Technology

So is the effort of sampling inner experiences a game worth the candle? The half century Hurlburt has spent collecting samples of conscious experience has yielded some interesting and important findings. The first finding, to which I can personally attest, is just how little most of us know about the characteristics of our own inner experiences. “That’s probably the most important finding that I’ve got,” Hurlburt said.

Inner speech, which many of us – including many philosophers and neuroscientists – believe is the common currency of consciousness, may actually not be all that common. Hurlburt estimates that only a minority of us are “inner speakers”. So why do we think we talk to ourselves all the time? Perhaps because we have little choice but to resort to language when asked to express what we are thinking. As a result, we’re “likely to assume that’s the medium for inner thought”. We’ve also read so much about the importance of words to thinking – words written by philosophers and scientists (not to mention novelists) for whom it may well be true.

But that doesn’t make it true for everyone. Fewer than a quarter of the samples that Hurlburt has gathered report experiences of inner speech. A slightly lower percentage report either inner seeing, feeling, or sensory awareness. Still another fifth of his samples report experiences of “unsymbolised” thought – complete thoughts made up of neither words nor images.

The fact that there is so much variation from person to person in our modes of thinking is itself an important finding of descriptive experience sampling. Most of us assume that our inner lives must be substantially similar – not necessarily in content but in the form our thoughts take. Hurlburt has suggested that we fail to recognise the diversity of thinking styles because we lump them all together under that single word – thinking – and assume we mean the same thing by it, though in actuality we don’t.

In your book, you say that one of the most significant developments emerging in pain treatment is the fact that the brain is at the center of any pain experience. Can you tell us more about why that matters?

What I think has become clear — and I’m not the first person to say this — is the idea that if the brain doesn’t decide you have pain, then you don’t have pain.

The brain can also create pain where it seems like it wouldn’t exist.

The team’s initial thought was that the differences in mortality rates across the country might be explained by deaths of despair—suicide, alcohol poisoning and drug overdoses such as from opioids. However, this was not the case. Deaths of despair only accounted for one-sixth of all midlife deaths.

They then looked at whether geographic differences in mortality rates could be explained by differences in education, such as if a person had a college degree, and whether states with more college graduates had better mortality than states with fewer college graduates. Education was not the root of the problem, as health inequality was still present after education at the state-level was accounted for, the researchers found.

The researchers also investigated how state-level income impacted the increased divergence in mortality rates. “Our findings show that over the past three decades, mortality rates have improved in states with initially high incomes in 1990 while the rates in low-income states have lagged behind,” says co-author Ellen Meara, an adjunct professor at The Dartmouth Institute and a professor of health economics and policy at the Harvard T.H. Chan School of Public Health. “In 2019, high-income states experienced the biggest drop in mortality rates relative to 1968 or 1990, whereas, the low-income states barely budged at all.”

It wasn’t income that drove the great geographic divergence in mortality, the researchers say. Instead, it appears to be the long-term benefits of public health and social policies that were enacted by higher-income states in the 1980s and 1990s, particularly relating to children and adolescents, as they started paying off at midlife in the 2000s and 2010s.

“Investments in public health—higher taxes on cigarettes, expansion of the earned income tax credit for families, and expansion of Medicaid to pregnant mothers in high-income states—are the most likely candidates for why some states gained and others didn’t,” says Skinner.

Meara says, “our results demonstrate how regional investments in health capital over the lifecycle, including policies aimed at adopting good health behaviors, can provide long-term benefits for residents, significantly increasing life expectancy.”