Bruce Hood - The Domesticated Brain - A Pelican Introduction (Pelican Books)

Those with TS fight a constant battle to inhibit their tics, especially in public, which usually makes the condition much worse, just like Basil Fawlty trying not to mention the war. As the pressure to behave normally in a social situation increases, the urge to tic increases, which makes it build up like a sneeze. And just like a sneeze, it becomes involuntary so that they must tic in order to get some relief. As one boy, Jasper, with TS explained on a HBO television special, ‘When I try to hold back too much, you can’t think of anything except holding them back and you can’t think of anything except doing them.’ 43

Similar intrusive thoughts are also reported in individuals with obsessive-compulsive disorder (OCD), another ICD that affects around two out of every hundred adults in the West. 44Obsessions are the tormenting thoughts whereas compulsions are the activities that the sufferer must engage in to counteract the obsession. If I am obsessed by thoughts of filth then I may feel the compulsion to wash my hands repeatedly.

Sir Aubrey Lewis, an English psychiatrist, described how obsessions generally fall into one of four categories: thoughts related to filth, thoughts related to harming oneself or another, thoughts about sex and the urge to blaspheme. What makes all these ICDs relevant to social acceptance is that all of these topics are associated with behaviours that need domestication. Inappropriate and excessive filth, harm, lusting and blasphemy would be frowned upon and so there is a need to keep such thoughts and behaviours in check. Currently the same inhibitory circuitry of the PFC and basal ganglia implicated in TS is also a prime suspect for OCD. 45Like TS, there is a heritability factor, with OCD running higher in families, and it is more common in identical than non-identical twins. Not surprisingly, around half of those with TS exhibit obsessive-compulsive behaviours.

Many of us have intrusive thoughts from time to time or engage in peculiar habits. It could be our morning bathroom routines or it might be the coffee break that we always take at the same time of the day at the same coffee shop. Habits and routines are part of normal life, but we can happily switch or stop them should the need arise. They don’t get in the way of us living our lives. However, individuals with ICDs can be ostracized from normal social integration. For many ICD sufferers, the worst aspect of their condition is not the disabling nature of their thoughts and behaviours, but the stigmatizing shame and embarrassment they can feel in public.

It wasn’t me but the wine talking

Most of us lose control occasionally and, for many, letting go is part of being sociable. Otherwise we are uptight, too rigid and too inhibited. This is one reason why people drink alcohol. Contrary to popular misconceptions, alcohol is not a stimulant that turns someone into a party animal, but rather a depressant that weakens the inhibitory capacity of the frontal lobes, thereby unleashing the wilder, undomesticated animal with all its untethered drives. That is why we eat more, get into fights, lose reason and become more sexually active when we are drunk. After a night of misguided behaviour, many people wake up and explain that ‘I was not myself’ or ‘It was the wine talking’. Of course, wine doesn’t talk and if you were not yourself, then who were you?

As a domesticated species that has evolved to get on with each other, we must be careful not to insult or upset other members of our group. However, some of us harbour illicit thoughts and attitudes that are best kept to ourselves. If we care about what others think, then we try to keep all of these stereotypes, biases, drives and mistaken beliefs under wraps because we know that they are unacceptable. We may even understand that they are wrong but nevertheless they linger in our unconscious. However, just like white bears and earworms, the more we try to suppress these negative aspects of our self, the more they can rebound back despite our best efforts.

Whether we can suppress unwanted thoughts or not, it does call into question what our true nature is. Is it the inner secrets that we keep under lock and key in our mind, or the public persona we share with the world? Most of us probably would prefer to know about someone’s secrets because ultimately we would be suspicious that individuals were not being honest about their true self. Even though someone might successfully hold back unpleasant aspects of their personality, the danger is that they might not always be able to control them.

The cost of control

Have you ever come out of a stressful exam or interview and thought that you could devour a whole tub of ice-cream? Or maybe it was an emotional movie that left you drained. Why do many people who endure a stressful experience want a stiff drink or to raid the fridge in search of comfort foods that are high in fat and sugar? One intriguing idea is that when we succumb to these temptations, we are experiencing ego depletion.

Ego depletion comes from American psychologist Roy Baumeister, who believes that enduring something stressful exhausts our capacity for willpower to the extent that we give in to temptations that we would rather avoid. 46In one of his studies, he made hungry students eat bitter radishes rather than delicious chocolate cookies. 47Even people who like a bit of radish in their salad would find that task difficult. However, Baumeister was not interested in eating habits. He was really interested in how long the students would persevere on an insoluble geometry task. The students who had been allowed to eat the cookies stuck at the geometry task on average for about twenty minutes, whereas those who were forced to eat the radishes gave up after only eight minutes. They had used up all their willpower to eat the radishes so they were left with less reserve to cope with another situation of completing a difficult problem.

Performance on one task that requires effort can therefore have unforeseen consequences for a subsequent situation that is completely unrelated except that it requires effort. This is why Baumeister regards willpower as a mental muscle that can become exhausted. We apparently spend quite a bit of time avoiding temptations. For one week, German adults carried around BlackBerries that quizzed them once in every two-hour period what they were thinking about. They were found to spend an average of three to four hours of each waking day avoiding temptations and desires. 48

Just maintaining one’s composure can be ego depleting. Not being allowed to laugh at hilarious comedy sketches, firing employees, enduring others in crowds are all situations where we have to exert self-control that leads to ego depletion. We exhibit more ego depletion at the end of the day, which is when couples are more likely to fight, after a hard day at the office. We become less tolerant of others and blame our spouses for the problems that are really generated by work.

When we are ego depleted, we eat more junk food, drink more alcohol, spend more time looking at scantily clad members of the opposite sex and generally have less control over our behaviour. Not only do we give into temptation, but we have an increased desire for forbidden fruit.

There’s no one in control

Most of us believe that we are in control. We may dilly and dally about making decisions, but we still think that we are the ones making the choices. We feel the authorship of actions and ownership of thoughts. And yet we sometimes surprise ourselves when we do things that seem so out of character. It’s as if we have an inner scorpion determined to behave the way it wants to.

We must keep these beasts at bay. In order to be domesticated, we must be able to control ourselves and learn when and where behaviour is appropriate. This self-control is our capacity to regulate and coordinate competing drives and urges. It develops over childhood, supported by the executive control mechanisms of the PFC that act to suppress and inhibit thoughts and actions that may potentially sabotage our goals. By observing others and learning what is appropriate, children learn to engage their self-control. When these control mechanisms are impaired, individuals are at the mercy of automatic thoughts and behaviours. Moreover, they are unable to foresee the consequences of their actions and become impulsive, trapped in the moment of immediate gratification.