January 2016 – Mind Hacks

Spike activity 22-01-2016

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

The New Yorker covers the shifting sands of autism in light of recent books that have rethought the history of the condition.

Brian Resnick at Vox asked twenty psych researchers: What do you hate about science journalism? Lots of good stuff.

Science reports big and welcome news: the Montreal Neurological Institute, one of the world’s leading brain research centres, is going entirely open science.

Why does the brain use so much energy? asks Wired UK.

The Independent has a piece on the history of the drug amyl nitrate, sold widely as ‘poppers’, and its place in gay culture, clubbing and sex.

I get interviewed by the Spanish-language blog Neuromexico – text in Spanish but audio largely in English.

The New York Times has a subtle first-person piece on prison psychotherapy.

A brief history of decapitation. Over at Inverse.

World’s stupidest drugs laws enacted by Britain

Yesterday, the UK Parliament approved the Psychoactive Drugs Bill which will become law in April. New Scientist pulls no punches in an uncharacteristically direct article and tells it like it is:

It’s official – the UK ban on legal highs that will begin in April is going to be one of the stupidest, most dangerous and unscientific pieces of drugs legislation ever conceived.

Watching MPs debate the Psychoactive Substances Bill yesterday, it was clear most of them hadn’t a clue. They misunderstood medical evidence, mispronounced drug names, and generally floundered as they debated the choices and lifestyles of people who are in most cases decades younger than themselves.

It would have been funny except the decisions made will harm people’s lives and liberty.

Parliament has just demonstrated you can invent nonsensical bullshit in place of science and get it passed as law as long as you claim it’s to ‘protect people’ from drugs.

Quite frankly, it’s an embarrassment.

Link to New Sci piece on “one of the worst laws ever passed”.

Spike activity 15-01-2016

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

The New York Times has a brilliant piece on the non-scandal around sociologist Alice Goffman that’s also a reflection on sociology itself.

There’s a fascinating piece on ‘super forecasters‘ – people who seem to have an exceptional ability to judge the outcome of future events – in the Washington Post.

Knowing Neurons is a relatively new neuro blog that just keeps getting better.

Applying a knowledge of cognitive biases to add reality to virtual reality. Aeon covers an interesting area of applied psychology.

National Geographic has a fantastic piece on the evolution of the eye.

A mathematician is using computers to manufacture award-winning illusions. Fantastic piece in Nautilus.

Where Are We Now? – David Bowie and Psychosis

The mercurial David Bowie has left the capsule and the world is a poorer place. His circuit is dead, and there definitely is something wrong, at least for those of us still on Planet Earth.

There have been many tributes, noting Bowie’s impact on music, art and cinema, and the extent of his eclectic tastes. But one significant part of Bowie’s life has barely merited a mention – his experiences with psychosis – despite the fact that it had a major impact on his life and featured in some of his most important work.

Bowie was familiar with psychosis from an early age, not least because it affected his close family. Two of his aunts were reportedly diagnosed with schizophrenia and third was confined to an asylum.

One of Bowie’s most influential early role models, his half-brother Terry, was diagnosed with schizophrenia and reportedly had marked periods of psychosis.

Here is Bowie, discussing one of his brother’s psychotic episodes, in a 1998 documentary for VH1:

Bowie’s brother was admitted to now defunct Cane Hill psychiatric hospital in South London and the experience heavily influenced 1970’s The Man Who Sold the World album with a drawing of the hospital appearing on the original sleeve art.

One of the songs on that album, All the Madmen, vividly describes madness and treatment in the old asylums, and was discussed in a 2010 article for the British Medical Journal:

“All the Madmen” was inspired by the mental health problems of David Bowie’s brother and was released 39 years ago (before Bowie achieved major fame), on the album The Man Who Sold the World. It recognises the separation from society of mentally ill people, who are sent to “mansions cold and grey.” In a lucid interval, spoken instead of sung, the national shame of mental illness and policies of alienation and institution are questioned with sadness: “Where can the horizon lie / When a nation hides / Its organic minds in a cellar.”

Faced with the prospect of discharge, the patient protagonist recognises his comfort in Librium, considers his ability to cope outside, and pushes the risk buttons with, “I can fly, I will scream, I will break my arm / I will do me harm.” He adopts a catatonic posture, standing with a foot in his hand, talking to the wall. He is accepting of electric shock treatment. When he asks, “I’m not quite right at all . . . am I?” is this a cryptic taunt that he knows he is putting it on, pushing the psychiatrist to keep his place in the institution? Or, more worryingly, is he questioning his own sanity and certainty?

Perhaps unsurprisingly, the themes of madness pervade Bowie’s work. The title track for the Aladdin Sane album (a play on “A lad insane”) was inspired by his brother, as was the song Jump They Say. Some other references are more obvious, such as in the song I’m Deranged, while some only allude to altered states and psychological alienation, as in The Man Who Sold the World.

Little known is that his most famous character, Ziggy Stardust, was based on someone who experienced striking periods of psychosis. In a 1996 interview, Bowie recounted how Ziggy was based on the obscure rock star Vince Taylor who Bowie met several times, presumably between the periods Taylor spent in psychiatric hospital.

Bowie himself was widely thought to have experienced an episode of psychosis himself, some years later, largely due to a period when he was taking very large amounts of cocaine while working on the album Station to Station.

Several biographies describe how he feared evil entities floating past his window, thought The Rolling Stones were sending message to him through their music and believed witches were stealing his semen.

But the semantic traffic between madness and Bowie’s work was not solely one way. The medical literature has reports of Bowie featuring in the delusions of people with psychosis. One case report described a “32-year-old divorced white female with a long history of affective and behavioral problems”:

She believed she was secretly married to the rock star, David Bowie, after supposedly meeting in a church camp several years previously. She described seeing him “wait for her” outside her hospital window. The onset of this delusion coincided with a local tour by Bowie.

As Bowie was the master of looping cultural expression, making his art reference himself reacting to cultural responses to his work, it’s a return acknowledgement he may have appreciated.

Spike activity 08-01-2016

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

The State of Texas now allows guns in state-run psychiatric hospitals, according to the Statesman. I am genuinely lost for words.

Sifting the Evidence has an excellent piece on the science behind the UK’s new lowered alcohol intake recommendations.

Scale Invariance: A Cautionary Tale Against Reductionism in Neuroscience. Thought-provoking piece from Knowing Neurons.

The New York Times has an excellent piece on the psychology of the con.

Human clinical trials planned for revolutionary neuroscience technique optogenetics, reports Scientific American.

The Atlantic has a wonderful piece on how we coordinate conversations between us with the most precise synchronisation.

There’s a good piece on the psychopharmacology of new psychoactive substances in Cerebrum.

The New York Times reports how psychologists have now been quietly but officially withdrawn from working with Guantanamo detainees.

We need more pieces like this on male mental health: Ex-editor of lad’s mags Loaded and GQ talks on “How therapy saved my life” in The Telegraph.

A radio station run by patients that broadcasts from inside an Argentinean psychiatric hospital. Al Jazeera with an excellent documentary.

Geek medal to this man: Neurosurgeon criticises latest Bond movie over anatomically inaccurate depiction of how to drill out the fusiform gyrus. Gizmodo has the story.

How to formulate a good resolution

We could spend all year living healthier, more productive lives, so why do we only decide to make the change at the start of the year? BBC Future’s psychologist Tom Stafford explains.

Many of us will start 2016 with resolutions – to get fit, learn a new skill, eat differently. If we really want to do these things, why did we wait until an arbitrary date which marks nothing more important than a timekeeping convention? The answer tells us something important about the psychology of motivation, and about what popular theories of self-control miss out.

What we want isn’t straightforward. At bedtime you might want to get up early and go for a run, but when your alarm goes off you find you actually want a lie-in. When exam day comes around you might want to be the kind of person who spent the afternoons studying, but on each of those afternoons you instead wanted to hang out with your friends.

You could see these contradictions as failures of our self-control: impulses for temporary pleasures manage to somehow override our longer-term interests. One fashionable theory of self-control, proposed by Roy Baumeister at Florida State University, is the ‘ego-depletion’ account. This theory states that self-control is like a muscle. This means you can exhaust it in the short-term – meaning that every temptation you resist makes it more likely that you’ll yield to the next temptation, even if it is a temptation to do something entirely different.

Some lab experiments appear to support this limited resource model of willpower. People who had to resist the temptation to eat chocolates were subsequently less successful at solving difficult puzzles which required the willpower to muster up enough concentration to complete them, for instance. Studies of court records, meanwhile, found that the more decisions a parole board judge makes without a meal break, the less lenient they become. Perhaps at the end of a long morning, the self-control necessary for a more deliberated judgement has sapped away, causing them to rely on a harsher “keep them locked up” policy.

A corollary of the ‘like a muscle’ theory is that in the long term, you can strengthen your willpower with practice. So, for example, Baumeister found that people who were assigned two weeks of trying to keep their back straight whenever possible showed improved willpower when asked back into the lab.

Yet the ‘ego-depletion’ theory has critics. My issue with it is that it reduces our willpower to something akin to oil in a tank. Not only does this seem too simplistic, but it sidesteps the core problem of self-control: who or what is controlling who or what? Why is it even the case that we can want both to yield to a temptation, and want to resist it at the same time?

Also, and more importantly, that theory also doesn’t give an explanation why we wait for New Year’s Day to begin exerting our self-control. If your willpower is a muscle, you should start building it up as soon as possible, rather than wait for an arbitrary date.

A battle of wills

Another explanation may answer these questions, although it isn’t as fashionable as ego-depletion. George Ainslie’s book ‘Breakdown of Will‘ puts forward a theory of the self and self-control which uses game theory to explain why we have trouble with our impulses, and why our attempts to control them take the form they do.

Ainslie’s account begins with the idea that we have, within us, a myriad of competing impulses, which exist on different time-scales: the you that wants to stay in bed five more minutes, the you that wants to start the day with a run, the you that wants to be fit for the half-marathon in April. Importantly, the relative power of these impulses changes as they get nearer in time: the early start wins against the lie-in the day before, but it is a different matter at 5am. Ainslie has a detailed account of why this is, and it has some important implications for our self-control.

According to this theory, our preferences are unstable and inconsistent, the product of a war between our competing impulses, good and bad, short and long-term. A New Year’s resolution could therefore be seen as an alliance between these competing motivations, and like any alliance, it can easily fall apart. Addictions are a good example, because the long-term goal (“not to be an alcoholic”) requires the coordination of many small goals (“not to have a drink at 4pm;” “not at 5pm;” “not at 6pm,” and so on), none of which is essential. You can have a drink at 4pm and still be a moderate drinker. You can even have a drink also at 5pm, but somewhere along the line all these small choices add up to a failure to keep to the wider goal. Similarly, if you want to get fit in 2016, you don’t have to go for a jog on 1 January, or even on 2 January, but if you don’t start doing exercise on one particular day then you will never meet your larger goal.

From Ainslie’s perspective willpower is a bargaining game played by the forces within ourselves, and like any conflict of interest, if the boundary between acceptable and unacceptable isn’t clearly defined then small infractions can quickly escalate. For this reason, Ainslie says, resolutions cluster around ‘clean lines’, sharp distinctions around which no quibble is brooked. The line between moderate and problem drinking isn’t clear (and liable to be even less clear around your fourth glass), but the line between teetotal and drinker is crystal.

This is why advice on good habits is often of the form “Do X every day”, and why diets tend to absolutes: “No gluten;” “No dessert;” “Fasting on Tuesdays and Thursdays”. We know that if we leave the interpretation open to doubt, although our intentions are good, we’ll undermine our resolutions when we’re under the influence of our more immediate impulses.

And, so, Ainslie gives us an answer to why our resolutions start on 1 January. The date is completely arbitrary, but it provides a clean line between our old and new selves.

The practical upshot of the theory is that if you make a resolution, you should formulate it so that at every point in time it is absolutely clear whether you are sticking to it or not. The clear lines are arbitrary, but they help the truce between our competing interests hold.

Good luck for your 2016 resolutions!

Psychotherapies and the space between us

There’s an in-depth article at The Guardian revisiting an old debate about cognitive behavioural therapy (CBT) versus psychoanalysis that falls into the trap of asking some rather clichéd questions.

For those not familiar with the world of psychotherapy, CBT is a time-limited treatment based on understanding how interpretations, behaviour and emotions become unhelpfully connected to maintain psychological problems while psychoanalysis is a Freudian psychotherapy based on the exploration and interpretation of unhelpful processes in the unconscious mind that remain from unresolved conflicts in earlier life.

I won’t go into the comparisons the article makes about the evidence for CBT vs psychoanalysis except to say that in comparing the impact of treatments, both the amount and quality of evidence are key. Like when comparing teams using football matches, pointing to individual ‘wins’ will tell us little. In terms of randomised controlled trials or RCTs, psychoanalysis has simply played far fewer matches at the highest level of competition.

But the treatments are often compared due to them aiming to treat some of the same problems. However, the comparison is usually unhelpfully shallow.

Here’s how the cliché goes: CBT is evidence-based but superficial, the scientific method applied for a quick fix that promises happiness but brings only light relief. The flip-side of this cliché says that psychoanalysis is based on apprenticeship and practice, handed down through generations. It lacks a scientific seal of approval but examines the root of life’s struggles through a form of deep artisanal self-examination.

Pitching these two clichés against each other, and suggesting the ‘old style craftsmanship is now being recognised as superior’ is one of the great tropes in mental health – and, as it happens, 21st Century consumerism – and there is more than a touch of marketing about this debate.

Which do you think is portrayed as commercial, mass produced, and popular, and which is expensive, individually tailored, and only available to an exclusive clientèle? Even mental health has its luxury goods.

But more widely discussed (or perhaps, admitted to) are the differing models of the mind that each therapy is based on. But even here simple comparisons fall flat because many of the concepts don’t easily translate.

One of the central tropes is that psychoanalysis deals with the ‘root’ of the psychological problem while CBT only deals with its surface effects. The problem with this contrast is that psychoanalysis can only be seen to deal with the ‘root of the problem’ if you buy into to the psychoanalytic view of where problems are rooted.

Is your social anxiety caused by the projection of unacceptable feelings of hatred based in unresolved conflicts from your earliest childhood relationships – as psychoanalysis might claim? Or is your social anxiety caused by the continuation of a normal fear response to a difficult situation that has been maintained due to maladaptive coping – as CBT might posit?

These views of the internal world, are, in many ways, the non-overlapping magisteria of psychology.

Another common claim is that psychoanalysis assumes an unconscious whereas CBT does not. This assertion collapses on simple examination but the models of the unconscious are so radically different that it is hard to see how they easily translate.

Psychoanalysis suggests that the unconscious can be understood in terms of objects, drives, conflicts and defence mechanisms that, despite being masked in symbolism, can ultimately be understood at the level of personal meaning. In contrast, CBT draws on its endowment from cognitive psychology and claims that the unconscious can often only be understood at the sub-personal level because meaning as we would understand it consciously is unevenly distributed across actions, reactions and interpretations rather than being embedded within them.

But despite this, there are also some areas of shared common ground that most critics miss. CBT equally cites deep structures of meaning acquired through early experience that lie below the surface to influence conscious experience – but calls them core beliefs or schemas – rather than complexes.

Perhaps the most annoying aspect of the CBT vs psychoanalysis debate is it tends to ask ‘which is best’ in a general and over-vague manner rather than examining the strengths and weaknesses of each approach for specific problems.

For example, one of the central areas that psychoanalysis excels at is in conceptualising the therapeutic relationship as being a dynamic interplay between the perception and emotions of therapist and patient – something that can be a source of insight and change in itself.

Notably, this is the core aspect that’s maintained in its less purist and, quite frankly, more sensible version, psychodynamic psychotherapy.

CBT’s approach to the therapeutic relationship is essentially ‘be friendly and aim for cooperation’ – the civil service model of psychotherapy if you will – which works wonderfully except for people whose central problem is itself cooperation and the management of personal interactions.

It’s no accident that most extensions of CBT (schema therapy, DBT and so on) add value by paying additional attention to the therapeutic relationship as a tool for change for people with complex interpersonal difficulties.

Because each therapy assumes a slightly different model of the mind, it’s easy to think that they are somehow battling over the ‘what it means to be human’ and this is where the dramatic tension from most of these debates comes from.

Mostly though, models of the mind are just maps that help us get places. All are necessarily stylised in some way to accentuate different aspects of human nature. As long as they sufficiently reflect the territory, this highlighting helps us focus on what we most need to change.

An inner beauty of neurosurgery

The New York Times has an excellent profile of British neurosurgeon Henry Marsh that manages to be an indiscreet but humane look at the medic now famous for his autobiography Do No Harm

It follows Marsh as he operates with colleagues in Albania and recounts both his work and personal style. It is written by the Norwegian novelist Karl Ove Knausgård and reads like downbeat gonzo journalism that hits some perfect notes along the way.

Could Marsh, this brilliant neurosurgeon, be troubled by a constant need to call attention to himself? Weren’t his extraordinary qualities, so obvious to everyone around him, fixed securely in his own image of himself?

I thought of what he said the night before, about keeping the wolf from the door. I had thought he meant something big. But perhaps, to the contrary, it was something very small?

I looked at him, there at the end of the table, seated at the place of honor, his strong fingers distractedly holding the stem of his wineglass as he talked, the round spectacles in his round, lined face, the lively eyes, which, as soon as he stopped talking, turned mournful.

I would also recommend an interview with Marsh in this week’s edition of BBC Hardtalk where he expands beyond his views on brain surgery to discuss healthcare in general. Well worth a listen.

Link to NYT article ‘The Terrible Beauty of Brain Surgery’
Link to stream / podcast of BBC interview.