Winter 2013

How the Paul D. MacLean Award for Outstanding Neuroscience Research in Psychosomatic Medicine Came to Be
Richard D. Lane, M.D., Ph.D. (APS President, 2005-6)
William R. Lovallo, Ph.D. (APS President, 2007-8)

In 2012 the APS Council established a permanent place in the Annual Meeting program for the MacLean Award, which honors outstanding neuroscientific research in psychosomatic medicine. A core goal of our field is to understand how our emotional make-up affects our bodies to either improve or worsen health. We recognize Paul MacLean for his pioneering vision of integrated physiology linking brain function, emotions and their impact on the body. Many years later, the revolution in the neurosciences has created unprecedented opportunities for advancing the study of emotion in medicine.

The year 1994 was the first time a modern functional neuroimaging study was presented at the Annual Meeting of the Society. Richard Lane presented a poster on the functional neuroanatomy of emotion using positron emission tomography (PET) which won the “Best Poster” award. This was a sign that the Program Committee recognized the potential of work in the neurosciences. The following year at the New Orleans meeting, Margaret Chesney organized a preconference workshop on “New Technologies in Psychosomatic Research.” This included an hour on PET scanning presented by Richard Lane, an hour on analysis of cardiovascular variability by Richard Sloan, and one on recent advances in genetic technologies by Linda Crnic. Richard Lane and Richard Sloan along with Gary Schwartz and Stephen Oppenheimer also organized a symposium titled, "Windows on the Brain: Descending Control of the Cardiovascular System." People seemed interested in what neuroimaging had to offer the field of psychosomatic medicine research.

At the 1998 meeting in Clearwater, FL Richard Lane chaired a workshop in which Bruce Rosen, M.D., Ph.D. from the Massachusetts General Hospital gave an entertaining and engaging presentation on the basics of “Functional Magnetic Resonance Imaging.” At that same meeting Richard Lane and Oliver Cameron co-chaired a symposium titled “Emotion and Related Phenomena: Functional Imaging Studies.” Two years later at the 2000 meeting in Savannah, GA Richard Lane presented “Neuroimaging in the context of cardiovascular measurement” at a preconference workshop titled “Brain-Heart Interactions in Psychosomatic Medicine” chaired by David Krantz and David Sheps. At that same meeting in Savannah Oliver Cameron and Richard Lane co-chaired a roundtable discussion on functional imaging. These sessions were well-attended and there was a distinct feeling that the new neuroimaging technology was catching on and generating some excitement within the Society.

At the Fall 2000 APS Council meeting Bill Lovallo and Richard Lane struck up a conversation about the new book called Cognitive Neuroscience of Emotion that Richard and Lynn Nadel from the University of Arizona had edited. Bill believed that our understanding of the brain basis of emotion had matured enough, and that the topic was central enough to psychosomatic medicine, that it was time to organize a major preconference workshop on the topic. Richard and Bill organized a “Master Workshop” at the 2001 meeting in Monterey titled “Neurobiology of Emotion in Psychosomatic Medicine,” which began with a tribute to Helen Flanders-Dunbar, whose 1935 book titled Emotions and Bodily Changes launched the creation of APS. The presenters were Drs. Larry Swanson (brain basis of emotion), David Amaral (social cognition), Dan Tranel (emotion regulation) and Wayne Drevets (depression). About 140 people attended and the event was considered a major success. This led Bill and Richard to organize 1-day preconference workshops on Neuroscience at the 2002 meeting in Barcelona (with a focus on cardiovascular regulation) and the 2003 meeting in Phoenix (with a focus on pain).

The next major event was the Annual Meeting in Denver in 2006 at which the theme was “Neuroscience” and Richard Lane was president. There was another preconference workshop, several symposia, plenary session talks and paper sessions. Hugo Critchley received the President’s Award. Many people at the meeting were excited by the presentations while others were concerned that it potentially diluted the psychosocial focus of the Society.

If neuroscience were to prosper in psychosomatic medicine, more neuroscientists needed to join the Society and non-neuroscientist members needed to collaborate and participate in the research. This led to two white papers on neuroscience being published in Psychosomatic Medicine in 2009 that were intended as a resource for non-neuroscientist members.

After the Denver meeting a Neuroscience Interest Group was formed which met at the annual meeting for the next several years. However, beginning in 2007, without targeted efforts to stimulate neuroscience submissions, the number of neuroscience papers declined steadily, and by the 2009 Chicago meeting neuroscience was only a minor presence on the program. That led Richard Lane in 2009 to propose an annual award to stimulate ongoing interest in this area and to recognize those who had made outstanding contributions using neuroscience methods in psychosomatic research.

What to name the award was not initially clear. Richard Lane’s work had been inspired by that of Paul MacLean, who had died just 15 months earlier in December 2007. Richard floated the idea of naming it after Dr. MacLean at the Chicago meeting and received very positive feedback about the name and the intent of the award. Paul MacLean was a fitting choice for many reasons. Paul MacLean began as a primary care physician who noticed that many of his patients had physical symptoms that had no objective medical basis. Instead emotional factors often appeared to play a role. MacLean sought an understanding of how emotional experience could be translated into physical symptoms. In so doing, he first described and named the brain’s limbic system and pioneered what became the fields of affective and social neuroscience. In 1949 he proposed the first modern theory of how the brain contributes to physical disease by linking altered conscious processing of emotional arousal to a disconnection between cortical and subcortical structures.

To launch the MacLean award required funding to attract high caliber speakers. Fortuitously, the MacLean family wanted to honor their patriarch and agreed to contribute generously. Funding was obtained from other donors, including many APS members and the James Harris family, and a goal of about $50,000 was attained, which was sufficient for 10 years of the award program, including the annual lecture and travel awards for five trainees. The APS Council approved the program, and Tor Wager became the first recipient in 2010 at the Portland meeting. Dr. Wager’s presentation was nothing short of dazzling, and it broke new ground in our understanding of the brain basis of the placebo effect and the visualization of cortical-subcortical interactions in the regulation of heart rate changes during the preparation of a stressful speech. This was followed by stellar presentations by MacLean award winners Richard Davidson in San Antonio in 2011, Stuart Derbyshire in Athens in 2012 and Gary Bernsten in Miami in 2013. In addition to the plenary award lecture, the MacLean Award recipient holds a private mentoring meeting with the 5 MacLean travel award winners and also hosts a roundtable discussion for the membership after the award lecture.

The idea of a permanent endowment for the MacLean Award came from president Mike Irwin in 2011. To create the needed endowment, Richard Lane proposed to the MacLean family an equal, matching contribution, guaranteeing half the funding if the family matched the APS contribution. The family graciously accepted, and the needed funding was in place for the 2012 meeting.

Many people, too numerous to mention, deserve credit for making the MacLean Award program a success, and a few deserve special notice. George and Laura Degnon and Sarah Shiffert have been especially helpful and supportive. The APS Council has backed this award from the start and has now approved a permanent set of award criteria, described in the companion piece in this issue of the Newsletter. The MacLean Award Selection committee is chaired by Richard Lane, assisted by Bill Lovallo, Hugo Critchley, Pete Gianaros, Leanne Williams (2008 President’s Award winner) and James Harris (Professor of Psychiatry at Johns Hopkins and former student of Paul MacLean's). In 2013 the committee adopted staggered terms, and beginning in 2014 some members will rotate off as new ones rotate on.

We are grateful to the APS leadership and membership for your support and welcome suggestions about how to make the MacLean Award program a force for the advancement of neuroscience in psychosomatic medicine.