Togetherness – Page 6

Amid the borderlands

I’ve got an article in The Observer on how some of the best evidence against the idea that psychiatric diagnoses like ‘schizophrenia’ describe discrete ‘diseases’ comes not from the critics of psychiatry, but from medical genetics.

I found this a fascinating outcome because it puts both sides of the polarised ‘psychiatry divide’ in quite an uncomfortable position.

The “mental illness is a genetic brain disease” folks find that their evidence of choice – molecular genetics – has undermined the validity of individual diagnoses, while the “mental illness is socially constructed” folks find that the best evidence for their claims comes from neurobiology studies.

The evidence that underlies this uncomfortable position comes recent findings that genetic risks that were originally thought to be specific for individual diagnoses turn out to risks for a whole load of later difficulties – from epilepsy, to schizophrenia to learning disability.

In other words, the genetic risk seems to be for neurodevelopmental difficulties but if and how they appear depends on lots of other factors that occur during your life.

The neurobiological evidence has not ‘reduced’ human experience to chemicals, but shown that individual life stories are just as important.

Link to Observer article.
Link to brief scientific review article on the topic.

The history of the birth of neuroculture

My recent Observer piece examined how neuroscience has saturated popular culture but the story of how we found ourselves living in a ‘neuroculture’ is itself quite fascinating.

Everyday brain concepts have bubbled up from their scientific roots and integrated themselves into popular consciousness over several decades. Neuroscience itself is actually quite new. Although the brain, behaviour and the nervous system have been studied for millennia the concept of a dedicated ‘neuroscience’ that attempts to understand the link between the brain, mind and behaviour only emerged in the 1960s and the term itself was only coined in 1962. Since then several powerful social currents propelled this nascent science into the collective imagination.

The sixties were a crucial decade for the idea that the brain could be the gateway to the self. Counter-culture devotees, although enthusiastic users of mind-altering drugs, were more interested in explaining the effects in terms of social changes than neurological ones. In contrast, pharmaceutical companies had discovered the first useful psychiatric drugs only a few years before and they began to plough millions both into both divining the neurochemistry of experience and into massive marketing campaigns that linked brain functions to the psyche.

Drug marketing executives targeted two main audiences. Asylum psychiatrists dealt with institutionalised chronic patients and the adverts were largely pitched in terms of management and control, but for office-based psychiatrists, who mainly used psychotherapy to treat their patients, the spin was different. The new medications were sold as having specific psychological effects that could be integrated into a Freudian understanding of the self. According to the marketing, psychoactive chemicals could break down defences, reduce neurotic anxiety and resolve intra-psychic conflict.

In the following years, as neuroscience became prominent and psychoanalysis waned, pharmaceutical companies realised they had to sell theories to make their drugs marketable. The theories couldn’t be the messy ideas of actual science, however, they needed to be straightforward stories of how specific neurotransmitters were tied to simple psychological concepts, not least because psychiatric medication was now largely prescribed by family doctors. Low serotonin leads to depression, too much dopamine causes madness. The fact these theories were wrong was irrelevant, they just needed to be reason enough to prescribe the advertised pill. The Prozac generation was sold and the pharmacology of self became dinner table conversation.

Although not common knowledge at the time, the sixties also saw the rise of neuroscience as a military objective. Rattled by Korean War propaganda coups where American soldiers renounced capitalism and defected to North Korea, the US started the now notorious MKULTRA research programme. It aimed to understand communist ‘brain washing’ in the service of mastering behavioural control for the benefit of the United States.

Many of the leading psychologists and psychiatrists of the time were on the payroll and much of the military top brass was involved. As a result, the idea that specific aspects of the self could be selectively manipulated through the brain became common among the military elite. When the two decade project was revealed amid the pages of The New York Times and later investigated by a 1975 Congressional committee, the research and the thinking behind it made headline news around the world.

Mainstream neuroscience also became a source of fascination due to discoveries that genuinely challenged our understanding of the self and the development of technologies to visualise the brain. As psychologists became interested in studying patients with brain injury it became increasingly clear that the mind seemed to break down in specific patterns depending on how the brain was damaged, suggesting the intriguing possibility of an inherent structure to the mind. The fact that brain damage can cause someone to believe that a body part is not their own, a condition known of somatoparaphrenia, suggests body perception and body ownership are handled separately in the brain. The self was breaking down along fault lines we never knew existed and a new generation of scientist-writers like Oliver Sacks became our guides.

The rise of functional neuroimaging in the eighties and nineties allowed scientists to see a fuzzy outline of brain activity in healthy individuals as they undertook recognisable tasks. The fact that these brightly coloured brain scans were immensely media friendly and seemingly easy to understand (mostly, misleadingly so) made neuroscience appear accessible to anyone. But it wasn’t solely the curiosity of science journalists that propelled these discoveries into the public eye. In 1990 President G.W. Bush launched the Decade of the Brain, a massive project “to enhance public awareness of the benefits to be derived from brain research”. A ten-year programme of events aimed at both the public and scientists followed that sealed the position of neuroscience in popular discourse.

These various cultural threads began weaving a common discourse through the medical, political and popular classes that closely identified the self with brain activity and which suggested that our core humanity could be understood and potentially altered at the neurobiological level.

These cultural forces that underlie our ‘neuroculture’ are being increasingly mapped out by sociologists and historians. One of the best sources is ‘The birth of the neuromolecular gaze’ by Joelle Abi-Rached and Nikolas Rose. Sadly, it’s a locked article although a copy has mysteriously appeared online

However, some excellent work is also being done by Fernando Vidal, who looks at how we understand ourselves through new scientific ‘self’ disciplines, and by Davi Johnson Thornton who studies who neuroscience is being communicated through popular culture.

Link to ‘The birth of the neuromolecular gaze’.

A fine art

It’s not often you get to enrage both feminists and misogynists at the same time but a new study, just published in the Archives of Sexual Behavior, may have managed this impressive feat.

It found that men’s preference for larger breasts was associated with having a greater number of oppressive beliefs about women.

Feminists can be enraged about how a natural variation in body shape has become associated with sexist attitudes while misogynists that their breast size preference can be thought of as a problem.

Social scientists, however, may be left relatively unperturbed at the thought of this study. But please, allow me.

So, come on now. What does it really tell us?

You can thank me later.

Link to coverage on Feminist Philosophers blog (via @KateClancy)
Link to locked study.

Your future self already exists in the cloud

The Economist has a short but fascinating piece on the work of physicist Chaoming Song who creates mathematical models to predict your future location based on your mobile phone and online activity. His accuracy rarely drops below 80%.

Song Chaoming, for instance, is a researcher at Northeastern University in Boston. He is a physicist, but he moonlights as a social scientist. With that hat on he has devised an algorithm which can look at someone’s mobile-phone records and predict with an average of 93% accuracy where that person is at any moment of any day. Given most people’s regular habits (sleep, commute, work, commute, sleep), this might not seem too hard. What is impressive is that his accuracy was never lower than 80% for any of the 50,000 people he looked at.

If you think this sounds a little far-fetched the findings have already been published – one paper in Nature Physics and the other in Science.

Yes folks, we’re all unique. Just like everyone else.

Link to The Economist on Chaoming’s network echo location work.

The Perfect Woman

The heaving busts and melodrama of a Latin American soap opera, a television industry desperate for a ratings hit, and the writer makes a woman with Asperger’s syndrome the love interest for the dashing plastic surgeon in the latest telenovela. It sounds like a recipe for disaster but it turned out to be a triumph.

The Venezuelan telenovela was called La Mujer Perfecta – The Perfect Woman. The name was a play on its plastic surgery theme, a subtle nod to the country’s obsession with surgical tweaks and a knowing satire on the fact that the heroine was unconventionally, well, perfect.

If you’ve never seen a Latin American telenovela most are like a crap version of Knots Landing that exist as the semi-official residence of ex-beauty queens. Occasionally, however, they soar into brilliance.

La Mujer Perfecta was one of those examples and it’s discussed in an English-language article by media researcher Carolina Acosta-Alzuru. Wonderfully, she writes the piece as a letter to the lead character Micaela.

Of these six women, you would be the most peculiar, Micaela. You, who had never gone under the plastic surgery knife and who had never fallen in love, would discover the symptoms of love on meeting Santiago Reverón, a famous plastic surgeon married to a diva with a body and face operated on to the point of perfection. And Santiago would fall in love with you, the strangest woman he had ever met. Among your peculiarities is that you process what you hear literally. You do not understand the nuances of spoken language, nor of body language. As such, you cannot parse metaphors, sarcasm, and jokes.

In addition, you lack social filters when speaking; hence, you never lie or sugar coat your expressions. Brilliant, with an intelligence that is above average and a photographic memory, you can speak extensively about some subjects in which you are particularly learned. At the same time, you have difficulty deciphering emotions — your own and those of others. You are methodical and attached to your routines. They are your safety net. Hence, you suffer if anything alters your habits or environment.

Your body language can confuse people: you have difficulty making eye contact and, in general, you do not like to be touched. At the beginning of La Mujer Perfecta, no one (not even you), knew the reason behind your characteristics: Asperger’s Syndrome, a condition that lies in the spectrum of autism. But Asperger’s would not impede the occurrence of your love story with Santiago. And, as you know, a central love story is the defining characteristic of telenovelas.

Imagine if you had the production values of Dallas but still managed to create a brilliantly subversive, interesting and entertaining TV show that the autism community were really proud of.

Imagine if it topped the ratings without resorting to a librarian moment where the lead character takes off her dorky clothes, flicks her hair and is suddenly ‘cured’.

Most of the series is on YouTube but even if you don’t speak Spanish, it’s worth checking out the scene where Micaela and Santiago have their first kiss. It’s incredibly touching.

Micaela says she doesn’t understand why he says ‘he feels butterflies in his stomach’. Santiago comes out with a passionate but poetic declaration of love that Micaela doesn’t get. He touches her. She asks him not to because it feels uncomfortable. He withdraws his hands.

He says he has been trying to distract himself but he constantly thinks about her and feels completely consumed by her. She asks, concerned, “is this bad?” “No”, he replies, “it’s spectacular”.

She smiles and their lips edge closer. The music surges …you seem the perfect woman for me…. They kiss, a gentle tender kiss. Butterflies are flying around them.

And the adverts come and ruin the moment.

Even the most subversive telenovela of its generation is still, after all, a telenovela.

Link to article in academic journal (via @autismcrisis)
Link to pdf of same.

Khat out of the bag

Finding myself at a loose end yesterday I decided I’d try and track down one of London’s mafrishes – a type of cafe where people from the capital’s Ethiopian, Somali and Yemeni community chew the psychoactive plant khat.

I’d heard about a Somali cafe on Lewisham Way and thought that was as good a place as any to try. The cafe owner first looked a bit baffled when I walked in and asked about khat but he sat me down, gave me tea, and went out back to ask his associates.

“Sorry, there’s no khat in Lewishman. We have internet?” he suggested while gesturing towards the empty computers at the back. I kindly declined but in reply he suggested I go to Streatham. “There are lots of restaurants there”, he assured me.

Streatham is huge, so I arrived at one of the rail stations and just decided to walk south. Slowly I became aware that there were more Somali-looking faces around but there were no cafes to be seen.

Just through chance I noticed some Somali cafes off a side street and walked into the first one I saw. “There’s none here, but next door”, I was told. The people in the next cafe said the same, as did the next, and the next, until I came to an unmarked door.

“Just go in” a cafe owner called to me from across the street, so I walked in.

The place was little dark but quite spacious. My fantasies of an East African cafe translocated to London quickly faded as my eyes adjusted to the trucker’s cafe decor. Inside, there were four guys watching the news on a wall-mounted TV.

The cafe owner greeted me as I entered. I asked my usual question about khat and he looked at me, a little puzzled.

“You know, khat, to chew?” I ventured. A furrowed brow. Thinking. “Oh, chat. Yes, we have bundles for three pounds and bundles for seven. Which do you want?”

“Give me one for seven” I said. “No problem” he replied cheerily. “Have a seat”.

This wasn’t the first time I had tried khat. Many years ago, when I was an undergraduate in the Midlands, I discovered khat in an alternative shop. It was sold as a natural curative soul lifting wonder plant from the fields of Africa.

I bought some, didn’t really know what to do with it, and just began to ‘gently chew’, as the leaflet advised, while walking through the streets of Nottingham.

So when my bundle of khat arrived, I just picked out some stems and began chomping on one end. “Wait, wait, stop!” they shouted in unison. “We’ll help you” said one and I was joined by the cafe owner and a friend. “Anyway, he said”, “you’re not allowed chew alone, it’s a social thing.”

I was given a bin to put beside my table, was shown how to strip off the stems and pick out the soft parts, and how to chew slowly. I was provided tea and water on the house and told to keep drinking fluids. Apparently, it can be a little strong on the stomach and the plant makes you go to the toilet a lot as, I was told, ‘it speeds up the body’.

I had the company of the cafe owner, a Somali Muslim, and his friend, an Ethiopian Christian.

Over the next two hours we chewed and talked. Ethiopian politics, football, living in another country, khat in Somalia, Haile Selassie, religion, languages, Mo Farah, stereotypes of Africa and family life in London.

People strolled in an out of the cafe. Some in jeans and t-shirt, others looking like they’d just walked in from the Somali desert. Everyone shook my hand. Some bought khat and left, others joined us, all the while chewing gently and drinking sweet tea. At one point I asked the Christian guy why he wore an Islamic cap. He whipped off his hat. “I’m bald” he said “and it’s the only cap you can wear inside” which sent me into fits of laughter.

Khat itself has a very tannin taste and it is exactly like you’d imagine how chewing on an indigestible bush would be. It’s bitty and it fills your mouth with green gunk. The sweet tea is there for a reason.

The effect of the khat came on gently but slowly intensified. It’s stimulating like coffee but is slightly more pleasurable. There’s no jitteriness.

It reminded me of the coca plant from South America both in its ‘mouth full of tree’ chewing experience and its persistent background stimulation. But while coca gave me caffeine-like focus that always turned into a feeling of anxiety, khat was gently euphoric.

My companions told me that it lifts the spirits and makes you talkative. They had a word, which for the life of me I can’t remember, which describes the point at which it ‘opens your mind’ to new ideas and debate.

The active ingredient in khat is cathinone which has become infamous as the basis of ‘bath salts’ legal highs which chemists have learnt to create synthetically and modify. But like coca, from which cocaine is made, the plant is not mental nitroglycerine. It has noticeable effects but they don’t dominate the psyche. It’s a lift rather than a launch.

The guys in the cafe were not unaware of its downsides though. “Don’t chew too often” they told me “it can become a habit for some”. I was also told it can have idiosyncratic effects on sexual performance. Some find it helps, others not so much.

Not everyone was there for khat. Some guys chewed regularly, some not at all, some had given up, some only on special occasions. Some just came to hang out, drink tea and watch the box.

Towards the end when I felt we had got to know each other a bit better I asked why the cafe was unmarked. The owner told me that while khat is legal they were aware of the scare stories and were worried about the backlash from less enlightened members of the community. ‘Immigrants sell foreign drug’ shifts more papers, it seems, than ‘guys chew leaves and watch football’.

Eventually, I said my goodbyes and decided I could use my buzz to go for a walk. I made London Bridge in a couple of hours. But I think my newfound energy came as much from the welcome as it did from the khat.

Link to Wikipedia entry on khat.

An online sickness

The first academic review article on ‘Munchausen by Internet‘ – where people fake the identity of an ill person online – has just been published in the Journal of Medical Internet Research.

Munchausen syndrome is a common name for facticious disorder where people consciously fake illnesses for their own gain.

This is distinguished from malingering – where the gain would be something obvious like money, drugs or missing military service – and instead the gain from factitious illness typically includes the indirect benefits of faking – like being cared for, avoiding family conflict and so on.

The person is deliberately faking but they may not be fully conscious of all the emotional benefits – they might just say ‘it feels right’ or ‘it helps me’.

Obviously, this has been a problem for millennia but there has been an increasing recognition that the phenomenon happens online. People take up the identity of someone with an illness that gives them a special place in an online community.

This could be a standard online community where their ‘illness’ becomes a point of social concern, or their pretence could allow them to participate in an online community for people with certain disorders or conditions.

The article gives lots of example and some ways of spotting Munchausen fakers that also gives an insight into their thinking:

Posts consistently duplicating material in other posts, books, or health-related websites.
Characteristics of the supposed illness emerging as caricatures.
Near-fatal bouts of illness alternating with miraculous recoveries.
Fantastical claims, contradicted by subsequent posts, or flatly disproved.
Continual dramatic events in the person’s life, especially when other group members have become the focus of attention.
Feigned blitheness about crises that will predictably attract immediate attention.
Others apparently posting on behalf of the individual having identical patterns of writing.

The piece gets quite wordy at times (well, it is an academic article) but it’s an interesting insight into a motivations of people who ‘fake sick’ on the internet.

Link to full text of article.

Hallucinations of the inner body

One of the least understood symptoms in psychosis are hallucinations called cenesthesias. These are ‘inner body’ feelings that often don’t correspond to any known or even possible bodily experiences.

A team from Japan has just published a study of patients who experience cenesthesias in the mouth. Here are a selection of the hallucinations:

“Feels like gas is blowing up in his mouth”, “feels like something is struggling, as if there is an animal in his mouth”

“Feels the presence of wires in the mandibular incisors [front teeth in the jaw] when removing dentures”

“Feels something sticky coming up rapidly in her mouth”, “feels like a membrane is covering and squeezing her incisors”

“Feels like trash is coming up behind her dentures”, “feels sliminess in her mouth”

“Feels slimy saliva”, “feels like her teeth are made of iron and is sore from chewing”

The study used a type of brain scanning called SPECT (essentially, injecting your brain with radioactive glucose, seeing where it ends up with a gamma camera) to look at the balance of activity over the two hemispheres when the patients were just resting.

They found that activity was relatively greater in the right hemisphere, which is a common, but not very reliable finding in psychosis research.

Link to locked study.

Emotions are included

New Republic has an interesting piece on how corporations enforce ’emotional labour’ in their workforce – checking that they are being sufficiently passionate about their work and caring to their customers.

It focuses on the UK sandwich chain Pret who send a mystery shopper to each outlet weekly and “If the employee who rings up the sale is appropriately ebullient, then everyone in the shop gets a bonus. If not, nobody does.”

The concept of ‘emotional labour‘ was invented by sociologist Arlie Hochschild who used it to describe how some professions require people to present as expressing certain emotions regardless of how they feel.

The idea is that the waiter who smiles and tells you to ‘have a nice day’ doesn’t really feel happy to see you and doesn’t particularly care how your day will go, but he’s asked to present as if he does anyway.

The idea has now moved on and this particular example is considered ‘surface acting’ or ‘surface emotional labour’ while ‘deep acting’ or ‘deep emotional labour’ is where the person genuinely feels the emotions. A nurse, for example, is required to be genuinely caring during his or her job.

‘Surface emotional labour’ is known to be particularly difficult when it conflicts too much with what you really feel. This ’emotional dissonance’ leads to burnout, low mood and poor job satisfaction. In contrast, ‘deep emotional labour’ is linked to higher job satisfaction.

The New Republic article links to a deleted but still archived list of ‘Pret behaviours’ written by the company to state what is expected of the employees.

Apart from some classic corporate doublethink (‘Don’t want to see: Uses jargon inappropriately; Pret perfect: Communicates upwards honestly’) you can see how the company is trying to shift their employees from doing ‘surface emotional labour’ to ‘deep emotional labour’.

For example:

Don’t want to see: Does things only for show
Want to see: Is enthusiastic
Pret perfect! Loves food

Cynics would suggest this is a form of corporate indoctrination but you could also see it as part of drive for employee well-being. You say tomato, I say “smell that Sir – wonderful isn’t it? Fresh tomatoes from the hills of Italy”.

Those of a political bent might notice an echo of Marx’s theory of alienation which suggests that capitalism necessarily turns workers into mechanistic processes that alienate them from their own humanity.

However, the concept of ‘deep emotional labour’ is really where the approach can start becoming unhelpful as it has the capacity to denigrate genuine compassion as ‘required labour’. I doubt many nurses go into their profession intending to ‘monetize their emotions’ or feel they have been ‘alienated’ from their compassion.

And as armies are loathe to admit, soldiers serve for their country but fight for their platoon mates. Is this really a form of ‘deep emotional labour’ or it is just another job where emotions are central?

Link to New Republic piece ‘Labor of Love’.

Culture of the digital playground

Anthropologist Gabriella Coleman has spent several years researching hacker culture, hanging out with coders, geeks and cypherpunks to understand the beliefs and boundaries of the community they inhabit.

If you want a flavour of what Coleman has been working on her interview in Wired is a good place to start but the best place to get the low down is in her book Coding Freedom.

You can buy it from your regular tax-avoiding online retailers but in the spirit of the culture it discusses it has been open licensed so you can download the full version online as a pdf.

Coleman is currently researching the culture of Anonymous and you can read a brilliant article by her on the revolutionary online chaos collective which has just been published in triplecanopy.

Expect more from her on this in the near future.

Link to Wired interview with Gabriella Coleman.
pdf of her book Coding Freedom.
Link to her article on Anonymous ‘Our Weirdness is Free’.

In the middle of a conflict

One of the things I quickly discovered while working for Médecins Sans Frontières in Colombia, was that while there is lots of research on people who have experienced armed conflict in the past, there was very little information on the mental health of people living in active conflict zones.

With MSF colleagues, we’ve just published a study that goes a little way to correcting that.

The majority of research on how war effects civilians is done on refugees or in post-conflict situations. Practically, this makes sense, as collecting data during an armed conflict can be both difficult and dangerous.

However, MSF in Colombia runs almost all its clinics in exactly this situation. The fact there was little research on which to base our interventions made my job a little challenging at times, but as we were also collecting systematic data on each consultation this also gave us a great deal of internal information on which to base decisions.

During my time there, we set ourselves the task of analysing and publishing some of this data to make sure others could benefit from it. This study has just appeared in the journal Conflict and Health.

The study looked at how symptoms of mental illness were related to experience of direct conflict-related violence (exposure to explosives, threats from armed groups, deaths of loved ones etc), violence not directly related to the conflict (domestic violence, child abuse etc) and what we called ‘general hardships’ – such as economic problems and poor social support.

We predicted that the more someone was exposed to violence from the armed conflict, the worse mental health they would have, but what we found was a little different.

Experience of the armed conflict was more linked to anxiety while non-conflict violence was more related to aggression and substance abuse. Depression and suicide risk, however, were represented equally across all of the categories.

This is interesting because a lot of conflict-related mental health interventions are focused on trauma and PTSD, where as our study and various others have found that trauma is only one effect of being caught up in an armed conflict.

It’s worth saying that being ‘trauma obsessed’ is really just a American and European condition – as I’ve discussed before, Latin American psychology in particular has a strong tradition of looking at problems on the community level rather than always aiming to treat the individual victims.

It’s worth saying that the study used clinical data, rather than data from a specifically designed study, so there is still a need for a systematic approach to the problem. But as study of over 6,000 patients who were seen in areas of active conflict, we hope it’s a useful contribution.

By the way, MSF’s work continues in Colombia. Everyday there are medical and mental health teams spending days, weeks or months in conflict zones to work with the local population who would otherwise have no access to healthcare. In over 60 countries around the world the organisation does something similar in very difficult conditions.

They also do lots of important research particularly into medical problems that often get neglected.

The majority of the staff are from the local country and they invest a lot into training.

Do drop them a donation if you get the chance.

Link to MSF Colombia study on the armed conflict and mental health.

Back to the old school

New York Magazine has a fantastic article on the psychological impact of high school and how it affects you through your adult life.

It’s a fascinating subject because so much of developmental psychology has focused on childhood and yet our adolescent school years are probably the most formative for our view of the social world.

Not everyone feels the sustained, melancholic presence of a high-school shadow self. There are some people who simply put in their four years, graduate, and that’s that. But for most of us adults, the adolescent years occupy a privileged place in our memories…

Yet there’s one class of professionals who seem, rather oddly, to have underrated the significance of those years, and it just happens to be the group that studies how we change over the course of our lives: developmental neuroscientists and psychologists. “I cannot emphasize enough the amount of skewing there is,” says Pat Levitt, the scientific director for the National Scientific Council on the Developing Child, “in terms of the number of studies that focus on the early years as opposed to adolescence. For years, we had almost a religious belief that all systems developed in the same way, which meant that what happened from zero to 3 really mattered, but whatever happened thereafter was merely tweaking.”

The piece is focussed on the American high school experience, with its weirdly formalised social structure – like a teenage Brave New World, but you can see the universal parallels.

Either way, it’s an excellent article that explores an oddly under stage of development. Recommended.

Link to New York Magazine on ‘Why You Truly Never Leave High School’.

Intoxicating tendencies

The latest edition of BBC Radio 4’s Thinking Allowed is a special on ‘intoxication’ looking at the uses, abuses and social function of drugs through the ages.

It’s a fascinating programme in itself but it is peppered with vivid excerpts from how drugs, altered states and drug users have been described historically and are discussed currently.

One example is this wonderfully, painfully descriptive piece from writer Kingsley Amis who brilliantly captured the hangover:

Dixon was alive again. Consciousness was upon him before he could get out of the way; not for him the slow, gracious wandering from the halls of sleep, but a summary, forcible ejection. He lay sprawled, too wicked to move, spewed up like a broken spider-crab on the tarry shingle of the morning. The light did him harm, but not as much as looking at things did; he resolved, having done it once, never to move his eye-balls again. A dusty thudding in his head made the scene before him beat like a pulse. His mouth had been used as a latrine by some small creature of the night, and then as its mausoleum. During the night, too, he’d somehow been on a cross-country run and then been expertly beaten up by secret police. He felt bad.

Oh, and Happy 2013.

Link to Thinking Allowed intoxication edition.
mp3 of podcast for same.

A depressing financial justification

One of the most controversial changes to the recently finalised DSM-5 diagnostic manual was the removal of the ‘bereavement exclusion’ from the diagnosis of depression – meaning that someone could be diagnosed as depressed even if they’ve just lost a loved on

The Washington Post has been investigating the financial ties of those on the committee and, yes, you guessed it:

Eight of 11 members of the APA committee that spearheaded the change reported financial connections to pharmaceutical companies — either receiving speaking fees, consultant pay, research grants or holding stock, according to the disclosures filed with the association. Six of the 11 panelists reported financial ties during the time that the committee met, and two more reported financial ties in the five years leading up to the committee assignment, according to APA records.

A key adviser to the committee — he wrote the scientific justification for the change — was the lead author of the 2001 study on Wellbutrin, sponsored by GlaxoWellcome, showing that its antidepressant Wellbutrin could be used to treat bereavement…

The association also appointed an oversight panel that declared that the recommendations had been free of bias, but most of the members of the “independent review panel” had previous financial ties to the industry.

Actually, it’s kind of sad that this isn’t a surprise, but perhaps more worrying is the fact that the chairman of the mood disorders panel that made the change, Jan Fawcett, doesn’t seem to understand bias.

“I don’t think these connections create any bias at all,” Fawcett said. “People can say we were biased. But it assumes we have no intelligence of our own.

Fawcett is assuming that bias means ‘dishonesty’ where people deliberately make choices for their own advantage against what they know to be a better course of action, or ‘sloppiness’ where people don’t fully think through the issue.

But bias, as you can find out from picking up any social psychology paper from the past century, is where incentives change our behaviour usually without us having insight into the presence or effect of the influencer.

This is exemplified in the work of Dan Ariely or the work that won Daniel Kahneman the Nobel Prize.

So when someone says, “I don’t think these connections create any bias” it means – ‘I’m not willing to think about the bias that these connections create’ which is a red flag that they won’t be recognised or addressed.

We’re all susceptible to them. The trick is to recognise they exist and put measures in place to account for them.

Sadly, it doesn’t look like this has happened with the DSM-5.

Link to WashPost article on the new depression diagnosis and industry ties.

A smoother flow

BBC Radio 1Xtra has just broadcast a fantastic programme about the rapper Scorzayzee who disappeared from the UK scene after, as it turned out, experiencing psychosis and being diagnosed with schizophrenia.

It’s a brilliant piece that not only tells the story of Scorzayzee but also cheekily tackles mental health in men – something which is rarely addressed in the media.

Virtually every documentary I’ve ever heard on psychosis is serious-voiced and worthy, while this is funny and engaging, with a fantastic sound-track.

One of Scorzayzee’s best known tracks is Great Britain – a brilliant angry push-back of a track that takes on everything from the economy to the Royal Family.

Apparently, Scorzayzee was paranoid when he wrote it but charmingly, in the programme, the BBC include a brief warning before playing it saying words to the effect of ‘please bear in mind that when Scorzayzee compared the Queen to Saddam Hussein, he was suffering the effects of psychosis’.

Thanks BBC.

You’ll be please to hear that Scorzayzee is now doing fine and makes a brilliant storyteller.

Oddly though, the piece is only online for seven days, so catch it while you can.

Recommended.

Link to ‘Scorzayzee and the S-Word’.

Relax ladies, I’m a scientist

A while ago I wrote a column in The Psychologist on why psychologists don’t do participant observation research – a type of data gathering where you immerse yourself in the activities of those you want to study.

In response, psychologist James Hartley wrote in and mentioned a remarkable study from 1938 where researchers hid under the beds of students to record their conversations.

The study was published in the Journal of Social Psychology and was titled “Egocentricity in Adult Conversation” and aimed to record natural conversations untainted by researcher-induced self-consciousness.

In order not to introduce artifacts into the conversations, the investigators took special precautions to keep the subjects ignorant of the fact that their remarks were being recorded. To this end they concealed themselves under beds in students’ rooms where tea parties were being held, eavesdropped in dormitory smoking-rooms and dormitory wash-rooms, and listened to telephone conversations.

Remarks were collected in waiting-rooms and hotel lobbies, street-cars, theatres and restaurants. Unwitting subjects were pursued in the streets, in department stores, and in the home. In each case a verbatim record of the remarks was made on the spot. Since the study is concerned with conversations, other sorts of talk, such as games and sales talk, were excluded.

The point of the study was to critique earlier research that had suggested that children tend to engage in lots of ‘ego-related’ self-referencing or self-centred talk which they later grow out of.

The researchers in this study found that college students seem to do so at about an equal level, suggesting that this style of communication may not change as we get older.

The researchers mention they did most of their data collection in a women’s college.

This was presumably in the day where “relax ladies, I’m a scientist” was sufficient to keep you out of jail.

Link to locked 1938 study.