Dementia, Sexuality and the Brain

Dementia, Sexuality and the Brain

I am currently recruiting for a fully-funded ESRC CASE 1+3 MSc. & PhD studentship in partnership with Manchester Carers Forum. The studentship is available to outstanding candidates wishing to commence their MSc. in September 2017 before moving onto the PhD studentship in September 2018. You will be based in the University of Manchester’s Morgan Centre for the Study of Everyday Lives, which is a world-leading institute for the study of personal life and for the development of creative qualitative methods. This is a great opportunity for a talented student to become part of a thriving research community, in one of the UK’s largest and most successful sociology groups.

So why this project? In recent decades dementia has grown in significance as a health condition, brought about by an ageing population, and presents challenges for understanding the complex changes which occur in the lives of people with dementia. For example, some people with dementia experience changes in sexuality and sexual activity. Such changes are characteristic of one form of dementia in particular, ‘behavioural variant frontotemporal dementia’ (bvFTD), and form one of the possible diagnostic criteria for this condition. This doesn’t always mean increases in sexual activity, sometimes it can be a reduction, as Robin describes in this video about her life with her husband. Robin’s video is a powerful example of a carer negotiating her experiences of changes in romance and love.

These kinds of changes are often explained to carers and people with dementia, whether in the medical context of diagnosis and treatment, or in the support literature provided by charities, as having been caused by chemical and structural differences in the brains of people with dementia. Of course, dementia does have important effects on the brain and it remains a terminal illness. So it is bound to cause changes in people’s capacities. However, our everyday understandings of love, sex and sexual identity do not always align with neurological explanations. This project explores how people with dementia, their carers, family and partners, make sense of changes in sexual and romantic lives by reference to the brain, or not. It examines the consequences for carers and people with dementia of explaining more of their lives through neurological evidence and ideas.

The project will use the personal life approach in sociology. This means understanding changes in the lives of carers and people with dementia as being fundamentally entangled phenomena, and exploring the ways in which the meaningfulness of everyday life is negotiated through interaction. The project will use creative qualitative methods to examine these issues. For more information on the kinds of methods the Morgan Centre works with, see some of our research projects. For example, you can see some of the sketches that Lynne Chapman has been doing as part of various research projects in the Centre, here, and in the picture below, which Lynne made as part of her work with me on my ‘Facets of Dementia’ project.

dementia-couple-sketch

As an ESRC CASE studentship, the PhD scholarship will also involve close work with Manchester Carers Forum. The successful candidate will volunteer at the Carers Forum as a member of their team, working directly to support carers of people living with dementia. The PhD student will work there for 3 months of the year, broken down into a certain number of hours per week. S/he will also produce materials which are of use to the Carers Forum as an impact of the project, meaning that the PhD research will help to support carers in negotiating changes in sexuality, sex and romance.

Studentship Details: The successful candidate will be supervised by Dr Andrew Balmer and Prof. Brian Heaphy in the department of Sociology. This ESRC CASE 1+3 studentship will cover tuition fees for the 1-year MSc. Sociology and the 3-year PhD Sociology courses at the University of Manchester. It will also pay a stipend during these four years of approximately £14,057 per annum. Continuation of the award is subject to satisfactory performance.

Entry Requirements: Applicants must hold a Bachelors First Class (or in exceptional cases an Upper Second Class Honours) UK degree in Sociology (or a closely allied discipline such as Anthropology). Degrees in Psychology and Health Sciences will not be considered acceptable. The successful student will register first for the ESRC-recognised MSc. Sociology course before proceeding on to the PhD course. You must satisfy ESRC UK residential criteria to qualify for this studentship (see page 4 of the document here.)

Candidates meeting the following criteria will generally be given preference: above 70% in their Bachelors; some demonstrable knowledge of the sociological literature on sexuality; demonstrable interest in qualitative research methods, and the ‘relational’ approach to sociology.

How to apply

Applicants should email Dr Andrew Balmer, Andrew.Balmer@manchester.ac.uk with:

1) a full CV, (including most up-to-date grade transcripts) and;

2) a covering letter explaining why you think the project is interesting and how you are qualified to conduct it.

Please note that applying for this PhD studentship funding is a separate process to applying for entry to the Manchester PhD programme.  The successful candidate will therefore also be required to fulfil the normal admissions criteria for the School of Social Sciences once they have been offered the NWSSDTP studentship.

The deadline for applications is 7th April 2017.

The project is a great opportunity not only to develop academic, research, writing and presentations skills through a PhD programme, but also to work with a charity for three to four years. We will be looking for someone who can produce a sophisticated, theoretically-informed, qualitative PhD, with interests which align with those of the Morgan Centre.

If you need some more information feel free to get in touch with me at: andrew.balmer@manchester.ac.uk.

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Images and Visualisation: Imaging Technology, Truth and Trust


Image courtesy of Mette Høst

I recently co-chaired (with Brigitte Nerlich and Annamaria Carusi) an ESF conference on visualisation, hosted by the University of Linköping but actually held in Norrköping, Sweden. It went swimmingly, with a variety of interesting and instructive presentations and posters, from philosophers, sociologists, anthropologists, nanoscientists, astronomers, clinicians, modellers and academics from a variety of other disciplinary backgrounds. We also had contributions from artists and designers, who provided an enlightening and importantly different take on the way in which representations of/in science are produced, circulated and used.

You can see the final programme here: http://www.esf.org/index.php?id=9613

There were too many participants to name them all, and I don’t think I could really choose the ‘best’ as it were. But here are some of the themes that we addressed over the course of the week.

  1. Images and bodies: visual representations of various aspects of human and animal bodies, from the brain to arteries and from unicorns to monsters, the epistemological challenges posed by such images, the problems they pose for public participation in science and the issues around their use in medical practice.
  2. Images between bodies: issues around the use and interpretation of images between practitioners, such as radiographers and radiologists, doctors and patients, novice scientists and mature experts, scientific communities and lay communities.
  3. Maps and mapping: from brain images to landscapes, GIS and google maps, from the quantum level to quasars, again the issue of how these maps function within and across expert and lay communities was important, but so was the concept of ‘mapping’ as process.
  4. Scales of images and issues of beauty: the issue of the aesthetic quality of images of various scales and what makes a ‘good’ image, who decides when it is ‘good’ and for whom, and in what context.
  5. Images and ethics: issues around truth and trust were discussed with relation to representations, for example in how astronomical images are used for public outreach and how engaging publics depends on images that attract attention. We discussed whether there was an ‘ethical’ balance between beauty and truth and how that was negotiated in practice.
  6. Images and epistemology: here the issue of ‘representation’ was crucial. Much of the discussion was concerned with escaping an extreme relativism or a naïve realism when thinking through the relation between an image and reality, between an image and our knowledge of reality, especially with relation to phenomena that are by definition invisible, i.e. below the wavelength of light for example.
  7. Images and the constitution of social facts we explore how representations were used in the constitution of the self through brain imaging or pain mapping, and the significance of documentary photography for famine in India during British colonialism.

Overall, it was fascinating and there was a lot of will to continue our interactions in the future. We’re hoping to set-up a visualisation and science wiki, and I’ll post on that in the future. In the meantime, we have an email list and if anyone would like to be added to it, then do let me know.

Gary James Smith v. State of Maryland

fMRI lie detection evidence, supplied by the company No Lie MRI, has been considered during pre-trial criminal hearings in the USA, this time in the case of Gary James Smith v. State of Maryland [1, 2]. The device has already had a couple of hearings as potential evidence, with tests conducted by rival company Cephos, first in New York [1, 2] in 2010 and then again in Tennessee [1, 2, 3, 4] later that year.

Gary Smith is accused of shooting Mike McQueen in 2006 and is about to go to trial for the second time, after the Court of Special Appeals affirmed the verdict of the trial court, and then the Court of Appeal reversed and ordered a retrial. The first verdict, which had found him guilty of second degree murder (or ‘depraved heart murder’) was overturned on the basis that the trial court had admitted prosecution evidence of the decedent’s ‘normal’ state of mind, but hadn’t allowed evidence to the contrary.

The case is an interesting and complex one, particularly as regards medical and scientific evidence. For a start, both Smith and McQueen worked as Army Rangers and served in the ongoing conflicts in Afghanistan and Iraq. As such, both parties, the defense and the prosecution, claim that post-traumatic stress is, in part, to blame for the tragedy. In the first trial, the prosecution suggested that Smith’s PTSD may have left him unstable, which may have contributed to him murdering McQueen, whilst the defense argued that McQueen’s PTSD led him to commit suicide. The case thus quickly became a focal point for a still ongoing debate over the hidden psychological and medical costs of the war on terror. Furthermore, two experts appointed by the court were divided over the blood spatter evidence, with one claiming it suggested suicide and another that it pointed towards murder.

Moreover, as part of his pre-trial hearing with Judge Eric M. Johnson, of Montgomery County Circuit Court, Smith recently sought admissibility for fMRI evidence of the veracity of his claim that he did not shoot and kill McQueen. The evidence, though the judge found it ‘fascinating’, was excluded. The decision appears to have been founded on the current lack of evidence that the device works as a lie detector, said Judge Johnson: “There’s no quantitative analysis of this procedure available yet.” In contrast, Joel Huizenga, CEO of No Lie MRI, said: “There is always room to do more research in anything, the brain’s a complex place. There have been 25 original peer reviewed scientific journal articles, all of them say that the technology works, none of them say that the technology doesn’t work…that’s 100 percent agreement.”

It shouldn’t be a surprise that community opinion has again been influential in determining admissibility of scientific evidence regarding veracity, it has long been so, particularly since the long-established Frye ‘general acceptance’ rule was decided on the same basis in the case of the exclusion of the polygraph, nearly one hundred years ago. However, proponents of fMRI lie detection, such as Steven Laken, CEO of Cephos, have argued that lie detectors are held to a higher standard than are other forms of scientific evidence: “But the standard is set even higher for these lie detectors because of this idea that the judge or the jury are basically the final determiners of whether someone is lying on the stand…The courts are unfairly putting a higher bar on that than they are on other scientific evidence like DNA.”

Expert testimony, like that of the gun splatter expert, gets enmeshed in legal talk in unpredictable ways. Various technologies are enrolled to understand the significance and reliability of new techniques under consideration. Indeed, the polygraph – for instance – has often been compared to fingerprinting or DNA evidence when deciding on its admissibility. The difficulty that those supporting fMRI lie detection face is in seeking to make it amenable to a complex system in which notions of responsibility, guilt, lying and truth are constantly at play between rules, precedents, expert evidence and legal talk during trials. Take, for instance, the following quote from the closing statement of the prosecution in the first trial of Gary Smith:

“It’s been 18 months since Michael McQueen was buried.  This defendant shot him.  It’s time for justice.  Healing begins when justice occurs. And the only just verdict in this case, the only proper verdict in this case is to hold that person responsible for [what] the physical evidence shows, no matter what experts you want to believe, that he was right there when he was shot.  What your common sense and understanding shows [is] that you don’t stage a scene, you don’t throw away a gun, you don’t lie and lie and lie and lie to the police, unless you’re guilty as sin.”

This decision seems, on the face of it, to be a further defeat for the corporations seeking to admit fMRI lie detection evidence. However, advocates of exclusion, such as the eminent law professor and scientifically well-informed Hank Greely of Stanford Law School, whose testimony has been influential in these early cases, might be wise not to rest on their laurels. There are likely to be more, and perhaps more significant, spaces in which the battle over fMRI lie detection will be fought. Importantly, however, these are not as easy to pin down as the criminal trial courts. Lessons from the history of the polygraph regarding its entanglement with governance teach us that exclusion from criminal trial courts is far from the end of the story as goes lie detection.

The rhetorical construction of the polygraph as the lie detector contributed to its being adopted in a wide range of spaces in the USA. For example, the polygraph continues to be used in the context of employee screening, espionage, police interrogations and private investigation. Or take one further example: paedophilia. In a week or so I’ll be reporting on the use of the polygraph machine in the context of sex and criminal sexual behaviour, where it is now commonly used in the USA to manage paedophiles during post-conviction probation. Such use of the polygraph was recently trialled in several UK regions and looks set to be taken-up more broadly. As such, even though the device was barred from criminal courts in Frye, the polygraph has since been used in very particular, but also very important, legal spaces close, but just outside of the trial.

fMRI appears to be going the same way. The No Lie MRI website boasts that: “The technology used by No Lie MRI represents the first and only direct measure of truth verification and lie detection in human history!” This rhetoric of direct measurement has been a key one in the articulation of the fMRI machine’s potency for lie detection. Constituting the brain as the location of truth and thus of lying, the fMRI researchers have frequently claimed that we are looking directly into the lie. This has been used to help position the fMRI machine as the natural successor to the polygraph by positing it as a technological improvement on the polygraph’s indirect measurement. No Lie MRI claims: “lie detection has an extremely broad application base. From individuals to corporations to governments, trust is a critical component of our ability to peacefully and meaningfully coexist with other persons, businesses, and governments.”

Irrespective of whether the technique ‘works’, more attention should be paid to the complex way in which lie detection evidence is negotiated in relation to medical diagnoses, like PTSD, and other technologies such as blood spatter, DNA or the polygraph. Moreover, we have to better understand how lie detection techniques have dispersed into the US (and now into other countries, such as here in the UK), how they are used and what their consequences are, in order to better respond to fMRI’s emergence as a lie detector. Otherwise, fMRI may be excluded from criminal trials in much the same way as the polygraph but still find use in a variety of significant social, legal and political spaces that are far more difficult to control. The fMRI machine looks new and shiny but as regards lie detection, it might all be a little bit of history repeating.