Tag Archives: Psychology

Who Is Normal, Anyway?

3 Oct

The Mad Hatter: Have I gone mad?

Alice: I’m afraid so. You’re entirely bonkers. But I’ll tell you a secret: all the best people are.

– Alice In Wonderland

People who have had nasty stuff happen to them are likely to act a bit differently, particularly when placed under stress.

Some people who don’t act normally are called mentally ill, and given labels to say they have this or that disorder.

While there is utility in such arbitrary labels, it is clear that there are also counterproductive results.

It’s a matter of subjective judgement whether certain behaviours are considered abnormal. And that’s often as much down to the way society works as the individual.

For example not so long ago homosexuality was a mental illness, with it’s own symptoms and then it wasn’t. Just like that. Now it’s considered as normal and healthy. Even nostalgia was defined as an illness until recently. Again, whether delusions are considered problematic can be a grey area: “Delusions, in the medical sense, are not simply a case of being mistaken, as the everyday use of the term suggests. They are profound and intensely held beliefs that seem barely swayed by evidence to the contrary – even to the point of believing in the bizarre.” Religion is a great example of this, but we don’t pathologise such behaviour. The thing is, everyone holds some delusional beliefs – it’s part of the human condition.

It seems clear that psychiatry makes some of these judgements based on what is acceptable to society as much as what is unhealthy for the individual. It’s not exactly rigorous science. While there are biological markers for a few states of mind, for the majority there are not, so we resort to classifying behaviour. How do we define what behaviours are the results of “mental illness” and what are normal? One suggestion is defining the behaviour of the majority as the norm, and classifying everyone outside of that average as disordered. The faults with that approach are immediately clear. Another suggestion is whether that behaviour causes self harm. If so smokers, or those with a bad diet, are defined as mentally ill.

So we then look to the perceptions and feelings of the person. Phenomenology, is the best tool for this, but is again subjective and imprecise. We can also look at whether these behaviours affect a person’s ability to lead a normal life, which requires normality within their culture to be defined.

Of course there are many difficult conditions that one would have difficulty arguing against being classified as problematic in any society. I’m acutely aware that severe depression can be debilitating, that psychosis can mean a person is unable to care for themselves. I’ve seen it first hand. Mind says that 1 in 10 adults are experiencing depression at any one time. Over 10% of mothers experience post-natal depression. Around 1% of people experience bipolar symptoms at some point.

However, while these methods will have clearer conclusions at the extremes of behaviour, there are massive grey areas in between.

The conclusion then, is that this is not a simple, easily solvable area. An acceptance that we don’t have black and white definitions is necessary, much as that is not satisfying. And as a result we don’t have panaceas either.

Part II – The Drugs in the next post

How We Decide by Jonah Lehrer

28 Dec

After following Jonah’s very readable blog for a while I decided I had to read his book. His blog introduced the latest neuroscience and psychological research in a very clear and digestible form.

That Lehrer has been embroiled in controversy for recycling his own work, and using unreferenced quotes from others is well known, however that of course does not detract from the message of his book in any way.

It’s an easy read, that is not too in depth and covers a lot of ideas about how the mind works that I’ve read before. While it’s not as incisive and informative as his blog, it is still useful, and reinforced ideas in a practical way.

He starts by describing how we use intuition (the examples of a quarterback & chess were used). Calculating faster than a computer, we are able to subconsciously make a good decision, if we have trained ourselves enough. We’ll “feel” that something is right without knowing why, or even needing to know.

However it’s important to know when we can use this intuition: if it’s an area you know well, where you have experience, then let the intuition lead. However if the decision is in a area in which you have had little practice, then don’t rely on your subconscious – think it through consciously.

Our subconscious training can be tripped up. Choking is well known, especially in sports, for example golf. If someone who is expert in an area consciously tries to figure out the technicality of what they’re doing, say understanding the position of their shoulder or the angle of their elbow, then they can easily lose the ability to fluidly use their body. Rather they must think in more general terms, such as a smooth golf swing.

There’s another way we can decide whether it’s best to use our intuition or our conscious mind to figure something out: if some problem has about 5 variables then we should use our conscious mind (the frontal cortex), however if there are a lot more variables, we should soak them all in, focus on something completely unrelated for a few minutes, then come back and make a decision – in that case the subconscious is good at sorting through the key facts.

He points out that the brain is an advanced pattern matching machine. This is very powerful when we want to figure out how things work, or make quick decisions, but it can lead to problems – recognising a face in clouds is a simple example. Also superstitions, seeing ghosts, etc. are faults with the system.

He talks about how morals are subconscious and are justified post-hoc, and are often not often logical.

He covers what Pinker would call the functional mind, i.e. that different bits of the brain will argue with each other, and once they’ve made a decision, present the result to the conscious part of the brain. He advises becoming aware of the argument, and embracing uncertainty until a good decision is found.

To be honest, having read a lot of stuff in this subject area I found this a really basic book, but if you are new to reading about neuroscience and how the mind works, it’s an easy-to-read introduction that you could get through in a few quick hours.

The best conclusion from this book is that we can understand how we work, use our inbuilt skills when they are appropriate, and train ourselves to make better decisions.

Mindfulness

8 Nov

Some people are instinctively cynical when mindfulness is mentioned. It can bring to mind new age, eastern, woo-woo nonsense.

However, when you take away some of the cultural and religious trappings around these mind practices, then you will find some very simple techniques that have surprisingly effective results.

Results that are proven by evidence.

Its popularity is steadily increasing: school children are taught it to help them get past exam stress and US marines are even trained in the practice.

What Is It?
Mindfulness is a purposeful awareness of your experience in the present moment.

The core of the technique is being aware of your breathing.

Once you’ve got that going it is expanded to get you paying attention to each thought or feeling.

Another way to describe it is as a state of clear, “present-centered awareness in which each thought, feeling, or sensation that arises in the attentional field is acknowledged and accepted as it is. [It] is characterized by curiosity, openness, and acceptance“.

A non-judgmental attitude is key – it means that you sit with your experience, whether good or bad, and accept it for what it is.

And that’s pretty much it.

What Has It Done For Me?
The benefits are wide ranging and no less than profound.

I began by doing a short 4 week course and immediately noticed the benefits. It reduced my insomnia like no other solution.

The increased self-awareness it brings means that I see more clearly how I am reacting to a situation. I am aware of my emotional response, and can see more clearly the choice I have of whether to allow that emotion to drive my actions, or to choose another path. This has clear applications in conflict situations. With this self awareness comes a greater awareness of how others respond to my actions too.

Given the increased awareness of the moment this mindset brings, I am able to enjoy the small things more. Simply paying close attention to the sensations when I’m eating a sandwich means it can become a much richer experience. Even something like doing the washing up can be more enjoyable.

I’ve also found it’s helped me to improve my concentration, because after all, it is at its core, exercising the ability to focus. Focus is closely related to willpower, which has been proven to be something we can improve.

The ability to focus in this way means that I can step back from the current swirl of thoughts in my mind. In this state I often find that important things I was forgetting bubble up to my conscious mind.

What Else Can It Do?
In these days, with so much data to look at, with so many demands on our time, to have the ability to better focus our attention, and to become aware when we’ve got distracted, is an invaluable skill.

Not only has mindfulness been clinically proven to reduce stress, blood pressure, depression and anxiety, but it has also been proven to help people sleep better, work more effectively and improve their personal and professional relationships. It even helps people cope with chronic pain.Be Mindful Online

Developing this quality of mind has been shown to reduce pain, anxiety, and depression; improve cognitive function; and even produce changes in gray matter density in regions of the brain related to learning and memory, emotional regulation, and self-awareness.Sam Harris

It reduces rumination, something at the core of the depressive mindset. It has been shown to reduce depression and bipolar symptoms. Increasing awareness, as every psychologist will say, is the first and hardest step in dealing with psychological problems.

Chade-Meng Tan describes how, when using these techniques, you watch your emotions and realise they are not you, but something you experience. “Therefore they are not permanent, they are changeable. This attitude, while seemingly simple, can bring great solace, and eventually significant change to people suffering from limiting psychological problems.

Jonah Lehrer said: “patients who escaped depression with the help of anti-depressants, and then stopped taking the drugs, relapsed about 70 percent of the time. The chemical boost was temporary. However, during the 18 month follow-up period, only 28 percent of patients in mindfulness therapy slipped back into the mental illness.

It can give you a greater awareness of your physical state, and of bodily reactions to your environment. It can even boost your immune system.

Neurological Effects
Andrew Newberg describes how brains scans of lifetime meditators show that “there is a diminution of activity in the parietal lobes, those areas responsible for self image, and perception of space and time. That means that people do – in their perception – transcend their bodies, space and time and are able to be “in the moment”. Great insights can come from this mind state, as well as increased peace and well-being.

Regular practitioners of mindfulness show increased activity in the frontal cortex and decreased activity in the amygdala. The amygdala is implicated in emotional responses such as fear, whereas the frontal cortex shows activity when exercising executive control, planning, etc. This means you become more able to control your emotional reactions.

It can even “lead to epigenetic alterations of the genome“.

How Can I Try It?
So give it a go. Sam Harris has published a helpful guided 9 minute meditation to start you off.

And if you really want to train yourself in the habit I recommend this online course. It costs £60, takes 4 weeks, and you’ll need to set aside a little time every day to do it. It gives guided meditations, instructional videos, and resources to help you track your progress.

Here are some great micro-goals to get you easily into the habit, and more tips here.

It’s a great practice that helps you enjoy the present moment and engage with life to produce a richer experience.

Bell

Feel the Fear . . . and Do It Anyway by Susan Jeffers

17 Sep

There are no big or small tasks. All are equally important.
– Shinzaemon Shimada – 13 assassins

I don’t remember how I came to read this book, but there’s something very enticing about that title.

Fear is something I’ve pondered before. There are different ways of viewing fear, or perhaps one could say there are different categories of fear. While there are many damaging and limiting fears that people can hold, I generally view fear as a useful tool to make me aware of either danger or my limits. To put it another way, it lets me know when I’m crossing the line I call my edge.

For example, with rock climbing, I started with very narrow limits, and a fear of putting my trust in the rope, but as I’ve learned to trust the rope and the person holding it, I’ve gone from tentatively putting my body weight on the rope to fearlessly throwing myself off the climbing wall, knowing that I’d be caught. At first I had a healthy fear of letting go of the holds as I perceived a chance of falling and hitting the ground, but as I learned the necessary trust, and I pushed through the fear, it subsided, and I was able to do more.

Similarly, when tree climbing without the safety of a rope, I was at first tentative, again being limited by safety fears, but as my climbing abilities increased, the fear receded, and my edge was pushed further away so I could make more apparently dangerous moves, opening up more possibilities for me.

And so it goes with the main principle in this book.

Jeffers talks of fear that stops us doing what we want, that keeps us from moving forward, or away from unhealthy relationships or jobs. She says that you will always feel fear, and if you’re not feeling fear it means you’re not growing as a person. She adds that the fear of trying new things and challenging yourself is smaller than the fear of being stuck and motionless.

She suggests some ways of dealing with this fear, such as understanding that whatever happens “I can handle it”, or realising that every choice will have a positive outcome, regardless of whether your initial goal is achieved. She justifies this by saying you’ll always learn from the choice, and the outcome you had envisaged may not happen, or even be desirable, as over time events will occur that make the outcome unlikely, and that will change your motives so that your end goal may change.

She describes how to have a balanced or “whole” life. By this she means we shouldn’t build our life around just one relationship or just our job. You become dependent on that thing / person and if it goes then it’s pretty hard to recover. So she discusses a balance between work, family, friends, hobbies, alone time, leisure, etc. She also valuably describes putting in 100% to each of these and, in each area, understanding that you are valuable, to “act as if you really count”.

Jeffers moves on to talking about giving from a place of love and trust, so not giving with an expectation of receiving something of equal value back. If you’re always expecting something back you’ll be disappointed and fearful. If you give with no expectation of receiving then in fact you’ll receive “so much richness back in return” anyway. She defines giving as giving thanks, information, praise, money and time.

She gets a bit weird in the penultimate chapter talking about getting with the vibe of the universe, but what she’s saying makes sense, and I guess she just hasn’t figured that bit out properly so resorts to a more ‘magical’ description as too many people do. She talks of saying “yes to your universe”, i.e. accepting what is. This is a key theme in just about any book of this kind, and is a prerequisite to enacting change.

She covered her bases well: when I had a question or an objection to what Jeffers was saying, she’d usually cover my issue in the following paragraph.

Yes, it’s essentially one of many American self-help books, however that’s no reason to be put off, because it’s a very practical book to help you live a more fulfilled, happy, positive and enriching life. Can’t complain about that. I’ve put in to practice what I’ve read to my benefit, and I’ve bought it for several friends one of which told me that it’s one of the best they’ve read.

The Drugs Don’t Work

15 Jul

Instead of asking what is wrong with you, we need to ask what has happened to you.

– Dr Lucy Johnstone

Recently the British Psychological Society called bullshit on those claiming the efficacy of the arbitrary psychiatric diagnoses in the DSM†, and the drug based treatments in which they usually result.

They have released a report whose abstract reads:

The DCP believes there is need to move away from psychiatric diagnoses such as schizophrenia, Attention Deficit Hyperactivity Disorder, personality disorder and conduct disorder, which have significant conceptual and empirical limitations, and develop alternative approaches which recognise the centrality of the complex range of life experiences in the emergence of mental distress, and the personal impact of social and relational circumstances including trauma.

The best overview of the report comes from this short interview with Johnstone on Radio 4, which is well worth the listen. I’ve added an abridged version of the interview text below.

Of course the BPS are not the only ones to hold this view. The National Institute of Mental Health issued an inflammatory press release criticizing current psychiatry for being “brainless and invalid“. Plenty of others have been publicly pushing this, and much stronger views, for many decades. For example, in the sixties, notable luminaries such as RD Laing and Michael Foucault, not to mention many “survivors” groups.

The Interview
John Humphries: “Schizophrenia is a terrible disease. It destroys many lives, the people who suffer and those who have to live with them, and yet there is no scientific evidence that a diagnosis of it is vital or useful. That is the view of the British Psychological Society itself. The same goes for bipolar disease.

I’m joined by Dr Lucy Johnstone who’s a Consultant clinical psychologist, and she’s on the working party that drew up that statement.

Dr Lucy Johnstone: “This isn’t an argument between psychologists and psychiatrists. Many psychologists, many psychiatrists and many health professionals are united in saying that the evidence for the current way of understanding mental distress, just doesn’t exist“.

The DCP [Division of Clinical Psychology, part of the BPS] has issued this consensus statement: there is actually no evidence for the current view – and we agree with many senior psychiatrists in saying that – we do have an overwhelming amount of evidence that even severe psychiatric breakdown is actually the end result of a complex mix of social and psychological circumstances. People who have suffered things like bereavement, loss, discrimination, poverty, trauma, abuse, domestic violence, in other words things that have happened to you.

John: “So where does that leave us in terms of treating it? Because there is no question that it is a disease. Schizophrenia is a horrible thing?

Lucy: “Well actually that’s exactly what we are questioning. We are questioning the disease model, along with many psychiatrists. Of course the distress is very real.

John: “Doesn’t that make it a disease? If you are desperately distressed, to the point sometimes of killing yourself, or harming somebody else perhaps, doesn’t that make it a disease?

Lucy: “Well there’s no evidence that it does. We are told a great deal of stuff about genes or biochemical imbalances, and as one of America’s most senior psychiatrists said only a couple of weeks ago, we have been telling patients for several decades that we are waiting for biomarkers, in other words evidence for a disease process. We are still waiting. So these are very serious problems, but there is an increasing amount of evidence that there is a way of understanding them, for example very often as the end result, not always, of extremely severe trauma.

John: “But you can’t turn back the clock, you can’t remove that trauma or make it never happen, so how do you deal with this, whatever you call it, disorder?

Lucy: “We would probably not want to use the term disorder. It does bring into question all the traditional vocabulary. We are actually calling for a change of language among other things.

John: “How does this understanding change the way you treat it?

Lucy: “It changes it in a very helpful and ultimately very productive way: in essence, instead of asking what is wrong with you, we need to ask what has happened to you? People break down for reasons, those reasons aren’t always immediately obvious, it can take quite a while to put the pieces together, but once we know those reasons we can offer them the right help to recover.

John: “Which would probably be counseling rather than drugs would it?

Lucy: “Well drugs might well play a part but i think we have to be clear about the role of medication. If we’re talking about the end result of complex social and relationship problems, by definition medication can’t solve those. It can certainly help keep people going, it can certainly help with some of the more overwhelming themes of distress. But essentially, what psychologists would say, we use a jargon word, which is formulation, which is a way of putting together the psychological evidence about the impact of very difficult life experiences, understanding how those affected the person in front of you, the personal meaning of those events, and on that basis you draw up an individual plan which will actually have a very good chance of helping that person recover.

John: “Well that’s encouraging. Dr Lucy Johnstone, thank you very much indeed.

Conclusion
As a close friend of mine with first hand experience of such issues said: “I sincerely hope that this discussion will eventually go on to reduce a lot of unnecessary suffering“.

† The DSM is the  Diagnostic and Statistical Manual of Mental Disorders, containing definitions of certain states of mind from depression to “Disruptive Mood Dysregulation disorder”, with has implications on how people are diagnosed and hence treated. I’ve referred to this previously.

The Wisdom Of Crowds by James Surowiecki

13 Aug

Surowiecki presents a nice approach to trusting “the crowd”, based on some interesting research.

His main proposition is that a group can come to a wiser decision than an individual if three conditions hold: diversity, independence and decentralization. He breaks such decisions into three categories: cognition, coordination and cooperation problems, giving examples of each.

– Diversity means that people have different experience, knowledge, and approaches and so add more little bits of wisdom to the crowd.

– Independence means that each member makes their own decision rather than being influenced by the decision of others.

– Decentralisation is talking about the idea that knowledge is spread so that those closer to a problem have the knowledge to solve it.

Then, aggregating the individual decisions gives an overall wise choice. Note that just because the group comes to a wise conclusion it doesn’t mean that the individuals within the group will. In fact, for a group to perform better it needs opposing ideas so that the consensus of the group is challenged and so strengthened or replaced.

The chapter on working in small teams covers this and other issues of influence within a group. I found this practical: e.g. the idea that when a group meets to come to a decision the first to speak will usually frame the possible solutions and thus limit possible outcomes. Also the one with most airtime is more likely to have a larger influence on the final decision.

He focuses on the financial markets and although a lot of what he said was conjecture, his conclusions backed up why around 80% of fund managers under perform the index they aim to beat.

His discussion about how capitalism is based on trust was a nice new paradigm. He looked at the example of how the Quakers did so well – they were trustworthy in pricing, quality of goods and upholding agreements. Funnily they did better than everyone else and eventually their competitors had to follow their business model, bringing us closer to the system we have today.

While Surowiecki presents a convincing case, the book is so filled with non-sequiteurs and a baseless view that the US is somehow fundamentally different to every other society it’s not always easy to take him seriously. Phrases along the lines of “it is clear that” or “you can’t disagree with the view” didn’t help.

That said, I valued what I learnt and will use the ideas in the future.

The Self Illusion

5 Jun

The excellent Jonah Lehrer interviews Bruce Hood about his new book The Self Illusion here.

I’ve included a few choice quotes, but recommend the whole article as a very interesting discussion around the self and consciousness, and it fits with the neuroscience books I’ve read. It’s an evidence-based view rather than the usual wishful thinking that gives us the tendency to think we’re something more than we are. It’s an approach that goes against our ego, which is kind of the point.

Personally I prefer Occam’s Razor when it comes to choosing the most likely explanation for a phenomenon, and Bruce Hood seems to take the same approach.

In his book The Self Illusion, Hood argues “that the self – this entity at the centre of our personal universe – is actually just a story, a constructed narrative.”

He uses “a distinction that William James drew between the self as “I” and “me.” Our consciousness of the self in the here and now is the “I” and most of the time, we experience this as being an integrated and coherent individual – a bit like the character in the story. The self which we tell others about, is autobiographical or the “me” which again is a coherent account of who we think we are based on past experiences, current events and aspirations for the future.

This is an important point to bear in mind when we justify our behaviour: “We can easily spot the inconsistencies in other people’s accounts of their self but we are less able to spot our own, and when those inconsistencies are made apparent by the consequences of our actions, we make the excuse, “I wasn’t myself last night” or “It was the wine talking!” Well, wine doesn’t talk and if you were not yourself, then who were you and who was being you?

It has been experimentally confirmed that we decide most of our actions subconsciously and our conscious mind then creates reasons for our behaviour post hoc.

Whole branches of philosophy are based around this one: “We have no direct contact with reality because everything we experience is an abstracted version of reality that has been through the processing machinery of our brains to produce experience.

And Hood comes to terms with his conclusion with equanimity; “I don’t think appreciating that the self is an illusion is a bad thing. In fact, I think it is inescapable… we know that the self must be the output of the material brain.

And there’s a fascinating section that concludes “the brain creates both the mind and the experience of mind”.

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