The neuroscience behind 'getting more social' ...

In a comment on one of my most recent blogs - 'Sensory involvement in Intensive Interaction - a straight forward and/or a difficult question? (10/09/18) someone mentioned American psychologist Abraham Maslow (thanks Rachel) who was best known for creating Maslow's hierarchy of needs (obviously, that being his name), this hierarchy setting out the basis of his theory of the prioritisation of human psychological need fulfilment (and the associated motivational drives to act in ways to fulfil such needs). 

Maslow, in his seminal and still much referenced paper ‘A Theory of Human Motivation’ (Psychological Review, 1943), concisely defined this hierarchy of such human psychological needs (starting with the basic physiological needs of the body): 

· The basic needs: the physiological needs of the body (at the hierarchy’s base)

· The safety needs: the need for physical and social security

· The love needs: the need for love and belonging

· The esteem needs: the need for self-esteem and respect

· The self-actualisation need: the need to realise one’s individual purpose and inner potential i.e. in his own words: ‘What a man can be, he must be’ 

This mention of Maslow then reminded me of something I had seen a while ago (although I can't remember who pointed me to it - but thanks anyway); it was a wide-ranging and very powerful TED talk by neuro-scientist Matthew Lieberman that contested the ordering of Maslow's hierarchy. In his talk ‘The social brain and its superpowers’ Lieberman says that being socially excluded is analogous to feeling physical pain (i.e. that 'social pain is real pain') and therefore social inclusion and connection is vital for our very survival – and states that 'being social' should be at the base of Maslow’s Hierarchy of Needs i.e. below and supportive of access to the other, higher level physiological needs.

As well as somehow mentioning the world champion of 'Rock, Paper, Scissors' (as an example of 'social thinking') Lieberman says that 'social connection is the best predictor of happiness and well-being', and also that for all of us, “getting more social is the secret to making us smarter, happier and more productive”. Here, here, I say. 

Why not have a look at it at: https://www.youtube.com/watch?v=NNhk3owF7RQ 

Sensory involvement in Intensive Interaction - a straight forward and/or a difficult question?

Last week a current and very reflective trainee on our Intensive Interaction modular training course emailed me with a question:

The question: I was just wondering if you had any information around the different senses involved in intensive interaction (do they have names when one sense is more dominant and favoured etc)?

My (at the time I think unsatisfactory) answer:

Actually I have nothing specific in terms of written out information on 'the different senses involved in intensive interaction', but there are obvious sensory issues to be taken account of in how we look to use Intensive Interaction with someone who might have particular sensory needs or presentations (although I would say that all people have sensory needs that are personal to them) i.e. sometimes it can be more visual (e.g. when we physically mirror some aspect of someone’s behaviour), sometimes more via sounds (e.g. when we echo back the sounds they make or make verbal/vocal commentaries on some aspect of their behaviour) and sometimes it can be physical or tactile e.g. via rhythmical touch to the person or via shared movements together without touching which could include rocking together or running and twirling together. 

Sometimes some practitioners talk about meeting the service user’s ‘sensory needs’, which can be done via the sensory integration work of specially trained OTs or physios (which I don’t pretend to fully understand - like most things!), but when done within Intensive Interaction engagements we are really looking from improved social and psychological and/or emotional outcomes (e.g. improved connection, better interactive rapport and relationship building) by working through a service user’s sensory preferences (again that is something we all have).

Now I currently feel that I have short changed my trainee in trying to answer this question in a fairly concise fashion (within the time constraints I had that morning), and rather than setting out to trawl through all the Intensive Interaction literature to find something someone else has said that would concisely and more satisfactorily answer this both straight forward and/or quite difficult question (the source of which I am currently unaware), I thought I would put it out for all our II community to mull over and hopefully join a usefully reflective debate. 

Now obviously Intensive Interaction does rely on the sociable use of a person's senses, all of them to some degree (probably) and more so via certain preferred or more acutely socially attuned senses; but within Intensive Interaction it is done with the person, not to them, and it is not done to meet any apparently identified sensory need - it is done to make a psychological not a sensory connection (although obviously again the two will in some way overlap and quite possibly be mutually interdependent, and hopefully mutually supportive). 

So, understanding a person's sensory preferences as demonstrated within a social interaction (as opposed to how they present in a individualistic or neurological sensory assessment type way) can surely be of some help to all people trying to engage with someone with a communicative or social impairment - but then I find myself asking another question: 

Could an attempt to consciously and proactively differentiate sensory preferences within an Intensive Interaction engagement deflect the practitioner from responding in an intuitive and attuned way, 'in the moment', to the person as a integrated social  actor, if they are trying to frame their responsiveness to fit with any apparently identified sensory needs first? 

Hmmm, a really good question, and yes, perhaps more difficult than straight forward to try to answer. Anyone else want a go?

Behavioural imitation and its affect on empathy in adults with high-functioning autism

I came across an interesting paper a few weeks ago that looked to investigate how some form of behavioural mirroring can positively affect the expressed feelings of empathy in adults with high-functioning autism (HFA). Below I have reproduced some extracts from the paper's abstract (and I have enbold-ed the 2 most important bits). The paper is:

The effect of being imitated on empathy for pain in adults with high-functioning autism: Disturbed self–other distinction leads to altered empathic responding 

 by De Coster,  Wiersema, Deschrijver & Brass (2017) in 'Autism', 22 (6), 712-727.

'Autism spectrum disorder is a neurodevelopmental disorder that is associated with problems in empathy. Recent research suggests that impaired control over self–other overlap based on motor representations in individuals with autism spectrum disorder might underlie these difficulties. In order to investigate the relationship of self–other distinction and empathy for pain in high-functioning autism and matched controls, we manipulated self–other distinction by using a paradigm in which participants are either imitated or not by a hand on a computer screen. A strong pain stimulus is then inflicted on the observed hand.'

'Behavioral and physiological results in this study showed that overall affective responses while watching pain movies were the same in adults with high-functioning autism as in controls. Furthermore, controls showed higher affective responding after being imitated during the whole experiment, replicating previous studies. Adults with high-functioning autism, however, showed increased empathic responses over time after being imitated. Further exploratory analyses suggested that while affective responding was initially lower after being imitated compared to not being imitated, affective responding in the latter part of the experiment was higher after being imitated. These results shed new light on empathic abilities in high-functioning autism and on the role of control over self–other representational sharing.'

Now this very carefully controlled study, with all its dense and at times difficult to understand language ('self–other overlap' and/or 'self–other representational sharing' anybody?), is non-the-less really interesting. 

Although obviously much more research is required in this area, this study seems to be suggesting that by deliberately imitating some aspect of the behaviour of a person with high-functioning autism over an extended period of time ('secondary analyses showed that the effect of imitation was strongly modulated by time'), and thus being in some way visibly more like the person with high-functioning autism, we enable them to be more empathetic to our condition and our potential feelings or emotions. 

In this study the 'imitation' was somewhat contrived using a videoed picture of a hand being somehow hurt (yes I know, it sounds a bit of a CGI lab-rattish nightmare doesn't it), but even then ... 

'Adults with HFA showed an increase of empathic responding over time in an imitation condition and a decrease over time in a non-imitation condition.' 

... but imagine if we took this out of the white-coated laboratory conditions; yes, imagine the extra empathic effects that might have accrued if it had been a real human being, doing real Intensive Interaction, and creating real two-way empathic communication?