Category: books

Last week’s ABC Radio National All in the Mind had a fantastic interview with journalist Ethan Watters whose book ‘Crazy Like Us: The Globalization of the American Psyche’ has been making waves with its criticism of the cultural dominance of American psychiatry.

I’ve promised a long overdue review of the book to The Psychologist so I won’t go into too many details here, except to say that although the book is not without its flaws, it remains an important take on how the DSM diagnostic manual is becoming a lens through which both professionals, and more importantly, regular folks, are interpreting their own distress.

This is not just a case of people using foreign terms to label mental disorder. The effect is much more profound. Our knowledge of illness, both physical and mental, affects how we experience distress.

Watters’ book investigates how ideas taken from Western society about the nature of mental illnesses are affecting other cultures, in terms of disease mongering by drug companies, inappropriate treatments being foisted on people in times of distress and local concerns being ignored because they “don’t fit the picture”.

These criticisms are not new, but Watters drags them from the depths of the anthropological research and vividly illustrates them by weaving them into personal and social stories from across the world.

The All in the Mind interview summarises and explores some of the most important and well-done pieces in the book and is definitely worth a listen.
 

Link to All in the Mind interview with Ethan Watters.

Tom kindly sent me a copy of his new book The Rough Guide to Brain Training which I’ve been thoroughly enjoying reading. I don’t think you’re ever going to get the most objective review from someone who’s already an admirer of Tom’s work, but I shall do my best.

I have to say, I’m not a big fan of puzzles, largely, it must be said, because I’m useless at them. The book is full of puzzles, but thankfully for me, they are interspersed by essays and snippets that give you a remarkably honest and science-based view of ‘brain training’ and the evidence for it.

In fact, right on the first page, in the introduction, the book is clear:

For now, it is safe to say that we don’t know of any magic bullets for brain training – there is no single kind of task or set of tasks which will improve brain fitness. And anyone who claims otherwise is probably trying to sell you something.

This is such as refreshing change from brain training books and games that make wild claims and go on about ‘neuroplasticity’ without understanding what it means and not knowing when it’s relevant.

There is none of that here. Everything is drawn from the science (Tom’s put all the references online, if you want to read up) and the book has many short essays that introduce you to how the brain works, how to keep it in good condition and how to optimise learning.

Also, virtually every page has a short paragraph giving a neuroscience fact taken from the research literature. For example:

American physician Robert Bartholow was the first to directly show that electrical activity on the surface of the brain controlled the body. In 1874, Bartholow was able to provoke movements of the body and limbs of patient Mary Rafferty by inserting electrodes through a hole in her skull.

There’s lots more where that came from. To be honest, if you’re not into puzzles there’s going to be a fair chunk of the book that’ll serve as no more than eye candy, but if you do, you’ll find them accompanied by some great short essays and snippets.

Link to more information on the book.
Link to essay written for the book but only available online.

Full disclosure: we both write for Mind Hacks, but I suspect if you’re reading this, you already know.

n+1 has an excellent article on how neuroscience is making an increasing appearance in novels, not only as a subject, but also as a literary device to explore characters and explain their motivations.

It marks the start of the trend from Ian McEwan‚Äôs Enduring Love and notes that in more recent years books such as Richard Powers‚Äôs The Echomaker, Mark Haddon‚Äôs Curious Incident of the Dog in the Night-Time and Rivka Galchen’s Atmospheric Disturbances have all drawn heavily from the medical and brain science literature for their main hooks.

What makes so many writers try their hands and brains at the neuronovel? At the most obvious level, the trend follows a cultural (and, in psychology proper, a disciplinary) shift away from environmental and relational theories of personality back to the study of brains themselves, as the source of who we are. This cultural sea change probably began with the exhaustion of “the linguistic turn” in the humanities, in the 1980s, and with the discredit psychoanalysis suffered, around the same time, from revelations that Freud had discounted some credible claims of sexual abuse among his patients. Those philosophers of mind who had always been opposed to trendy French poststructuralism or old-fashioned Freudianism, and the mutability of personality these implied, put forth strong claims for the persistence of innate ideas and unalterable structures.

And in neuroscience such changes as the mind did endure were analyzed in terms of chemistry. By the early ’90s, psychoanalysis—whether of a Lacanian and therefore linguistic variety, or a Freudian and drive-oriented kind—was generally considered bankrupt, not to mention far less effective and more expensive than the psychiatric drugs (like Prozac) that began to flow through the general population’s bloodstream. The new reductionism of mind to brain, eagerly taken up by the press—especially the New York Times in its science pages—had two main properties: it explained proximate causes of mental function in terms of neurochemistry, and ultimate causes in terms of evolution and heredity.

It’s really well researched piece and neatly outlines the play between literature, science writing, culture and neuroscience through the development of numerous popular novels in the area.

Link to n+1 article ‘The Rise of the Neuronovel’.

From p312 of anthropologist Kate Fox’s entertaining book Watching the English:

Tea is still believed, by English people of all classes, to have miraculous properties. A cup of tea can cure, or at least alleviate, almost all minor physical ailments and indispositions, from a headache to a scraped knee.

Tea is also an essential remedy for all social and psychological ills, from a bruised ego to the trauma of a divorce or bereavement. This magical drink can be used effectively as a sedative or stimulant, to calm and soothe or to revive and invigorate. Whatever your mental and physical state, what you need is ‘a nice cup of tea’.

If you’re not from the UK, you may be interested to know that what the medical literature calls social support is often referred to as ‘tea and sympathy’ by the Brits.

Actually, the paragraph above is not particularly representative of the book’s careful observations of the English but I can’t resist the opportunity to discuss the mental health benefits of tea.

But even if you’re not particularly interested in the English themselves, the book is also wonderful if you’re intrigued by how social anthropologists think and work.

However, the book is more like sitting in the pub with a social anthropologist than being in a lecture with one, as it’s a combination of an academic approach to the study of the implicit rules of English culture and Fox’s subjective opinion about what these rules mean.

After downing a few chapters, the author gets a little more opinionated and less observational. Although the book is no less entertaining as Fox becomes a bit loaded, you can see she isn’t taking herself too seriously by the end.

Which, as she notes, is a very English trait.

Link to details of Watching the English.

Lisa Appignanesi’s book Mad, Bad and Sad: A History of Women and the Mind Doctors from 1800 to the Present is a romantic tour through the last 200 years of psychiatry and the feminine, although probably not in the sense you’re thinking of.

The romantic movement was a literary and artistic phenomena that emerged in the 1800s as a backlash to the rationalism of the enlightenment. They railed against science as a dehumanising force, although this view was not its most lasting legacy.

Perhaps the biggest impact of the romantic movement was to seed the idea that the scientific and the humane were contradictory and incompatible, suggesting that it is not possible to be both scientific and compassionate, rational and poetic, or objective and understanding at the same time.

These are the two cultures, of which C. P. Snow famously spoke, and applied to the mind the romantic view suggests that an interpretative psychology touches the very core of our humanity, whereas the empirical barely scratches the surface.

It’s a false dichotomy because we are neither the facts of biology nor the feelings of the mind. We are at all times, both. Each is just a shadow of the whole that, paradoxically, has no single identity.

The colours of romanticism run through Appignanesi’s book, who hails from a cadre of the feminist literati who have become respected psychoanalytic thinkers. As she notes in her book, heavyweights like Julia Kristeva and Juliet Mitchell were literature PhDs before training as analysts, and although Appignanesi maintains a critical distance, the same vein runs through her work.

This is most apparent in her explorations of the lives of famous women who have shaped our ideas about the feminine and mental illness. It is Freudian literary analysis which forms the backbone of personal explanations in the book, as each person’s inner life is poetically explored without significant recourse to other ways of interpreting their motivations and desires.

It is also the case, however, that this period of history is the most gripping of the book, not least because it features the players for which Appignanesi has the most passion, but also because of her careful historical work, weaving the developments in the understanding of the mind to the social, to the personal, and back again.

But it is not the focus on the poetic psychologies that gives the book its romantic tone, so much the coldness for science which most clearly shows itself as the book rolls on to the present.

This is partly reflected in the numerous minor neglectful errors that pop up in the final section: atypical antipsychotics are described as have ‘far fewer side-effects’ than the older types when we’ve known this not to be the case for many years; the ‘diazepams’ are described as a drug class when diazepam is a single specific medication; cognitive therapy is described as being based on an ‘underlying assumption that people are rational beings and ever-capable of self-assessment, without any self-deception’ when it is based, and always has been, on exactly the opposite premise.

With this section also comes unconcealed hostility for new evidence-based methods of mental health: psychometric tests are dismissed as ‘fun as parlour games’, cognitive therapy is bizarrely accused of being akin to ‘brainwashing’ and standardised questionnaires as pathologising teenagers.

The fact that these could be the effective tools of humane and sensitive clinicians seems almost impossible in this light. The rise of science in psychological treatment is portrayed as antagonistic to empathy and the true work of understanding the soul, when, in fact, they are complementary to it.

The likes of Elaine Showalter’s Hystories does not share this romantic slant, and manages to remain more broad in its overview, although is more limited in its scope.

But despite the slant, I found Mad, Bad and Sad both powerful and enlightening, gripping in places, and compelling in many of its arguments.

It is perhaps, the best romantic history of psychiatry available, although, it is not as purely historical as it claims.

 
Link to book details.

Bonk: The Curious Coupling of Science and Sex is a hugely entertaining book on sex research that is chaotic, delightful and utterly compelling.

The book is by science writer Mary Roach, whose past book Stiff: The Curious Lives of Human Cadavers is one of my favourite science books of all time and when the publishers offered to send me a free copy of her new book I jumped at the chance.

Roach does something different to most other science writers – she writes about the research itself and not just about the findings. This means you get a fascinating insight into how people go about researching sex, what motivates them, and often most surprisingly, what exactly they’ve chosen to investigate.

One of the joys of the book is its asides and footnotes which make it a bit like getting a bit drunk with a knowledgeable and slightly overenthusiastic friend. Take this section on spinal cord injury and orgasm:

It’s strange to think of orgasm as a reflex, something dependably triggered, like a knee jerk. [Sex researcher] Sipski assures me that psychological factors also hold sway. Just as emotion affect heart rate and digestion, they also influence sexual response. Sipski identifies orgasm as a reflex of the autonomic nervous system that can be either facilitated or inhibited by cerebral input (thoughts and feelings).

The sacral reflex definition fits nicely with something I stumbled upon in the United States Patent Office web site: Patent 3,941,136, a method for “artificially inducing urination, defecation of sexual excitation” by applying electrodes to “the sacral region on opposites sides of the spine.” The patent holder intended the to help not only people with spinal cord injuries but those with erectile dysfunction or constipation.

The author also takes part in several studies herself, describing the slightly surreal situations that arise from bringing the personal into the lab, and doesn’t lapse into nods and winks when the gritty detail is needed.

Like, Jeff Warren’s excellent The Head Trip: Adventures on the Wheel of Consciousness it’s sort of an educational travelogue through the world of science, where we encounter the people associated with sex research and the research itself. It’s both completely fascinating and very funny in places.

Link to more details about the book.
Link or mp3 to Salon interview with Roach on the book.
Link to review from the International Herald Tribune.
Link to interview on NPR radio.

Salon has a good discussion of a new book on the culture and pseudoscience of vaccination scares by a paediatrician who received death threats after his public debunking of the overblown dangers.

The book is Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure and the paediatrician is Paul Offit, who examine both the claims and culture of the anti-vaccination lobby who are currently obsessed with autism.

This hasn’t always been the case though. As Ben Goldacre has noted, the US lobby seems to be concerned with thimerosal while the UK lobby believe the same thing about MMR, whereas previous unsupported scares have focused on hepatitis B jabs and multiple sclerosis.

In fact, as a BBC Radio 4 programme documented, a vaccination scare happened as the first ever vaccine for small pox appeared.

It’s a timely article, note least because yet another study has recently been published showing MMR vaccination was unrelated to autism. This is one of many many others, and an excellent article by Respectful Insolence rounds up the past evidence but also notes this latest study is particularly poignant as the first author is someone who has previously supported the scare.

Link to Salon article.
Link to more info on book Autism’s False Prophets.
Link to Respectful Insolence summary article.

Madness and Civilization was a hugely influential book by the French post-modernist philosopher Michel Foucault and is often cited as a key ‘anti-psychiatry’ text owing to its claim that the modern concept of madness was an Enlightenment idea developed to allow the confinement of people that others in society found unacceptable.

What I wasn’t aware of is that Madness and Civilization is actually a cut-down translation of the original French text where most of the references to source material remained untranslated.

A full translation, renamed with its correct title History of Madness, was released last year and was given a damning review in The Times by medical historian Andrew Scull who derided Foucault’s “isolation from the world of facts and scholarship”.

Actually, Foucault’s major claim that 17th Europe undertook the “great confinement” of the mad through the building of asylums has been debunked before. The much-missed medical historian Roy Porter pointed out that France was the only country in Europe to centralise its administration of services for the ‘pauper madman’ while other countries didn’t typically have any legislation in place until the 19th century.

I was also interested in Scull’s debunking of the myth that visitors could pay to view the patients of London’s ‘Bedlam‘ Hospital:

Foucault alleges, for example, that the 1815–16 House of Commons inquiry into the state of England’s madhouses revealed that Bedlam (Bethlem) placed its inmates on public display every Sunday, and charged a penny a time for the privilege of viewing them to some 96,000 sightseers a year. In reality, the reports of the inquiry contain no such claims. This is not surprising: public visitation (which had not been confined to Sundays in any event) had been banned by Bethlem Royal Hospital’s governors in 1770, and even before then the tales of a fixed admission fee turn out to be apocryphal.

I looked this up in Russell’s Scenes From Bedlam (ISBN 1873853394) that confirms the ban on visitation in 1770, but does make reference to paying visitors, although it gives the impression that the arrangement was much more ad-hoc than is commonly assumed and casts doubt on the huge figures Foucault quotes.

Unfortunately, it doesn’t reference any historical documents on the matter, and neither does any other book I have, so I’ll have to do further investigation.

However, this is just one point among many where Scull notes that with the benefit of the fully translated version, we can see that Foucault’s research is just not up to scratch and doesn’t support his major historical claims.

But it’s probably worth saying that Foucault’s other major idea, that madness is not a fixed entity but is defined as much socially and politically as in medical terms is still as valid today. Particularly in an era where we are increasingly medicalising what we previously considered unfortunate but non-medical problems and stresses.

Link to Times article ‘The fictions of Foucault’s scholarship’.

September’s New York Review of Books has an extended piece by Oliver Sacks where he reviews Hurry Down Sunshine, a memoir of a parent’s experience of seeing their daughter spiral into mania and psychosis.

In typical Sacks style it is more than just a book review, as it takes us through the history of manic-depression and discusses its the various literary treatments over the years.

I always thought manic-depression was a much better name for what is now diagnosed as bipolar disorder, precisely for the reason Sacks states in his review – that ‘bipolar’ suggests a kind of emotional see-saw, where you’re either up or down, where in reality, mixed emotional states occur in a significant minority of people with mood disorders.

Only one thing about the article made me roll my eyes (OK, two if you count the minor quibble that psychologist Kay Redfield Jamison is misdescribed as a psychiatrist).

Sacks says that “Mania is a biological condition that feels like a psychological one” and suggests it is due to “chemical imbalance in the brain”.

Of course, mania is both a biological and psychological condition (as we think with our brains, how could it not be?) and the references to a ‘chemical imbalance’ is a misleading oversimplification.

Otherwise, it’s as clear and engaging a piece as you’d expect from one of our best writers on the mind, brain and human condition.

Link to Sacks’ NYRB review ‘A Summer of Madness’ (via MeFi).
Link to more information on Hurry Down Sunshine.

The Guardian is currently running a series of extracts from Ben Goldacre’s new book, Bad Science. The first two are witty, acerbic and address how implausible vaccine scare stories get picked up by a scandal hungry media, and how pharmaceutical companies attempt to persuade us that every discomfort is a medical disorder.

Actually, I’m still waiting for the copy I’ve ordered to arrive so haven’t seen the whole thing yet, but if you’re a fan of the Bad Science column then the extracts suggest that the book will be just as insightful.

Times have changed. The pharmaceutical industry is in trouble: the golden age of medicine has creaked to a halt, the low-hanging fruit of medical research has all been harvested, and the industry is rapidly running out of new drugs. Fifty “novel molecular entities” a year were registered in the 1990s, but now it’s down to 20, and many of those are just copies of other companies’ products, changed only enough to justify a new patent. So the story of “disease mongering” goes like this: because they cannot find new treatments for the diseases we already have, the pill companies have instead had to invent new diseases for the treatments they already have.

Recent favourites include social anxiety disorder (a new use for SSRI antidepressant drugs), female sexual dysfunction (a new use for Viagra in women), the widening diagnostic boundaries of “restless leg syndrome”, and of course “night eating syndrome” (another attempt to sell SSRI medication, bordering on self-parody) to name just a few: all problems, in a very real sense, but perhaps not necessarily the stuff of pills, and perhaps not all best viewed in reductionist biomedical terms. In fact, you might consider that reframing intelligence, loss of libido, shyness and tiredness as medical pill problems is a crass, exploitative, and frankly disempowering act.

Night eating syndrome? No wonder those Goths look so pale.

Link to ‘The media‚Äôs MMR hoax’.
Link to ‘The Medicalisation of Everyday Life’.
Link to book details.

I cannot recommend strongly enough Goodale & Milner’s book on vision ‘Sight Unseen’. The title refers to the idea they pursue throughout the book that our everyday conception of vision is thoroughly misleading. Rather than vision just being ‘what we experience’, it is, in fact, a collection of specific eye-behaviour links (‘visuomotor functions’) of which our conscious perception of the world is only an evolutionary-recent addition. Goodale & Milner have spent their careers investigating this area and base their narrative around a selection of seminal experiments and case-studies of patients with selective brain injuries. Almost no background knowledge is assumed yet the book takes the reader into the intricacies of the psychology of vision. The triumph of the book is that it gives a flavour of how research proceeds while also managing to provide an intuition-shaking overview of the whole topic. I will never think about seeing in the same way again. This is a rare book which is accessible but will also be of interest to those working in the field. If you have any interest in how a research field develops or in the psychology of vision then you should read it.

Goodale, M. & Milner, D. (2004). Sight Unseen: An Exploration of Conscious and Unconscious Vision. Oxford: Oxford University Press

(Full disclosure: I did not get asked to do this review, nor did I receive payment or a free book. I did it because I liked the book. I am actively engaged in research in this area)