Hi Reddit! I’m Joel Salinas, a neurologist, clinical fellow in behavioral neurology and neuropsychiatry, and research fellow at Harvard Medical School and Massachusetts General Hospital.

Verification photo:

I have synesthesia, which is a sensory processing condition that means that, when I experience something with one of my senses, I involuntary experience it through other senses, too (from hearing colors and tasting sounds to experiencing people as numbers). One particular form of synesthesia I have is mirror-touch synesthesia, where I physically feel everything the people around me physically feel. For example, if I were to see someone touch your cheek I would simultaneously, involuntarily, and vividly experience the same sensation of being touched on my own cheek. If you get a slap on the wrist, I feel a slap on my wrist. If you have a needle placed in your arm, I feel the needle placed in my arm… and so on. While it’s a very natural part of my day-to-day life given that I’ve had it since I can remember, being a neurologist that works with patients on a daily basis and having mirror-touch synesthesia makes for an interesting experience. It certainly gives a whole new meaning to “empathy”! It also makes practicing mindfulness go from optional to obligatory.

A recent piece in Pacific Standard Magazine told my story and touched on my work: http://www.psmag.com/health-and-behavior/is-mirror-touch-synesthesia-a-superpower-or-a-curse

Having a little more insight into what my patients are feeling than most, I've always placed a lot of importance on my patients' needs as a person. Our thoughts, our feelings, and even the ability to simply perceive the world around us is precious. It helps shape who we are as a person. To me, it seems far too simple how that can all be stolen tragically by age-related brain diseases like stroke and dementia. That's why I made the decision to become a neurologist and work on developing the science and clinical application of preventive neurology and cognitive medicine. I believe both are critical to helping people live happier, healthier, and more fulfilling lives.

As a researcher, my goal is to answer two big questions:

  • How do we develop and practically apply strategies to prevent the onset of devastating, chronic, age-related brain diseases (such as dementia and stroke)?
  • How can we preserve and optimize cognitive function over the course of the human lifespan?

Reach out to talk about synesthesia, brain health, early prevention of neurologic disease, healthcare delivery systems, unconventional ideas in health and technology, or anything else!

You can check out a talk I gave at the Tate Modern in London describing some of my mirror-touch experiences here - @2:35 mark.

If you need more convincing I’m real: http://www2.massgeneral.org/neurologyresidents/team/2015.html http://med.miami.edu/news/profiles/salinas-packs-his-impressive-resume-for-harvard



Really looking forward to chatting with you!

UPDATE: The AMA time is almost up, but I'll try to stick around to answer more questions.

UPDATE: I wish I could keep answering questions but have to run--thank you for all the great questions!

UPDATE: Since there were so many great questions I couldn't get to, I figured I'd hop back in briefly while I had some time.

Comments: 185 • Responses: 53  • Date: 

Xarieste75 karma

I'll be the one to ask the big question: What happens when you watch porn? I'm genuinely curious.

Also, I've heard a lot of good things about developments in Alzheimer's research and given my grandma died of it, how close are we to understanding and treating it?

joelsalinas51 karma

Fortunately my optic nerves aren’t selective based on subject matter... and the MPAA doesn’t regulate my occipital cortex....

In terms of Alzheimer’s research, we’ve made some huge advances in the last few years -- molecular models (see Alzheimer's in a dish) and other treatments that involve multipronged interventions (check out the FINGER study from Finland--it’s a great leap forward in this area). There's a lot going on here and a lot to discuss. Sorry about your grandma.

Xarieste20 karma

Thank you for a prompt and professional answer to a rather awkward question. Thanks also for bringing me new research to show my Dad!

joelsalinas17 karma

Of course!

chezPJ20 karma

Have you ever seen someone die? If so, how did that reflect on you?

joelsalinas52 karma

Unfortunately, as a physician, I’ve seen a fair number of people die. It’s a really a unique experience that is really worth just having a discussion on it’s own. More than anything, there’s just such a pronounced feeling of stillness. A kind of emptiness that screams that there should be something there, but it’s gone now... with the added weight of permanence. Death is something you never really get used (this is true of probably most physicians). Because of the mirror-touch I think, it also led making the experience of death extremely vivid. With each death, it’s almost as if I’ve died as well. Except, I’m not dead. I was fortunate. These experiences (and my own experiences with near-death, including a devastating car accident) have really helped me not only be grateful for every second of life, but also aware of how important it is to take the time to truly appreciate it and let it sink in. You’ve got to live with everything you’ve got.

chezPJ10 karma

Appreciate your response, although I admit I'm disappointed that it's not more descriptive of how you experience it differently. Maybe all of us have a touch of mirror sense when we see death!

joelsalinas38 karma

I actually do think we all have some degree of mirror-touch. More specifically, at least in my own case, what I really am feeling is the absence of the mirror-touch sensations that had been ongoing (e.g., the sensation of the chest rising and falling with breaths, movements of limbs, facial expressions). When all of this halts suddenly, when there’s a constant din of mirror-touch synesthesia going on, it is very unsettling.

ungame18 karma

Hi Dr. Salinas,

Does your empathy have an impact on your ethical views? For instance, many people who are vegetarian or vegan say that their empathy for animals explains their decision not to exploit animals. Do you find that your empathy has influenced your life and decisions in this kind of way?

joelsalinas18 karma

I think so... Empathy is just one of the many cognitive functions that are going on in the background all the time, which shape who we are and what we do. Having experiences and sensations mirrored on myself is a way of making closer to others that perhaps I might have been otherwise. I do try to stay objective to a certain degree and think things through and try to make objective decisions -- especially with really tough ethical decisions which come up a lot in working with patients.

JackTheSkipper17 karma

I can't be the only one wondering, does your "mirror-touch" also apply to sexual stimulation?

joelsalinas39 karma

You’re not alone to wonder this! It’s usually one of the first questions my friends ask as well! Be it pain, grief, happiness, or any form of physical affection -- as long as the visual stimuli enters my optic nerves, there’s no discriminating there.

4and20blackbirds14 karma

My dad has dementia and ever since he got diagnosed, he's become more and more resistant to going to his neurologist, taking his medicine, and undergoing any further diagnostic tests. He says he wants to treat himself, by eating well and exercising. It's hard for me to tell whether these are his true wishes, or if they're affected by his condition. Paranoia is common with dementia, right? Has this ever happened with your patients? What are the ethics here? Am I supposed to think of him as an adult with the right to choose his own medical treatment? I'm so confused!

joelsalinas16 karma

This is true--paranoia, or just anxiety and even depression in general, are common in dementia. In particular, having difficulty with attend to things or keeping track of memories can lead to confabulations or delusions which can sometimes lead to paranoia. In these situations, there’s actually an assessment that can be done for what we call “decision-making capacity” in order to understand whether a person is able to make decisions on their own -- often on a case by case basis.

Dachannien12 karma

So, what happens if you see someone being touched with an object, and they react as if being touched is painful (e.g., as if the object is hot)? What do you feel?

Does your sensation change if you are told ahead of time that the object is not hot, but they still react as if it is? Or if you're allowed to feel the object ahead of time?

joelsalinas14 karma

I feel the sensation more of them moving away or the actual physical touch that caused the pain. If someone were to hold their hand over a flame, for example, I would feel the light sensation on my skin of the flames moving along my hand but no true temperature. The expectation of whether the sensation (like hot or not) doesn’t really change, but unexpected sensations tend to be more salient (like being caught off guard all of a sudden by watching someone get punched).

choixpeau11 karma

What happens if someone around you is feeling a kind of pain that you've never felt before? For example, what if you're in the presence of a woman who's giving birth?

joelsalinas14 karma

Hmm... it can actually be pretty surreal (a la Jerry giving birth). My body will still perceive the sensations regardless of whether I’ve felt it before on my body--even if the parts don’t exactly match up. Internally, I have to wrestle with the “Um... what is this I’m feeling right now...” moment. Being curious, I usually try to appreciate it for what it is. If it’s way too uncomfortable, then I can easily just move my attention elsewhere.

MatthewSMarkert11 karma

Temple Grandin made an amaaaazing picture of her brain with an MRI-SPECT....do you think you could do this an let us see what your fantastic brain looks like??? Please? If you don't mind coming to Kansas City for a visit, I'm sure I can get one for a fellow 'cane for free :-)

joelsalinas15 karma

Let’s do it! Direct message me @joelasalinas

CheeseDischarge10 karma

I once knew someone who had this and they said that pickles tasted like triangles. Do you have any other examples of something like that?

joelsalinas14 karma

I do--like mashed potatoes are rounded fluffy circles, carrots are spikey with prickly ends to it. The descriptions of each can actually get quite complicated depending on how much I attend to it, which other synesthetes experience as well. These synesthetic experiences can quickly turn into a Google image search deep-dive-dream-like experience.

TheCometCE9 karma

I was actually talking with my sister who's working towards her MA in art therapy about that condition last night, interesting stuff!

so I guess I'll fire the first shot: when you meet someone who has some kind of pain, be it neurological or physical, how soon do you tend to pick up on it as far as your condition goes?

joelsalinas12 karma

Pretty quick--and usually before I it even enters my consciousness. The physical sensation occurs in response and milliseconds later I’m actually able to process and understand the significance, which can be pain, grief, discomfort, or any other sensation/experience.

Riotsquad90008 karma

When you have been examining someone's brain, has it ever turned into a puddle of metallic goo and then reformed into the T-1000 and asked you if you've seen Jon Conner?

joelsalinas26 karma


MatthewSMarkert8 karma

Hello Dr. Jo-el Salinas! :-)

I'm so delighted to see you here. Your patients are lucky to have you.

How has your experience helped you understand the difference between reception, and perception? For example, in your article you say you are less likely to feel something if a picture gives the impression of a staged event. Prior to that realization, for example when you were younger, were there times when you wondered if you were actually feeling the same thing they were - communicated into you by some unknown force - and now do you believe your brain is PERceiving what it thinks someone else is likely to have felt?

I echo your goal regarding the preservation and optimization of cognitive function over the course of a human lifespan. Does your sensitivity to synthesezic influence change through improved mindfulness exercises?
i.e. - if you meditate, or feel more "present," are you able to be more sensitive to the feelings of others? Less (in cases where it's distracting, are you better able to tune it out?)

Cheers, and harmonius notes, Matthew

joelsalinas8 karma

It really has helped me appreciate the difference between reception and perception, partially because I need it to be able distinguish between what’s “real” and what’s “internal.” I often find that I need to take a second with the perceptions to make the determination for myself--”am I feeling this because it’s actually an emotion that’s intrinsic to me and what’s going on with me, or is this the emotion or sensation of the other person being imprinted on myself?” I think a lot of people can relate with this experience. Because the experience is so vivid, it requires a bit of introspection and a lot of respect for that fuzzy boundary between reception and perception.

Mindfulness really does help, and not just as a broad concept but the specific techniques that are often taught. Including knowing when to sit and appreciate and really be AWARE of the sensation and when it’s okay to dissociate or draw your awareness to something that’s more productive or positive when needed.

JackBurtonPorkChop7 karma

I've often heard that caregivers have to learn to occasionally distance themselves from the pain and suffering of their patients in order to perform their duties. This must be infinitely harder for you. Are you in a unique position to advise colleagues on techniques they can use?

joelsalinas10 karma

It’s definitely a balance -- you’re supposed to have empathy, but also you’re not supposed to let it get in the way of taking care of medical needs. This is where taking the time to appreciate when is the right time for what becomes really important. I find that skills that are taught through mindfulness and resiliency are the techniques that can make a big difference.

mustyrats7 karma

This is bit broad of a question but here it goes: how do you think synesthesia and your career in neurology has affected your ability to be present? I found that my courses in neuroscience left me feeling a little disassociated and was wondering how you've come to terms with this.

joelsalinas7 karma

This is bit broad of a question but here it goes: how do you think synesthesia and your career in neurology has affected your ability to be present? I found that my courses in neuroscience left me feeling a little disassociated and was wondering how you've come to terms with this.

Feeling dissociated can happen a lot--mostly out of necessity. The mirror-touch sensations can be pretty intense and consuming in terms of keeping my attention, which requires me to dissociate. In order to be present (truly present) I have to just reign myself back in. I tend to do this with easy physical cues that are grounded in actual physical touch. For example, I’ll often bring my attention to my toes--sort of putting myself back into my own shoes and that really helps me be present.

geshikhte7 karma

Has anyone, knowing about your condition, used it to hurt you? Like in a fight with a partner or something, have they ever intentionally hurt themselves in order to hurt you?

joelsalinas32 karma

“Quit hittin’ yourself! Quit hittin’ yourself!” I think having someone think that they could hurt me by hurting themselves is a great strategy to win. Sun Tzu would be proud.

chrispiiiii6 karma

Assuming this was present for you as a child how long did it takes for your parents, doctors, others to identify and diagnose it and at a young age how did it effect you?

joelsalinas13 karma

In the end, it was my parents or others who diagnosed so much as realizing that my experience was different from others.

Me: “Wait, doesn’t everyone see colors in letters? You do, right?” My friend: “Uh... NO.”

I did end up getting more formally “diagnosed” or evaluated with VS Ramachandran and using the synesthete.org battery of tests and also at the labs of Jamie Ward and Michael Banissy.

DarkGodBane6 karma

I'll try to phrase this cleanly because I'm legitimately curious. With your condition does it change the experience of being intimate?

joelsalinas13 karma

It’s a complex experience--becoming intimate with someone and reflecting it back on yourself. It’s kind of like seeing your reflection through multiple mirrors.

mr_427 karma

Wow. It's crazy to think you don't know how normal touch actually feels, there's always something else attached to it... right? Do you wonder how it is to be "normal"? Is there some type of chemical that turns off the synestesia for a bit? Have you tried psilocybin?

joelsalinas9 karma

Not really--because all of our brains our diverse I think it can be hard to pin down on normal and this experience is so natural to me now that anything else would likely feel abnormal. There isn’t chemical that might turn off synesthesia (like an antidote to Altruizine exposure (HT anigbrowl), though propofol would likely do the trick (and then some).

TheBeifongGuy6 karma

Are there any cool advantages to your condition?

joelsalinas9 karma

Interestingly, it really does also help with learning and memory, random associations (which really help with idea generation and creativity), and I found out with some testing in Ramachandran’s lab that my reaction time to mixed sensory stimuli is three times faster than non-synesthetes.

GoRacerGo6 karma

What is eating with other people like? Do you feel what they feel?

joelsalinas12 karma

Yup--mostly it’s the sensation of the foods as it enters their mouths and movements of chewing or drinking. I don’t really mind it. I was what science would call a “fat kid,” so the more chances I had to enjoy eating the better!

rationalthinker15 karma

Do you taste the food?

joelsalinas7 karma

I wish! I do have the physical sensation of the chewing of the food, but I don't taste their food... Though now I'm actually thankful that I don't taste somebody else's chewed food.

joethetipper5 karma

Can you describe the tastes of colors? Does red/blue/whatever color always taste the same? Do darker shades taste stronger than lighter ones?

On a more basic note, what is the single biggest advantage and disadvantage that your condition has had on your career as a physician?

joelsalinas9 karma

Colors can have tastes, though usually the tastes are not always perfect cookie-cutter-pick-from-a-list flavors. The brain can be a bit messy, but that’s ok! There are inherent properties across many synesthetes. For example, lighter colors can have higher-pitch sounds tied to them while darker ones have lower pitch sounds. Lighter colors for myself typically are on the more sour or sweet spectrum, which darker are more on the bitter or umami spectrum.

I would say, single biggest advantage is being able to vividly and involuntarily put myself in the shoes of my patients. Single biggest disadvantage is that sometimes you really do need some distance and vividly and involuntarily putting yourself in their shoes constantly makes that process all the more challenging.

LittleBlueEyes5 karma

If you don't know a person is experiencing pain (perhaps you're not looking at them, or haven't read the chart yet, or are walking toward the room still), do you still experience their pain?

joelsalinas8 karma

It depends--typically I actually because I might feel the sensations of posture or other changes that cue me into their discomfort. It’s usually not the dramatic sensations that are most powerful. It’s more the many many little data points of sensation that come together to form an experience. It’s similar to studies of biological motion perception where just a few points are all that are needed to raise high up into cognitive perception.

rakaja5 karma

How is your experiece with movies or shows that are based on really intense scenes?

joelsalinas16 karma

They can be really immersive--the more effort gets into making the scene unexpected and graphic, the deeper the experience can be. In really great movies, it feels as though I almost lose the boundaries of myself and sort of just become the movie. It’s like having a dream while awake.

YonicJedi5 karma

There might not be a good way to put this, but I'm curious what happens when you watch people being sexual, do you feel that and would it apply to both genders. Like maybe if you saw a man or woman by themselves, would you feel what the lady feels? Im not trying to be gross or anything, I'm really genuinely curious how you react to that.

joelsalinas11 karma

No need to feel gross about it--it’s sex! It’s life!
Sensations are certainly much more salient with adrenaline, dopamine, serotonin, etc (it’s similar with caffeine) -- and it’s even more salient the more similar corresponding parts are. The more corresponding (like-to-like) bodies are, I find that there’s an added dopamine rush almost. Like a bit more of a relief -- like scratching an itch that you didn’t realize you had, but are so glad you found it.

MumblesInTheCorner4 karma

Holy fuck this is a thing? I had this as a child, I would feel.the same pain if a friend skinned their knee or had hurt feels. Thought I was just crazy, the emotional side still tears me up.

joelsalinas7 karma

You probably aren’t! Sharing my story has been an interesting experience. I thought it was just be an article that would get tucked away into the deep recesses of the internet, but I’ve been pleasantly surprised at people’s response to it. There’ve even been a few people, such as yourself, who have told me that they’re glad that there’s a name to what they’ve been experiencing.

Akshatfcb4 karma

Hi Doctor , So how long do these feelings last , do they instantly stop on withdrawal of contact or do they persist for some time ?

joelsalinas7 karma

They’re usually quite brief and tied to the extend at which my attention is on the physical touch. If someone experiences touch in front of me, I’ll feel it usually for the exact same duration as they are; however, if the experience was particularly vivid it might linger for a few seconds or resurface when (involuntarily or not) reflecting on it.

balraj_014 karma

Dumb question here. Do you only feel sensation if you see it happen? What about if you are listening or visualizing?

joelsalinas3 karma

No problem--the mirrored sensation only comes from seeing it occur. I do have proprioceptive and some tactile synesthetic associations with sounds, but they wouldn’t be the same as with the sensation from mirror-touch where the visualized touch maps directly to the corresponding part of my body that is matched in a manner that is mirrored (if face-to-face) or anatomic (if side-by-side).

mikesbad4 karma

Are there phsyical senstations to a person having something like Alzheimers? Possibly a senstation that is so miniscule within the brain the person isn't aware. If so, would this affect your own cognitive functioning by working with patients like this?

joelsalinas3 karma

Not really specific to Alzheimer’s -- the physical sensations based on their clinical presentation may aid my ultimate diagnosis (just based on syndrome). For example, I may feel a slight change in posture or gaze that wouldn’t be consistent with normal attentional functioning which might cue me into a syndrome that has a very subtle amount of encephalopathy and would be concerning for early loss of executive functioning.

In terms of the effects on my own cognitive functioning by working with patients, I tend to have the most vivid mirror-touch synesthetic experiences when I encounter something unexpected or novel. I know that the mirror-touch sensations tend to catch me off guard the most when I’m working with a patient that has either a significant facial or body deformity (because the sensations mapped on my body map in ways that I am not familiar with--like feeling a blinking sensation near my mouth in the case of a significant facial deformity), severe trauma patients (partially because of my own experience being in an ICU after a devastating car accident--the sensations are far too real and it becomes a bigger challenge to differentiate between reception and perception), and patients with tic disorders or Tourette syndrome (the tics can happen erratically and can catch me off guard). The latter group is one that I look forward to working with in my own clinic as it creates an opportunity to really connect--precisely because of how significant the mirror-touch experiences can be in this group.

ImNeverAFK3 karma

Hello Dr.,

The mirror-touch synesthesia is intriguing, but I don't have time right now to look deeper into it (but I will). Is it only that you feel what the person feels when you see it or are the other sense that make you feel the same (hearing?). No need to answer this question, I already read your other responses

I can imagine mirror touch synesthesia is something like a lot of people (men) experience when someone gets a kick to the family jewels, is this true? I would expect we act that way because we know how the feeling is. Do you have the same feeling when you have never experienced it yourself?

Thank you for doing this AMA.

joelsalinas6 karma

It’s predominantly dictated by sight. That said, synesthesia in and of itself comes in many forms. I actually do have proprioceptive (body position) associations with sounds as well as sensations (particularly on my tongue--perhaps because of the amount of cortex dedicated to tongue movements?).

I do think that these experiences are intrinsic to the human experience and that we all fall along a spectrum. We all have what’s been speculated to be mirror-neurons that help us to simulate the environment around us internally, particularly with other people--which is where the whole discussion of its potential evolutionary tie with empathy comes out.

If I experience something that I have not experienced before, I will still experience the sensations; however, these experiences tend to be much more salient. Even moreso, if unexpected.

dawsnow3 karma

So I'm guessing no surgery, right?

joelsalinas7 karma

I think you’re asking whether I do surgery or not, which would be accurate. Neurologist:Neurosurgeon::Internist:General Surgeon. We still do a fair amount of procedures, but certainly not craniotomies or craniectomies. We’re often the ones making complicated diagnoses or managing the complex medical neurological issues. We work closely together--teamwork FTW!

dawsnow3 karma

If you ever had to do surgery, do you think your mirror touch would affect you?

joelsalinas6 karma

It would depend. I've seen a fair amount of surgeries at this point, so the experience is easy to dissociate from; however, at first it was definitely a little gruesome.

plasticcastle3 karma

I hope I'm not too late, and thanks for the AMA.

Have you participated in a rubber hand illusion scenario? Do you feel the pain "experienced" by the fake hand?

joelsalinas2 karma

Not too late (I’m still trying to get everyone’s questions).

In terms of the hand illusion--I have actually! I feel the sensations on the fake hand as if it were that of an actual person pretty reliably.

cinnabunz3 karma

Two questions:

Did your experience with your condition influence your decision to become a doctor, or a neurologist specifically?

What is one research project you are working on that you are really excited about and are able to share?

joelsalinas10 karma

Definitely. If anything, the mirror-touch experiences remind me how important it is not just to see someone suffer, but to truly do something about it. Becoming a doctor was how I felt I could make an impact on this. I went into neurology, because I realized how critical it is to take care of the brain, which is the home for our reality and our perception of the world around us.

One research project I’m working on and am really excited about is looking at the effect of psychosocial factors on developing disease and the biological mechanisms that govern our brain’s development, learning, and memory.

downtherabbittrail3 karma

The idea that our psychosocial experience may create disease in us is something my client and I agree on -- I would love to hear about that research or read it. Would that be possible? Also, do you have need of volunteers to conduct your research?

joelsalinas4 karma

Direct message me @joelasalinas and I can follow up with you.

Jobcv3142 karma

What precautions do you take in your regular life, social, out with friends, to prevent you from having this special gift interfere with your true emotions?

Also in an unrelated topic, do you see any breakthroughs in Narcolepsy in the next ten or so years? (Thought I'd ask for a friend who isn't on reddit) thanks!

joelsalinas2 karma

Often, it’s a matter of being able to dissociate when needed as well as being able to reflect on what emotions I’m feeling in order to discern whether or not they are more consistent with myself or someone else’s feelings. For example, feeling suddenly irritated or angry while around someone who is experiencing frustration when I might not have any true cause to be irritated or angry.

With regard to narcolepsy, the field of sleep medicine is constantly developing and I wouldn’t be surprised if promising clinical trials led to some new potential drugs. For now, it’s still standard of care. Hope your friend is being followed by a sleep specialist that they like!

jimkgeorge2 karma

The article in Pacific Standard states that "an estimated 1.6 percent of the general population" experience mirror-touch synesthesia. Are people generally unaware that they have this condition? I can imagine their quality of life could be dramatically decreased by simply not knowing.

joelsalinas3 karma

This is unfortunately the case for some. I’ve already had a few people reach out to let me know that they’ve experienced and what a relief it feels to know that it has a name. I’m hoping that a lot of good will continue to come out of driving more awareness about synesthesia, and particularly mirror-touch synesthesia.

qpid4202 karma

Hi! When you touch someone else, say on the cheek, do you also feel it on your cheek? Does anticipating an action alter your experience?

joelsalinas3 karma

If I were to touch someone’s left cheek (their left) as I’m facing them, then I would feel the sensation of touch on my right cheek.

Anticipation can play a role in increasing the strength of the sensation (I think in part to the shifting of my attention to that sensation), so if I’m focused on the act of tapping someone on the shoulder I’m then much more cued into the synesthetic sensation of ghost-tapping on my own shoulder when eventually do /poke.

downtherabbittrail2 karma

What a blessing to get to ask you some questions. Ok. I work with a post stroke client, ischemic -- 4 years ago -- right middle cerebral, hemi-plegic, left side -- what are some cognitive exercises that I can I can encourage to maintain or improve his cognitive function? Current symptoms worsening -- easily confused, some short term memory loss

EDIT: also blood pressure rises with frustration. Frustrated easily.

joelsalinas1 karma

These are the kind of patients I really appreciate seeing in my clinic because of how much impact we can have on their long term cognitive functioning. Because it’s tough to give recommendations without actually getting to know this patient further and examine them in person, it might be worth referring them to a neuropsychiatrist or even a clinical psychologist in your area. They can help with both the cognitive functioning and the lability in mood. Referring to a trained therapist in your area with experience in cognitive behavioral therapy might also be indicated in this situation.

rockhoundlounge2 karma

Here's the scenario: Several people standing in front of you. Each has objects -- lets say a small rod. Each individual rod has its own characteristics, for example, one is very hot, another is very cold, another has a very rough texture, another is vibrating, etc. etc. You are allowed to feel the rods and verify that these characteristics are true. Then all of the people in front of you simultaneously touch one part of their body. What do you feel then? I'm also assuming you are in a position where you can see them all at once such that you're not focusing on one individual at a time.

Edit: when I say "touch one part of their body" I mean they all touch the same part of their body.

joelsalinas4 karma

This question was totally on my MCAT exam (if only!).
This is an interesting question--kind of like a parallel processing v. queue situation. Actually this is almost the case all the time--all visual stimuli competing for my attention. It’s typically a matter of shifting attention. So, for example, even if I see all simultaneously, my attention will still drive what sensation I feel first. However, if I attend to the scenario as a whole, the visual image as a whole creates a sensation. So, if all of them have the rod up against their right elbow with the rod angle at a 45 degree angle, then I would actually feel more of a sensation of tiny rods along my face (that is, it becomes more about patterns and shapes, then the corresponding sensation affecting that specific corresponding body part on my own body).

LT_PhD2 karma

Hi Dr. I am curious if you have other synesthetic modes involving touch, specifically, if during palpation you are able to "see" inside a patient's body? Some manual therapists experience this, and also "hearing" various physiological phenomena through touch, such as fluid movement, or nerve impingement. Can you refer me to any research on these types of synesthesia? Thanks.

joelsalinas1 karma

I do have synesthetic associations with sounds and touch that have come in handy while palpating (for example an abdomen), however, not to the degree where I would clearly associate so well that I could ever come close to the resolution of, say, an ultrasound. However, I might perhaps pick up quicker on a physical exam finding from a synesthetic association. For example, the sound of fluid in the abdomen (even if subtle) is rounded, yellow, and with little frayed spikes. I would have the synesthetic experience immediately and then would make the higher order cognitive connection seconds afterwards that it’s likely related to fluid -- at which point I might repeat the exam maneuver or do a few others to confirm my suspicion.

For some basic references on research for various types of synesthesia, you can start with this great general resource.

SL1282 karma

I know it's not exactly your thing, but do you have any general advice for a prospective cognitive/behavioral neuroscientist?

joelsalinas2 karma

Sure, though it’s a broad topic to discuss in general, and I think that general career advice tends to be less helpful than advice that’s tailored to you. Direct message me @joelasalinas and we can chat more.

turquoisestar2 karma

I am curious if this mirror-touch synesthesia is always as strong as it is in your case, or if there is a lesser version. I am very intuitive with massage and I can often sense what muscle needs to be released, or how to stretch a muscle etc. Is it possible to have a mild version of this, or is that "regular" empathy?

joelsalinas3 karma

I think a lot of these synesthetic experiences are actually intrinsic to our human perception and how we associate, but it’s possible that we all fall along a spectrum. Daphne Mauer actually did some great research that shows that we’re all quite synesthetic as infants and over time (with white matter pruning) we’ll often lose some of these synesthetic associations.

pudles1 karma

So if you're watching an action movie, do you feel all the explosions and gunfire? Do you have a similar experience seeing pictures of feelings, for instance a ball hitting a receivers hands in an ESPN photo, do you feel it even though it's still? Further, do you feel things your mind thinks of? So if you pretend in your mind you are catching a ball and imagine it, will your hands feel it in real life?

Very interesting! Thanks!

joelsalinas3 karma

Definitely to both questions--in movie theaters, I fortunately don’t thrash around in my chair, but the experience is certainly vivid and involuntarily. It is constantly occurring at all times. The experience is kind of like processes running on a computer. I’m able to minimize the window when needed, but the process is still affecting the rest of the computer’s function.

jimkgeorge1 karma

You noted that the sensations can be "more salient the more similar corresponding parts are". Do you believe that synesthesia and sexual orientation are related?

joelsalinas3 karma

It’s an interest thought and one we could definitely speculate on. If I were to speculate freely (thank you, don’t mind if I do!), then I would say that it’s likely.

However, there’s not much evidence available to tie specifically mirror-touch synesthesia with what we know about the neurobiology of sex and gender-based attraction. With synesthesia in general, though, there has been some suggestion (from Cytowic and a few others) that having same-sex attraction occurs in about 10% of synesthetes and that there may be some biological mechanism that might explain this (see: Geschwind, N. & Galaburda, A.M. (1987) Cerebral Lateralization: Biological Mechanisms, Associations, and Pathology. Cambridge: MIT Press.).

NeinNoNon1 karma

Hello Dr. Salinas, does your condition only cause you to feel sensations you have previously felt or do you experience new sensations through synesthesia? For example, you know what getting slapped on the wrist feels like so seeing it recalls the memory of the feeling causing it to physically manifest. If so, what new sensations have you experienced through synesthesia?

joelsalinas3 karma

If I’ve felt the sensation before, it’s often not as salient; however, if I’ve had the sensation before and it was a particularly vivid experience, then the synesthetic experience or mirror-touch experience is all the more prominent. For example, as a kid, I put my hand on a teddy bear palm and got spines all over my palm. Henceforth, whenever I see something that resembles the bark of a teddy bear palm or if someone has many spines (like in a movie or image where someone has multiple porcupine spines, etc), then it’s likely a vivid synesthetic experience.

However, new sensations through synesthesia--I would say yes. Yes, because it’s not always a very clean, nameable sensation (spikey, soft, fluffy), which is why it can be so hard to describe sometimes. There just really aren’t that many words that are readily available in my own vocabulary to define it exactly. In the end, though, I’m ultimately forced to try to make sense of it through the filter of my own previous experiences.

sackwenga1 karma

Hi Dr Salinas:

1- I am very curious: what is your IQ? My friend has synesthesia and is a Mensa member. 2- The condition you describe is quite amazing: how does it fit into our current understanding of how the brain works?

joelsalinas2 karma

I haven’t done IQ testing before, but have done subtests which are a lot of fun though no formal scoring.

Your second question is a big topic, however, I’ll do my best to synthesize. It has a lot more to do with multi-modal sensory perception and how that sensory stimuli is integrated through our neural networks in order to create a behavioral response. In essence, some have found it helpful in generating theories about how our brain puts together information, how we make associations and analogies, how we tie memories to our experiences and future responses, and even the temporospatial resolution of our brain’s response to stimuli. Some even have brought it into theories for larger and more complex cognitive domains, such as language and emotion.

Ned_Schneebly1 karma

Has your "mirror-touch synesthesia" ever been subjected to objective scientific testing (i.e. have you monitored your brain activity v.s. the brain of the observed subject)?

joelsalinas1 karma

It has actually. My mirror-touch synesthesia was specifically evaluated in the labs of Jamie Ward and Michael Banissy. We didn’t do any tests looking at that specific task, but it would be interesting to try and set up a feasible study design.

At VS Ramachandran’s lab, we attempted to do an impromptu mirror-touch study which involved a MEG, which is basically like being Professor X trapped under an over-sized Cerebro, and the process of smacking people with what looked like a fiber optic unicorn tail...

ISmileSexy1 karma

What country are you from?

joelsalinas2 karma

My family's from Nicaragua and I was born in the United States.

MA11281 karma

Hello Doctor Salinas, I would like to ask a few questions:

Do you meditate? What's your understanding of love? And if you listen to this link, https://www.youtube.com/watch?v=qDql2AmopI0

Would you describe what's going through your senses when you heard it?

Thank you so much.

joelsalinas3 karma

I do meditate--but perhaps not like a mountain guru for hours on end. I actually just focus on a 15-1-7 guideline--spending to myself at least 15 minutes a day, 1 day a week, and 7 days a year. If I’ve spent most of my day mindful of my experience (appreciating the movements of walking, being aware of the experience of eating, or a visual experience), then the actual meditation is not as necessary.

OOooo I love that sound! There’s so much reverberation in lots of round echoing spots (similar to seeing drops of water falling in water--like during rain fall). It’s also got some great color qualities: hues of lavender, sky blue, whisps of gray, and little tiny tips of a slightly yellow hue at the center at times. Thanks for sharing!

EtovNowd-1 karma

  1. So if I randomly showed you gay porn, would you flinch your sphincter?

  2. Heartburn, do you feel it if I feel it?

  3. Orgasms, can you experience it without touching yourself?

  4. If I get extra hot salsa on my tacos, are you screwed?

  5. Have you ever tried to see if you feel the synesthesia while you're looking at your reflection in a mirror? That is, so that your mind has two different inputs to interpret (your naturally occurring synesthesia and the the visual input that nothing is touching you)

  6. Favorite Thundercat?

  7. Do you still feel the mirror-touch under the effects of alchohol?

  8. If you could have one superpower what would it be?

  9. Watching someone get kicked in the balls... do you laugh? Or fall in pain?

joelsalinas8 karma

  1. More like raise my eyebrow.
  2. Not the heartburn itself, so much as the discomfort from the heartburn. If I did feel the heartburn, I would not love watching competitive eating as much as I do.
  3. Fortunately, this is something that’s biologically possible everyone. Thank you, human biology!
  4. Only if you’ve hogged it all and there’s none left for me.
  5. Because the perception of sensation comes from both nerve-endings in the skin and also your brain’s higher order perception of what you’re feeling, the actual physical touch on the skin would be prominent enough to drown out the diplopic potential mirror-touch experience.
  6. Tygra--all about the bolo whip.
  7. Yes, and actually (with decreased executive function inhibition) it becomes much more prominent.
  8. I really like Peter Petrelli’s empathic mimicry.... Then again, being Galactus could be fun.
  9. Laugh in pain.