Monthly Archives: September 2009

Too "Wired" to Sleep?


Whereas yesterday’s post dealt with getting back to sleep in the middle of the night, today’s topic is Getting to Sleep in the First Place. Brace yourselves. I am going to fly in the face of New Age holistic medicine here, and share the wisdom gleaned from years of Continuing Education seminars presented by molecular biologists. As they say in the UK, I’m going to “blind you with science.” [That’s not what happened to Lili. She’s posing as an insomniac.]

First, of course, we need an animal metaphor. Let’s go with twin ferrets. These well-meaning creatures inhabit our Autonomic Nervous System [a kind of auto-pilot, formerly believed to be unconscious and involuntary, which regulates stuff like heart rate, breathing, and speed of digestion]. One ferret, with the clunky name of Parasympathetic, just wants us to chillax, already, so he uses that ever-so-trendy neurotransmitter, serotonin, to slow down the beating of our heart. His [please don’t think of him as evil] twin, Sympathetic, is there to prevent us from flat-lining, and uses the much-maligned norepinephrine to jolt our heart back up to a life-sustaining rate [like a furry little pacemaker]. Though seeming to work at cross-purposes, they both want the same thing: homeostasis. Like Goldielocks, they want the rate of everything in the body to be Just Right.

So, now, have you ever noticed that on the nights when you are utterly shattered, whacked, whipped to the bone, and you figure it should be easy to fall asleep, what happens instead is a series of short dreams, in which you are falling, and from which you jerk awake, often with an audible gasp? Yeah, that’s the Twin Ferrets, just trying to keep you alive, man. “Paras” knows you need the rest, so he slows your heart rate way down [whence, the falling sensation]. Then “Sym” wigs out, for fear that your heart will stop altogether, and zaps you “back to life.” [The jerk.] [That’s what your body does. I’m not dissing “Sym,” here.] Eventually, these guys find a homeostatic heart rate and let you go to sleep; but the more fatigued you are, the more jactitation [jerking awake] you have to go through, to get there.

Back to Sleep Hygiene for a moment. Sleep is more easily initiated when the body’s core temperature is warm, but the room temperature is cool. One traditional way to warm your core is a hot bath; but who, other than little kids, has time for that at night? An even older strategy is a warming beverage. But which one? The traditional “nightcap” of high-proof alcohol doesn’t actually warm your body’s core [only the cockles of your heart], unless you go to the trouble of heating the liquid, itself, in which case, as long as you’re in the kitchen anyway, you might as well make the gold standard of soporific drinks, beloved by Europeans since the Explorers brought the main ingredient back from the New World: a cup of hot chocolate.

“No way!” I hear you object. “Chocolate has caffeine in it! That’ll just keep me up!” Obviously, you are only thinking about the agenda of “Paras.” “Sym” has a horse in this race, too, ya know. Here’s what the molecular biologists say. The milk and sugar contain tryptophan, which turns into serotonin [the sleepytime molecule] in the body, thus satisfying “Paras.” Also, the heat of the drink warms your core. But here’s the Beauty Part! The small amount of caffeine in the chocolate speeds up the heart just enough to mollify “Sym,” who can then hold off on delivering that jolting dose of norepinephrine.

Frequently Asked Questions: “How ’bout sugarfree cocoa mix?” That works, but add more milk, as your source of tryptophan. “How ’bout a glass of cold Nesquik?” Did you miss the part about warming the core? Now you’ll need to take a bath, just like a kid. “What if I can’t stand/am allergic to chocolate?” You can try a cuppa [hot tea with milk], but don’t try coffee, unless you make it weak and add lots of milk.

Final observation: Europeans consume far fewer pharmaceutical sleep-aids [per capita] than we do in the US; and they manage to get through their days & nights fairly well, non? There is a British watchdog of correct English usage who deplores the current fad of prefacing remarks with, “At the end of the day…” She declares, “The only correct use of that phrase is, ‘At the end of the day I drink a cup of hot chocolate.'” Nar’mean?

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Filed under altered states, limbic system

The Sandman Cometh


Here is Solipsistic Seamus Sleeping Supine on a Chicago Sofa. [Say that 3 times, fast.] The topic is Getting Enough Shuteye (without further enriching the fat cats @ Big Pharma). He is your role model, not I. My expertise on this subject comes as much from personal experience, as from all the Sleep Hygiene lectures & literature I have absorbed over the decades, since I inherited the tendency for insomnia from the gent who also brought me Non-linear Thinking: my father.

Thus, I know that “better lifestyle choices,” while helpful, are not the complete solution. Unlike my father [for large parts of his life], I neither drink distilled spirits, nor smoke tobacco–both of which interfere with the brain’s natural circadian rhythm. Where I can control my nighttime environment [at home, not in hotels], I go for dark, cool & quiet. If quiet isn’t an option, I go for white noise [like a fan]. After you live in a big city for awhile, though, you become so used to the soundtrack of “the lullaby of Broadway” [emergency vehicle sirens, mostly], that it becomes the white noise; whereas those suburban or rural crickets make an infernal, sleep disturbing, racket. My family moved to Tarrytown, NY in 1953, just as the Tappan Zee Bridge was being built; and our white noise was the bang-bang-bang of steam pile drivers. On the rare days when work was suspended, “the silence was deafening,” and nobody could get to sleep.

But now for a little myth-busting. Contrary to what sleep-aid vendors would have you believe, mankind was not meant to sleep “8 uninterrupted hours.” There is meant to be a brief intermission in the middle of the night, for a bit of a walkabout: to do the needful (see to the children, visit the loo, stoke the fire, ward off ravening beasts). It is not so much this interval, but the sleeper’s negative response to it, that leads to most of the inconvenient [not awful] amygdalar arousal [known in the Sleep Hygiene biz as Subjective Insomnia]. We got fear: “Oh no! I’ll never be able to get back to sleep, and I’ll be useless tomorrow!” [Notice that this line of thinking occurs most often on a week night?] We got intrusion: “Gordon Bennet! Your snoring/that commotion in the street/my hypervigilant-not-to-say-paranoid dog just woke me up from a sound sleep!” [But your own alarm clock? Not always…] And we got the pain & suffering of just lying there [or prowling around in the dark, stubbing your toe, or worse], feeling all alone [even in a crowded house], and trying not to dwell on Dark Thoughts.

Well, here’s what I do about the Dark Thoughts. I have someone read me a bedtime story. Low-fidelity cassette tape players cost about $20 tops these days; and the public library is full of Books on Tape. I try to choose a narrator whose voice is pleasant, and a story that is distracting enough to derail my train of Dark Thoughts [but not so riveting that it keeps me up nights, ya know?]. I made a big mistake with a this week’s selection: the late Frank McCourt reading his own last book, Teacher Man. It’s wonderful [yet triste] to hear his voice again, but it’s too compelling; and I fought falling back to sleep [even though I knew I had the option of rewinding the tape in the morning and listening to it again in daylight]. This is rather ironic, since the main point of the book is McCourt’s career-long quest to hold the interest of his public high school students. [Well, he got mine.] I got about 3 hours’ sleep the night of Teacher Man; but, lo! I was still able to drive adequately, to scamper through the woods with Lili, to do hours of clinical paperwork, and [tra-la] to write this blog. [I loaded up a duller Book on Tape for the next night, though.]

More on sleep anon. Meanwhile, try out Seamus’ new yoga position: Flaked-Out Ginger Cat.

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"A nod is as good as a wink to a blind horse."


This old Cockney expression, first cited in 1794, means, “Do I have to spell out the obvious to you? You know what I mean.” [Lately, contracted to the Phatic, “Nar’mean?”] Well, here is my corollary: “A diss is as bad as a threat to a young man.”

Waratu Sato [& colleagues] of Kyoto University have made headlines this week with their research on 24 incarcerated juvenile delinquents, compared to 24 “control” subjects, whose average Verbal IQs were 28.4 points higher than their jailed brethren. [The Controls’ mean Verbal IQs were in the High Average range, whereas the JDs’ were in the Low Average range.] As the discussion portion of this breathlessly-hyped-in-the-media article points out, the IQ factor might account for all the difference between the two groups’ performance on the task. Meanwhile, let us consider the task, itself. Each subject was shown a series of photographs of faces “portraying” one of 6 emotions, which they had to identify correctly. [Wait. Remember the dog-bark-translator, also from Japan, which categorized canine utterances into one of 6 emotions? Hmm…] Anyway, the headline was that the 24 JDs kept “misrecognizing” facial expressions of disgust for anger. So, incidentally, did the Control subjects, but 17.2% less often [which the researchers, themselves, acknowledge is “not a large difference”]. And their conclusion? “One of the underpinnings of delinquency might be impaired recognition of emotional facial expressions, with a specific bias toward interpreting disgusted expressions as hostile angry expressions.” On the other hand, as has been empirically demonstrated for centuries, one of the underpinnings of delinquency might be lower verbal IQ. Nar’mean?

But this is not Sato & Co.’s first foray into studies involving distressingly Photo-Shopped facial expressions. As reported in NeuroImage in 2004, 5 females and 5 males [mean age 24.4 years] volunteered for a [non-diagnostic] fMRI study, comparing their amygdalar responses to facial expressions described as angry or neutral, sometimes facing head-on, and sometimes slightly averted. Guess what they found. Head-on angry faces aroused an amygdalar response [in both men & women], whereas averted angry faces did not. Nor did neutral faces, no matter which way they were pointed. And these subjects weren’t even delinquents!

Apparently, even in Japan, researchers enjoy circling the lamppost, in order to discover that which is already known. Are you tellin’ me, the culture which introduced the Western World to the notion of seppuku [aka, hara-kiri] as a rational response to “loss of face” [aka, receiving a look of disgust, or a diss] doesn’t see the nexus between disgust and anger? Well, I do, and I’m Irish. Anyone who has ever read urban anthropology [or the newspapers] is aware that most youthful violence is triggered by one party giving the other party such a look [of disrespect], that honor demands a hostile response [usually towards the dissing party, but sometimes, turned inwards towards the dissed, himself, out of unbearable humiliation]. Nar’mean?

Street savvy youth [and their elders] learn to avoid inadvertently giving such facially expressed offense by taking a leaf out of the Viennese [Dissed] Clever Dog’s book, and averting their gaze. Further, those of us using public transport in the wee hours, learn to “keep our eyes in the boat” and/or to monitor our facial subtext for inadvertent expressions of disgust, and to verbally override them, with such remarks as, “Yuck! I think I may have food poisoning! Oh, well. Worse things happen at sea, right?” The only threat such a remark poses to fellow travelers, is to their clothing, not to their self-worth. No diss, no hostilities. [Usually, not always.]

I was waiting on line at the clinic pharmacy today, where the TV had some inane talk show on, with a guest who may have been the younger brother of a Backstreet Boy; and the interviewer said to him, “What other people think of you is none of your business.” Well, the studio audience applauded. [And so would I have, except that I was at the clinic pharmacy.] What a wonderfully powerful antidote to the infuriating toxin of humiliation! If someone gives you a look of disgust, it’s none of your business. Avert your gaze and tell the wolf in your brain to pipe down, already. Nar’mean?

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Filed under confounds, murky research, power subtext, semiotics

Attractive Nuisance Doctrine


First let me make a cheap pun at Zanzibar’s expense, and say that because he is usually purring at my elbow when I’m writing this blog, it is his fault that I don’t catch all the typos before hitting “publish.” Like typing “Packer Leader,” when I meant, of course, “Pack Leader,” in the previous post. “If only his eyes weren’t so adorably blue…”

As those of you who have a swimming pool on your property know [and we learned, when we bought Dusk the QuarterHorse], an “Attractive Nuisance” is a term of art in tort law, referring to any animate or inanimate object which poses a threat, “because of its attraction, to children who will be unlikely to recognize its dangerous quality.” [Webster’s 1988 ed.] In Michigan [where tort lawyers abound] we had to buy Attractive Nuisance liability insurance on Dusk, even though she lived at a private riding stable, across town from our home. [In fact, she lived in Sterling Heights, whence cometh Marshall Mathers III. Check it.]

Now let us consider the External/Internal Locus of Control doctrine, which the UK researchers tried to measure in 10-year-olds, with a self-report questionnaire. A girl with a high level of External Locus of Control will tell her parents, “The horse whinnied at me, so I knew it was hungry, so I gave it my Ice Lolly to lick [remember, we’re in the UK], and it bit my hand!” [In Michigan, that would be a Popcicle.] Was a sign posted on the stall door, saying “Do not feed this horse without owner’s permission”? Not good enough. What if the child is too young to read? Tell you what the management at the London Zoo do. They post this surreal but high concept sign with a human hand, out of which a cookie-cutter-[or, biscuit-cutter]-shaped chunk is missing, near the cages of animals whom it is dangerous to feed. Next time I own a horse, I’m posting that sign on the stall door.

What if the horse spared the child, but ate the rod [in this case, the Ice Lolly/Popcicle stick]? Would the family of the young doner of the ill-advised confection be liable for the vet bill, to remove the wood splinters from the horse’s throat? Not bloody likely! The horse would be diagnosed with “Dietary Indiscretion,” and its owner would be charged for its treatment.

So, you see where I’m going with this, right? Up to a certain age, the law attributes External Locus of Control to young ones, and blames bad outcome on others [man & beast]. After that age, though, all bets are off. If, as a teenager, you schmize my horse into eating a dangerous stick [and I catch you at it], you’re guilty of animal abuse. An adult caught feeding a zoo animal will be prosecuted [right after being discharged from the ER]. So, how is this shift from External to Internal Locus of Control supposed to happen? Passage of time? Trial and error? Fairy dust?

I happen to believe it happens by grown-up Pack Leaders [there!] keeping an eye on young ones, and issuing Conative commands to them [such as “Don’t feed the animals, unless you ask first.”], along with a Sound-Bite-on-Why-Not. [“Cuz I say so,” does not count as a Sound-Bite-on-Why-Not, incidentally.] So, here’s what I’m saying, grown-ups. Man up, and risk the humiliation of a hissy fit from the thwarted young person [or their doting parents], in the name of animal welfare, of child welfare, of public order. Think of these Sound-Bites-of-Why-Not as your own, award winning Public Service Announcements. The more novel and amusing [usually], the more effective they are.

The alternative is the intrusive mission creep of increasingly silly tort avoidance notices from which we now suffer, warning us that a cup of Hot Chocolate “might be hot.” That raw eggs may contain salmonella. That roads may be slippery when wet.

Get working on those PSAs, folks.

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Filed under leading a pack, locus of control, pro bono publico, semiotics

"Over a Barrel"


Riding my usual hobby horse today: the double [sometimes, opposite] meanings of certain figures of speech. When you hear the title phrase, do you think “at someone’s mercy,” or “having been rescued from near-drowning, being draped over a barrel to clear the lungs of sea water”? According to all my UK etymological sources, the latter is the first meaning; and it supposedly originated in the States in the 1800s. Only later, in the early 1900s, did it come to mean “being hazed, as in a college fraternity ritual.” Also, supposedly, an exclusively American practice.

Oh, yeah? Well, I’ve just been browsing the British House of Commons debates from 1846 and 1906, concerning punishment by flogging in the Royal Navy. [Actually, I knew about this before, but it’s a trip to read the debates verbatim.] In the former debate, a bill was put forth stipulating that flogging could be legally administered only after a Court Martial [not just at the whim of any officer on board]; and the 1906 bill advocated the abolition of flogging, altogether. Incidentally, the euphemism for a sailor’s being tied to the barrel of a ship’s cannon, in the proper position to receive up to 48 lashes with a cat-o’-nine-tails, was “kissing the gunner’s daughter.” And when someone says of a tight space, that “there’s hardly room to swing a cat,” they are referring to this man-made flayer of human flesh [not a pussycat]. On some ships, though, a milder version of flogging for sailors under the age of 16 substituted a whip of 5 [not 9] strands, without the 3 knots per strand, which was called a “boy’s cat” or “pussy.”

And now, to the [metaphorically] related topics of a modern form of child discipline in America [the Time Out], on the one hand, and invasive medical procedures, on the other. Consider first the aphorism, “A kitchen contractor is a vandal that you pay; and a surgeon is an assailant that you pay.” Partly because of the truth of the first statement, more and more of us opt to Do-the-Home-Improvement-Ourselves; but very few of us opt to perform surgery on ourselves [not even physicians]. So we pay [or at least co-pay] to be assaulted [you know, like, cut open], in the hope that some good will come of it. No matter how much reasoning with yourself you do, about why a given procedure is necessary, there’s no escaping the Big Four irritants: the intrusion, the humiliation, the fear, and the pain & suffering. And what if the procedure doesn’t even purport to be curative, but only diagnostic? [Let your wolf mull that over a bit.]

So, back to Time Out. When a parent says to her/his obstreperous child, “Do you want a Time Out?” I always wonder if they really mean, “Do you want a [mild form of] punishment?” or “Do you want to take a moment to try to compose yourself [with a variant of Zen meditation]?” Is it a threat or a Serving Suggestion? Is it rhetorical [like “Do you want to make a scene?”], or is it Conative? Remember, way back in the beginning of this blog, Jakobsen’s 6 Speech Functions; and one of them was to Give an Order [Even to Oneself]? So, either “Do you want a Time Out?” is a roundabout way of saying “Do you want to pipe down?” or “Why don’t you pipe down?” or even “Pipe down, already!” Trouble with being Conative, though, is that it’s so in-your-face-and-on-your-case. It’s so I-am-the-boss-of-you: so…Packer Leader. [Mull it over.]

When, as a Lieutenant Commander, I used to stand the ER watch at Newport Naval Hospital, back in the day, with my [future] husband, I got to listen to him try to avoid giving direct orders to his patients [even though, as a Naval Officer, he outranked most (not all) of them, especially the drunk & disorderly sailors who made up the lion’s share of our nighttime clientele]. “Why don’t you get up on the exam table?” said he [rhetorically, I assume]. “Cuz I don’ wanna!” replied one under-age-but-way-over-the-limit young man. “Sailor, get yourself up on that table!” the future father of my future children commanded. And thus did an Able Bodied Seaman [a rank, not a diagnosis] begin his ordeal of intrusive, humiliating and painful [but life-saving] treatment for acute alcohol poisoning, for which, given the venue, he was not even charged a co-payment.

You might say that the Navy [and, especially, the ER treatment team] had him over a barrel.

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Filed under gets right up my nose, power subtext, semiotics

Bad Fairy at the Christening


Backstory to Sleeping Beauty: two Good Fairies offer upbeat predictions for baby Aurora; then a Bad Fairy [name of Maleficent] predicts that on the girl’s 16th birthday, she’ll prick her finger with a spindle and die. A 3rd Good Fairy softens the malediction from “die” to “fall asleep.” Then they put the baby into a witness protection program [changing her name to Briar Rose]. You remember the rest.

So here’s the malediction du jour from BMC Medicine 2009, 7;46: based on a decades-long study of 16,496 kids, all born in the UK, in the same week of April, 1970. When they were 10 years old, several tests & measurements were administered. Less subjectively, their Body Mass Index [as well as that of their parents] was obtained by “a qualified nurse.” The Social Class of their parents was calculated, based on Dad’s line of work [if any]. Their teacher filled out a “modified Rutter B” questionnaire [which assessed each kid for how “worried,” “miserable,” “tearful,” and/or “fussy” they were]. Hands up, if you ever were assigned Robert Rosenthal’s 1968 educational classic, Pygmalion in the Classroom. If so, you already know how this study is going to turn out; but don’t spoil the surprise for the others.

Then these UK 10-year-olds were given 3 read-it-yourself-and-fill-in-the-answers surveys. The so-called Self-Report test had just 2 items: “I worry alot,” and “I am nervous,” to which the kid could answer “Not at all,” or “Sometimes,” or “Often/usually.” [Let’s cut to the chase on this one, and say that it predicted nowt, bupkes, nada.] Ah, but there followed the 12-item LAWSEQ [“yes,” “no,” “don’t know”] to assess Self Esteem; and the 16-item CAROLOC [“yes,” or “no/don’t know”] to assess External/Internal Locus of Control. The scoring on each test was like golf [not basketball]: lower was better. Did you ever study the “Yea-sayer Effect”? [As the name suggests, some folks Just Cain’t Say “No” on questionnaires. That’s why well-designed surveys throw in some “Yes, we have no bananas” type of questions, just to catch out the “yea-sayers.” Not these two tests, though.]

Okay, so fast-forward 20 years. Of the original cohort, less than half the 30-year-olds [mostly women] chose to contact the researchers, with their self-reported Body Mass Index. Now for the high-concept title of the article: “Childhood emotional problems and self-perceptions predict weight gain in a longitudinal regression model.” And now, for what the data actually show. “The strongest predictors of weight gain were BMI @ age 10 and parental BMI.” “[For women only] External Locus of Control and Low Self Esteem predicted weight gain on a par with Social Class.” “The Rutter B predicted increased BMI [for women].”

So–before we all start wringing our hands like the guests at Aurora’s Christening party, at the “Statistically Proven Fact” that highly-strung 10-year-old girls [or those who Just Cain’t Say No on questionnaires], whose teachers have already pigeon-holed them as Nervous Nellies, are doomed to become overweight 30-year-olds–let’s consider an unexplored bias in the data. As Rosenthal’s [much more robust] results have shown, a teacher’s subjective assessment of each student has a powerful effect–for good or evil–not only on the teacher’s predictions of that kid’s academic and social success, but on the kid’s actual success.

So, here’s my advice to concerned parents of young girls. Listen carefully at those parent-teacher conferences; and if you’re getting the vibe that the teacher has your kid in “negative halo” mode, either change the teacher’s attitude or change which teacher your kid has. I have no doubt that my father’s move-in-October Navy schedule fortuitously rescued me from some toxic negative halo situations [inasmuch as I was an Exceedingly Highly-Strung, ergo annoying, young pupil]. And twice, my parents insisted that I switch teachers, even when we weren’t blowing in or out of town.

Ya gotta be your kid’s Press Agent, and package ’em, like an Oscar nominee. Ya gotta win the Bad Fairies over, and get them to revise their own predictions of your kid’s prospects. Also, it couldn’t hurt to coach your kid to charm it up a little, no? And for those of you waiting for the Up Your Nose nexus here, say it with me: Childhood humiliation [at not being one of the teacher’s faves] leads to anger [often, directed against oneself] and to dumping cortisol, which leads to weight gain…along with other forms of pain & suffering.

But watch out for that 16th birthday, anyway. It’s a risky time for most girls.

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Filed under attribution theory, body image, confounds, locus of control, murky research, stress and cortisol

Lili the Rorschach


This morning’s walk through the woods was a harbinger of Fall: cool, blustery, intermittently overcast, with a forecast of rain. I put on a waterproof, fawn-colored riding jacket, and off we set. At the midway point of the trail through the woods, I heard my least favorite sound: gunshots, very close. I happen to know that deer hunting season is weeks off, so neither Lili nor I were wearing our day-glow safety vests. In fact, obscured by the leafy trees, we might have been mistaken for a wolf and a deer. Spurred on by fear, not to mention the intrusion of [let’s just hope] hunters jumping the gun, we picked up the pace and headed for the relative safety [because of our higher visibility] of the playing fields. But just as we approached the turn off, we heard police sirens near the school, and decided to stay on the lower-viz, wooded path. By the time we reached the paved road that leads back to where the car was parked, both the gunshots and the sirens had stopped, so we relaxed the pace to a brisk, dog-show trot.

When we reached the car, it was blocked by two county utility vans. “Oh, swell!” I thought. “Having dodged bullets in the woods, now we’re going to get hassled on the open road.” The driver of one truck rolled down his window and asked, “Where’d you get that dog?” “In Virginia,” I said with a smile [projecting my best not-your-victim-not-your-enemy subtext]. “I’ve never seen anything like it! What’s ‘he’ weigh?” Going into my Lili-is-not-your-enemy mode, I said, “She’s a girl, and she only weighs 71 pounds, under all that fur. Soaking wet, she looks like a greyhound.”

To which he replied, “It looks like a bat! Never seen anything like it! Have a nice day!”

And the point of this little vignette? Scary is in the eyes [and ears] of the beholder [listener]. Unless I hear on the news about a gun battle in my local woods [which is not unprecedented], my amygdalar arousal was as much of a false alarm as was the initial reaction of our new friend, “Bat man.”

But I think we’ll start wearing those safety vests again, in any case.

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Filed under attribution theory, limbic system, semiotics