The father of Randle P. McMurphy

An article in the Journal of Medical Humanities has a fascinating look at one of playwright Samuel Beckett’s early novels – an exploration of madness and mental health care that foreshadowed One Flew Over the Cuckoo Nest.

Beckett is best known for Waiting for Godot, but his novel Murphy was previously one of the best known literary treatments of mental ill health until Ken Kesey’s famous work.

It turns out that Kesey gives a knowing nod to Beckett’s earlier work through his character Randle McMurphy.

As far as twentieth-century accounts of mental health nursing and psychiatry go, Beckett’s (1937) tale of Murphy has been much over-shadowed by Ken Kesey’s One Flew Over the Cuckoo Nest. For better or for worse, Kesey’s nurse Ratchet became the epitome of the 20th century asylum attendant. But it was a notable act of approbation by Kesey to name his main protagonist, Randle P. MacMurphy, with due deference to Beckett; ‘MacMurphy’ literally meaning ‘son of Murphy.’

The comparison between the two novels is interesting, because Kesey drew his inspiration from his time working as a staff member on a psychiatric ward while Beckett drew his inspiration from being a patient.

Link to locked article (the humanities are deadly in the wrong hands).

Preferences of the lady wooers

A study on female breast size attractiveness just published in the Archives of Sexual Behaviour highlights the remarkable gap between academic discourse and everyday language.

Female Breast Size Attractiveness for Men as a Function of Sociosexual Orientation (Restricted vs. Unrestricted)

Arch Sex Behav. 2011 Oct 6.

Zelazniewicz AM, Pawlowski B.

Mate preferences are context-dependent and may vary with different ecological conditions and raters. The present study investigated whether sociosexual orientation influenced men’s rating of attractiveness of female breast size. Participants (N = 128) rated female breast attractiveness as a function of size (five levels) and viewing angles (front view, oblique view, and side view). Men were divided into two groups (restricted and unrestricted), based on their responses to the Revised Sociosexual Orientation Inventory (SOI-R). As predicted, men with higher SOI-R scores (unrestricted) generally gave higher ratings than did men who scored lower on the SOI-R (restricted), but the difference was significant only at larger breast sizes. We also found that medium to large sizes were rated as the most attractive by both male groups and that viewing angle changed rating of female attractiveness and breast presented in oblique view were rated generally higher than in side view. The results of the study indicate that sociosexuality influences male perception of female breast attractiveness and confirm that accentuation of female-specific physical traits produces a stronger response in unrestricted than in restricted men.

Translation: Guys who want to shag around prefer bigger tits.

Obviously, you can’t use the word tits in a scientific article so you’d have to say ‘Gentleman who want to woo more ladies prefer larger hooters’.

And they say science isn’t relevant to the man in the street.

Link to full text of open-access study.

Bookended by amnesia and neurofeedback

A new edition of RadioLab has just hit the wires which riffs on the concept of loops and is bookended by an initial piece on transient global amnesia and a closing piece on the use of neurofeedback to control pain.

The programme is a sublime, lucid trip into a series of cycles, from the effects of memory disruption to the unprovability of mathematics.

Our lives are filled with loops that hurt us, heal us, make us laugh, and, sometimes, leave us wanting more. This hour, Radiolab investigates the strange things that emerge when something happens, then happens again, and again, and again, and again, and again, and … well, again.

As always, enchanting stuff.

Link to RadioLab edition on loops.

Entertainingly mislead me

A beautifully recursive study has shown that viewing an episode of the psychology of deception TV series Lie To Me makes people worse at distinguishing truth from lies.

The TV series is loosely based on the work of psychologist Paul Ekman who pioneered the study of emotions and developed the Facial Action Coding System or FACS that codes even the slightest of changes in facial expression.

Although in poplar culture Ekman and the FACS are often associated with the detection of lies through changes in ‘micro expressions’, there is actually no good research to show it can help detect falsehoods.

However, the TV series relies heavily on this premise and suggests that there is more of a scientific basis to lie detection than is actually feasible and that it is possible to detect deception through careful observation of specific behaviours.

This, however, is not very accurate. The authors of the study don’t mince their words:

Lie to Me is based on the premise that highly accurate deception detection is possible based on real-time observation of specific behaviors indicative of lying. The preponderance of research demonstrates that the exact opposite is true.

Lie to Me also suggests that certain people are naturally gifted lie detectors. This is also inconsistent with the preponderance of research. Thus, when looking at the evidence generated across several hundred individual studies, the idea of Lie to Me is highly implausible and almost certainly misleading.

Rather shrewdly, this new study, led by psychologist Timothy Levine, decided to test whether this misleading view of lie detection might actually influence the viewer’s ability to detect lies.

They split participants into three groups, one who watched and episode of Lie to Me, another an episode of Numb3rs – in which crimes are solved by a genius math professor, and a final group who didn’t watch anything.

Afterwards, everyone saw a series of 12 interviews – half of which were honest and half which involved lies – and were asked to rate the truthfulness of the interviewee.

Normally, when we do tasks like this where honesty and deception are present in equal numbers, we tend to over-rate how truthful people are – probably due to the fact that in everyday like most people are being genuine with us, so we have a tendency to assume people are telling the truth – even when we know there’s some falsehood to be found.

In the study, those who had just watched Lie To Me didn’t show this truth-accepting bias, they were more skeptical, but crucially, they were actually worse at distinguishing deception than the others.

They applied their skepticism in a blanket fashion and became less accurate as a result.

In other words, not only does the programme misrepresent the psychology of lie detection, but this has an effect on the psychology of the viewers themselves.

Which, by the way, would make a great plot device for Lie To Me.

Link to locked study (via @velascop)

A history of the mid-life crisis

Scientific American’s Bering in Mind has a fantastic article on how the concept of the mid-life crisis was invented and whether it has any evidence behind it beyond the occasional inadvisable pair of cycling shorts and sudden interest in cheesy sports cars.

It turns out that the idea of the ‘mid-life crisis’ is surprisingly new – first touted in 1965 – but was invented to refer to a crisis of creativity in geniuses – rather than a sudden urge to dye one’s greying hair.

There isn’t actually any evidence that middle age is more of a time of crisis than any other period of life, but the concept has stuck.

In the decades since Jacques and Levinson posited their mostly psychoanalytic ideas of the midlife crisis, a number of more empirically minded psychologists have attempted to validate it with actual data. And with little success. Epidemiological studies reveal that midlife is no more or less likely to be associated with career disillusionment, divorce, anxiety, alcoholism, depression or suicide than any other life stage; in fact, the incidence rates of many of these problems peak at other periods of the lifespan.

Adolescence isn’t exactly a walk in the park either—as a teen, I’d worry so much about the uncertainties of my future that I vividly recall envying the elderly their age, since for them, no such uncertainties remained. Actually, old people—at least Swiss old people—aren’t fans of the “storm and stress” of adolescence, either. Freund and Ritter asked their elderly respondents which stage of their lives they’d prefer to return to, if they could. Most said middle age.

From another point of view, of course, the concept could also be a socially convenient way of helping to curtail certain behaviours in men when their actions are no longer thought to be age appropriate.

That’s my theory and I’m sticking to it.

Link to Bering in Mind on the mid-life not so crisis.

Epilepsy as a door between worlds

There’s a wonderful anthropology study on beliefs about epilepsy among the Guaraní people in Bolivia in the latest Epilepsy and Behavior.

The Guaraní believe that people with recurrent seizures are a gateway between the worlds of life and death.

Among the Guaraní, epilepsy is called mano-mano, which literally means “die-die” and refers to the concept of death with a notion of frequency (die several times) and also of being in a constant passage between life and death. In other terms, this word means always being on the border between life and death, reflecting the fact that mano-mano produces a constant interruption of life or a “partial death.”…

In fact, the expression mano-mano is meaningful. It refers to the idea of a round trip between life and death. This concept addresses the loss of consciousness and shows that epilepsy is recognized mostly in terms of generalized seizures. The uncertain state between life and death is seen as a kind of “third possible condition” for a human being, a state that generates hesitation over what attitude to hold. PWE [people with epilepsy] are omano-mano-vae, the “undeads,” different from the other members of the community and considered both as victims of this life–death relationship and as enablers of the meeting of these two worlds…

The representation of epilepsy as a state of human being and the perception of this in a vision that involves the entire community allow an interpretation of Guaraní attitudes toward PWE [people with epilepsy]. Guaraní PWE are rarely condemned, misjudged, or isolated as in other cultures. Apparently, PWE do not represent a threat to the Guaraní, who seem to hold the attitude of helping and protecting PWE. As noted, the restrictions and prohibitions cited by the Guaraní appear to derive from the need to take care of PWE, as heavy work, traveling alone, and being involved in problems are believed to worsen the condition or trigger seizures in PWE.

It’s worth noting that while their perception of people with epilepsy is generally positive, several of the people interview gave advice about avoiding contact between affected people and children or pregnant women.

As the researchers note this raises questions “that could be related to a belief that was not mentioned: possible transmission of the disease to those who are considered the weakest and most defenseless in the community.”

However, their general outlook is markedly positive in light of widespread beliefs about epilepsy being the results of evil spirits or a divine punishment.

In contrast, the Guaraní most frequently cited epilepsy as being caused by a “failure to observe the Yekuaku, a fasting period linked to special events”.

Link to locked anthropology study.

A profession with “no” at its core

I’ve just finished Randy Olson’s “Don’t be Such a Scientist: Talking Substance in an age of style” (after loving his article in New Scientist, “Top five tips for communicating science “). Olson is a marine biologist turned filmmaker, so knows the world of science from the inside, and from the outside perspective.

This book is 75% solid gold – absolutely essential perspective for scientists who want to communicate outside of their specialism. But it is also 25% misleading and elitistic simplification. At heart, Randy Olson’s message as a populariser ends up pandering to a mistaken belief in scientific exceptionalism – that what scientists do and who scientists are is so beyond the ken of the rest of the population that it cannot be conveyed to them, that we have to use a pound of silly songs and fart jokes to make the public to swallow an ounce of important information. Sorry, Randy, but when you underestimate the public taste you end up demeaning it.

Part of the 75% I loved is Olson’s perspective on the value of acting and improv classes for science communicators. This something close to my heart, after I had my own mind-blowing experience of improv training. An essential – some would say the essential – of improv is to avoid negating your fellow improvisers suggestions. Whatever happens, improvisers are taught to accept and build – using a “yes and” mindset instead of a “no but” one. This lends itself to humour and creativity. Science, on the other hand, tends to downplay “yes and” at the favour of “no but”, lending itself to rigour and certainty, at the risk of cynicism and myopia. Olson puts this particularly well in the following passage:

The entire profession of science has at its core a single word, and that word is “no”. Science is a process not of affirming ideas but of attempting to falsify ideas in the search for truth. This is what a hypothesis is – an idea that can be tested and possibly falsified and rejected.
When you give a scientist a paper, he or she reads it with the assumption that the writer is guilty of being wrong until proven innocent. The writers proves his or her innocence by either presenting data or citing sources. With each statement made in the paper, the scientist reading it says “I’m not sure I believe this.” As the author presents graphs and tables of data and cites sources, the good critical scientist attempts to falsify what is being said.
Eventually, after the scientist has examined the data, looked up the cited sources and found that in fact, despite considerable effort, the hypothesis presented cannot be falsfied – only then does the scientist finally start to relax and a bit and say, “Well, okay, I think I can probably live with this.”
Tough buisness. It really is. As I waded through my first decade of rejection in Hollywood as a filmmaker, people would ask me whether I found the rejection hurtful or depressing. And I would respond, “Are you shitting me? Do you have any idea what it’s like to deal with the rejection of scientists? Hollywood folks reject things on the basis of the idea that ‘it just didn’t grab me,’ and they can’t even articulate the reason for their decision. When scientists reject you they hit you with a stack of data and sources that are the basis for it. That’s the sort of specific, substantive rejection that truly hurts (p128-129)

Link to page for Randy Olson’s “Don’t be such a scientist”

I wrote about improv for Prospect magazine, here

The death of atypical antipsychotics

The British Journal of Psychiatry has just published the latest in a long line of studies to find that the newer ‘atypical’ or ‘second generation’ antipsychotic drugs are barely better than the old style medications and has a stinging editorial that accompanies the piece calling out years of drug company marketing spun as an illusory advance in medical science.

Unfortunately both are locked (after all, you’d just worry yourself with all those facts) but here is the last paragraph of the editorial. It leaves no ass unkicked.

In creating successive new classes of antipsychotics over the years, the industry has helped develop a broader range of different drugs with different side-effect profiles and potencies, and possibly an increased chance of finding a drug to suit each of our patients. But the price of doing this has been considerable – in 2003 the cost of antipsychotics in the USA equalled the cost of paying all their psychiatrists.

The story of the atypicals and the SGAs [‘second-generation antipsychotics’] is not the story of clinical discovery and progress; it is the story of fabricated classes, money and marketing. The study published today is a small but important piece of the jigsaw completing a picture that undermines any clinical or scientific confidence in these classes.

With the industry reputation damaged by evidence of selective publishing and its deleterious effects, and the recent claims that trials of at least one of the new atypicals have been knowingly ‘buried’, it will take a great deal for psychiatrists to be persuaded that the next new discovery of a drug or a class will be anything more than a cynical tactic to generate profit. In the meantime, perhaps we can drop the atypical, second-generation, brand new and very expensive labels: they are all just plain antipsychotics.


Link to locked editorial ‘The rise and fall of the atypical antipsychotics’.

The New York Times wees itself in public

The New York Times has just pissed its neuroscientific pants in public and is now running round the streets announcing the fact in an op-ed that could as easily been titled ‘Smell my wee!’

The piece is written by Martin Lindström, famous for writing the ‘neuromarketing’ best-seller Buyology, but infamous for not making any of his data or studies public.

In fact, despite constantly mentioning the astounding conclusions from numerous brain imaging studies he was run, not one has appeared in the scientific literature.

But even without knowing about the reliability data or the quality of the analysis, it’s easy to see that he’s talking through his hat because the interpretations are so over-the-top that they are actually beyond what is possible with brain imaging science.

The piece is full of nonsense of various sorts.

I carried out an fMRI experiment to find out whether iPhones were really, truly addictive…

In each instance, the results showed activation in both the audio and visual cortices of the subjects’ brains. In other words, when they were exposed to the video, our subjects’ brains didn’t just see the vibrating iPhone, they “heard” it, too; and when they were exposed to the audio, they also “saw” it. This powerful cross-sensory phenomenon is known as synesthesia.

Actually, this is known as bullshit because synesthesia is where a conscious sensory experience in one sensory domain produces a conscious experience in another.

In other words, synesthesia is defined by the experiences that someone has, not where brain activity shows up.

The fact that brain activity occurs in an area previously linked to a different function does not mean it is being used for that function or that the person is having a related conscious experience.

If this is not entirely clear, think of it like this. Imagine, for the first time in your life, you just heard the sound of a guitar being played as part of a pop song. You’d be a bit daft if every time you heard guitar chords you told people that the music must be a pop song. After all, there’s a guitar in it, right?

Clearly, this is ridiculous because the guitar is an instrument that appears in lots of musical styles but Lindström is doing the neuroscience equivalent of over-interpreting guitar sounds throughout his terrible article.

He starts going on about how activation in the insula, detected in his privately conducted otherwise unknown study, means the person is experiencing love for their iPhone because insula activity has previously been linked to love.

The trouble is, as neuroimaging researcher Russ Poldrack just pointed out, it is one of the most common brain areas that turns up in fMRI studies and appears in about a third of imaging studies no matter what is being studied. In other words, it’s linked to just about every experience and behaviour you can think of.

In fact, it is probably most famous, not for its association with love, but for its association with digust, but Lindstrom apparently decided to avoid this particular interpretation.

This is just one example among many and if you want a breakdown of why the article really is full of crap, I recommend neuroscientist Tal Yarkoni’s point-by-point analysis and facepalm jamboree.

In fact, the op-ed has annoyed so many people there is now a letter to the editor signed by just about every big name in fMRI research on its way to the New York Times in an attempt to open the windows and get rid of that uncomfortable smell.

Link to NYT pissing itself in public.
Link to Tal Yarkoni’s excellent mopping up exercise.