There's a lot of noise in this operating theater,
but I want you to listen out for something.
In preparation for this patient's neurosurgery,
doctors have put electrodes into his brain
to record the activity.
Through a speaker, we can hear
the firing of individual neurons.
He's agreed to help me with
an experiment about decision making.
Ok, can you tell me what you're seeing,
so it's very simple.
Without him knowing it,
his brain will decide whether this is a rabbit or an ostrich.
It could be seen as either.
What do you say? An ostrich?
As his brain comes to a decision,
there's a subtle change in the audio.
It's buried in that pop-pop-pop.
This is the sound of a decision getting made.
We're eavesdropping on single neurons,
working in concert with billions of other neurons
to land on a choice.
This is what every decision
in the history of the human species looks like.
Every marriage proposal, every declaration of war,
every leap of imagination, every mission we've launched,
every bit of human magic looked just like this.
Our brains are constantly making decisions.
Some we're aware of.
Most we're not.
Deciphering what we hear, or see, or smell.
These are decisions.
So is being afraid, falling in love, giving in, resisting.
Decision-making is what allows us
to navigate a course through life.
And your lifetime of choices has sculpted you into
the person you are right now.
No matter how easy your day seems,
your brain is always hard at work...
making choices, weighing up different options.
And it's often in a state of conflict...
locked in a great power struggle... with itself.
Let me show you what I mean.
Right now, I have to make a momentous decision.
Mint frozen yogurt? Or lemon?
This is serious business... because I like both.
Inside my brain, this choice unleashes
a whirlwind of activity.
Neurons are wildly getting in touch with one another.
They're forming competing networks.
One favors the zing of the zesty lemon,
the other the freshness of the mint.
When I finally go for the lemon,
I have no real idea why I chose it.
But if I could see under the hood, I would find that
the lemon network has fought harder and won,
squelching my mint network.
And it's not just mint versus lemon.
I'm wondering whether to eat this yogurt at all,
because part of me wants it but
part of me knows that it's fattening.
And it's because of this sort of conflict
that we can get angry at ourselves
and cuss at ourselves and cajole ourselves.
Who's talking with whom exactly?
It's all you, right?
But it's different parts of you.
These rivalries are with us in every decision that we make.
They're usually so easily resolved
that we're unaware of them.
But in some situations, they show themselves.
We can feel the tug of different networks.
I'll show you what I mean... if I can find a willing volunteer.
Excuse me, do you want to participate in an experiment?
I don't think so. Ok.
Excuse me, do you guys want
to participate in an experiment?
This will only take 30 seconds.
Sorry, we're late. Ok. Ok.
Would you participate in an experiment for 30 seconds?
Ok. Ok, so here's what you're gonna do.
Put your hands out. Ok.
And I'm going to ask you to name the color of the ink.
Ok, so what color is that ink?
Red. Good. Ok.
What color is that ink? Blue.
This is a pretty easy task.
Red. Blue.
But introduce a conflict... Between
the word and the color of the ink, and the situation changes.
Blue... Yellow... Orange...
Orange... Blue... Green..., uh, blue.
Ok.
Orange... Green... Blue... Red...
Orange... Blue... Green...
I had to close my eyes!
Yeah, I saw that.
It's hard because of rivalries
playing out inside the brain.
One network is involved in naming colors,
another has a lifetime of training in reading words.
Red... Blue.
With both networks battling it out,
you can directly experience the conflict.
To get the right answer, you have to actively suppress
the word reading to name the color.
There are occasions when rival networks can't be reconciled,
and those offer a special insight.
In this rare footage, we can see conflict
in the brain expressing itself in the body.
Psychologist Matt roser is a specialist
in a condition known as alien hand syndrome.
This is a rare side-effect of a split brain surgery
which is sometimes used to treat epilepsy.
A split brain surgery is the disconnection of
the two hemispheres of the brain,
the two halves of the brain.
By cutting the brain in half, you control the epilepsy better.
In this patient, it has further,
disturbing consequences.
It affects all her motor skills,
particularly the movement of her hands.
She can do what the doctor asks with one half of her body...
Can you lift your hands up in the air?
But she has no conscious control
of the other half.
Can you give me a thumbs up with this hand?
Give me a thumbs up.
Show me the index finger of your...
Her right brain takes control of her left hand
and fights for attention.
What's going on? Tell us what's going on.
Can you show me your pinky?
Ok, good.
Can you take your pinky and touch your forehead, please?
The hand just doesn't respond to commands,
it seems to have a will of its own.
Because now there are almost like
two half-patients inside one body.
Can you show me your thumb?
Show me your thumb.
For this patient, her alien hand syndrome
was eventually brought under control.
Yeah, I can't stop it.
But the disorder reveals something
that's normally hidden,
giving us a window into the struggle
that's waged inside our heads every day.
Can you show me... Can you show me your thumb?
Show me your thumb.
In the business of decision-making,
two big systems that often come into conflict
are those we can summarize as reason and emotion.
These systems work together, so we're generally not aware that
more than one thing steers our decisions.
But some situations can tease them apart.
Consider the trolley dilemma.
- Hi. - Hi.
I'd like to invite you to step into this booth here,
and we're gonna show you a video
and just ask you a question about what you would
do in this sort of scenario. Ok.
You see a train trolley whose brakes are broken.
It's barreling down the track out of control.
In its path, you see 4 workers.
They're too far away to warn, but if you don't do something,
they face certain death.
Then you see a lever.
If you pull it, you'll divert the trolley onto another track
and those 4 workmen will be saved.
But here's the thing: Another man
is working on the other track.
If you pull the lever, he will definitely die.
So do you pull the lever?
Probably now.
Ok, did you pull the lever?
I pulled the lever. Ok. Great.
Now here comes scenario two.
There's one more scenario here.
Ok, great... here we go.
This time, the dilemma is slightly different.
There are still 4 workers in the path
of the out-of-control trolley.
But now there's no lever...
No way to divert the trolley.
Instead, there is a large man
standing on a water tower next to the track.
Push him off, into the trolley's path,
and his weight will be enough to stop the trolley.
You'll be sacrificing one to save the others.
So do you push the man?
Ok, did you push the man off?
Absolutely not.
Ok, what did you do in the first scenario?
Did you pull the lever?
I pulled the lever.
Because it's trading one life for 4 lives, right?
So what's the difference between the two scenarios?
The physical contact of causing death...
even though I can see where they were the same thing,
they would have the same result...
my gut feeling was... Was averse to that.
Everyone I ask makes the same choice.
They'll pull the lever, but they won't push the man.
- No. - Ok.
It's the same ethical dilemma in both cases.
Would you trade one life for 4?
In the first scenario, it's just a math problem.
In the second one, you have to
physically interact with the man,
push him to his death, and that recruits
other networks in the brain involved in emotion.
So what's going on behind the scenes?
The conflict is being played out across the brain.
At first, the logic system dominates,
but introduce the idea of killing a man with your bare hands
and the emotion system comes online, tipping the balance.
You're caught between competing drives, with the result that
your decision can change entirely.
The trolley dilemma sheds light on real-world situations.
Think about modern warfare.
When you launch a long-range missile or pilot a drone
or program a cyber attack,
these cause damage at a distance.
The rational networks are at work,
but not necessarily the emotional networks.
Detachment reduces internal conflict.
It's more like pulling the lever than pushing the man.
War is easier to wage at a distance.
If we're capable of bypassing our emotional systems,
why do we have them at all?
So often in neuroscience, we learn most about the brain
when things go wrong.
For two decades, tammie Myers had
a successful career as an engineer and a happy marriage.
Then, two years ago, there was an accident.
That morning we got up and rode about an hour.
From what my friends tell me,
we went into a 90-degree turn that was not marked.
And, um, tried everything we could to get around the turn.
The bike went down.
From there I don't remember anything.
Tammie recovered from the crash,
but one problem remained.
We're gonna need 4, 'cause it's...
She now struggles to make even the simplest decisions.
I don't... i don't...
I don't... i don't care.
I'm going to start crying.
I don't want to cry.
But there's too many things in there.
There's good days and there's bad days...
and you don't necessarily know what day it's gonna be
when you wake up in the morning.
You know, I'm waiting for the day that...
Water, 2 cups.
You know, that she's normal.
I can't make any... It's too many things
for my brain to process that's just absolutely stupid.
Tammie's brain damage is in the pre-frontal cortex.
Her logic and emotion systems have become disconnected.
They're still working... but her emotions are
no longer linked to her intellect.
Tammie's injury reveals that
even in the most basic situations,
emotion is a necessary component of decision-making.
To understand the damage, tammie's neurologist Dr. eslinger
has brought her here to the grocery store.
to drape them over the ham.
Tammie still experiences
some level of emotional expression.
It's just that it's very kind of elementary in a way
and it's not linked into the logical system.
I don't understand what the difference is
of all these things.
Right, if I forget things, I'll get my husband to pick them up, 'cause...
Eslinger wants to see how Tammy copes with
the most basic of choices... what should she buy for dinner?
So here you have some choices.
How do you decide what it is you would like?
Um, I just look
at different things that are here
and the different prices,
and, uh,
I don't want big potatoes.
I'd probably just pick up a bag of, like...
Maybe the gold potatoes or...
She was taking in the information accurately
about what she was seeing and the fact there was cost
and there was size and color.
So her brain was processing all the logical information
but the emotion system wasn't coming into play,
linking to that logic system.
There is so many.
Why do you need so many potatoes?
That's right.
My chest is all tight, thinking about all this.
Well, why is that?
Because it's stress, it's a decision,
it's, um... there's a lot of stuff laying here.
Tammie quickly became overwhelmed with information
that she couldn't prioritize.
The route that she took was,
"well, let me take that one and get out of here."
I can't process the information.
It's too much.
Now, was that true before your accident?
No, no. I was an engineer.
I could do everything, but now I can't,
can't pick a ham, let alone... Make 10 decisions
at work within the next hour...
10 decisions maybe in the week.
The situation makes tammie stressed
but she can't make herself care about her choices.
To make a decision, she needs to somehow
value one option over another.
It's a lot of information to process.
That's what it is...
And that can only be done with
the help of the emotions.
It's information that you have to put
into your head, I guess...
The logical brain system still is very strong
and we want to force it to tap into the emotion system.
So one of the things we do day to day
is we discard things that are not so important.
And sometimes it's our emotions that
help us do that separation.
By having that logical brain system work on the process,
we may be able to break through
at least in some ways to reconnect those.
I... i... I just sit...
I don't know what tomorrow is...
am I gonna be better, am I gonna be worse?
Yeah.
It seems like the pieces of the puzzle
could be coming together in a gradual fashion,
but it's really slow... as far as
my past being would have accepted.
Tammie's story shows how important
emotions are in making decisions.
But here's the thing.
Emotions don't just happen inside the brain.
Our emotional systems interact with the rest of our physiology.
When we're faced with choices, our muscles imperceptibly tense,
our hormone levels fluctuate.
These are automatic, physical reactions... gut feelings.
And we need them.
I'm trying to decide what kind of soup I want,
but it's a really difficult choice.
There are so many details for my brain to compute.
There is calories and price and taste and salt and packaging.
There are a million details here,
and I'm gonna be paralyzed all day
under this mountain of data, so what I really need is
some sort of summary, a quick read,
and that's what the physiologic states of my body give me.
It allows me to put a value on this choice
and a value on that choice
and that's what allows me to make the decision.
This conversation between the body and the brain never stops.
But it really comes to the fore
when we're stressed or in danger.
Take this situation.
Before I think rationally about what's going on,
I react physically.
My sweat glands open...
My heart rate increases...
My pupils dilate.
My body's screaming a simple message...
"Get me out of here!"
Every day, we experience emotional states like this
but because they're mostly subtle and unconscious,
we're not typically aware of them.
But it turns out these states are crucial for navigating
all the decisions in our life.
Most of us tend to distrust decisions based on feelings,
rather than intellect.
So it can be surprising to learn
just how much insight feelings can give us.
Richard tunney is an experimental psychologist.
He studies the formation of unconscious decisions.
Just gonna connect these electrodes...
He's running an experiment known as the Iowa gambling task.
I need you to keep your hands still
'cause that will affect the measurements that we make.
A volunteer chooses to draw a card from one of 4 decks.
Each time she draws a card,
she wins some amount of money and she loses some.
Her task is to earn as much as possible.
As she plays, she's hooked up to a machine
similar to a lie detector.
It monitors tiny changes in the sweat glands in her skin.
What she doesn't know is that
the decks are not random but rigged.
If she keeps choosing from decks a and c,
she'll end up making the most money.
The question is, how long before she figures that out?
The participant will explore the decks
in the first instance and they'll choose from all 4 decks,
but doesn't really begin to choose from the good decks
consciously until they're in the region of 20-30 cards.
The monitor indicates that
volunteers figure out which decks
are good and bad much earlier.
After only 10 tries, there is a spike of activity...
a warning sign... whenever she reaches for the bad decks.
She doesn't realize it, but that's the beginnings
of a hunch... an understanding that her body registers
before her conscious mind.
What we're seeing here is we're seeing some
physiological response prior to making the decision.
This spike here in effect predicts the choice
the participant is going to make.
As her hunch grows stronger, she marries logic
to what her body's been telling her...
which decks to draw from and which to avoid.
Ok, Elena, can I stop you there for a moment
and can I ask you if you had to choose
any one of those 4 decks for the rest of the experiment,
which one would you choose?
I think I would choose deck c.
Ok. Right, carry on.
It may feel like a logical deduction,
but it's built on a physical foundation.
The body and the brain are all integral to one another.
It's all part of the same system.
If physiology always plays a part
in our decision-making, what does that say about us?
Do we ever act in a purely rational way,
or is that simply an illusion that we cling to?
Well, consider this.
If you ever come before a parole board, keep an eye on the clock.
We would all hope that lady justice is impartial,
but studies say otherwise in a way that might surprise you.
Two men come up for parole on the same day but 3 hours apart.
They've committed the same offense
and served the same sentence.
So what does the judge decide?
Now, here's what happened.
The first prisoner was granted parole
and the second was denied. Why?
Given the crime was the same,
what influenced the decision?
Was it race? Age? Looks?
Well, one study analyzed
a thousand rulings from different judges
and they found it wasn't about those factors.
It was about this.
According to the research, prisoners were
3 times more likely to be given parole just after lunch...
when board members were well-fed...
than just before lunch when they were feeling hungry.
Having to make decisions all morning is mentally taxing,
and the judges were suffering from
what's known as "ego depletion."
Their brains were running low on energy
and that especially affects the prefrontal cortex,
which is involved in decision-making.
Traditionally, we assume that
humans are rational decision-makers.
They take in information, process it,
and come up with the best answer.
But real humans... even judges...
don't operate that way... they're biological creatures.
The court system sets out to be rational and balanced,
so it's a disturbing thought that it could be hijacked
by the basic chemistry of our bodies.
Even judges can be imprisoned by their biology.
The story's the same with some of life's other big choices,
where the decisions we make
aren't necessarily conscious ones.
Instead, we're tugged along by hidden biological forces.
Evolutionary psychologist Geoffrey Miller has come up with
an interesting way to show this.
His team recruited the help of 18 lap dancers in new Mexico
and got them to record their earnings over 3 months.
We know that lap dancers' earnings fluctuate a lot.
Some nights they earn $800,
other nights they might earn only $150.
Um, and they're very conscious of how much they earn.
So it seemed like an ideal set-up
for being able to ask them how much
have you earned night by night, shift by shift,
and to be able to track that in relation to
where they are in the menstrual cycle.
Miller wanted to know if a woman becomes
more attractive to a man when she's ovulating.
At that point in her cycle when she's most fertile,
a surge of the hormone estrogen makes her skin softer,
her features more symmetrical,
and her hip to waist ratio larger.
The changes are subtle, but men's brains
pick up on those cues unconsciously.
The results were surprisingly strong.
When women are ovulating, they're earning about
twice as much as they were earning
when they were menstruating.
But they were also earning a lot more than before menstruation.
So the real pattern is... if you're ovulating,
you're a lot more attractive to men.
You're earning higher tips,
you're getting called over for more lap-dances,
and we thought that was a pretty cool way
of quantifying female attractiveness to males.
Your hidden biological drives
help you to select a partner.
But what makes you choose to stay with a partner?
It has something to do with your values and your morals, right?
Actually, your hormones are doing
a lot of the deciding for you.
One of them is this.
It's called oxytocin.
Sometimes called the love hormone,
oxytocin strengthens the bonds we feel
when we're in a relationship.
In a recent study, heterosexual men who were in love
were given a dose of oxytocin.
They were then asked to rate
the attractiveness of different women.
The men who were given oxytocin
found their partners to be more attractive,
but not other women.
In fact, with other women, they kept
a slightly greater physical distance.
So, an attractive woman walks into the bar.
Lots of men clock her arrival.
But not this guy... he's in love with his partner...
and pumped up with oxytocin, his attention doesn't wander.
From an evolutionary perspective, you might expect
that you don't want monogamy.
You want to have as many offspring as possible.
So why do we have chemicals in the brain that enhance bonding?
Well, for the survival of the children,
having two parents around is better than having one.
It's so important that our brains
make this decision for us.
In fact, the evidence suggests
that some of our most complex decisions...
the ones we like to think of as carefully thought out...
are pre-programmed... influenced by our DNA...
almost no choice at all.
If you feel the least bit uncomfortable,
just squeeze the squeeze bulb that's in your hand
and we'll stop and take you out.
Read montague uses neuroscience to analyze...
and predict... voting patterns.
It turns out that political ideology has strong
biological underpinnings which you can
inherit from your parents.
Montague has found a link between a person's politics
and one basic reaction: Disgust.
He has volunteers go into an mri scanner
where they look at a series of images.
I show them somebody with
a knife to somebody else's throat,
physically threatening stimulus, a dead corpse.
Something that was gross, like flies on a salad
or something like this.
These things elicit responses in your nervous system
and we record their brain activity.
Then we ask them... and not everybody agrees... we ask them,
"hey, we have this other experiment we want you to do,"
and they go into a booth and they answer
a political ideology survey.
How do you feel about gun control, abortion,
pre-marital sex, things like that.
Montague's results are striking.
The greater the disgust response in the brain,
the more conservative the person is likely to be.
A smaller response correlates with a more liberal outlook.
The link between your neural response
and your political affiliation is not conscious,
but it's powerful.
I think if you ask 9 out of 10 people on the street,
how did you decide to vote for candidate x,
they would give you a long narrative about
what they cared about,
the issues that candidate x supported,
which side of those issues you were on
and how that person represented them,
but that is only half the story.
The shocking part is that your response to
a single disgusting image can predict your score on that test
with 95% accuracy.
That kind of prediction is uncanny.
I show you a disgusting image, I know how
you're gonna vote in 2016.
We may refine our political arguments,
they may become more sophisticated,
but the decision about our basic persuasion... that's already made.
So far, we've been looking at decisions in the here and now.
What soup do I want?
Do I pull the lever?
Who do I vote for?
Orange. Green.
But there's another aspect
to the story of decisions...
predictions about the future.
We have to weigh different options
and guess how things might turn out
at a time that doesn't yet exist.
How does your brain pull off that trick?
I have one hour of free time today
and I'm trying to decide what to do.
I know I have to get to the grocery store;
on the other hand, I need to get to a coffee shop
to work on a Grant deadline,
and I'd like to be able to play with my son at the park today.
So how do I decide?
Well, ideally, I'd like to be able to know
what each of these possible futures would be like...
but I can't time travel.
Or can I?
It may sound like the plot of a movie, but wouldn't it be great
if we could make decisions by looking back from the future?
Well, that's exactly what our brains
are trying to do all the time...
running simulations of the future
and giving each of them a different value.
Think of valuations like neural price tags
that tell us how much we think something is going to be worth.
So going grocery shopping will put food in my fridge.
Let's say that's worth 10 units to me.
Writing a Grant will fund my lab, but it's difficult.
Let's say that's 25 units.
I love spending time with my son at the park,
so let's say that's 50 units.
Now, here's the thing... Those prices can change through time.
If we get there and we run into friends
and it's better than expected, that ups my price tag
for the next time around.
If we get there and the swings are broken and it's raining,
that lowers my price tag for the next time.
And that's important.
That's what allows us to prioritize
how we make our decisions based on the brain's
best guesses for the future.
And it turns out there's a tiny, ancient system in the brain
whose whole job is to keep updating
our assessments of the world.
I'm talking about the dopamine system.
The chemical dopamine typically has a constant rate of release,
but when something turns out better than expected,
there's a burst of dopamine.
That tells other parts of the brain
they should increase the value of that option.
When something is worse than expected,
the dopamine drops and the value goes down.
In most of us, this system works pretty well,
but it's delicately balanced.
Too much dopamine, and that loop of positive feedback
gets out of control.
This is the root of addiction.
Neuro-psychiatrist Valerie voon studies addictive behavior.
She's interested in patients with Parkinson's disease.
They're producing less dopamine than normal
so they're routinely put on medication
to raise their levels.
What happens with dopamine medications
that the patient with Parkinson's is on
is that it can potentially hijack the system.
Patients who were previously moderate in their behavior
suddenly develop addictions
to gambling or food or sex.
These dopamine stimulating drugs are overstimulating
the regions involved in reward and motivation.
You see the cue and your expectation of the reward
becomes much larger than it should be.
When you take the medication away, they are always
a bit dumbfounded about how they ended up
acting the way they did.
As long as there's nothing wrong with
our dopamine systems, it should be straightforward
for us to control our impulses, right?
Don't be so sure.
Take the sub-prime mortgage meltdown of 2007.
Between bankers hunting a quick profit,
and borrowers hunting their too-good-to-be-true dream homes,
it turned into a storm of disastrous decisions.
As a neuroscientist, what fascinates me is how
everyone involved gave less weight to future consequences
and were instead seduced by what was right in front of them.
The very low interest rates plugged right into
the I-want-it-now circuitry.
The idea is "take this house right now."
Live better than you thought you could."
At some point in the future, the interest rates will go up,
but that's a long way away.
Because the pull of the now is so hard to resist,
the world economy almost tanked.
This present moment is a rich multi-sensory experience
that's hitting me right now, but the future, that's just an idea.
That's a simulation that takes place in my neural circuits
and it's a pale shadow compared to
immediate experience.
It has less emotional pull than whatever is
right in front of me.
So once again, the brain is in conflict.
Different networks are battling it out
between the present and the future.
Instant gratification or long-term reward?
When faced with these sorts of decisions, what do we do?
We rely on our willpower.
Think of willpower as that thing that
allows you to pass on that cookie
or at least the second cookie
or the thing that allows you to hit that deadline even though
you want to be out in the sunshine.
We all know what it's like to have strong willpower
and we also know what it feels like
when you just don't have enough of it.
In one experiment, people watch a wildlife film
about animals in distress.
Half the audience has been told to react normally,
to cry if they feel like it.
The other half are instructed to curb their emotions,
using their willpower to squelch their feelings.
The key is what happens next.
After the movie, participants were given one of these...
A hand exerciser.
And they were asked to squeeze it as long as they could.
The people who curbed their emotions
give up squeezing sooner than the others.
They've exerted so much mental effort not to cry,
they actually have reduced physical strength.
This kind of self-control... it takes energy.
And it turns out that resisting temptation
or making hard decisions or taking initiative...
all of these draw from the same well of energy.
So willpower isn't something that we exercise,
it's something that we use up.
It's like a tank of gas.
So there's a good reason why we can't always
rely on our willpower to make us stand by our decisions.
Our willpower might be running on empty.
We all know that it's hard to get ourselves
to do certain things... like going to the gym.
I want to be in shape, but when it comes down to it,
there's usually something going on right in front of me
that's more enjoyable.
So the pull of what's happening right then is more powerful than
the abstract future notion of fitness.
So to make certain that I come here, I take inspiration from
a man who lived 3,000 years ago.
In classical mythology, the hero Ulysses
lashed himself to the mast of his ship
so that he could hear the bewitching song of the sirens
without steering into the rocks.
Ulysses knew that his future self
wasn't gonna be in any position
to make a good decision, so he structured things
so that he couldn't do the wrong thing.
This sort of deal that's struck between
your present and your future self
is known as a Ulysses contract.
My own Ulysses contract is to arrange with a friend
to meet me here at the gym,
and that way the social pressure lashes me to the mast.
My friendship is collateral in the deal that
I'm making with my future self.
This allows me to be the person I want to be...
making good decisions... resisting the seductive power of now.
Come on, come on. Yeah.
Oh, yeah, nice.
Our prisons are full of people
who struggle with this.
They're unable to lash themselves to any mast,
to avoid the rocks.
Attention.
For 7 out of 10 prisoners jailed in the U.S.,
their ability to make long-term decisions is compromised.
They are there because of drugs.
For 4 decades, we have waged a war on drugs.
The U.S. invests $20 billion each year into this fight,
but there's no sign of victory.
And destroying the crop
before the opium could be harvested from it.
The difficulty with drug supply
is that it's like a water balloon.
If you press it down in one place,
it'll come up somewhere else.
So instead of attacking supply,
a better strategy is to address demand.
And demand is in the brain of the addict.
So if the problems lie in the brain,
maybe the solutions do, too.
A couple of miles from my laboratory,
there's a crack house.
It's abandoned now, but this was once
a regular hang-out... for Karen.
It brings tears to my eyes.
Because this was part of the lowest part I hit
when I smoked crack.
And I can't believe that I was part of that crowd.
If you're not strong enough, you just can't handle it.
It kind of draws you in.
Karen has had an addiction to crack cocaine
for many years.
I thought I was in control of everything,
but that was the drug.
I mean, I wasn't in control of anything.
I was a mess.
Dirty, hair matted up, clothes look like
they were in a mud fight.
I couldn't believe it, and then I stepped back
and think, "damn, how did I drop so low?"
Karen's story makes her an ideal candidate
for a new program we're running in my laboratory.
Rather than simply forcing drug addicts to go cold Turkey,
we're trying to treat them with neuroscience...
Getting the brain to take control of its own addiction.
Inside the mri machine, Karen watches
images of drug use and drug paraphernalia.
We ask her to go ahead and feel her cravings.
We measure the networks in her brain
associated with that craving.
Then we switch and ask her to suppress the craving.
Ok, Karen, when you're thinking about suppressing your craving,
think about the costs this has had to you in terms of money,
in terms of relationship,
in terms of employment opportunities.
Ok.
We show her the same images
and measure the regions in her brain that are active
when she's trying to resist the desire to use.
These are the networks that become active in Karen's brain
when she's craving cocaine.
Now, when she thinks about all the reasons to resist it,
then these networks come online here.
And these networks, the craving and the suppressing,
are always locked in battle.
Here's the key... we now superimpose a Gauge...
which tells Karen how the battle is going.
Her job is to move it by tipping the balance
of the suppressing over the craving.
They show you pictures of different things.
You have to do suppress and then not suppress.
It was like a little meter.
When it got... the first time, I couldn't do it at all.
Then the second time, I got wind of it.
And I had to really concentrate and say, "hey, this is it."
"This is what I've been missing,
"that your brain is the one who told you you needed crack,
"so why can't you train your brain
to tell you it's not time for crack?"
I mean, I can suppress other things.
Why can't I suppress crack?
At the moment, she's looking at
this background picture of cocaine
and she's working her way over to suppressing that craving
and holding it there successfully.
Now, the idea is that she can practice this in the scanner
and learn how to get better at it,
and the key is when she's back out in the real world
and somebody offers her crack cocaine,
she'll have the tools available to know how to resist.
I'm not gonna say I'm cured,
because how do you get cured of something
that your brain conjures up, your subconscious conjures up?
So I take steps to when the thought goes through,
I push it out, I suppress it.
You know, I'm not gonna say 3 months from now,
a year from now, I'll be clean,
but that's what I work towards daily.
For me, Karen offers a glimpse of how neuroscience
can help people with addiction.
She's re-wiring her circuitry.
She's shaping her brain to be better aligned
with who she would like to be.
The future is filled with promise.
I'm married, I have a great husband, I have a great life,
and I don't want to jeopardize that just for a hit of crack.
So I mean, it is even more of a reason why I quit crack.
It helps my suppression state because I can actually stop
and I'm doing it for myself, but I'm doing it for others...
my husband, my dogs, my family,
and that's what's important to me.
Karen has hope for resolving the conflict that
constantly rages in the hidden world of her neural networks.
I think a biological approach stands
a better chance of working than mass incarceration.
As we learn more about our own brains,
we can break away from slavery to our impulses
and earn the freedom that comes with having greater choice.
Decision-making lies at the heart of everything...
who we are, what we do, how we perceive the world.
Without the ability to decide, we would be stuck in limbo
between conflicting desires.
We wouldn't be able to navigate the now or plan for the future.
Neuroscience shows that you are not an individual...
you're made up of multiple competing drives.
And by understanding how choices battle it out in the brain,
we can learn how to make better decisions
for ourselves and for society.