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Why some people can't tell left from right

By Kelly Oakes12th January 2023

It can seem like an almost childish mistake, but a surprising number of adults confuse left from right and scientists are only just starting to understand why.

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When British brain surgeon Henry Marsh sat down beside his patient's bed following surgery, the bad news he was about to deliver stemmed from his own mistake. The man had a trapped nerve in his arm that required an operation – but after making a midline incision in his neck, Marsh had drilled out the nerve on the wrong side of his spinal column.

Preventable medical mistakes frequently involve wrong-sided surgery: an injection to the wrong eye, for example, or a biopsy from the wrong breast. These "never events" – serious and largely preventable patient safety accidents – highlight that, while most of us learn as children how to tell left from right, not everyone gets it right.

While for some people, telling left from right is as easy as telling up from down, a significant minority – around one in six people, according to a recent study – struggle with the distinction. Even for those who believe they have no issues, distractions such as ambient noise, or having to answer unrelated questions, can get in the way of making the right choice.

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"Nobody has difficulty in saying [something is] front and back, or top and bottom," says Ineke van der Ham, professor of neuropsychology at Leiden University in the Netherlands. But telling left from right is different, she says. "It's because of the symmetry, and because when you turn around, it's the other way around, and that makes it so confusing." 

Left-right discrimination is actually quite a complex process, calling upon memory, language, visual and spatial processing, and mental rotation. In fact, researchers are only just beginning to get to the bottom of exactly what's going on in our brains when we do it – and why it's much easier for some people than others.

Former US President Donald Trump was briefly flummoxed when leaders were asked to cross hands at a summit in the Philippines in 2017 (Credit: AFP/Getty Images)

HOW BEING LEFT-HANDED CHANGES YOUR BRAIN

 

Around one in 10 people are left-handed, and studies on twins have shown that genetics has a role to play. A study at the University of Oxford recently revealed four regions in human DNA that seem to play a role in determining if someone is left or right handed.

Those who were left-handed were found to have "mutations" in four genes that code for the body's cytoskeleton – the complex scaffolding that sits within cells to help organise them. Scans of people with these mutations showed that the white matter in their brains had a different structure. The left and right sides of the brains of left-handed people were also better connected than in right-handed people.

"Some individuals can tell right from left innately, just can do it without thinking," says Gerard Gormley, a GP and clinical professor at Queen's University Belfast in Northern Ireland. "But others have to go through a process." In an effort to understand what happens in wrong-sided medical errors, Gormley and his colleagues have conducted research on medical students' experience of making left-right decisions and examined the process.

"First of all, you have to orient right from left in yourself," he says. When the answer doesn't come instantly, participants described various techniques, from making an L shape with their thumb and index finger, to thinking about which hand they use to write, or strum a guitar. "For some people it's a tattoo on their body or a piercing," Gormley says.

Then, when figuring out which side is someone else's left or right, the next step is mentally rotating yourself so you're facing in the same direction as the other person. "If I'm facing you, my left hand will be opposite your right hand," says Gormley. "That idea of mentally rotating an object adds an extra degree of complexity." Other research shows that people tend to find it easier to judge if an image shows a left or right hand by imagining their own hand or body rotating.

Research published by Van der Ham and her colleagues in 2020 found that around 15% of people rate themselves as insufficient when it comes to identifying left and right. Almost half of the four hundred participants in the study said they used a hand-related strategy to identify which is which.

The more asymmetrical someone's body is – in terms of writing hand preference, for example – the easier they find it to tell left and right apart

The researchers used something called the Bergen right-left discrimination test to dig deeper into how these strategies work. Participants looked at pictures of stick people either facing toward or away from them, with their arms in various positions, and had to identify their highlighted hand as their left or right. "It seems simple, but it's kind of frustrating if you have to do a hundred of these as quickly as you can," says Van der Ham.

In the first experiment, the participants sat with their hands on a table in front of them. "There was a very clear effect from how this little stick figure was positioned," says Van der Ham. "If you were looking at the back of the head, so it was aligned with you, people were a lot faster and more accurate." Similarly, when the stick person was facing the participant but had their hands crossed, so their left hand was on the same side as the participant's left hand, people tended to do better.

"That tells us that the body really is involved in this," says Van der Ham. The next question was whether participants were using cues from their body at the time of the test to identify left and right, or referring to a stored idea of their body instead.

To answer that, the researchers repeated their experiment, but this time tested four different scenarios: participants sat with their hands either crossed or uncrossed on the table in front of them, and had their hands either visible during the test, or covered with a black cloth.

But the researchers found that none of those changes influenced test performance. In other words, participants didn't need to actually see their hands in order to use their own body to distinguish right from left.

"We haven't completely solved the issue," says Van der Ham. "But we were able to identify our bodies as being a key element in identifying left from right, and that we consult our body representation as we have it in a more static way."

Mistakes made during medical procedures due to left-right errors have led some surgeons to take extra steps to ensure they operate in the right place (Credit: Tommy London/Alamy)

In Van der Ham's experiments, the boost in performance that came from being in line with the stick person was more pronounced in people who said they use a hand-related strategy to tell left from right in their daily lives, as well as in women generally. The researchers also found that men tended to be faster in responding than women, but the data did not back up previous research showing that men perform better overall in left-right discrimination tests.

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Exactly why people differ in their ability to tell left from right isn't clear, though research suggests that the more asymmetrical someone's body is (in terms of writing hand preference, for example) the easier they find it to tell left and right apart. "If one side of your brain is slightly larger than the other, you tend to have a better right-left discrimination," says Gormely.

But it could also be something that we learn in childhood, like other aspects of spatial cognition, says Van der Ham. "If kids are in charge of finding the way around, if you just let them walk in front of you for a couple of metres and make the decisions, those are the kids that ended up being better navigators," she says.

Research by Alice Gomez and colleagues at the Lyon Neuroscience Research Center in France hints that left-right discrimination is something that children can pick up quickly. Gomez designed a two-week intervention programme, delivered by teachers, designed to increase five-to-seven-year-olds' body representation and motor skills.

When they were tested on their ability to locate the correct body part on themselves or a partner – their right knee, for example – after the programme, the number of left-right discrimination errors were almost halved. "It was very easy for us to increase the abilities of children to be able to locate the [body part] on the basis of the name," says Gomez.

One reason for this might be that the children were taught a strategy – to think about their writing hand – for when they couldn't remember right and left. The programme's focus on children's own bodies is another possible explanation, especially as other research shows that an egocentric reference frame is key when we make left-right decisions.

In a typical classroom, children might label body parts on a diagram rather than their own bodies, because the latter is more time-consuming and difficult to assess for a teacher, says Gomez. "It's very rare that they will have the time to be egocentric," she says.

Most of us can distinguish up and down intuitively, but working out left from right can take more mental gymnastics (Credit: Alamy)

While there are plenty of everyday scenarios where knowing left from right is important, there are some situations where it's absolutely critical. Brain surgeon Marsh was able to put right his wrong-sided trapped nerve surgery – but a surgeon removing the wrong kidney or amputating the wrong limb, for example, would have devastating consequences.

Medicine is not the only field where left-right errors can make the difference between life and death: it's possible that a steersman turning the ship right instead of left was a contributing factor in the sinking of the Titanic.

But while some people have to put in more effort to judge left and right, everybody has the ability to get left-right decisions wrong, says Gormley. He hopes that more awareness of how easy it is to make such a mistake will lead to less stigma for those who need to double check their decision.

"As health care professionals, we spend a lot of time labelling spatial orientations: proximal, distal, superior, inferior, but really pay no attention to right or left," he says. "But actually, of all the spatial orientations, that is the most challenging."

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Almost without exception, serious artists describe how they carry a sketchbook and draw - on public transportation, in doctor's offices, in the car, on land, sea and air . . . wherever they are, wherever they go. I've tried it and failed. Obviously, I'm not serious artist. I am, however a proponent of creative expression for health and well-being. (We have posted many tutorials on easy ways of doing "art" for the non-artist. Check the links below)

These artists often explain that when they create it clears their head, makes them feel calmer and more relaxed. Research supports their experience.


It turns out there's a lot happening in our minds and bodies when we make art or engage in any form of creative expression: drawing, painting, collaging, sculpting clay, writing poetry, cake decorating, knitting, scrapbooking the sky's the limit.



Judy doing art

"Anything that engages your creative mind — the ability to make connections between unrelated things and imagine new ways to communicate — is good for you," says Girija Kaimal. She's a professor at Drexel University and a researcher in art therapy, leading art sessions with members of the military suffering from traumatic brain injury and caregivers of cancer patients.

Everybody, no matter what your skill level, is something you should try to do on a regular basis. Here's 5 reasons why:

1. Creative expression helps you imagine a more hopeful future

Our brain is a predictive machine.

Art's ability to flex our imaginations may be one of the reasons why we've been making art since we were cave-dwellers and might serve an evolutionary purpose. Girija Kaimal,art therapists holds the theory that art-making helps us navigate problems that might arise in the future.

Her theory builds off of an idea developed in the last few years — that our brain is a predictive machine. The brain uses "information to make predictions about we might do next — and more importantly what we need to do next to survive and thrive.

"When you make art, you're making a series of decisions — what kind of drawing utensil to use, what color, how to translate what you're seeing onto the paper. And ultimately, interpreting the images — figuring out what it means."

"So what our brain is doing every day, every moment, consciously and unconsciously, is trying to imagine what is going to come and preparing yourself to face that," she says.

"Kaimal has seen this play out at her clinical practice as an art therapist with a student who was severely depressed. "She was despairing. Her grades were really poor and she had a sense of hopelessness," she recalls."

The student took out a piece of paper and colored the whole sheet with thick black marker. Kaimal didn't say anything.

"She looked at that black sheet of paper and stared at it for some time," says Kaimal. "And then she said, 'Wow. That looks really dark and bleak.' "

And then something amazing happened, says Kaimal. The student looked around and grabbed some pink sculpting clay. And she started making ... flowers: "She said, you know what? I think maybe this reminds me of spring."

Through that session and through creating art, says Kaimal, the student was able to imagine possibilities and see a future beyond the present moment in which she was despairing and depressed.

"This act of imagination is actually an act of survival," she says. "It is preparing us to imagine possibilities and hopefully survive those possibilities."

2. Creativity activates the reward center of our brain


For some people, making art can be intimidating - I'm not an artist. What would I make? What if it sucks? Studies show that despite those fears, "engaging in any sort of visual expression results in the reward pathway in the brain being activated," says Kaimal. "Which means that you feel good and it's perceived as a pleasurable experience."

She and a team of researchers measured blood flow to the brain's reward center, the medial prefrontal cortex. In 26 participants as they completed three art activities: coloring in a mandala, doodling and drawing freely on a blank sheet of paper. there was an increase in blood flow to this part of the brain when the participants were making art.

This research suggests making art may have benefit for people dealing with health conditions that activate the reward pathways in the brain, like addictive behaviors, eating disorders or mood disorders.

3. Creative expression lowers stress

There's evidence that making art can lower stress and anxiety. Researchers measured cortisol levels of 39 healthy adults. Cortisol is a hormone that helps the body respond to stress.

They found that 45 minutes of creating art in a studio setting with an art therapist significant lowered cortisol levels.

The research also showed that there were no differences in health outcomes between people who identify as experienced artists and people who don't. So no matter your skill level, you'll be able to feel all the good things that come with doing creative expression.

4. Creativity lets you focus deeply - creates a meditative state


"Ultimately, says Kaimal, making art should induce what the scientific community calls "flow" — the wonderful thing that happens when you're in the zone. "It's that sense of losing yourself, losing all awareness. You're so in the moment and fully present that you forget all sense of time and space,"

And what's happening in your brain when you're in flow state? "It activates several networks including relaxed reflective state, focused attention to task and sense of pleasure," she says. Kaimal points to a 2018 study published in the journal Frontiers in Psychology, which found that flow was characterized by increased theta wave activity in the frontal areas of the brain — and moderate alpha wave activities in the frontal and central areas.

What kind of "art" should you try?

Not into painting or knitting? There are types of art appear to yield greater health benefits than others.

CLAY: Kaimal says modeling clay, for example, is wonderful to play around with. "It engages both your hands and many parts of your brain in sensory experiences," she says. "Your sense of touch, your sense of three-dimensional space, sight, maybe a little bit of sound — all of these are engaged in using several parts of yourself for self-expression, and likely to be more beneficial."

COLORING: A number of studies have shown that coloring inside a shape — specifically a pre-drawn geometric mandala design — is more effective in boosting mood than coloring on a blank paper or even coloring inside a square shape.

There's no one medium or art activity that's "better" than another.

5. Creativity helps process your emotions


It's important to note: if you're going through serious mental health distress, you should seek the guidance of a professional art therapist.

However, if you're making art to connect with your own creativity, decrease anxiety and hone your coping skills, creative expression can help. For example:

Draw or scribble lines, shapes and colors translate your emotional experience.

Focus on feelings or sensations that you feel in your body, your memories.

Pick magazine pictures that intuitively catch your attention for a collage.

"Creativity in and of itself is important for remaining healthy, remaining connected to yourself and connected to the world," * Read for further suggestions:

*Christianne Strang, professor of neuroscience at the University of Alabama Birmingham and the former president of the American Art Therapy Association.








I believed my first loves (I’m using the plural in order to propagate an image of being one of the “popular” girls) were indelibly etched in my heart. The experiences we shared together, and even how we separated, stay with me in a positive and healthy way and helped form the person I am today. Now I learn that all my first loves are not in my heart. They are lodged in my BRAIN. Experts say the neurological attachment that happens between young lovers is not unlike the attachment a baby forms with its mother. Hormones like vasopressin and oxytocin are key in helping create a sense of closeness in relationships and play a starring role in both scenarios. If that person was your first, best or most intimate, the mark is even more indelible. Such preferential encoding in the brain is one reason why stories of people reconnecting with a high school or college flame are commonplace. Feelings of romantic love trigger the brain’s dopamine system, which drives us to repeat pleasurable experiences. The brain’s natural opiates help encode the experience, and oxytocin acts as the glue that helps forge those feelings of closeness.* “Oxytocin unleashes a network of brain activity that amplifies visual cues, odors and sounds,” explains Larry Young, a psychiatry professor at Emory University in Atlanta. That, plus the effects from your brain’s natural opiates and dopamine, and your romantic partner’s traits — strong jaw, piercing blue eyes, musky scent — leave a sort of neural fingerprint. Those preferences become soft-wired into your reward system, just like an addiction.” Even creatures prone to promiscuity, like rats, are often primed to revisit their first pleasure-inducing partner, according to a 2015 study co-authored by Pfaus. And it seems humans may follow a similar pattern.

“WHO said I was promiscuous?” Seeing a first love can instantly reactivate the networks your mind encoded decades ago. Throw a bear hug into the mix — and the accompanying flood of oxytocin — that old brain circuitry lights up like fireworks. Justin Garcia, the associate director for research and education at the Kinsey Institute, says that just like a recovering alcoholic craving a drink after decades of sobriety, we can still be drawn to an old lover. “It doesn’t mean you still want to be with that person,” he says. “It doesn’t mean there’s something wrong with you. It means there’s a complex physiology associated with romantic attachments that probably stays with us for most of our lives — and that’s not something to be afraid of, particularly if you had a great run.” When Reconnecting Makes Sense – single, divorced or widowed? “Most people have a lost love they wonder about. Someone who held your hand through transformative moments and helped you define you. Love research supports the notion that it’s psychologically intoxicating to reconnect with a former flame you still feel friendly toward; the brain lights up the same way a cocaine addict’s does before a hit.” “But, unless you’re single, divorced or widowed, it’s probably best to avoid searching for that old love on Facebook. According to psychologist Nancy Kalish, professor emeritus atCalifornia State University, Sacramento, when social media collides with a generally happy marriage, the results can be disastrous. A whopping 62 percent of married folks in her study wound up having an affair with their ex — even though they didn’t reach out to them with any such plan in mind.” “You can’t compare the person who you experienced a first or early love with to someone who you’ve had a deep abiding love with for many years through the course of a marriage,” Kalish says. “Both are good and both are powerful.” “So before you follow an ex on Twitter, send them a Facebook message or stalk them on Instagram, consider two big factors: Are you single? And if not, are you prepared to let reconnecting with your ex devastate your current relationship? If the answer to either question is “yes,” you could be in for a pleasant reunion with an old friend,” Kalish says. http://discovermagazine.com/2017/april-2017/fired-up *According to a 2010 study published in The Journal of Neurophysiology



I prefer to call myself a multi-tasker who has so many projects going there's never enough time to finish any . . . rather than a procrastinator

  • I prefer to call myself a planner who takes planning so seriously that there is never enough time to finish the planning stage . . . rather than a procrastinator.

  • I prefer to call myself a creative type who is more invested in the process than the product . . . rather than a procrastinator.

I took this quiz to make sure I was right in my self assessment. (JW)


Your Procrastination Style Quiz

from: It's About Time: The 6 Styles of Procrastination and How to Overcome Them by Dr. Linda Sapadin


Directions

If "MUCH OF THE TIME" is MOSTLY correct for you with each question just circle the question number. Otherwise, go on to the next question

1. Do you have difficulty completing a project because your own high

standards have not been met?

2. Do you get preoccupied with details, rules or schedules that others don’t

seem to care much about?

3. Do you think a lot about things you want to accomplish, but rarely get them

off the ground or finished?

4. Do you wait for opportunities to drop into your lap rather than take an

active, “go-get-‘em” approach?

5. Do you paralyze yourself before starting a project, worrying so much about

the “what ifs” that you are too anxious or out of time to do the task?

6. Do you hesitate to leave your comfort zone, avoiding situations that might

cause stress or anxiety?

7. Do you become sulky, irritable or argumentative when asked to do a task

that you don’t want to do?

8. Do you take offense or are annoyed at suggestions from others regarding

how you could be more productive?

9. Do you ignore or put off deadlines, then at the last-minute work frantically

to get things done?

10. Do you enjoy, or take pride in, taking risks or living on the edge?

11. Do you have difficulty saying “no” to other’s requests and then feel

resentful or overwhelmed when it’s time to do them?

12. Do you run around doing things, without really feeling that you’re

accomplishing very much?

Your Procrastination Style Answers

If you’ve answered “Yes, that’s frequently me” to any of these questions, you probably know you’ve got a procrastination problem (You probably knew it before you took the test)

Now take a look at your “Procrastination Style(s)

If you:

  • Answered Yes to Questions 1 & 2 You are a Perfectionist Procrastinator

  • Answered Yes to Questions 3 & 4 You are a Dreamer Procrastinator

  • Answered Yes to Questions 5 & 6 You are a Worrier Procrastinator

  • Answered Yes to Questions 7 & 8 You are a Defier Procrastinator

  • Answered Yes to Questions 9 & 10 You are an Crisis-Maker Procrastinator

  • Answered Yes to Questions 11 & 12 You are an Over doer Procrastinator

Here’s a summary of what fuels your procrastination style:

  • Perfectionists procrastinate because they want everything to be perfect (that seems obvious!)

  • Dreamers procrastinate because they hate dealing with all those pesky bothersome details and enjoy the “what if”.

  • Worriers procrastinate because they are afraid of change and worry about “what if”.

  • Defiers procrastinate because their difficulty with authority makes them resent and resist doing tasks.

  • Crisis-Makers procrastinate because they love living on the edge, only get motivated at the last minute to enjoy the adrenaline that comes with crisis.

  • Over doers procrastinate because they have too much on their plate, don’t prioritize well and have difficulty getting it all done

Now I'm completely confused. I answered yes to half of each in perfecting, dreamer, over-doers. Luckily, I'm not a worrier or defier cuz I always defy myself to worry.

(jw)

What did you learn ABOUT YOUR STYLE?




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