Mind Hacks

Monday morning is not the best time to be told to ‘bridge the quality chasm’ and ‘identify your value stream’. I was having the misfortune of starting my week with a talk that introduced new health-service management ideas based on psychological sounding ideas such as ‘lean thinking’ and ‘connected leadership’.

Now, I’ve got no problem with things sounding like bullshit, as long as they work. After all, medicine is one of the few places where you can get away with calling the practice of squirting cold water in the ear ‘vestibular caloric stimulation’.

No-one minds that much, because it’s been very well researched and is known to have a profound, albeit temporary, effect on a number of neurological conditions.

So if I wanted to find out whether any of these new management techniques made an organisation more efficient, the first thing I’d do is find out what the research says.

In health and medicine, the ‘gold standard’ for finding our whether an intervention has an effect is the randomised controlled trial or RCT.

It’s a simple but powerful idea. You get a group of people you want to study. You measure them at the beginning. You randomly assign them to two groups. One gets the intervention, the other doesn’t. You measure them at the end. If your intervention has worked, one group should be different when compared to the others.

Of course, it gets a bit more complex in places. Making the comparison fair and deciding what should be measured can be tricky, but it’s still a useful tool.

After my traumatic Monday morning experience I went to see what randomized controlled trials had been done on management techniques.

To my surprise, I found none. Not a single RCT in any of the business psychology literature.

Now, this may be because I know little about organisational psychology, and literature searches are as much about knowing the key words as knowing what you want. So maybe RCTs are called something completely different, or I’m just looking in the wrong places.

So, if you know of any RCTs done on leadership and management techniques, please let me know, I’d be fascinated to find out.

I could completely wrong, but if I’m not, I want to know why are there no randomised-controlled trials in organisational psychology?

And as a corollary, are we spending millions on organisational interventions to supposedly help patients that have been tested no further than the pseudoscience we reject for every other area of medicine?

UPDATE: Some interesting comments from organisational psychologist Stefan Shipman:

It may be that the complexity lies in that organizational research is always secondary to doing business. I can remember in some of my early research that I attempted to implement a new human resources program in one department. The program was successful in its early stages and was (despite my suggestions) implemented company wide.

I think your post absolutely speaks to the frustration of all organizational psychologists because the zeal of organizations to find “new” ways of doing business that are hopefully more effective. This zeal often reduces the “completeness” of research. As organizational psychologists we accept the conditions under which real world research can be done. We encourage the assignment of conditions but accept that some ideas or programs might “leak” into other parts of the organization.

Hysteria, or conversion disorder as it is now known, is when neurological symptoms such as blindness or paralysis are present but no neurological problems or brain abnormalities can be found.

The issue of whether such patients are ‘faking’, whether the neurological abnormality just hasn’t been found yet, or whether the problem is best understood in psychological terms, has been vexing clinicians for the best part of 200 years.

This is a fascinating quote from the introduction to Contemporary Approaches to Study of Hysteria (ISBN 019263254X) by Halligan, Bass and Marshall:

…how can we discover if someone is indeed faking it? (We use ordinary language here rather than the more obviously psychiatric terms such as factitious disorder and malingering: clarity and logic are best served by calling a spade a spade.) The simple but totally impractical solution would be 24-hour surveillance on audio- and video-tape unbeknownst to the patient. Anyone who behaved perfectly normally when alone but who invariably developed the ‘disability’ when in company might be plausibly thought to be feigning.

Short of this Big Brother solution, investigators have tried to devise catch-trials and catch-tests to detect the cheater. For example, it is sometimes assumed that a patient who ‘guesses’ a randomized stimulus sequence (touch, touch, no touch…) significantly below chance must be faking it.

But the existence of such phenomena such as blindsight, unfeeling touch, unconscious perception in visual-spatial neglect and priming in amnesia show how misleading it can be to assume that odd relationships between behaviour and verbal report necessarily constitute evidence of cheating.

We do not impinge on the honesty of patients who perform visual discriminations at above chance level while claiming to have seen nothing. Why should we perforce distrust those who score below chance? In short, the detection of lying in the neurology clinic is at least as difficult as it is in a court of law.

Link to book details.
Link to previous Mind Hacks article on hysteria.
Link to great NYT article on hysteria.

The New York Times discusses an upcoming study that has found that Freud and psychoanalysis form a key part of the teaching in the humanities, while being virtually extinct in psychology departments in the same universities.

As some of the psychologists in the article suggest, many of the problems with psychoanalysis are because those who believe in the theories have been reluctant to submit the ideas to rigorous empirical testing.

Where this has been done, the results have been fascinating. As we reported in June, empirical work has supported some of Freud’s ideas on transference (how feelings from one relationship can affect another if the two people share similarities).

Moreover, an upcoming London conference aims to get the hard nosed cognitive and neuroscientists talking to the psychoanalysts to thrash out ways of separating the wheat from the chaff and to inspire research with new ideas.

These are largely the exceptions, however, and more often than not, psychoanalysis has continued developing its ideas without much recourse to outside testing.

Psychology now runs on the mantra of ‘evidence-based practice’, which has meant the science-flimsy Freudian ideas have been largely rejected.

However, subjects like film, literature and history have no such restrictions and have found psychoanalysis a useful discussion point.

Interestingly, there are some moves to introduce cultural analysis based on cognitive science into these subjects.

Buckland’s book The Film Spectator: From Sign to Mind (ISBN 9053561315) investigates whether its possible to understand how we interpret film using cognitive linguistics and the science of perception.

Link to NYT article ‘Freud Is Widely Taught at Universities, Except in the Psychology Department’.