Concerning anxiety: art meets neuroscience

Brian Hyland in conversation with artist (& occasional poet) Mike O’Kane

In the corner of my office, I have a sculpture on loan from artist Mike O’Kane. It confronts me every day with a wonderful juxtaposition of the themes of my work in neuroscience: how the brain works, and the personal experience of conditions that strike to the sense of self and the equilibrium of mood and emotion. An extremely prevalent example is anxiety disorder. Many of us have either personally experienced this, or know of someone who has.

Mike built the sculptural piece in response to a family member’s experience of anxiety with panic attacks, to explore the possibility of achieving a therapeutic in(ter)vention through art.

destination or journey
journey or destination
relax gadget mind
silence

you don’t know me
but it is me, sort of

The idea was that the sufferer would wear the device and through manipulation of something still under their control – the physical motion of the hand – they could, via an external loop, create influence on the internal processes that were currently out of their conscious, internal control.

The sculpture consists of a modified face safety visor, worn by the sufferer to help deflect the slings and arrows of seemingly outrageous fortune – those uncontrollable outside signals and events that elevate stress and can trigger the internal machinery of anxiety.

breath in
breath out
washing
breath

Arrayed around the visor headband are four hammers with modified hinge mechanisms. These are derived from the carcass of an old piano. They are wooden, with a dense felt block. The felt block was originally designed to strike piano wire with percussive force, evoking a sound. In other words it was capable of imparting significant energy to the substrate, resulting in a transformation from action to sensations. It was a ‘transducer of intention’.

you are here, you find me
yet
I need to know
things go wrong

the hand I touch with
you are mine but not me
sometimes you are here
reassuring

The hammers are attached through aluminium brackets so as to be aligned at the correct striking distance and angle to the skull. These brackets also guide the cables that control the hammers into the correct configuration across the hammer hinge. The actuating system for the hammers utilises modified bike control cables that are guided to align with the fingers of one hand by an aluminium bridge on an adjustable leather wristband. The cables are then attached to lugs on four anodised aluminium rings, set at different distances from the hammers, such that each sits naturally at around the first joint of each finger.

fingers speak
but
watch what you say

What Mike has captured in the sculpture are the key elements of our current understanding of how the brain works and fails. In neuroscientific understanding,  normally functioning brain tissue is the platform from which all experiences of mind and behaviour control arise. Mike’s artistic vision has converged on this conception in many important ways, from a non-scientific starting point.

Anxiety can be seen as a problem of out of control loops of thinking linked to the raw biology of the body. Systems designed to detect and protect us from harm become deregulated, for whatever reason, and more active than they should be. Self-sustaining loops take over, and normal mental experience is hijacked by the parts of the brain responsible for anxiety reactions. We even use the term ‘to lose one’s mind’. The brain circuits responsible for the patterns of thought we call anxiety are linked strongly to the pathways that prime the body to respond to real threat by raising the heart rate, inducing sweating tensing muscles and hyperventilating (the famous ‘fight or flight’ response). Self-perception of these bodily changes is fed back to the brain, much like a perception of outside events, further magnifying activity in those internal loops.

This is a classic positive feedback system, and it cries out for some intervention to break the internal loop and allow normal transmission to be resumed. The sculpture reflects Mike’s intuition that the anxiety trap might be broken, if only there was some way to make an impact on the system from the outside. But look at the hand: that’s still working. Can we utilise this controllable extremity, which is as far removed as possible from the gut churning anxiety, to break the loops?

In the sculpture, this insight is realised through an artificial, external link from the fingers to the skull-hammers. This is intended to allow the brain itself, through its control of the hand, to ‘speak’ to other regions of its own structure via a long external pathway. The hope raised by  Mike’s work is that those elements of the self that remain under appropriate control – here the control of the limbs – could choose to engage with the anxiety problem and do something about it, if only it were given the means through such an external loop. The neuroscientific interpretation is that this hammering could break or interrupt those internal maladaptive loops that have spiraled out of control. These insights show strong parallels to, and could be thought of as a metaphor for, the ability of the conscious self to self-treat its own thought e.g. the strategies of thinking provided by Cognitive Behavioural Therapy (CBT).

There are also clear parallels to the effectiveness of other externally applied interventions. For instance, electrical shocks are applied to arrest abnormal heart rhythms (the lifesaving defibrillator) to allow restoration of normal activity. More controversially, such shocks can be applied to the brain, for much the same purpose, through electroconvulsive therapy, and more recently, various more localised and subtle procedures such as deep brain stimulation. All of these are explicitly designed to transiently interrupt abnormal patterns of electrical activity in the body, to allow the normal to reassert itself.

who will hurt me
I survive I win
maybe I’m ready for
my apotheosis now
who will bring me home

if I could just be
good
without trying

breath out
breath
in

chest muscles
shoulder blades
I did not send you
energy
to hold so tight

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Poem and drawings by Mike O’Kane

Mike O’Kane studied art in Nelson, Canberra and Dunedin, and has a Bachelor’s degree in Fine Arts from Otago Polytechnic. He has a number of solo and group exhibitions at regional and privately run galleries. He lives in Dunedin. Find out more about Mike’s work on his website here.

Brian Hyland studied medicine and neuroscience at Otago, and is currently Professor and Head of Department, Department of Physiology, School of Biomedical Science, University of Otago, in Dunedin.