The Patient's Brain: The neuroscience behind the doctor-patient relationship by Benedetti Fabrizio

Author:Benedetti, Fabrizio [Benedetti, Fabrizio]
Language: eng
Format: epub
Tags: The Patient’s Brain
Publisher: Oxford University Press, USA
Published: 2010-10-07T00:00:00+00:00

5.2.2 Visual stimuli are the basis for nonverbal communication

Among the great variety of visual information that reaches the patient’s brain when he meets a therapist, we have seen in section 5.1.2 that facial expressions play a key role in complex cognitive functions such as trustworthiness decisions. The face is an excellent source of information and plays a fundamental role in signalling social intentions from which people infer meaning, such as personality traits and complex social characteristics (Frith and Frith 1999). Generally, people form reliable and strong impressions on the basis of facial appearance. Figure 5.2 shows that when judgements are aimed at detecting either trustworthy or untrustworthy faces, they are also entangled with other features of the facial expressions, such happiness and anger. Indeed, several brain regions are involved in detecting subtle differences in facial expressions, and these regions make up a complex network which is specifically aimed at processing facial emotions, whereas facial identity is processed by a different network (Todorov 2008; see also section 5.1.2).

Face perception is in many ways a microcosm of object recognition. The specialness of face processing is shown by the fact that even a split-second glimpse of a person’s face tells us his/her identity, sex, mood, age, race, and direction of attention (Tsao and Livingstone 2008). Even monkeys have been found to respond selectively to faces, and neurons in the inferotemporal cortex and superior temporal sulcus have been found to be driven by complex biologically relevant stimuli, such as hands or faces (Gross et al. 1969, 1972; Foldiak et al. 2004). Face cells are not just selective for individual features but rather they require an intact face. For example, Kobatake and Tanaka (1994) recorded from the inferotemporal cortex of monkeys and found that neurons only responded when the stimulus looked like a face, no matter how simplified. Figure 5.7 shows a cell that responds best to the face of a toy monkey (a), as well as to a configuration of two black dots over a horizontal line within a disk (b), but not in the absence of either the line (c) or the spots (d) or the circular outline (e). The circular outline alone does not produce any response either (f). The contrast between the inside and the outside of the circle is not critical, as the cell still responds (g). White spots and white horizontal line do not elicit any response (h). Therefore, face-responsive neurons detect a particular spatial configuration that looks like a face as a whole.

In human brain imaging studies, although face-specific activation can be seen in the superior temporal sulcus and in part of the occipital lobe, a number of studies support the idea that the lateral side of the right mid-fusiform gyrus, the ‘fusiform face area’ or FFA, is activated robustly and specifically by faces (Kanwisher et al. 1997; Tsao and Livingstone 2008). It should be noted, however that the FFA does not respond only to face stimuli but also to non-face objects, albeit less robustly. This might indicate

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