Category: Other People

The wonderful image is an original drawing by the artist Masonic Boom, aka Kate St.Claire, as part of her series of psychological self portraits.

The quote in the image is from the author and philosopher G.K. Chesterton.

He was once asked by The Times to write an article on ‘What is wrong with the world?’ and send the following piece:

Dear Sirs,

I am.

Sincerely yours,
G. K. Chesterton

Thanks to Katie for allowing us to feature the image and it’s really worth seeing full size at the link below.

Link to full size image on Flickr.
Link to Masonic Boom collection.

I’ve just found an eye-opening 2003 article in the Journal of the American Medical Association on the work on 19th century neurologists George Beard and Silas Weir Mitchell, who thought the pace of life and the effect of new technology was harming the mind and brain of citizens in 1800s America – echoing similar concerns we still hear today.

The two physicians were influential in pushing the idea that these effects resulted in ‘neurasthenia‘, a kind of fuzzy catch-all diagnosis for mental or emotional malaise.

What’s interesting is we’re experiencing something almost identical over 100 years later.

As we’ve noted several times, leading scientists or commentators can make international headlines by simply suggesting that new technology is harming the mind, brain and relationships of the modern citizen, despite a general lack of evidence or flat out evidence to the contrary.

The JAMA article notes how neurasthenia was associated with the cultural concerns of the time:

Families migrated from the countryside to the city, men left traditional jobs as tradesmen and farmers to join the growing ranks of businessmen and office workers, women went from being mothers and daughters to also being university students and physicians, and technological developments such as telegraphs, telephones, and railroads became increasingly common parts of everyday life. As a diagnosis, neurasthenia commanded an intuitive legitimacy because it incorporated the anxieties that arose from these changes into the way people thought of their health. It could attribute a bank manager’s headaches to his hectic schedule and the obsession for detail his job demanded.

Similarly, a young woman’s depression could be understood as neurasthenia brought on by the mental drain of attending a newly founded coeducational university, where she competed for grades. In many cases, diagnoses of neurasthenia attached themselves to traditional ideals, such as the restorative virtues of farming vis-√†-vis the fast-paced stress of modern business or the Victorian belief in women’s disposition for motherhood rather than scholarship. For Beard and Mitchell, neurasthenic patients were casualties of modern society whose bodies and minds simply could not keep up with the seemingly accelerated lifestyles of men and women in the latter part of the 19th century.

It’s a lovely illustration of the fact that since the dawn of popular medicine, our cultural concerns about changes in society are likely to be expressed in the language of illness and disease.

The article also notes that then, like now, the concerns are accompanied by an encouragement to return to the traditional ways of doing things (in this day and age – encouraging kids to ‘play proper games’ or have ‘genuine relationships’) rather than highlighting ways of healthy adaptation to the new technology.

This is not to say that all fears about new technologies are unfounded, but its clear that they are quickly medicalised and get far more prominence than the evidence supports, both in the 19th century and in the 21st.

Link to JAMA article ‘Neurasthenia and a Modernizing America’.

Lee Tracy is an artist who creates poems out of brain scans.

The image is from a 2006 exhibition called Negative to Positive that was shown in the International Museum of Surgical Science in Chicago.

Each image is an CT scan of the artist’s brain, mounted in a light box and etched with a statement of the profound to the whimsical.

If you’re a neuroscientist and your lab needs more poetry or you’re an artist and your studio needs more neuroscience, you can purchase the pieces from the artist through Etsy.

Link to Lee Tracy’s poetic CT scans on Etsy (thanks Sandra!).
Link to Time Out review of ‘Negative to Positive’.

Psychologist Bill Richards studies the medical potential of the hallucinogenic drug psilocybin, the active ingredient in ‘magic mushrooms’.

He’s part of the research team at the respected Johns Hopkins Medical School who are studying whether psilocybin-assisted psychotherapy can help people with cancer cope with the psychological impact of their condition.

The project is a hot topic at the moment, partly because the research team are looking for volunteers with a diagnosis of cancer to take part in the pioneering study, and also because several of their recent findings have made headlines.

These have included the widely-reported results from their recent studies where participants reported that some of the psilocybin experiences remained deeply and personally meaningful, even after a year.

Bill has been a clinical psychedelics researcher since the 1960s and so has a wealth of experience with these curious compounds, and he’s also kindly agreed to talk to Mind Hacks about the current pioneering research project.
 

Continue reading “Five minutes with psychedelics researcher Bill Richards”

I’ve just got round to watching the Seed Salon discussion between novelist Tom Wolfe and neuropsychologist Michael Gazzaniga where they debate free will, criminal responsibility and the similarities in the creative processes of writers and scientists.

Wolfe is best known as the author of ‘The Electric Kool-Aid Acid Test’ and ‘The Bonfire of the Vanities’, but wrote a highly influential 1996 article for Forbes magazine titled ‘Sorry, But Your Soul Just Died’.

The piece is worth re-reading now because its a look ahead to the forthcoming neuroscience revolution written 12 years ago, when the ‘Decade of the Brain’ initiative was only just past the half way point.

It’s revealing because it describes a society still quite resistant to what we consider relatively banal in 2008 – the fact that there may be neurobiological or genetic factors to behavioural differences.

It also fortells our concerns over widespread use of methylphenidate (Ritalin) in children and the interest in a psychology of happiness, but does have a curious paragraph about the ‘IQ Cap’ which could apparently predict IQ to within half a standard deviation based on an EEG reading.

As far as I know, it’s never been heard of since and seems to have been lost in history, presumably as it sounds a bit far fetched and probably never worked as advertised.

Link to Wolfe and Gazzaniga discussion.
Link to ‘Sorry, But Your Soul Just Died’.

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.

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.

Bookslut has an interview with Jeff Warren, author the excellent The Head Trip: Adventures on the Wheel of Consciousness, a book I raved about last year after having a copy thrust into my hand by Tom.

It sounds like a recipe for disaster on the surface – a guy writing about his altered states charted on a self-invented ‘wheel of consciousness’ – but it’s scientifically thorough, philosophically engaging and avoids every clich√© you think it might throw up.

The interview is great fun too, and contains some interesting points about what we prioritise, mentally or scientifically, when thinking about consciousness-warping states.

Except for one footnote, you largely avoid the question of drugs and altered consciousness…

I‚Äôm interested in drug-induced alternations of consciousness, but my feeling is they‚Äôre the really obvious shit. Too many ‚Äúinvestigators of consciousness‚Äù overlook the fine-grained shifting texture of day-to-day consciousness. It‚Äôs the difference between the big budget Hollywood blockbuster and the art house Henry James adaptation. Drug-induced alterations of consciousness have great CGI — which is fine, I mean who doesn‚Äôt appreciate form constant explosions and DMT Machine Elves? — the problem is, character development sucks, or rather, the characters — and by characters I mean the objects of consciousness — tend to be cartoons. They‚Äôre exaggerated, that‚Äôs what psychedelics do — ‚Äúnon-specific amplifiers‚Äù Stanislav Grof calls them. They expand the whole topography of the mind. It‚Äôs possible more than this is going on but that‚Äôs another story.

This expansion can be valuable for understanding consciousness since it boosts the resolution of previously discreet mental dynamics. But cartoons, of course, are caricatures. If you watch only Jerry Bruckheimer movies you risk losing your ability to appreciate — and even notice — the subtleties and complexities of real life and consciousness, which, to circle back to my original metaphor, is more like a Henry James adaptation.

Link to Bookslut interview with Jeff Warren.

I am currently reading Daniel Moerman’s “Meaning, medicine and the ‘placebo effect'”. As well as containing many interesting asides, the book discusses what is at the heart of the so-called placebo effect: patients’ response to the meaning of their treatment. Moerman calls this the ‘meaning response’. This response to meaning explains why two inert pills produce more cures than one inert pill, and why inert injections are even more effective (because “everybody knows” that injections are more powerful than pills). But importantly, it is possible to show that doctors are as important in producing the meaning response as patients. Gracely et al (1985) looked at the effect of placebo on pain in patients having their wisdom teeth extracted. The study was set up as a standard double-blind (neither the doctor nor the patient knows if the patient is getting a real medicine or an inert placebo), with the possibilities being a placebo, fentanyl (which usually reduces pain) and naloxone (which usually blocks reduction in pain, so could be expected to increase the pain of the procedure). The twist was that for the first half of the experiment the doctors, but not the patients, were told that a supply problem meant that no patient would be getting the pain-relieving fentanyl. In the second half the doctors were told that the problem had been resolved, so that now the patients might receive fentanyl. By comparing levels of patient pain in the placebo condition is possible to gauge the effect of doctor expectations on the meaning response of the patients. In this condition patients are all receiving inert substances, and they all ‘know’ the same thing: they might receive a placebo, pain-relief or ‘pain-enhancement’. The doctors don’t tell them about the supply problem and, for that matter, they don’t know themselves for definite what the patient is given. The only difference is that for the patients in the first half, the doctors think they know that pain-relief is not a possibility, whereas in the second half it is. The graph of the results, copied from Moerman’s book is below:

As you can see, patients in the PNF group — those whose doctors thought they might receive pain-relief had a large pain-relieving placebo effect compared to those in the PN group — those whose doctors thought they couldn’t receive pain-relief (update in the original edit of this post I had these labels the other way around, incorrectly)

What I think is interesting about this study is, firstly, it confirms the need for rigorous double-blind controls in studies of medicine and, secondly, just how significant an effect this subtle manipulation has. The doctors don’t know anything definite, and they certainly aren’t telling the patients what they suspect or guess, but somehow — a look? a slightly brighter smile? a slightly lowered tone? — they communicate their knowledge of the probabilities to the patients who then experience a real change in their levels of pain because of it.

A striking aspect of the meaning response is that one could suppose that patients have control over their experience of different levels of pain. After all, we know that the pills are inert. Could we just imagine ourselves a ‘placebo effect’ in all situations where we have unnecessary pain? Sadly, normally we can’t do this — the meaning response doesn’t work like that. Doctors are required to give patients permission to feel less pain. Perhaps a fundamental part of the creation of meaning is that it requires other people.

Update: A great recent post by Vaughan ‘placebo is not what you think’, which deserves to be linked up with this post

Refs

Gracely, R. H., Dubner, R., Deeter, W. R., & Wolskee, P. J. (1985). Clinicians’ expectations influence placebo analgesia. Lancet, 1(8419), 43.

Moerman, D. E. (2002). Meaning, medicine, and the “placebo effect”. Cambridge University Press: New York.

The Observer discusses the recent and somewhat lonely death of Adam Laing, the son of revolutionary psychiatrist R.D. Laing, in an article tinged with both sadness and irony.

Adam Laing was apparently found alone in a remotely pitched tent on the Spanish island of Formentera, surrounded by mostly emptied bottles of alcohol, having had a heart attack during a drinking binge.

R.D. Laing was famously troubled himself, suffering from both alcoholism and depression, and for a psychiatrist that specialised in the influence of the family on mental health, he was a notoriously absent father.

He is often, rather clumsily, associated with ‘anti-psychiatry’. Although he rejected the label himself and was certainly not against psychiatric treatment, he did propose some radical ideas that chimed with the counter-culture of the 1960s.

One of this most important contributions was suggesting that family dynamics had an influence on the development and expression of psychosis.

In many ways his ideas were the forerunner of subsequent work on psychosis and ‘expressed emotion’ – another clumsy term that is used to described the extent to which family members talk about another family member in a critical or hostile manner or in a way that indicates marked emotional over-involvement.

In a now widely replicated finding, the number of critical and undermining comments made in a family to a person with psychosis is known to predict the chance of relapse. This has led to the development of family therapy for psychosis which has been shown to reduce relapse rates.

Laing was more concerned with the development of psychosis and argued that the content of hallucinations and delusional beliefs often reflected thoughts that would otherwise be inexpressible in the fraught emotion of a dysfunctional family.

Perhaps Laing’s most naive, and ironically, most popular essays, The Politics of Experience and The Bird of Paradise suggested that madness was a quasi-mystical state in which the psychotic person had been thrown into a process of ‘ego transcendence’.

Psychosis was, therefore, a process of catharsis and the person should be guided on their journey, rather than treated to moderate their chaotic mental state.

For some people, this is almost certainly true, but these people are sadly in the minority. Most find psychosis a disturbing experience and we there is now accumulating evidence that outcome is far worse for people who have longer periods of untreated psychosis.

Laing was important in pointing out that the mental health system can often add to the disturbing experiences rather than temper them, but he often wandered off into vaguely focused anti-authoritarian diatribes in both his writing and talks which made him a darling of the underground but which obscured his more valuable insights.

The Observer article discusses the contrast between Laing’s work and his difficult personality and family life.

Like this one, it’s an article on the death of a man that largely talks about his long departed father.

It’s difficult to read without being struck by the irony that even in death, R.D. Laing’s work and personality have overshadowed his family life.

Link to Observer article on Laing (thanks Tom and Karel!).

The last few months have seen the passing of Frank Ayd and Charles Brenner, two huge figures in American psychiatry. Their obituaries in The New York Times reflect the ideological divide between psychoanalysis and pharmacotherapy that defined stateside psychiatry during the 20th century.

Ayd, pictured top, was one of the pioneers of antipsychotic drug therapy in the states. Although it was already popular among European psychiatrists, Ayd was one of the first to try chlorpromazine (more commonly known as Thorazine) with some of his outpatients.

As well as noticing the huge potential for the drug, virtually the first ever effective treatment for severe psychosis, he was also persistent in publicising the disabling side-effects when many others were dismissing them as part of the illness or ‘hysterical’ in nature.

In contrast, Brenner was a mainstay of mainstream Freudian psychiatry for most of his life.

Interestingly, both Brenner and Ayd came from similar backgrounds. In their early years, both published on drug treatments and lobotomy (then at the height of its popularity), although Brenner later trained as a psychoanalyst and began to focus almost entirely on a Freudian approach.

Brenner is perhaps best known for his ‘conflict theory’, first presented in an influential paper entitled The Mind as Conflict and Compromise Formation.

This overturned the distinction between the Id, Ego and Superego and the Freud’s idea of the unconscious as being nothing more than metaphors, and proposed a model of the mind which we would now recognise as a constraint satisfaction approach – where the mind attempts the best compromise between the satisfaction of drives while accounting for emotions and defences.

While Anglo-European psychiatry tended to lean toward the biological approach, in the mid-20th century American psychiatry was largely Freudian. This is partly to do with the differing practice traditions, European psychiatry was largely hospital based and focused on psychosis while American psychiatry was largely concerned with office practice and neurosis.

The shift to a more scientific approach to psychiatry in the 1970s was led by several US psychiatry departments who were more Anglo-European influenced (Washington University, Johns Hopkins, Iowa Psychiatric Hospital, New York Psychiatric Institute).

This hit psychoanalytic psychiatry hard. One of the major blows was the 1980 publication of the DSM-III diagnostic manual that threw out almost all Freudian-influenced diagnoses after studies found them unreliable.

Link to NYT obituary of Frank Ayd.
Link to NYT obituary of Charles Brenner.

A quote from the sardonic Alfred Hitcock where he notes the curious interaction between mind doctors and the moving image:

“Television has done much for psychiatry by spreading information about it, as well as contributing to the need for it.”

I suspect he was commenting on concerns about negative effects of television, although I wonder whether he still might say the same, in light of the enduring influence of pharmaceutical adverts and claims of disease mongering.

Hitchcock himself was famously fascinated by the psychiatry of the day, and his films are well known for containing Freudian themes.

The most obvious was Spellbound, which featured psychiatrists, a psychoanalytic plot, and a symbolic dream sequence designed by Salvador Dalí.

On the Ropes, BBC Radio 4’s programme about people in difficult situations, interviews author Terry Pratchett about his recent diagnosis of Alzheimer’s disease.

In the first half of the interview, Pratchett talks about his early years as a writer and how he came to write the Discworld series and other novels.

In the latter half, he talks through the realisation that he had Alzheimer’s, from being tested for his initial relatively minor stroke, to being more comprehensively assessed for his ongoing cognitive difficulties.

He gives a fascinating first-person account of how he experiences the difficulties and the effects of the medication on his mind.

After his diagnosis, Pratchett was surprised at how little Alzheimer’s disease research was going on and donated half a million points pounds to scientific research.

Pratchett fans have set up Match It For Pratchett, a drive to match the Discworld author’s donation and boost degenerative brain research.

Link to On the Ropes interview with Terry Pratchett.
Link to Match It For Pratchett.

BBC Radio 4 have just broadcast a fantastic new radio series called Case Study that looks at some of the most influential, and most remarkable, case studies in the history of psychology.

The most recent edition was on the famous case of Phineas Gage, the 19th century American railway worker who had a 6 foot tamping iron shoot through his head during a railroad construction accident.

Gage’s job was to clear boulders by drilling holes in them, filling the hole with gunpowder, and tamping the charge down with a large iron bar.

If ever there was an accident waiting to happen, this was it, and lo and behold, the iron bar sparked on the rock, igniting the charge and firing the metal rod through his frontal lobes.

The rest, they say, is history. Or rather, is one of the histories, as there are many legends and stories surrounding his life which turn out to be less than reliable.

The programme looks at the known facts, the speculation, and the huge impact of the case on the development of neuroscience, which had never known a patient with such damage to the frontal lobes who had survived before.

The other programmes are equally as interesting, one edition covers the story of the ‘Wild Boy of Aveyron’ who largely grew up in the woods without any human contact, while another edition tackles the case of Kitty Genovese, a young woman who was murdered apparently in full sight of bystanders who failed to intervene.

Needless to say, influential cases attract influential myths and psychologists’ favourite ‘fireside stories’ of what occurred don’t always match the known facts.

The series is presented by Claudia Hammond, who also presented the excellent Mind Changes series about influential psychologists, and who will be presenting the upcoming series of BBC All in the Mind.

Thanks to Tenyen for letting me know about the series, although I notice I was pre-empted by Neurophilosophy.

Link to programme on Phineas Gage.
Link to programme on The Wild Boy of Aveyron.
Link to programme to Kitty Genovese.

Robert Burton is a neurologist and novelist who has recently turned his attentions to the complexities of belief and the brain.

Unlike the recent trend for focusing exclusively on religious belief and the neuroscience of mystical experience, Burton explores something much more essential – how do we have beliefs, any beliefs, at all?

His recent book, On Being Certain, tackles the neuropsychology of belief, certainty and conviction and has garnered some excellent reviews along the way, including one in this month’s Scientific American Mind.

As well as wrestling with the fundamentals of human cognition, he’s also been kind enough to share his beliefs about belief with Mind Hacks.

Continue reading “Five minutes with Robert Burton”

“Contrary to what we usually believe, moments like these, the best moments in our lives, are not passive, receptive, relaxing times – although such experiences can be enjoyable, if we have worked hard to attain them. The best moments usually occur when a person’s body or mind is stretched to its limits in a voluntary effort to accomplish something difficult and worthwhile.”

Like pronouncing the name of psychologist Mihály Csíkszentmihályi whose book Flow this quote is taken from.

UPDATE: Thanks to the ‘in-the-zone’ Chris Green from AHP for emailing to say it’s pronounced “chick-sent-me-high”. Great name for an indie band that.