A sugar pill for creativity

Following hard on the heels of a post about the possibility of creativity existing in a machine (and how we could tell if it did), today we look at recent research from the Weizmann Institute of Science (of Rehovot, Israel) showing that your creativity can be increased...

... by a placebo.

In a paper released last month, neuroscientists Liron Rozenkrantz, Avraham E. Mayo, Tomer Ilan, Yuval Hart, Lior Noy, and Uri Alon used three standard measures of creativity -- the creative foraging game, alternate uses test, and Torrance test of creative thinking -- to see if subjects' creativity levels improved if they were given a vial of a cinnamon-scented liquid to sniff beforehand.  The interesting thing is that the aromatic chemical in the liquid isn't neuroactive, but some of the test subjects' creativity improved anyhow.

As long as they were told ahead of time that's the effect it would have.

[image courtesy of the Wikimedia Commons]

The authors write:

Creativity is the ability to generate ideas, solutions or insights that are new and potentially useful.  Creativity is often viewed as a trait characteristic of a person; however, creativity can also be viewed as a state, affected by expectation and motivation...  

We find that placebo can enhance the originality aspect of creativity...  What are the psychological mechanisms that allow placebo to increase the originality aspect of creativity?  There are at least two possibilities. The first mechanism is based on extensive research by Amabile and Deci and Ryan, that suggests that creativity is modulated by motivation.  Extrinsic motivators were shown to be mostly detrimental to creativity, whereas intrinsic motivation is conductive to and strongly associated with creative abilities.  A key factor in intrinsic motivation, according to self-determination theory, is the belief in one’s competence.  For example subjects who practiced encouraging statements (related to self-confidence, releasing anxieties etc.) and omitted self-incapacitating statements showed improved creativity scores.  This is in line with the verbal suggestion in our study that the odorant increases creativity, which may have made subjects feel more competent.  Additional components of intrinsic motivation, such as social relatedness, may also have been increased by experimenter effects in the present study, by the experimenter’s perceived interest in the effects of the odorant. 

A second possible psychological mechanism of placebo, as suggested by Weger et al., is to weaken inhibitory mechanisms that normally impair performance.  Creativity was found to increase in several studies that tested conditions with reduced inhibitions, such as alcohol consumption.  Wieth and Zacks showed that creative problem solving was improved when participants were tested during non-optimal times of day, and suggested that this is due to reduced inhibitory control... This effect was suggested to be in line with paradoxical functional facilitation theory, which attributes improved performance of damaged nervous system to release from inhibition. Informal notions in improvisation theatre suggest that the inner critic is a source of inhibition that limits creativity.  The verbal suggestion made in our study that the odorant increases creativity and reduces inhibitions may thus work through a reduced-inhibition mechanism and/or by increasing belief in one’s competence.

So this suggests that there are two outcomes, here:

• Anything that works to increase your confidence in your own creativity will improve your ability.  This undoubtedly varies greatly from person to person, but it does make me wonder if all of the happy-talk "self-affirmation" stuff, which I had previously derided as pop psychology, might not have something to it.
• Ernest Hemingway may have been right when he said, "Write drunk, edit sober."

I can say from my own experience that frustration is the thing that kills my creativity the fastest.  Whether with music or writing (my two main creative outlets), if I start becoming frustrated with my skill, output, or proficiency, all it serves is to get in my way and make things worse.  I used to grit my teeth and try to plow through it, but I learned that this only tightened the downward spiral -- once frustration has set in, every fumbled note, every clumsy sentence, only serves to further shut me down.  The only solution was to leave the instrument or the keyboard behind -- not easy to do for a tightly-wound type-A personality like myself -- and do something completely different, preferably something active like going running.

Afterwards, it was amazing how the cogs had been loosened and the cobwebs blown away.  With writer's block, I often found that it was while I was running that the solution to whatever plot point I was wrestling with suddenly came to me, seemingly out of nowhere.  The research by Rosenkrantz et al. suggests that the loss of inhibition and cessation of negative self-talk from switching gears entirely might have been what shook the ideas free.

In any case, it's fascinating to find how malleable our minds are, how amenable to suggestion.  It also brings to mind the 2010 study that found that placebos work even when subjects know they're being given a placebo -- and makes me wonder if I should take a good whiff of cinnamon before I next sit down to write.

Voodoo in the brain

I'm sure you've heard about the placebo effect, but have you heard of the nocebo effect?

If you know a little Latin, you can guess what it means.  Placebo is Latin for "I will please;" nocebo for "I will harm."  The nocebo effect occurs when you expect something to cause you unpleasant symptoms, and even though what you've consumed is harmless, you experience the symptoms anyhow.

We've known about the nocebo effect for some time.  It gained prominence due to investigations of "voodoo curses," where someone was cursed through a voodoo ritual, and lo and behold, the cursed individual sickens and dies.  Skeptical researchers don't credit this with voodoo actually working; they have come to realize that when a person thinks they're going to become ill, perhaps even die, the expected outcome manifests in the body.

[image courtesy of photographer Marie-Lan Nguyen and the Wikimedia Commons]

A recent study gives us an even better lens into the nocebo effect, and how the brain influences health.  Any medical researcher will tell you that people in clinical trials of medications will often stop taking the pills they were given, usually citing unacceptable side effects.  What is less well known is that a substantial fraction of the people who end up dropping out of the trial actually were receiving an inert substance.

So the control group, in other words.  They were taking a sugar pill, but because they expected to have side effects from the medication, they went ahead and had side effects anyhow.

The most recent study, which was published in Science last week, was the work of four researchers at the University Medical Center of Hamburg, the University of Colorado, and Cambridge University, and had the unwieldy title, "Interactions Between Brain and Spinal cord Mediate Value Effects in Nocebo Hyperalgesia," and it had a fascinating result:

People in the control group of pharmaceutical clinical trials are more likely to have spurious unpleasant side effects if they're told the medication is expensive than if they're told it's cheap.

Furthermore, they have pinpointed the areas in the brain that are responsible for the foul-up.  The authors write:

Value information about a drug, such as the price tag, can strongly affect its therapeutic effect.  We discovered that value information influences adverse treatment outcomes in humans even in the absence of an active substance.  Labeling an inert treatment as expensive medication led to stronger nocebo hyperalgesia [negative side effects] than labeling it as cheap medication.  This effect was mediated by neural interactions between cortex, brainstem, and spinal cord.  In particular, activity in the prefrontal cortex mediated the effect of value on nocebo hyperalgesia.  Value furthermore modulated coupling between prefrontal areas, brainstem, and spinal cord, which might represent a flexible mechanism through which higher-cognitive representations, such as value, can modulate early pain processing.

Which is kind of amazing.  People who experience unexpected side effects are often labeled as hypochondriacs -- i.e., that they know perfectly well they feel fine, and are making up or exaggerating their symptoms out of fear or a desire for attention.  What's really happening appears to be far subtler.  Because of an expectation of harm, the brain actually manifests the symptoms the person feels they're likely to have.  Labeling the medication as expensive increases the subject's sense of having put something unusual into their bodies, resulting in more anxiety and worse side effects.

For me, the most interesting thing about this is the interaction of the brainstem and spinal cord, two parts of the central nervous system that are usually regarded as controlling completely involuntary responses, with the prefrontal cortex, often considered the most advanced part of the human brain -- the part that is associated with reasoning, decision making, and logic.  The fact that a freakout (to use the scientific terminology) in the prefrontal cortex activates a response in the brainstem is astonishing -- and also explains why people who experience the nocebo effect can manifest actual measurable medical symptoms.

And why some of them die.

All of which brings home once again how incredibly complex the brain is.  We're living at an exciting time -- the point where we're finally beginning to understand the thing in our heads that artificial intelligence pioneer Marvin Minsky called a "three-pound meat machine."  And, apparently, how easy it is for the machine to get fooled.  Kind of humbling, that.