Mind Hacks

Where Are We Now? – David Bowie and Psychosis

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Spike activity 08-01-2016

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

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

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

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

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

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

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

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

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

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

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

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

How to formulate a good resolution

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

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

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

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

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

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

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

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

A battle of wills

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

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

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

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

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

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

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

Good luck for your 2016 resolutions!

Psychotherapies and the space between us

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

An inner beauty of neurosurgery

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

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

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

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

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

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

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

Cognitive Sciences Stack Exchange

Cognitive Sciences Stack Exchange is a question and answer forum for Cognitive Science. The Stack Exchange model works well for computer programming and now cogsci.stackexchange.com is one of the 150+ sites in their family, which includes topics as diverse as academia, mythology and pets.

There’s a dedicated community of people answering questions and voting on answers, producing a great resource patterned around the questions people have on Cognitive Science topics. Three examples:

So head over, if you have questions, or if you can lend an evidence-based, citation-supported, hand in working on answers:

Link: Cognitive Sciences Stack Exchange

The underground smart drug amendment

Last week, some amendments were quietly slipped into the disastrous Psychoactive Substances Bill that’s currently going through parliament. Surprisingly, a new list of permitted substances has been added. Almost all are poorly evidenced substances used informally as ‘smart drugs’.

The bill is an embarrassingly bad piece of legislation that aims to ban all psychoactive substances by relying on the scientific impossibility of adequately defining ‘psychoactive’. It allows for a ‘whitelist’ of approved drugs which until last week, only included alcohol, nicotine and caffeine.

On December 15th, an amendment was added that greatly increases that list. It now includes:

Racetams
Pramiracetam, Oxiracetam, N-phenylacetyl-L-prolylglycine ethyl ester, Phenylpiracetam, Nefiracetam

Cholinergics
L-Alpha glycerylphosphorylcholine, Citicoline, Meclofenoxate

Miscellaneous
L-Theanine, Oxitriptan, Tongkat Ali, Resveratol, Trans-resveratol, Sulbutiamine

The list is followed by a note which says:

The substances in this amendment are commonly used to improve individuals’ cognitive performance and have been found to have positive effects in a number of academic studies.

The list almost entirely consists of drugs that are widely used by smart drug or nootropics enthusiasts. But to imply that there is good evidence that they have ‘positive effects’ on cognition is entirely misleading.

While some studies have claimed these effects we simply do not have the quality of evidence needed to demonstrate this. Most of the studies that have shown benefits are small and poorly designed.

We know that some of the substances are likely to be low risk in small doses. Oxitriptan, for example, is better known as 5-HTP and is a precursor to the neurotransmitter serotonin and is present in, among other things, bananas. Sulbutiamine is essentially a slightly tweaked version of vitamin B₁.

But several of the others are actually quite poorly researched in terms of safety. Typically, few side-effects were reported in the not-very-good-quality studies, but we really know very little about their long-term effects.

What is most striking about this sudden addition to the bill is how odd it is. Suddenly, a list of poorly tested and little understood drugs have been exempted from a ban if the bill becomes law.

The backers of the bill claim that it is needed to protect us from an influx of new poorly tested substances from grey market labs, and then have just exempted a bunch of them based on poorly evidenced claim that they improve cognition.

It’s like someone read the pop-up banner ads for a dodgy internet ‘smart drug’ store and decided to change the proposed law as a result.

The Psychoactive Substances Bill has gone from bizarre to baffling.

Link to December 15th bill amendments (via @JonBuchan)

The Peer Reviewers’ Openness Initiative

“The Peer Reviewers’ Openness Initiative” is a grassroots attempt to promote open science by organising academics’ work as reviewers. All academics spend countless hours on peer review, a task which is unpaid, often pretty thankless, and yet employs their unique and hard-won skills as scholars. We do this, despite misgivings about the current state of scholarly publishing, because we know that good science depends on review and criticism.

Often this work is hampered because papers don’t disclose the data upon which the conclusions were drawn, or even share the materials used in the experiments. When journal articles only appeared in print and space was limited this was excusable. It no longer is.

The Peer Reviewers’ Openness Initiative is a pledge scholars can take, saying that they will not recommend for publication any article which does not make the data, materials and analysis code publicly available. You can read the exact details of the initiative here and you can sign it here.

The good of society, and for the good of science, everybody should be able to benefit from, and criticise, in all details, scientific work. Good science is open science.

Link: The Peer Reviewers’ Openness Initiative

Spike activity 18-12-2015

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

12% of women have eyes with four colour-detecting cone cells instead of three. Why don’t they all have superhuman colour vision? Fascinating piece from great new blog Neurosphere.

The BMJ has a genuine but wonderfully sarcastic fMRI study on a Christmas spirit network in the brain. “Further research is necessary to understand this and other potential holiday circuits in the brain”

In a mass of tissue as densely packed and hard-working as the brain, even the holes among the structural elements have jobs to do. Good piece from American Scientist.

The Maudsley Psychedelic Society launched this week with an inaugural lecture by Professor David Nutt. Visuals are suitably blurry in places but great talk.

Trying to simulate the human brain is a waste of time and energy. Critical piece in Aeon.

The Atlantic has an excellent piece on the emotional impact of working with traumatised patients if you’re a therapist. Ignore the daft headline on ‘PTSD being contagious’.

Good piece in MIT Tech Review. Can This Man Make AI More Human? One cognitive scientist thinks the leading approach to machine learning can be improved by ideas gleaned from studying children.

The Lancet has an excellent piece on hallucinated voices, identity, and meaning-making.

A Brief History of New York City’s Heroin Scene. Excellent Vice article from someone who was there.

Neurocritic covers ‘This Week in Neuroblunders: fMRI Edition’.

Why human sleep is an evolutionary anomaly. Fascinating piece in The New York Times.

Alzheimer’s from the inside

There’s an excellent short-film, featuring journalist Greg O’Brien, who describes the experience of Alzheimer’s disease as it affects him.

It’s both moving and brilliantly made, skilfully combining the neuroscience of Alzheimer’s with the raw experience of experiencing dementia.

I found it in this Nautilus article, also by O’Brien, who has taken the rare step of writing a book about the experience of Alzheimer’s disease before it affected his ability to write.

Link to short film Inside Alzheimer’s on vimeo.
Link to Nautilus article.

Drug control through fantasy neuroscience

I’ve got an article in today’s Observer about the disastrous Psychoactive Substances Bill, a proposed law designed to outlaw all psychoactive substances based on a fantasy land version of neuroscience.

“The bottom line is, the only way of knowing whether a mystery substance alters the mind is to take it. You simply can’t tell by chemical tests, because there is no direct mapping between molecular structure and mental experience. If you could solve the problem of working out whether a substance would affect the conscious mind purely from its chemistry, you would have done Nobel prize winning work on the the problem of consciousness. A second-rank approach is just to see whether a new substance is similar to a known family of mind-altering drugs, but even here there are no guarantees. A slight tweak can make a similar drug completely inactive and about as much fun as Theresa May at a techno night.”

Although I talk about the scientific problems of the Psychoactive Substances Bill, the whole process has been a farce.

From the minister in charge clearly not understanding his own legislation to the Government having to reassure churches that incense won’t be banned.

It’s been criticised from everyone from the Royal Society of Chemistry to traditional Tory supporters stalwarts like The Spectator.

The Medical Research Council have expressed concerns that it could “inhibit worthwhile research and/or potential new therapeutics”.

Just as the rest of the world is turning away from the failed ‘war on drugs’ approach to drug legislation, the UK has decided to make up its own scientific impossibilities to support it.

Normally, scientific impossibilities would be the death knell for proposed regulation but for drugs laws I have long since stopped believing that scientific incompetence was any barrier to enacting legislation.

Link to article ‘Theresa May’s futile war on psychoactive drugs’

5 classic studies of learning

I have a piece in the Guardian, ‘The science of learning: five classic studies‘. Here’s the intro:

A few classic studies help to define the way we think about the science of learning. A classic study isn’t classic just because it uncovered a new fact, but because it neatly demonstrates a profound truth about how we learn – often at the same time showing up our unjustified assumptions about how our minds work.

My picks for five classics of learning were:

Bartlett’s “War of the Ghosts”
Skinner’s operant conditioning
work on dissociable memory systems by Larry Squire and colleagues
de Groot’s studies of expertise in chess grandmasters, and ….
Anders Ericcson’s work on deliberate practice (of ‘ten thousands hours’ fame)

Obviously, that’s just my choice (and you can read my reasons in the article). Did I choose right? Or is there a classic study of learning I missed? Answers in the comments.

Link: ‘The science of learning: five classic studies‘

A temporary blindness during a wrongful conviction

I’m just reading Clinical Psychology in Britain: Historical Perspectives which is a wonderful book if you are a clinical psychologist but probably about as exciting to non-clinical psychologists as you might expect. However, it does contain a few gems of wider interest.

This is a remarkable story from the chapter on the history of forensic clinical psychology which concerns the case of Barry George during the original trial that wrongfully convicted him for the murder of television journalist Jill Dando.

On 26 April 1999, Jill Dando, the presenter of BBC programme Crimewatch, was shot dead outside her home in Fulham, London. On 2 July 2001 Barry George, who lived nearby, was convicted of her murder. Prior to the trial, three defence experts, Gisli Gudjonsson, Susan Young and Michael Kopelman, had reported that Mr George’s fitness to stand trial was contingent on his receiving clinical psychological support in court throughout the trial, which lasted from 23 April to 2 July 2001.

Mr George had a complex presentation, including a long history of primary generalised epilepsy (first identified at age two or three), severely abnormal EEG, intellectual deterioration, significant cognitive and executive deficits, rigid and obsessive personality structure, hypochondriacal preoccupations, and an extreme reaction to stress in the form of anxiety and panic attacks, which increased the frequency of absence epileptic seizures. The court appointed Susan Young, a forensic clinical psychologist, who initially sat in the dock with Mr George and provided him with the required assistance. On 26 April 2001, on the fourth day of the legal arguments and prior to swearing in the jury, Mr George turned to Susan Young and declared, ‘I can’t see’. Prior to this Mr George had been observed having difficulties concentrating on the legal arguments and he claimed to be experiencing petit mal epileptic seizures in the dock.

The trial before the jury was due to commence on 2 May, but the court determined that the trial could only proceed if Mr George’s eyesight could be restored. On the morning of 1 May, all three defence experts were asked to meet Mr George and try to restore his eyesight by 2pm (when the court commenced that day). Michael Kopelman conducted a medical examination and informed Mr George that there was no physical explanation for his blindness. All attempts to persuade Mr George that it was in his interest to to regain his eyesight proved fruitless; he simply kept saying ‘I can’t see’.

At 12.30pm Gisli Gudjonnson, who was trained in hypnosis techniques, suggested that hypnosis might prove successful in bringing back his sight. Mr George agreed to this approach. After an initial induction to the process, Mr George was asked to imagine that he was being taken through a tunnel, accompanied by suggestions that his eyesight would gradually return during the journey and improve further during the lunchbreak (i.e. posthypnotic suggestion). After being brought out of the hypnosis, Mr George said he could see but his eyesight was blurred. He was reassured that it would continue to improve and by 2.00pm his eyesight had fully recovered and after the final legal arguments that afternoon, the trial commenced before a jury.

The defence experts construed Mr George’s blindness as being psychogenic in origin caused by the inability to cope with the stress generated by the legal arguments (i.e. putting a physical barrier between himself and the court), which was unlocked by the process of hypnosis. This was not the first time Mr George had presented with psychogenic symptoms as he had presented with a functional aphonia (i.e. nonorganic loss of speech) following a stressful environmental event in 1994. Psychogenic blindness and psychogenic aphonia are both a form of ‘conversion disorder’ and are often caused by stress that manifests itself as physical symptoms.

Gisli Gudjonnson was originally a policeman in his native Iceland but became interested in the psychological aspects of the crimes he was investigating, moved to the UK to study psychology, and has been massively influential in the development of forensic psychology.

He has been involved in some of the most high profile cases in the country and, TV producers, is the likely subject of your next Nordic detective drama.

Link to details of Clinical Psychology in Britain: Historical Perspectives.

Spike activity 04-12-2015

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

Sleep Paralysis’ Demons: Influenced by Culture and Fed by Our Fears. Interesting piece at Brain Decoder.

The Telegraph has an excellent piece on artist Alice Evans, her work and her experience of schizophrenia.

What we can learn about the latest epidemic of opioid drug abuse from the opium wave of 100 years ago. Good piece in the New England Journal of Medicine.

Aeon has a good piece on the possibilities of stem cell therapy for fixing neurodegeneration in dementia.

Beard-envy, Freud and the gentleman’s excuse-me. Amusing look at facial furniture by neuroscientist Sophie Scott in Standard Issue.

Neuroskeptic has a fascinating piece on whether bilingual people have a cognitive advantage.

Felton et al. ranked the relative hotness quotients of professors in 36 different fields. The Monkey Cage has the data.

The New Yorker has a typically brilliant piece from Rachel Aviv on war, refugees and mental health. One of the best writers on mental health anywhere.

Was the counterculture’s favourite psychiatrist a dangerous renegade or a true visionary? The Independent has an extended piece on R.D. Laing.

TechCrunch has an excellent piece on decision science – an increasingly important area in cognitive science.

Neuroimaging in 20 minutes

Neuroscientist Matt Wall did a fascinating talk on all things neuroimaging at a recent TEDx Vienna event. It’s a gently funny, engrossing talk that both introduces brain imaging and discuss some of the cutting-edge developments.

He particularly talks about some of the recent fMRI ‘mind reading’ studies – which are more complex, limited, and interesting than many people assume.

Recommended

Link to Matt Wall’s TEDx Vienna talk on neuroimaging.

Why do we forget names?

A reader, Dan, asks “Why do we forget people’s names when we first meet them? I can remember all kinds of other details about a person but completely forget their name. Even after a lengthy, in-depth conversation. It’s really embarrassing.”

Fortunately the answer involves learning something fundamental about the nature of memory. It also provides a solution that can help you to avoid the embarrassing social situation of having spoken to someone for an hour, only to have forgotten their name.

To know why this happens you have to recognise that our memories aren’t a simple filing system, with separate folders for each kind of information and a really brightly coloured folder labelled “Names”.

Rather, our minds are associative. They are built out of patterns of interconnected information. This is why we daydream: you notice that the book you’re reading was printed in Paris, and that Paris is home to the Eiffel Tower, that your cousin Mary visited last summer, and Mary loves pistachio ice-cream. Say, I wonder if she ate a pistachio ice cream while up the Tower? It goes on and on like that, each item connected to every other, not by logic but by coincidence of time, place, how you learnt the information and what it means.

The same associative network means you can guess a question from the answer. Answer: “Eiffel Tower?” Question: “Paris’s most famous landmark.” This makes memory useful, because you can often go as easily from the content to the label as vice versa: “what is in the top drawer?” isn’t a very interesting question, but it becomes so when you want the answer “where are my keys?”.

So memory is built like this on purpose, and now we can see the reason why we forget names. Our memories are amazing, but they respond to how many associations we make with new information, not with how badly we want to remember it.

When you meet someone for the first time you learn their name, but for your memory it is probably an arbitrary piece of information unconnected to anything else you know, and unconnected to all the other things you later learn about them. After your conversation, in which you probably learn about their job, and their hobbies, and their family or whatever, all this information becomes linked in your memory. Imagine you are talking to a guy with a blue shirt who likes fishing and works selling cars, but would rather give it up to sell fishing gear. Now if you can remember one bit of information (“sell cars”) you can follow the chain to the others (“sells cars but wants to give it up”, “wants to give it up to sell fishing gear”, “loves fishing” and so on). The trouble is that your new friend’s name doesn’t get a look in because it is simply a piece of arbitrary information you didn’t connect to anything else about the conversation.

Fortunately, there are ways to strengthen those links so it does become entrenched with the other memories. Here’s how to remember the name, using some basic principles of memory.

First, you should repeat any name said to you. Practice is one of the golden rules of learning: more practice makes stronger memories. In addition, when you use someone’s name you are linking it to yourself, in the physical act of saying it, but also to the current topic of the conversation in your memory (“So, James, just what is it about fishing that makes you love it so much?”).

Second, you should try to link the name you have just learnt to something you already know. It doesn’t matter if the link is completely silly, it is just important that you find some connection to help the name stick in memory. For example, maybe the guy is called James, and your high school buddy was called James, and although this guy is wearing a blue shirt, high school James only ever wore black, so he’d never wear blue. It’s a silly made up association, but it can help you remember.

Finally, you need to try to link their name to something else about them. If it was me I’d grab the first thing to come to mind to bridge between the name and something I’ve learnt about them. For example, James is a sort of biblical name, you get the King James bible after all, and James begins with J, just like Jonah in the bible who was swallowed by the whale, and this James likes fishing, but I bet he prefers catching them to being caught by them.

It doesn’t matter if the links you make are outlandish or weird. You don’t have to tell anyone. In fact, probably it is best if you don’t tell anyone, especially your new friend! But the links will help create a web of association in your memory, and that web will stop their name falling out of your mind when it is time to introduce them to someone else.

And if you’re sceptical, try this quick test. I’ve mentioned three names during this article. I bet you can remember James, who isn’t Jonah. And probably you can remember cousin Mary (or at least what kind of ice cream she likes). But you can you remember the name of the reader who asked the question? That’s the only one I introduced without elaborating some connections around the name, and that’s why I’ll bet it is the only one you’ve forgotten.

This is my BBC Future column from last week. The original is here