Lisa Appignanesi on Women and the Mind Doctors

Bookslut has a fantastic interview with writer and historian Lisa Appignanesi who wrote the recently published and well-received history of women and madness Mad, Bad, and Sad.

The book has been praised for being a remarkably balanced account in a field which tends toward the polemical, and for carefully examining the interaction between culture and our experience of mental distress.

…it became quite clear for me that there are rather strict rules about how to behave when you’re crazy in any given epoch, as Ian Hacking has so pithily put it. There are ways in which the cultural understanding of mind and body at any given time plays into the nature of diagnoses, along with historical and sociocultural forces. The way in which we express our discomforts, dissatisfactions, excesses, madnesses is through those particular understandings. So symptoms will feed into diagnoses, diagnoses will feed back on symptoms. Institutional forms, media, and everything else all comes into play, and you end up having a model, or “most-expressed” disease for any given period.

So, for example, towards the late part of the nineteenth century, many explanations had to do with nerves, and you had a disease called neurasthenia, which actually covers a great gamut of problems and disorders. Following on that you have hysteria, that very interesting set of ways of behaving which actually shows women suffering from anesthesia — they can’t feel their skin — and various forms of paralyses and mutisms. In a way, all of these reflect the kinds of things that are wanted of women in that period, and also the kinds of prompts fed to them as they live their condition. And so once a particular kind of liberty for women comes into play, hysteria begins to alter, to change into other things.

Today we have one of the dominant ways for women to express discomfort with who they are is to develop a body illness such as anorexia or bulimia. Many things come into play, but one of them is that we live in an increasingly virtual age, where the body itself is problematic. Body disorders are one way of expressing our misery. So, yes, there’s a cultural expression to symptoms and indeed diagnoses.

The interview is also interesting for a brief outburst of resentment stemming from the current state of UK mental health politics.

The UK government is in the process of spending £300 million on making psychological therapies widely available on the National Health Service. Not unsurprisingly, it has focused its money on therapies which have been proven to be effective through randomised controlled trials.

As cognitive behavioural therapy has the most evidence for its effectiveness most (although not all) of the money is going to fund CBT. Needless to say, this has caused all sorts of hell from the tribes of mental health.

This month’s British Journal of Psychiatry has an article entitled “Wake-up call for British psychiatry” where some of Britain’s leading psychiatrists argue that this money is being spent to the detriment of medical services.

I think this is a valid point. It’s an argument over which evidence-based treatments the government should spend its money on. However, some of the strongest attacks have come from other schools of therapy, especially those evidence-shy Freudians.

Appignanesi, chair of the trustees of the Freud Museum, manages a wonderfully misinformed put down. Apparently CBT is being touted as:

a cure-all for everything. And of course it’s not. It’s merely a form of self-control over the mind. It obviously helps adolescents to order their lives in some ways, but may not help much more than that, and to think of it as a cure-all is not going to help many people. It may make an intervention in the first instance but it won’t work over the longer term

In fact, it’s being funded to treat conditions in adults for which there is evidence for its effectiveness, and there is good evidence that it has lasting long-term beneficial effects, particularly for depression.

In the same vein, Mick Cooper, a leading existential psychotherapist, recently issued a widely reported statement saying the idea that CBT is more effective is a ‘myth’ because that while there had been more studies on CBT, but that did not necessarily mean it was more effective than other types of therapy.

Unfortunately, it seems he can’t distinguish between ‘more evidence for its effectiveness’ and ‘more effective’, which, of course, are quite different.

To get any particular therapy funded, it just needs research to show its effectiveness. It’s a fairly straightforward ‘put up or shut up’ situation.

Of course, the issue of who funds the research is another matter, but as psychoanalysis largely survives through the private patronage of the upper middle classes and aristocracy in the UK (I kid you not), you would think it shouldn’t be too hard to get someone to fund the studies.

Link to Lisa Appignanesi interview.

The economics of a prisoner of war camp

R.A. Radford was an economist taken prisoner during World War Two who later wrote about the complex cigarette-based economy that thrived in the POW camps in a fascinating 1945 article.

You can also read it online as a pdf if you want to see it in its original type-print glory, which I have to say, does rather add to the atmosphere it so wonderfully evokes.

It’s a vivid insight into the social organisation of the camps, and just the descriptions of the market pressures are quite interesting in themselves.

For example, the standard currency was a cigarette, but heavy air raids meant people would smoke more, presumably owing to stress, thereby altering the value of the currency through scarcity.

The camp residents imposed trade regulations, had trading areas, and some even developed businesses:

Around D-Day, food and cigarettes were plentiful, business was brisk and the camp in an optimistic mood. Consequently the Entertainments Committee felt the moment opportune to launch a restaurant, where food and hot drinks were sold while a band and variety turns performed. Earlier experiments, both public and private, had pointed the way, and the scheme was a great success.

Food was bought at market prices to provide the meals and the small profits were devoted to a reserve fund and used to bribe Germans to provide grease-paints and other necessities for the camp theatre. Originally meals were sold for cigarettes but this meant that the whole scheme was vulnerable to the deflationary waves, and furthermore heavy smokers were unlikely to attend much. The whole success of the scheme depended on an adequate amount of food being offered for sale in the normal manner.

To increase and facilitate trade, and to stimulate supplies and customers therefore and secondarily to avoid the worst effects of deflation when it should come, a paper currency was organised by the Restaurant and the Shop.

It’s completely readable even if you’re not familiar with economics and is a captivating window into POW camp society as seen through the eyes of a monetary expert.

Link to article (via MeFi).
pdf of article.

Our time is up

Writer director Rob Pearlstein created a completely endearing 15 minute short film called Our Time is Up about a therapist who discovers he has six weeks to live. It’s wonderfully produced and even got nominated for an Oscar in 2006.

To be fair, it’s initially a bit reliant on some rather tired clich√©s about patients and therapists, but despite itself, it’s disarmingly warm and funny.

The writing is excellent, wrapping up what could have been a series of short sketches into a gently poignant and thought-provoking story.

Link to ‘Our Time is Up’ on YouTube.
Link to the film’s website.

Selling the ‘battle of the sexes’

Slate has just finished an excellent five-part series on two recent books which have attempted to paint men and women as vastly different in mind, brain and behaviour by exaggerating the science of sex difference.

The books in question are Louann Brizendine’s The Female Brain and Susan Pinker’s The Sexual Paradox.

Both have been influential because the authors write from an explicitly feminist angle, and both claim to be drawing on the latest neuroscience, suggesting that they’re overthrowing the mushy political correctness of “everyone is the same”.

The Slate series pulls no punches though, saying “Ultimately, the evangelists aren’t really daring to be politically incorrect. They’re peddling one-sidedness, sprinkled with scientific hyperbole.”

Of course, there are cognitive differences between men and women, but the punchline of almost all sex difference research is that the extent of the difference between any two individuals, be they male or female, tends to vastly outweigh the average difference between the sexes.

Furthermore, while some of these books suggest the differences are innate many studies have found the differences change markedly over time and are influenced by cultural or social factors.

The series is well-researched, easy to digest and looks at the areas of communication, empathy, maths ability and development during childhood. It’s also accompanied by a three-part video discussion, which tackles similar issues.

Slate have been doing a great job of getting some accessible, level-headed neuroscience out there recently, and this is another great example. Good work science writer Amanda Schaffer.

Link to Slate series on ‘The Sex Difference Evangelists’.

Brain twister

In 1941, brain specialist Russell Brain published an article about the brain in the brain science journal Brain. Owing to Brain’s extensive work on the brain, he later became editor of Brain. His work treating brain disorders and his editorship of Brain were some of the reasons he was made Baron Brain, in 1962.

Last year, Brain published a tribute to Brain’s brain article in Brain, owing to its massive impact on our understanding of the brain.

It was written by Alastair Compston.

2008-07-04 Spike activity

Quick links from the past week in mind and brain news:

Scientific American looks at the neuroscience of dance, and includes one of my favourite studies on ballet dancers and capoeira artists.

War on Drugs bulletin: a World Health Organisation study finds the USA leads the world, by quite a wide margin, in per capita consumption of illegal drugs. Globally, there seems no relation between drug consumption and legal restriction. $500 billion well spent then.

Sharp Brains rounds up some of their recent brain enhancement articles by the SB team and guest scientists.

Separated at birth: celebrity psychologists Linda Papadopoulos and Robi Ludwig. That’s just spooky isn’t it?

A 2005 paper in the American Journal of Clinical Hypnosis reports on a man with phantom limb who finds it involuntarily responds to hypnotic suggestions.

The Neurocritic finds the ‘watermelon works like viagra’ nonsense is, well, nonsense.

The NYT Freakanomics blog has a fascinating piece on why people lie on social welfare applications, in the opposite direction than you’d think.

From deceiving others to a great piece on self-deception, in the International Herald Tribune.

Mixing Memory is doing an excellent in-depth review of Lakoff’s new book ‘The Political Mind’. Just check the blog and look for the past pieces and forthcoming updates.

Cypress Hill vindicated! Cognitive Daily reports on a study finding that high-pitched voices are generally rated as more attractive.

The BPS Research Digest tracks down a fascinating book on the history and philosophy of jokes.

Enhancing your cognitive ability with electricity makes a comeback. Technology Review looks at transcranial direct current stimulation.

Developing Intelligence has another fascinating piece – this time on how the cognitive benefits of meditation are likely to be available to everyone.

The excellent Advances in the History of Psychology finds a interesting paper on a seemingly apocryphal 1868 dust-up between Paul Broca and John Hughlings Jackson.

Push the button: Milgram rides again

The New York Times has a good article on some recent replications of Milgram’s infamous conformity experiment where he ordered participants to give what they thought were potentially lethal shocks to an actor pretending to scream in pain.

They’re not quite replications, because Milgram’s experiment as it was actually run is considered unethical, but they’re pretty close and the results are frighteningly similar.

There’s also an interesting twist in one of the studies, that suggests people who go on to give the more dangerous shocks think about responsibility differently, assuming they are not responsible because they’re being ‘ordered’.

In the other paper, due out in the journal American Psychologist, a professor at Santa Clara University replicates part of the Milgram studies — stopping at 150 volts, the critical juncture at which the subject cries out to stop — to see whether people today would still obey. Ethics committees bar researchers from pushing subjects through to an imaginary 450 volts, as Milgram did.

The answer was yes. Once again, more than half the participants agreed to proceed with the experiment past the 150-volt mark. Jerry M. Burger, the author, interviewed the participants afterward and found that those who stopped generally believed themselves to be responsible for the shocks, whereas those who kept going tended to hold the experimenter accountable. That is, the Milgram work also demonstrated individual differences in perceptions of accountability — of who’s on the hook for what.

I recommend the picture on Jerry Burger’s webpage. I swear he must of practised that movie villain grin especially for the Milgram replications.

Link to NYT article ‘Would I Pull That Switch?’

Impossible experiments

Psychology Today have asked a group of leading thinkers to discuss their ‘impossible experiment’, if the impractical, unethical or unattainable was not an obstacle to the ultimate mind and brain study.

Presumably riffing on the BPS Research Digests’ search for the ‘most important psychology experiment that’s never been done’, they’ve gathered proposals that involve everything from brain swapping to behavioural mega-economics.

My favourite is from psychologist Bella DePaulo who has come up with a cunning way of studying the psychological effects of marriage:

I’d like to take couples who are living together and randomly assign half of them to marry and the others to stay unmarried. Then we could really know something about the implications of co-habitation vs. marriage. More outrageously, take people who are not in a serious romantic relationship, and assign half of them, at random, to marry. Single people are randomly assigned to a spouse who is chosen at random, or to a spouse who fits their description of their perfect partner, or to stay single. Who do you think would end up the happiest a decade later? Same for divorce. If married parents are already at each other’s throats, is it better for the children if they divorce, or stay together? Randomly assign half of them to divorce, and half to stay together; then we’ll see. Now take married couples who say they are happy and are not considering divorce. Randomly assign half of them to divorce! Now who will be happier ten years hence?

There’s plenty more blue sky thinking, and a curious video involving a mannequin.

Link to ‘Impossible Experiments’.

What is it like to drill a hole in your head?

Neurophilosophy has secured an interview Heather Perry, a lady who has drilled a hole through her own skull as part of a self-treppaning ritual, and is asking readers to suggest questions.

Treppaning is an ancient art but for obvious reasons, it’s rarely done these days except during brain surgery.

Nevertheless, a dedicated band of devotees argue it has spiritual and psychological benefits.

I have to admit, I’m more than a little sceptical of these benefits, but I’d be fascinated to hear from anyone whose had it done.

So if you’ve got any burning questions, head on over to Neurophilosophy and Mo will select the best ones from the comments to put to Heather.

Link to Neurophilosophy call for trepanning questions.

Connected to the highways of the brain

A fantastic new study which looked at the ‘connectedness’ of the human brain has identified which aspects of the underlying network are the most important routes of communication.

The research was led by neuroscientist Patric Hagmann and combines brain imaging with network mathematics to not only visualise the brain’s network but also to understand which are the most important hubs and connections.

The study used diffusion spectrum imaging or DSI to map out the white matter wiring of the brain in five healthy individuals.

It’s a type of diffusion MRI that identifies water molecules and tracks how they move. In a glass of water, water molecules will move randomly, but when trapped inside nerve fibres, they move along the length of the fibre, allowing maps to be created from the average paths of the moving molecules.

The researchers then took the maps of fibres, as illustrated by the top image, divided the brain up into sections, and created a simplified network map, shown in the bottom image, which allowed them to mathematically test how connected the different areas were.

They used network theory, more typically used in social network analysis, which allows mathematical measures of network properties.

The researchers calculated which areas were the most connected to the rest of the network in terms of connections going directly in and out of the area, but also which areas were the most strategically important ‘hubs’.

This meant the researchers could identify areas of the cortex that are the most highly connected and highly important, forming a structural core of the human brain.

You can see two of the maps on the right. The one in red illustrates which brain areas are the most highly connected. You can see it’s the area at the top and back of the brain. As you can see better on the original image, its very centrally located, like a neural mohawk.

The image in blue on the right shows the network ‘backbone’, the information highways of the brain.

What’s perhaps most interesting it that the most connected brain areas are many of those which are more active when we’re at rest, compared to when we’re engaged in a mental task that requires concentration and effort.

This has been dubbed the ‘default network’ in the scientific literature, and, rather annoyingly, the ‘daydreaming network’ by the popular press.

It’s not entirely clear what the network is for, with some studies directly linked it to ‘stimulus independent thought’ (yes, daydreaming), while others more explicitly define it as internally focused, rather than externally focused thought and cognition.

Unfortunately, most cognitive neuroscience experiments work by measuring the effect of tasks on brain function, so a brain network which seems to be switched off by any sort of task is quite hard to study. A recent study found that even the noise of the brain scanner affects it.

Link to PLoS Biology article on brain connectivity.
Link to write-up from The New York Times.
Link to write-up from Neurophilosophy.
Link to write-up from Science News.

Clutter press

For those wanting an update on the ‘phone network causes suicide’ nonsense that inexplicably made it onto the front page on a national newspaper, Ben Goldacre over at Bad Science contacted the person behind the story who apparently claims to have ‘lost’ the data behind the nonsensical claims.

I contacted Dr Coghill, since his work is now a matter of great public concern, and it is vital his evidence can be properly assessed. He was unable to give me the data. No paper has been published. He himself would not describe the work as a “study”. There are no statistics presented on it, and I cannot see the raw figures. In fact Dr Coghill tells me he has lost the figures. Despite its potentially massive public health importance, Dr Coghill is sadly unable to make his material assessable.

The claims didn’t even make sense as they were reported, and the fact this sort of rubbish managed to get on the front page of a paper is quite shocking.

Bad Science does a great job of picking up on all the bizarre angles of this ‘funny if it wasn’t so influential’ piece of headline scaremongering.

Link to Bad Science on Coghill nonsense.

Intuitions about phenomenal consciousness

Illustrating how this ‘experimental philosophy’ idea has really struck a chord, Scientific American Mind has an article on our intuitions about whether things can have mental states, whether that be animals, humans, machines or corporations.

The piece is by philosopher Joshua Kobe and contains lots of fascinating examples of how we tend to be comfortable attributing mental states likes ‘beliefs’ to corporations, but not emotions.

The same goes for robots, it turns out, but one key factor seems to be not what we think about its thinking ‘machinery’ but how human the body seems.

In one of Huebner’s studies [pdf], for example, subjects were told about a robot who acted exactly like a human being and asked what mental states that robot might be capable of having. Strikingly, the study revealed exactly the same asymmetry we saw above in the case of corporations.

Subjects were willing to say:
• It believes that triangles have three sides.
But they were not willing to say:
• It feels happy when it gets what it wants.

Here again, we see a willingness to ascribe certain kinds of mental states, but not to ascribe states that require phenomenal consciousness. Interestingly enough, this tendency does not seem to be due entirely to the fact that a CPU, instead of an ordinary human brain, controls the robot. Even controlling in the experiment for whether the creature had a CPU or a brain, subjects were more likely to ascribe phenomenal consciousness when the creature had a body that made it look like a human being.

Link to ‘Can a Robot, an Insect or God Be Aware?’
pdf of draft Huebner paper.

Dan Gilbert on the importance of social psychology

Dan Gilbert has a brief interview in this month’s (paywalled) Psychologist magazine. From which the following nugget of wisdom:

Psychologists have a penchant for irrational exuberances, and whenever we discover something new we feel the need to discard everything old. Social psychology is the exception. We kept cognition alive during the behaviourist revolution that denied it, we kept emotion alive during the cognitive revolution that ignored it, and today we are keeping behaviour alive as the neuroscience revolution steams on and threatens
to make it irrelevant. But psychological revolutions inevitably collapse under their own weight and psychologists start hunting for all the babies they tossed out with the bathwater. Social psychology is where they typically go to find them. So the challenge for social psychologists watching yet another revolution that promises to leave them in the dustbin of history is to remember that we’ve outlived every revolutionary who has ever pronounced us obsolete.

Link Gilbert Lab
Link Psychologist Magazine (sorry, subscribers only, but you can browse issues older than six months for free)