An enormous and rapidly growing amount of information on the brain and pain exists. For example, there are at least 30,000 books in English on the brain, classic texts such as Kandel et al’s Principles of Neural Science run to 1750 pages, the Textbook of Pain to 1200 pages and there are 2765 pages in Ramachandran’s Encyclopaedia of Human Behaviour. It would be an easy trap, especially for beginners, to believe we know everything about the brain and pain. I and other teachers stand up in front of groups and tell all we know as if it was all there is to know. But maybe, with the goal of advancing knowledge, we should also be realising, teaching and acknowledging what we don’t know?
The case for teaching ignorance
A recent short article by Jamie Holmes in the International New York Times (Aug 25) – The case for teaching ignorance struck a chord. The study of ignorance (agnotology!) is in its infancy and certainly not taking off rapidly. After all who would want to come to a course on ignorance? Holmes mentions some texts and university classes on the subject and in particular introduced me to the delightful book Ignorance: How it drives science by Stuart Firestein, a Columbia University neuroscientist. I couldn’t put it down, which is remarkable as it is actually about scientific method and such books are usually boring, but this is a great read about the place and power of the study of ignorance. “Ignorance” is an evocative word, used here to discuss the unknown.
What don’t we know?
How do we know what we don’t know? It comes down to having questions, the freedom to question, valuing questions and availability of stimuli to construct questions – a theme of Firestein’s book. I think of it as healthy ignorance. We are also reminded about how accepted knowledge can get in the way of healthy ignorance. Examples in Firestein’s book include the tongue maps of regional sensitivities (they just don’t exist despite being in every textbook), the relentless pursuing of brain knowledge via examination of electrical spikes and missing chemical signalling and faulty numbering such as the much repeated 10 times as many glial cells in the brain than neurones (I am guilty here too!)
Recent research suggests there are an equal number of glial and neuronal cells (Herculano-Housel S 2014 Glia 62:1377)
In my own small way, my contribution to healthy ignorance is to insert an “ignorance” section at the start of an Explain Pain course and summarise it by some of the questions I would like answered. There are plenty and they include:
- How does the brain work?
- Why are things changeable in some people but not others?
- Why in some people are certain homeostatic coping mechanisms selected, while different ones are selected in others?
- What happens in the brain during a ‘revelation’?
- Why can’t apparently clever people accept biopsychosocial thinking?
- How far and fast can information laden synaptic juice in the brain travel?
There are so many questions. I am feeling quite ignorant at the moment!
What questions would you like answered?
I’m with you on this one. A quote from Chuang Tzu –
The most extensive knowledge does not necessarily know it;
Reasoning will not make men wise in it.
The sages have decided against both these methods.
The things we all want (peace, happiness, comfort) are not gained by knowing more. Knowledge is so limited in its reach, and yet we chase it like it’s gold! More research! More knowledge!
Letting go of the aspect of mind that is desperate to ‘know and understanding everything’ is a great challenge. It’s the basis of meditation. One has to surrender everything in order to gain peace, happiness and comfort. Everything that is known and cherished – including who you are, where you’re located in space, what you’ve achieved, whom you’re related to – it all has to be surrendered temporarily. I believe anyone willing to do that will be able to cure their pain completely. I have enough ordinary, every-day knowledge to prove this to my satisfaction (and I’m very hard to please). Right now I don’t feel like I need to know anything else.
It’s a huge challenge. Having found the right approach for me, I can now do it every day. Just a matter of practice, practice, practice until the default mode is silenced. The default mind mode, driven by concern for survival, reproduction and achievement is the only true source of pain and suffering. All the top therapists and scientists throughout history have achieved some degree of freedom from this default mode ( the “peace… which passeth all understanding”). I’d like to get there myself.
A healthy place to be David with more questions than answers. The day we think we have all the answers is the day we should pack up and leave.
Apparently one of my annoying first questions as a child was ” where does the light go when you turn off the switch?”. I’ve remained inquisitive all my life……
David – look in the fridge!
As my wife and my sons consistently attest, I am an expert on ignorance. When the boys were younger, at least twice a day they would look at me with an all too familiar look and just go “0h Dad”. Now that they are older, they just look at me, shake their heads, and laugh. My wife has been abetting that process for years.
As a family attested expert on ignorance, I have to say “Way to go Dave”. Positive ignorance, as you call it, is all too often given short shrift and no respect. Great Piece and the NYT piece is excellent.
Our political season demonstrates the problem of the more common form of ignorance- the ability to demonstrate your absolute correctness and sureness of answers in the absence supporting facts or even contradictory information. There is no harm and great power is saying ” i do not know”. There is great danger in saying ” I am sure that I know the answer”. luckily you just got rid of your Abbott but we are stuck with a lot of Costello’s who are in no way as funny or as insightful as that comedy team that continually demonstrated positive ignorance. TGD
My sense from getting to the leading edge of scholarship in several fields, as a reader that is in all but one, is that in that space there are lively disputes about some of the fundamental propositions, yet little of this survives in the u/g curriculum dished up to students. That gives them a skewed impression of the field and an excess of confidence in making statements about phenomena.
Undergraduate curricula often suffers from a lack of healthy ignorance in my view, not helped by university resources focussing more on research than teaching, and long tenured staff trotting out the same stuff every year. I am stunned at how much new grads think they know, but then again I am an old fart. I do have a fear of going to the grave and realising I knew very little!