ELECTRIC DREAMS

Navigating the very human side effects of neurotechnology.

By Hannah Ongley

In the early 1950s, as lobotomies were falling out of fashion, Dr. Robert G. Heath pioneered a cutting-edge neurosurgical procedure that involved implanting electrodes in deep cortical regions of the brain. Two photographs from Studies in Schizophrenia show one of Heath’s patients demonstrating the physician’s plug-in contraption: a plastic headpiece fitted with an electrode connector, hooked up to wires coming out of the patient’s scalp. Controversial at the time and often obscured in historical accounts of deep brain stimulation, Heath’s experiments were not only an attempt to treat patients with schizophrenia, but also a form of conversion therapy.

Some 70 years later, despite the advent of psychopharmacology, the general population’s mental health is steadily declining. According to the NIH, an estimated 21 million adults in the US had at least one major depressive episode in 2021, representing 8.3 percent of the demographic. This prevalence was higher among adult females (10.3 percent) compared to males (6.2 percent), and highest among individuals aged 18 to 25 (18.6 percent). What’s more, one-third of people with mental illness are resistant to first-line medications like antidepressants. Deep brain stimulation is now a widely used therapeutic approach for mental disorders including schizophrenia, anorexia, depression, and addiction.

Against this backdrop of a pharmaceutical-industrial complex in crisis, psychosurgery is making a comeback. Brain-computer interfaces (BCIs) like Elon Musk’s Neuralink represent the next frontier for diagnosing and treating mental illness. Today’s neural implants are far more discreet than Heath’s electrode headpiece—Motif Neurotech’s neuromodulation device, for instance, can be implanted in about 30 minutes via a minor outpatient procedure that its founder likens to skin surgery, while the makers of NeuralTree are exploring a function that would allow the device to self-update from inside the skull. But, echoing their predecessor, they are the product of pushing ethical boundaries in a limited regulatory environment.

And the “non-invasive” version is hardly less controversial. Consumer neural devices promise to make monitoring brain health as easy as tracking biometric insights on an Apple Watch, thanks to a chic wearable that collects vast amounts of highly sensitive neuro data outside of the clinical setting—meaning it’s not protected by HIPAA nor by the UK’s Data Protection Act. But assuming we even read the small print, do we care? Neural data could be highly shareable social capital in a world where wellness influencers get high on preaching unnecessary pain and sacrifice. (Out: citalopram. In: positive mantras, sleep starvation, and painful home-births in an inflatable pool.)

It’s human nature to want to self-optimize—we are wired to seek pleasure and avoid pain. Psychiatrist Anna Lembke, in her 2021 book Dopamine Nation: Finding Balance in the Age of Indulgence, suggests this is the very thing making those of us living in the wealthiest nations so damn miserable; with unlimited access to massive dopamine hits at our fingertips and prescription drugs also plenty accessible, our culture conditions us to prioritize pleasure and distraction over happiness and resilience. Is the solution really more information and expensive toys? Our brains can’t keep up with the technological state of the art as it is. At the end of the day, we’re just apes shooting up semaglutide so we can feel safe, look sexy, and pass on our genes.

Prosthetics, like plastic surgery, were originally created for war casualties. Young soldiers, disfigured and dismembered on the battlefield, returned home, hoping to serve as functioning members of society. During the Cold War Space Race, space medicine created the figure of the cyborg as a means of extending man’s unconscious, self-regulatory controls. In 1960, scientists Manfred E. Clynes and Nathan S. Cline of Rockland State Hospital (now Rockland Psychiatric Center) stressed the importance of a symbiotic relationship between man and machine: “The purpose of the Cyborg, as well as his own homeostatic systems, is to provide an organizational system in which such robot-like problems are taken care of automatically and unconsciously, leaving man free to explore, to create, to think, and to feel.”

Prosthetics today allow people not just to receive new limbs but also to recover their unalienable rights to life, liberty, and the pursuit of happiness.

It’s not necessarily war that drives biomedical advancement—it’s unexpected survivors. However, military forces continue to play a starring role in the advancement of cybernetics. One of the many controversies around Heath’s deep brain stimulation experiments was his involvement in the CIA’s mind-control program MKUltra. Today, the Defense Advanced Research Projects Agency (DARPA) is using DBS to understand how deep sub-networks function in the brain, to develop interventions that allow for maintaining, “a healthy brain state within a normal range of emotions.”

While a lot of attention has been given to China’s use of AI emotion-recognition software, which can generate detailed reports on individuals who exceed their negative emotions quota, the same media outlets seemingly only have praise for the US’s own military-funded emotion- and thought-modulation technology. “We don’t want this to be described as mind control,” one of the creators of SUBNETS told the website MeriTalk in 2017. “We work in a field of telling people not to kill themselves. Helping someone’s decision is not always a bad thing.”

Civil liberties, lest we forget, are not “rights;" they are restraints on arbitrary government interference. But corporations, the US Supreme Court keeps reminding us, are people. They are free to strip-mine workers’ brain data in order to monitor their emotional states and productivity levels, as long as they do it in a non-discriminatory manner. The global emotion detection and recognition market was valued at $26.26 billion in 2022 and is projected to reach $74.80 billion by 2029. This growth is attributed to advances in wearables, smartphones, and the Internet of Things, with a vast market of goods that employ facial recognition, speech and voice recognition, biosensing, and gesture and posture recognition. The same senseless argument is made for such intrusions on citizens’ privacy: Our freedom depends upon that of Big Brother.

Freedom has long been considered central to human happiness and flourishing. Spinoza looked to Aristotle’s concept of Eudaimonia, from the Greek philosopher’s early treatise on the science of happiness, and considered happiness the highest good—emphasizing the ethical pursuit of the good life and a definition of freedom that was less about agency and more about virtue. In cyborg socialist-feminism, the cyborg was rescued from Cold War space medicine and came to represent liberation from binaries, allowing women to move beyond the limitations of traditional roles and feminist politics. But what would freedom look like in a world where your boss could read your mind and the government could help you make your decisions?

“We have all these philosophical conceptions of human flourishing—none of them contemplated a world in which our brains and mental experiences could so easily be hacked and manipulated,” says Nita Farahany, a lawyer who argues for a concept called “cognitive liberty”—including freedom of thought and self-determination. Our mental health information is already being sold to advertisers, and more recent neuro-technological advancements will only ramp things up. Last year, it was revealed that online counseling service BetterHelp shared users’ data with major advertising platforms including Facebook, Snapchat, and Pinterest. According to the FTC, “the company repeatedly pushed people to take an Intake Questionnaire and hand over sensitive health information through unavoidable prompts.”

Author Martin Seligman, known as the founder of positive psychology, was a big fan of the concept of “flourishing.” Using fancy scientific nomenclature and a series of very generous grants from the conservative John Templeton Foundation, Seligman repackaged the self-help movement of the 1970s as pop-sci bestsellers like Learned Optimism: How to Change Your Mind and Your Life and Flourish: A Visionary New Understanding of Happiness and Well-Being. Self-help and self-care, which had been central to mental health advocacy, social justice, and collective activism, became the foundations of the wellness industry we know today. Billionaire industrialists ate it up. Seligman’s empirical data said nothing about material needs; their unhappy workers simply had a mindset problem.

Today, the language of pathology is increasingly being phased out, with the distinct symptomatology of mental disorders rebranded under the hazy umbrella term “health and wellness.” At the same time, especially on social media, we’re seeing a return to the personal responsibility model of mental disorder, where psychological suffering is evidence of not meditating hard enough or failing to engage in a nightly gratitude practice. Ours is an economy of emotions where positive ones are an important part of the customer experience and there’s constant pressure to feel upbeat. Neural prosthetics can let us see negative emotions as what they really are: valuable data.

In the capitalist marketplace, however, a medical device can be both revolutionary and completely useless. Cutting-edge technology is often developed without—and sometimes without even considering—the end user, so many of the most groundbreaking devices being made today won’t be adopted in a clinical setting. There’s seemingly no better symbol of freedom and liberty under late capitalism than the US healthcare system: In Los Angeles, there are plenty of cosmetic surgeons willing to act against your best interest for the right price; likewise, if you have enough money to be one of the first to undergo experimental neurosurgery, legislation exists essentially only to protect you from being turned away because of your race or religion.

Whether neurotechnology will be “good” or “bad” for people’s mental health will vary greatly across countries and income brackets. We tend to obsess over the possible existential implications of new technology, like AI gaining consciousness or BCIs facilitating genocide à la Black Mirror—legislation like the EU AI Act, which went into force on August 1, brings legitimacy to these important but unlikely scenarios while ignoring the everyday ethical consequences of biomedical advancements, such as its potential to exacerbate the gap between the haves and the have-nots. In reality, the field of neural prosthetics might look more like precision mental health for the rich and positive mantras for the poor.

And what are the implications for other vital elements of being human, like art and creativity? The link between creativity and mental illness has been so well-documented and ingrained in our culture that it suggests there’s a startling upside to the failings of modern psychiatry. But what about the link between creativity and mental well-being? Recent studies looking at the neural basis of creativity could have hopeful implications for patients with conditions such as depression that cause cognitive distortions like black-and-white thinking. There are neurotech innovations for evaluating neural responses to the arts—promising a number of exciting neuromodulation-based art therapy applications as well as arts integration in education, travel, gaming, and design.

In June, a study published in the journal BRAIN provided a detailed picture of how creative thoughts happen. Thanks to electrodes that had previously been implanted to monitor seizures in 13 patients with epilepsy, researchers were able to obtain precise recordings of electrical activity in the brain’s default mode while they engaged in spontaneous and divergent thought—two processes that have been associated with creative thinking. “These findings shed light on the neural constructs supporting different forms of cognition,” the study read, “and provide causal evidence for the role of DMN in the generation of original connections among concepts.”

But will precision neurotech simply accelerate us towards a future where creative pursuits are left to rich people, who can afford to have their posterior cingulate cortices electrically stimulated with a precision wearable, or to algorithms, where we increasingly turn to delegate creative but cognitively demanding tasks so we can chase the Trojan horse of true happiness: productivity? Empirical data is great, but when it comes to the psychological impact of trying to decode exquisitely detailed information on what all of our 100 billion neurons are up to, the primary outcome is exhaustion. As modern happiness guru Arthur Brooks says, our human problems are complex only in the sense that they are interconnected—they are not that complicated.
We only really have proof of the reality of our own minds. René Descartes’s first principle, “I think, therefore I am,” suggests the importance of engaging with art created by humans. Whether robot art is any good is kind of besides the point; our experience of a painting or piece of music is fundamentally impacted by knowing it has been created by a human, because it confers an awareness of consciousness outside our own.

For centuries we’ve been told to look inwards to resolve our psychological suffering. But there’s plenty of empirical data saying to look outwards—that we are happiest when we are focused on caring for others and searching for something larger than ourselves.