 1960, 373–382. For a thorough discus-sion on the topic of atypical orgasms, see: Komisaruk et al. 2006, 199–225.

4 Komisaruk, Barry R., Whipple, Beverly. Love as Sensory Stimulation: Physio-logical Consequences of its Deprivation and Expression. – Psychoneuroendocrinology, Vol. 23, No. 8, 1998, 935.

5 Komisaruk & Whipple 1998, 937.

6 Bianch-Demicheli & Ortigue 2007, 2646.

7 Bianchi-Demicheli & Ortigue 2007, 2646 (with references to: Meston, C. M., Hull, E., Levin, R. J., Sipski, M. Women’s Orgasm. – Sexual Medicine: Sexual Dysfunctions in Men and Women. Edited by T. F. Lue et al. Paris, Health Publications, 2004. Pp.

783–850).

Obviously, this definition is gender-specific. However, it can easily be mo-dified to apply to males, too. Its elegance (and use, within the present context) lies in the fact that it makes it unambiguously clear – orgasm is an altered state of consciousness. Note that the physiological signs of orgasm are – in this defi-nition – carefully kept apart from the experience itself by the phrase ‘usually accompanied by’. On the one hand, such a definition allows one to incorporate the above described atypical orgasms into the same model. On the other hand (and more importantly for the present discussion), it provides a near-perfect reference point to directly compare orgasms to what is known about MSCs.

§ 2. Re-engaging the “rivaling” ANS twins

Both orgasms and MSCs, thus, can be viewed as somewhat unusual states of consciousness. The question, within the present context, though, is – to what extent and in what sense are they unusual in the same way. James Austin, a renowned zen scholar and neuroscientist, has noted – while discussing the suspected neural link between orgasms and MSCs – that orgasm is sometimes referred to as “the little death” (French le petit mort). He relates this idiom to MSCs (known in zen as kensho’s and satori’s) which are sometimes characterized as “the great death”. Austin argues that the notion of death stands, in both cases, for a loss of the sense of self involved. ‘Little’ and ‘great’, then, describing the “amount” of the loss of ego-centered awareness.⁸

This is an intriguing way of looking at the matter. Remember that Newberg and d’Aquili ascribe the loss of self-awareness during MSCs to the deafferentation-deactivation of the PSPL. If this theory is correct, then, based on Austin’s idiom, one would expect to find comparable changes in the functioning of the PSPL during orgasms as well. Methodologically, this would suggest directly comparing the brain scans of subjects having MSCs and those of people having orgasms in order to decide whether the MSC-orgasm link can be backed up. Such a strategy would be in good accordance with Bianchi-Demicheli and Ortigue’s position that orgasms are to be thought of as primarily a brain phenomenon and that too much effort has gone into analyzing the objective physiological signs involved.

I shall undertake just such a task in chapter VII. For now, though, despite Bianchi-Demicheli and Ortigue’s position, I consider it necessary to engage in the “mundane” task of comparing the ANS-related “objective physiological signs” (as Bianchi-Demicheli and Ortigue call them) of orgasms to the ANS-based data on MSCs. I have several reasons for this. First of all, in Newberg and d’Aquili’s model the idea of PSPL deafferentation does not stand alone. The PSPL is deafferented as a result of the taking of effect of a complex pattern of brain activity that involves a delicately orchestrated, integrated response from the ANS, the hypothalamus, several other limbic structures and multiple cortical

8 Austin 2006, 93.

areas. The deafferentation is directly dependent on the hypothalamic “spillo-ver”. Therefore, it seems useful – prior to going into looking for similarities in the functioning of the PSPL during orgasms and MSCs – to see if anything like a neural “spillover” from one branch of the ANS to the other can be seen in action during orgasms, too and where do the hypothalamus and other limbic structures fit in.

Furthermore, with one significant exception to be discussed in chapter VII, Newberg and d’Aquili – in relating MSCs to orgasm – always appeal to the

“spillover” in the ANS (and not the PSPL deafferentation) as the main parallel between orgasm and MSCs. They do discuss changes in the sense of self during states that are related to sexuality (such as romantic love⁹) but do not directly link the loss of self with orgasm. Again, then, this suggests looking into the ANS parallels first. The more so because, according to Newberg and Lee, in research into MSCs, the ANS activity based approaches continue to be by far the most common¹⁰ and because ANS activity cannot be analyzed via brain-scanning.

On these considerations I shall begin the comparative analysis from first establishing whether there is, actually, enough evidence to argue for the existence of 3^rd stage (or “spillover”) autonomic states (for example, it may easily be that what appears to be a simultaneous activation [coactivation] of the ANS branches is simply a well-orchestrated alteration between sympathetically and parasympathetically dominated states with no “third stage” involved). I shall then be looking for independent data for the involvement of the 3^rd stage states in both orgasm and MSCs.

B. AUTONOMIC INTERACTIONS AND THE DUAL PHYSIOLOGICAL CHARACTER OF MSCs AND ORGASM

§ 1. Evidence for 3^rd stage states and their involvement in orgasm The ANS is responsible for regulating fundamental functions such as heart rate, blood pressure, body temperature and digestion. At the same time, because of its connections to higher brain structures, it also has a significant role to play in mediating many higher functions, including the generation of emotions.¹¹ For example, Sue Carter notes that the involvement of the ANS in mediating

9 E.g., in: d’Aquili, Eugene G., Newberg, Andrew B. The Neuropsychology of Aesthetic, Spiritual and Mystical States. – NeuroTheology: Brain, Science, Spirituality, Religious Experience. Edited by R. Joseph. San Jose (California), University Press, 2003. P. 245.

10 Newberg, Andrew B., Lee, Bruce Y. The Neuroscientific Study of Religious and Spiritual Phenomena: or Why God Doesn’t Use Biostatistics. – Zygon: the Journal of Religion and Science, Vol. 40, Issue 2, June 2005, 473–474.

11 WGA, 38.

emotion is evident from how emotional feelings tend to be associated with visceral sensations. Think, for example, of concepts such as love sickness and heartaches or folk sayings such as the way to a man’s heart is through his stomach.¹²

I emphasize the link between the ANS, the heart and the viscera for a reason.

When it comes to 3^rd stage ANS states – states that involve a coactivation of the sympathetic and parasympathetic system, then a routine data search on PubMed¹³ reveals that the issue is most often discussed in relation to cardiac function, usually within the context of pathologies such as bradycardia, tachy-cardia and malignant arrhythmias.¹⁴

Thus, 3^rd stage states are discussed and thought to occur. But there is a problem. As Newberg and d’Aquili, too, admit (in an endnote to WGA) – there is actually very little specific evidence for the involvement of 3^rd stage states in MSCs. This is due to the fact that the differential activity in the ANS is difficult to measure directly. Typically, ANS-dependent variables such as heart rate or blood pressure are employed. The problem emerges in interpreting the changes in these measures. Increased heart rate, for example, can be seen either as an increase in sympathetic activity or a decrease in parasympathetic activity. How would one, then, measure when both arms of the ANS “fire” at once?¹⁵ In other words – assuming that 3^rd stage states do occur, what would signal their presence?

In this regard, there is an excellent study by Kiyomi Koizumi and colleagues from 1982 that Newberg and d’Aquili also occasionally refer to. Basically, it consists in experimentally testing the hypothesis that ANS states are possible in which the reciprocity or “antagonism” of the sympathetic and parasympathetic nerve action is overruled. The study was performed on dogs, with the main conclusion that 3^rd stage ANS states are possible and that they result in – nota bene – an even more augmented increase in total cardiac output than in the case of sympathetic stimulation only.¹⁶

12 Carter, C. Sue. Neuroendocrine Perspectives on Social Attachment and Love. – Psychoneuroendocrinology, Vol. 23, No. 8, 1998, 808. Another excellent study on the ANS in its relation to emotion (and 3^rd stage states) is: Porges, Stephen W. Love: an Emergent Property of the Mammalian Autonomic Nervous System. – Psychoneuro-endocrinology, Vol. 23, No. 8, 1998, 837–861.

13 An online service of the U.S. National Library of Medicine. See:

www.ncbi.nlm.nih.gov/pubmed (accessed 05/01/2009).

14 For a recent review, see: Paton, Julian F. R., Nalivaiko, Eugene, Boscan, Pedro, Pickering, Anthony E. Reflexly Evoked Coactivation of Cardiac Vagal and Sympathe-tic Motor Outflows: Observations and Functional Implications. – Clinical and Experi-mental Pharmacology and Physiology, Vol. 33, No. 12, December 2006, 1245–1250.

15 WGA, 192–193.

16 Koizumi, Kiyomi, Terui, Naohito, Kollai, Mark, Brooks, Chandler McC.

Functional Significance of Coactivation of Vagal and Sympathetic Cardiac Nerves. – Proceedings of the National Academy of Science, Vol. 79, March 1982, 2116–2120. The

Significantly for my present purpose, Koizumi and colleagues argue that – when it comes to heart function – while reciprocity between the sympathetic and vagal (parasympathetic) “controls” seems to be a general rule, both reciprocal and nonreciprocal reactions can be evoked – by stimulating different areas of the hypothalamus. They then elegantly show how such nonreciprocal ANS states can be beneficial in terms of heart function.¹⁷

These classical findings are strongly supported by a recent data review by Julian Paton and colleagues. These authors, too, emphasize that the coactivation of sympathetic and vagal/parasympathetic heart controls results in even greater total cardiac output than in the case of sympathetic stimulation alone. Curiously, Paton and colleagues further argue that when it comes to heart function, the

“usual”, reciprocal (or “antagonistic”) relationship between the ANS branches may, in fact, be an exception rather than the rule.¹⁸

Be that as it may, it seems that the possibility and significance of non-reciprocal ANS states is by today more or less generally acknowledged. Gary Berntson and colleagues have argued that the modes of autonomic control do not lie along a single continuum extending from parasympathetic to sympathetic dominance but rather distribute within a two-dimensional space, suggesting that nonreciprocal ANS states may be much more common than previously thought.¹⁹

While such considerations do not resolve the issue of how precisely to decide whether observed changes in, say, heart rate or blood pressure signal a 3^rd stage state or not, they do provide enough basis to maintain that (1) 3^rd stage states are possible, (2) they are not (necessarily) dysfunctional and (3) they can be elicited via stimulating certain areas of the hypothalamus.

Now, what about the involvement of 3^rd stage ANS states in orgasm? Is there any evidence of it? In The Mystical Mind – while discussing sympathetic/ergo-tropic functions – Newberg and d’Aquili list ejaculation as being a specifically sympathetic function.²⁰ (The sympathetic-orgasm link is also made in a compar-able passage of WGA.²¹) As to the specifically parasympathetic/trophotropic functions, The Mystical Mind lists penile erection.²² (In a comparable passage in WGA, however, no link is made with sexual behavior.²³) Since from the perspective of successful reproduction erection and ejaculation have to occur at

results of this study are in excellent accordance with Stephen Porges’s polyvagal theory (Porges 1998) discussed in chapter VIII in order to reframe the MSC-orgasm link.

17 Koizumi et al. 1982, 2116; 2120.

18 Paton et al. 2006, 1245.

19 Berntson, Gary G., Cacioppo, John T., Quigley, Karen S. Autonomic Deter-minism: the Modes of Autonomic Control, the Doctrine of Autonomic Space, and the Laws of Autonomic Constraint. – Psychological Review, Vol. 98, No. 4, October 1991, 459–487.

20 D’Aquili & Newberg 1999, 23.

21 WGA, 38.

22 D’Aquili & Newberg 1999, 24.

23 See: WGA, 38–39.

the same time, a reasonable inference is that during orgasm the sympathetic and parasympathetic systems must coactivate.

As it turns out, independent evidence in support of this view is not hard to find at all. Particular terms and concepts differ but the basic idea that orgasm (and sexual response generally) presupposes simultaneous sympathetic and parasympathetic nerve action keeps surfacing.

In Bianchi-Demicheli and Ortigue’s 2007 metastudy, for example, one finds the following argument: human sexual response can be viewed as consisting of three basic phases – desire, arousal and orgasm. The phases are mediated by separate and interconnected neurophysiological mechanisms: desire is generated by limbic activation, whereas arousal and orgasm are mostly connected with the stimulation of reflex pathways in the spinal cord. The orgasmic stage happens when excitement seems to go over the edge.²⁴

I shall discuss the limbic system connection in this train of thought in the next chapter. For now, note that the metaphor of excitement “going over the edge” is highly reminiscent of the “spillover” metaphor. Taken together with Bianchi-Demicheli and Ortigue’s above reviewed position that orgasms should be considered an altered state of consciousness, one has an argumentation structure that is obviously parallel to and commensurate with those of Newberg and d’Aquili.

What in Bianchi-Demicheli and Ortigue’s case is a mere similarity of meta-phors becomes an explicit discussion in Ion Motofei and David Rowland’s analysis of orgasm and sexual arousal. They write, “[S]exual arousal requires simultaneous activation at the cerebral level of both the parasympathetic and sympathetic autonomic systems, systems traditionally viewed as antagonistic rather than complementary systems.”²⁵ Motofei and Rowland also defend the view that (the male) orgasm – even if only the ejaculatory phase is considered – is, physiologically, a “dual” process in which seminal emission is sympathe-tically and expulsion parasympathesympathe-tically controlled.²⁶

Apparently, Motofei and Rowland find the idea of simultaneous sympathetic and parasympathetic nerve action puzzling (this indicating how deeply the notion of “antagonism” between the ANS branches is rooted) because they have constructed a detailed hypothesis to explain how, on the cerebral level, might

Apparently, Motofei and Rowland find the idea of simultaneous sympathetic and parasympathetic nerve action puzzling (this indicating how deeply the notion of “antagonism” between the ANS branches is rooted) because they have constructed a detailed hypothesis to explain how, on the cerebral level, might

Im Dokument of Sexual Response? (Seite 84-0)