'We want things to be a certain way'

While inaccurate beliefs about the brain have been around since the days of Aristotle, they persist even in the face of modern science and brain imaging evidence. Neuromyths, and the reasons they persist even in the face of good evidence, were up for discussion at the British Neuroscience Association's Christmas Symposium held at King's College London in front of a lively audience.

Given the topic of Professor Cordelia Fine's talk – Eight/Seven things to know about sex, gender, brains and behaviour: A guide for academics, journalists, gender diversity advocates, social justice warriors, tweeters, Facebookers, and everyone else not otherwise specified – it is perhaps understandable why she felt safer delivering it via Skype more than 9,000 miles away.

A Professor of History and Philosophy of Science (University of Melbourne), and the author of Testosterone Rex, Fine advised on the questions people should ask to best distinguish between reasonable claims and 'grade A drivel' in research, and subsequent media coverage, on gender differences in behaviour and the brain. Fine works alongside Daphna Joel, Professor of Psychology and Neuroscience (Tel Aviv University) and Gina Rippon, Professor of Cognitive Neuroimaging (Aston University), in tackling myths held about the 'female' and 'male' brain and the supposed differences between them.

The first, and most fundamental, of these questions is whether a difference actually exists. Fine also implored the audience to question how large, and what kind of sex difference had apparently been found, and to ask if the study had been carried out in various environmental conditions with different human populations. If, after asking the above questions, you are certain a difference does truly exist, ask where that difference comes from and whether indirect circumstances could affect the brain, hormones and behaviour.

If a difference is considered in isolation from other factors, or if inferences about behaviour are drawn from factors such as local connectivity, structure or size we should also be wary. Finally, if evolutionary explanations are given to explain a sex difference, we should ask whether that variation could be genetically heritable and look at whether cultural influences had been considered in a study. Fine concluded that while asking questions about apparent differences in male and female brains is sometimes said to be driven by a political ideology, or thinking that equality depends on psychological sameness, 'This isn't political correctness, it's scientific correctness.'

Dr Christian Jarrett, Editor of the British Psychological Society's Research Digest blog and author of Great Myths of the Brain, discussed why brain myths are so persistent and believed by so many. He pointed to statistics showing that even people with training in neuroscience believe neuromyths; for example that we only use 10 per cent of our brains, or that people learn better when presented with information in their preferred learning style.

Jarrett suggested that these myths seem to stick because many are open to interpretation, they give an appealing 'insight' into humans and their potential, and often contain grains of truth. For example, it is true that many people have a preferred learning style and feel they learn better when that style is used, even though there is no evidence they actually do. The idea also gives people an excuse for why they may not be learning something easily if it is presented in the 'wrong' way.

Jarrett also emphasised that prior beliefs and bias may affect how we assess the validity of certain myths. Of course, scientists themselves are not immune from the effects of this. There is also a lack of understanding that science is a process – that what was once fact can become myth. This may explain the persistent nature of some neuromyths. He pointed to the idea that adults can grow new neurons, once considered a myth… a later study suggested it might be fact, and then a more recent study has planted this idea back in the 'myth' category… for now at least. 

Pseudonymous blogger Neuroskeptic took the audience on a journey through historical neuromyths to the present day and possible future, suggesting – quite depressingly – that very little has changed or will change.

Phrenology or the idea that the brain is divided into functional organs, the size of which can be determined by feeling the shape of the skull with larger areas having more influence, emerged in the late 18th century. While it is true that the brain is modular, and different areas serve different purposes, recent studies have shown no link between the shape of the scalp and brain. Studies have also shown that bigger areas of the brain are not necessarily 'better', as suggested by phrenology. Neuroskeptic pointed to an fMRI study of professional footballers moving their foot compared with amateurs, with the professionals showing less brain activity with the movement, suggesting that smaller areas of activation may simply be indicative of efficiency rather than unimportance.

While more of a bodily fluid myth that became a neuromyth, the idea of the four 'humors' – having excess blood, phlegm, yellow or black bile, affecting temperament – has evolved and persists to this day. The four neurotransmitters, Neuroskeptic suggested, are the four humors of our time. While the specific neurotransmitters vary, testosterone, oestrogen, serotonin and dopamine are often haphazardly blamed for certain personality traits.

But why, in the past and present, are we beguiled by these innaccurate explanations for human behaviour? Neuroskeptic suggested a need for us to relate abstract ideas such as personality and temperament to physical traits or substances, whether correctly or not. 'Neuromyths don't just occur at random, myths aren't born from random accidents or misunderstanding, they happen because we want things to be a certain way and to understand the world in a certain way.'

Professor Helene Joffe (UCL) suggested one important neuromyth to consider is the idea that expert thinking holds the truth, while public thinking is emotionally-driven and ignorant. This assumes expert knowledge is easily knowable, unanimous and unchanging. Joffe has examined media representation, and public understanding, of neuroscientific research and where misrepresentations may emerge.

In one study she and her colleagues examined 3,630 articles published on neuroscience research between the year 2000 and 2012. The majority were related to brain optimisation and training, pathological conditions and basic functions such as memory. In a second study involving free-association interviews with 48 people on their perceptions of brain research, Joffe uncovered four themes. First, that people saw the brain as a domain of science that was interesting but not personally salient. This distance people felt from science sometimes evoked admiration, and sometimes hostility. Second, people saw the brain as something that goes wrong and were often drawn to reading about neuroscience after personal or family experiences of problems with the brain, such as dementia. Third, Joffe found that people saw the brain as a source of human variation, and fourth that people saw the brain as a resource that is subject to individual control. People spoke of a desire to improve their brain function, with many believing that only a small percentage of the brain is used. Joffe pointed out that while we have long had an obsession with improving our bodies, a newer emphasis is placed on 'optimising' the brain.

Joffe moved on to trace the journey of a single study from publication, through press release, to subsequent media coverage. While the study reported findings that male brains show more communication within brain hemispheres and women's brains show more communication between hemispheres, the later press release mentioned a potential explanation for women's apparent ability for multitasking compared with a single-task focus in men – something the study did not suggest. From that press release emerged 87 newspaper articles, 162 blog posts and hundreds of reader comments.

Joffe said media reports introduced discussion, based on these findings, of differences in emotion, rationality, parenting and housework. The research was presented as vindicating the legitimacy of stereotypes, celebrated for undermining political correctness and perpetuated a view that women's inferiority was biologically ordained. 'As the information moved away from the original source it became more infused with the values of those who assimilated it.'

Joffe's first and second studies highlighted the focus people have on self-control and brain optimisation – a feeling that with enough work on our brains and bodies we can control our destiny. However, Joffe noted that when the reports of neuroscience findings take this view and people's place in the world is seen as deserved, the role of environmental and other factors is obscured.

Neuropsychopharmacologist Professor David Nutt (Imperial College London), who was sacked as a government advisor on drugs after delivering a speech in the very same room he spoke in at this event, asked whether antidepressants are magic or myth. He explained that antidepressant denial comes from a range of sources: anti-pharmaceutical ideology, opportunities for compensation, ignorance of the illness itself and a naïve belief that placebos would work as well as the drugs.

The nervousness around antidepressant use isn't new. In the 1980s selective serotonin reuptake inhibitors (SSRIs) were introduced to the market and were met by enormous resistance in Britain, being one of the last countries in Europe to take up prescription of the drugs. While this new class of antidepressants was much safer than earlier tricyclic drugs, there were concerns they could cause suicide and even homicide, lead to bad withdrawal effects and that they were ineffective. However, in the decade where both tricyclic and SSRIs were being prescribed in Britain, more than 2,500 deaths could be directly linked to the use of tricyclics, while seven were attributed to SSRIs. Nutt said probably around 5,000 people died because doctors wouldn't switch to the new drugs.

In a review of antidepressant efficacy, Irving Kirsch and colleagues claimed the drugs don't work and placebos or psychotherapy should be used instead. However, Nutt said, the authors included the drug nefazodone, which is no longer used… once this drug is removed from the analysis the drugs are shown to be effective, and subsequent reviews by regulators have again shown them to be effective.

While many suggest that psychotherapy could be an alternative to antidepressants Nutt said although sometimes it works no psychotherapy trials would meet the criteria for being licensed by the European Medicines Agency – many are not multi-centre trials, do not use a placebo or have an active control and instead use waiting list controls. There is also no auditing of the research output of psychotherapy trials and nor is it free from adverse effects: Nutt pointed to a shocking statistic that 40 per cent of all US psychotherapists have had sex with their patients.

Some have suggested replacing antidepressants with placebos. However, Nutt argued this could be unethical, unlicensable and ineffective. In treating pain, at least, if a doctor is aware they're using a placebo they tend not to work.

When assessing the effects of drugs on depression there tends to be a focus on acute effects, but if we look at preventing relapse in people with depression we see the effect size of anti-depressants is huge. In one study of depressed people who had been taking antidepressants and having psychotherapy, some stopped taking their drugs and continued therapy while others carried on as normal. After six months those who had stopped their drugs had largely relapsed, even with ongoing psychotherapy. In Europe drugs are put through a six-month continuation analysis. Nutt said these prove they work and continue to work: for example there is only a five per cent chance of relapse when taking paroxetine. 'Anti depressants are the most powerful drugs we have.'

Moving on to some of the biological bases of depression, Nutt pointed to the importance of the 5-HT or serotonin system in the brain, and his recent work on the effects of psilocybin in depression. Psilocybin is the active ingredient of magic mushrooms, and in an initial trial one dose has been shown to improve depression symptoms, even six months after that dose. These findings have led Nutt to suggest there may be two serotonergic routes to treating depression – through anti-depressant drugs which act on 5-HT1A receptors, and psilocybin which has a more immediate effect on 5-HT2A receptors. He has been in the process of starting a trial to put both these treatment routes to the test. 

The day also saw talks from Emma Yhnell (brain training), Duncan Astle (education), Chris McManus (left and right, hands and brains) and Chief Executive of the BNA Anne Cooke. There was plenty to exercise our brain cells. Indeed, as Neuroskeptic pointed out in the panel discussion, if the '10 per cent' myth were true, then 'we could be so much better, smarter, and achieve so much more.'