According to Collins English Dictionary, the main meaning of the word "confused" is:
confused [kənˈfjuːzd] adjThat sounds about right. But hang on. Isn't there something odd about this: "feeling or exhibiting an inability to understand..."?1. feeling or exhibiting an inability to understand; bewildered; perplexed
Those are two completely different things. Sometimes people exhibit a lack of understanding and don't feel it - they think they understand, but actually they don't. Indeed, that's the worst kind of confusion, because it leads to people making mistakes based on wrong assumptions. Whereas feeling confused is much less of a problem. If you know you're confused, you won't go around acting as if you're not.
The feeling of confusion happens when you've just avoided being confused, or just come out of it. Confusion is a feeling, and also, a status, and the two are not just separate but (to some extent) mutually exclusive. If you feel confused, you can't actually be seriously confused.
Yet we use the same word for both, and the dictionary treats them both as being not just the same but part of the same definition. Confusing.
Or take being drunk. "Drunk" is a feeling, certainly. It's also a state, and they only sometimes go together. You can be drunker than you feel, with hilarious or tragic consequences. Everyone knows that you can't trust a drunken person to know how drunk they are.
Consider "depression". Depression is a feeling. No question about that. We've all felt at least a little depressed. Depression is also a state, that certain people go into as a result of mental illness, physical illness or as a side effect of certain drugs.
But the state of depression is no more equivalent to the feeling of depression than being confused means feeling confused. In my experience of depression, feeling depressed is a sign that I'm only slightly depressed. When I'm really depressed, I don't think I'm depressed at all.
This is one of the most insidious things about depression: it 'creeps up on you'. Over a period of time - usually several days, in my case, but it can be much longer or shorter - your mind changes.
You stop noticing opportunities, and become obsessed with risks. Your ability to take decisions and come up with ideas withers and your imagination fails you. Your thoughts get stuck in loops. You feel weary doing the things you used to enjoy and angry around people you used to like.
In other words, your mind changes. Your memory, thinking and perceptions are all altered - but you don't notice that. You notice the effects, of course, but you think they're outside: you think the world has suddenly become less friendly. A classic case of confusion, in the worst sense.
24 comments:
Bleh. This wasn't very advanced or useful at all. Probably only interesting to those who are absolutely clueless in psychological thinking.
Damn the bloggers who advertise their friends' blogs regardless of content.
I'm off to other websites now. No use in bashing me now, NS fans.
About 6.7 billion people don't read my blog so you are in good company Anonymous.
Anonymous, thank you for providing us with such useless information. I bet you had a big urge to write a comment....
Very nice blog post! It is important for people to understand that the use of superficial subjective self-awareness and confidence level to assess understanding is potentially dangerous. The policy leaders and politicians really need to take this into consideration.
My initial "descent" into depression was overnight, fueled by illegal drug use...tranquilizers. I was 17 and it lasted about 6 months. (Which is interesting, they say the onset of schizophrenia is hastened by cannabis use.) Later, in my 20's, I would feel it coming on and avoid it at times. By my 30's it had arrived and taken up residence. I attempted to use pharmaceuticals in my 40's, and found the right one in my 50's.
My mind DID change...It's wonderful to know what it feels like to not be overwhelmed by feelings of dis-ease with life. I hope I am on track for happiness in my golden years.
In my deepest depression, others saw it much more than I did.
You notice the effects, of course, but you think they're outside: you think the world has suddenly become less friendly.
Very wise. Very, very wise. I prefer wisdom to intelligence, wisdom fuels understanding, so much deeper than knowledge. I'll try to internalize this when things feel overwhelming...that it is, somewhat, an illusion. I wonder if it will make a difference?
Anon @ 14:27 only likes his/her own opinion, and probably reposts the same comment everywhere.
If appreciation for the author's post makes me "absolutely clueless in psychological thinking", I will accept that complement gracefully.
As always, if you can't baffle them with b.s., confuse them with the facts. kudos, Neuroskeptic!
reneabarry@msn.com
This is actually a subject that I've been thinking about for a while, and one that I've been having a hard time getting my head around. Maybe you can help me.
I would agree that people can have subjective, internal states and not realize that they're having them, or at least that they're having them to the extent that they are (ex. I didn't know I was that depressed).
But at the same time, we normally accept that people are the most informed about their own experience. If somebody stubbed their toe, and said that it hurt, and I tried to correct them, I would catch a lot of flack for it. And rightfully so. Because the assumption is that individuals know their internal states better than anyone else.
I'm not sure how to put that in the form of a question. But basically I'm having a hard time reconciling those two ideas. Do you have any thoughts on that?
I think in some ways what is even more insidious is when you finally recognize that you have "suddenly" become depressed. Because at that point, it is very easy to feel too helpless to do anything about it.
As for confusion, I'd like to think that I am usually fortunate enough to recognize this state of mind when it is upon me. Although, I might just be confused about the distinction between feeling confused and being confused, as it seems like a very fine one.
--
Anonymous, I kind of feel sorry that you are only interested in blogs that feature "advanced psychological thinking". Whatever that is, I'm sure its offered in a course at the local university.
Peter: It's a good question. There's a big philosophical literature on this topic and I don't really know it.
However my feeling is that while people have privileged access to the "raw" internal states, they don't have privileged knowledge of what those states are.
They get the states but they don't come with built-in labels saying "This Is Pain" or "This Is Anger".
We learn to label states as we grow up.
With physical pain it's fairly easy to label it. So if someone says they are in physical pain I would say you can take that as given.
But with other states labelling them (i.e. interpreting them) can be tricky. So taking drunkenness, someone who is very drunk may claim to be sober; presumably they do feel very drunk - in the sense that they feel whatever you feel when you're very drunk, which might mean euphoric, confident, whatever - but they don't realize that that feeling is being-very-drunk. They think it's just a normal emotion.
wtf? i'm confused.
Andreea,pseudonymoniae and their kindred spirits
Shame on every one of you.
You uncompassionate idiots.
Anonymous is a sufferer: for some reasons unknown to a poor psychiatrist - I am not a psychic- reading very a well written, honest, coragious and food for think post made him suffer to the point of making himself try to hurt neuroskeptic.
I hope that other readers of that excellent blog, especially this post understand know why so many bright professors of so called neuroscience have a much more confortable work when they don't think about the usefullness of their work on the clinical field.
I must confess that myself had to use all my mind over mood techniques to repress myself from writing silly when neuroskeptic -and friends- made me suffer when he attacked thoughtlessly homeopathy just with science. i used homeopthy with great success and of course I would like to know for sure if it is only the most sophisticated placebos because so many people believe in his efficacy like antidepressants from big pharma is often with more side effect than placebos.
Luckilly the man who tries to make neuroimagery researchers not cleaning too many flies at the writing stage made me laugh.
Sorry for my poor English and lack of concision but as Pascal - a scientist who like neuroskeptic and unlike Anonymous dare to think about human suffering also- excused himself to a friend: I wrote this long due to a lack of time for making it shorter.
It applies also for my bad English spealing.
By the way, the French egomaniac who wrote to your post that he was ashamed of the Nobel prize laureat who thought and demonstrate that HIV was due to a virus should be put on treatment and homeopathy won't be strong enough.I advise brain transplantation.
mind you that I am ashamed as an MD that a portugese surgeon obtained the Nobel prize for the lobotomy treatment of the mentally ill.
Ivana FULLI declare a conflict of interest: GM bought her lunch in a good restaurant in 2009 to discuss homeopthy research in the good compagny of an ingeneer from one of French top school.
Peter
You feel pain with your brain
wiring of course and chemicals impregnation but also with your mood.
It is still possible for an honest observer to contest the suffering intensity proclaimed by - lets say an Italian soccer player during a match after an opponent had make him fall.
What makes Neuroscientist courageous post fascinating for me is that it not only poses the problem about wrong self diagnostic of a mental state like being drunk or depression but NS dare to use a wondereful instrument of knoledge, the dictionary, to make clear the difference between the observer and the sufferer.
I would like to make a point there: it is not only the sufferer who can evaluate wrongly the mental state of a person and a white coat brainwashed by big pharma can be very dangerous.
An aspie told me once with the fixed gaze aspies often have when they look in your eyes instead of refusing to met your gaze-that the surgeons at a reputable Parisian academic hospital had told him that they had never see a case like his in France because came on his own legs to the hospital for an emergency like an Afgan warrior or a poor African walking without crunches on a broken leg to the medical facilities available sometimes for miles.
The guy was lucky to have been met by surgeons who found him quite rational apart not suffering like he should have, being a French man with that pathology. Surgeons are very knowledgeable people and bright people.
If my pro bono client had met with a French psychiatrist before being taken into the good care of the surgeons he would have probably been labelled delusional (for some reasons of theirs almost every french psychiatrist do not believe in autism with high enough IQ in adults.)and put on a regiumen of antipsychotic medication.
Hmm...feeling confused, feeling drunk, feeling depressed, feeling like an jerk. Exhibiting jerkiness. NOT TEH SAME...
It works on so many levels.
Sorry. Comments needed a bit o' levity.
Dis-ease and depth seem to go together. What a blessing, eh? I wonder why that is?
To paraphrase TS Eliot:
Between the feeling
And the exhibition
Between the sign
And the symptom
Between the subject
And the object
Falls the Shadow
I would be grateful to Neuroskeptic if he would publish that to extract myself of possible misinterpretations of a sentence of mine in my 29/08/11 comment.
I want to make clear that I was writing about the surgeons at a Paris academic hospital who treated my pro bono client and I have no notion that any of them could have been British.
I was not thinking of any former British surgeon and researcher when I wrote that surgeons are very knowledgeable people and very bright.
I intended to be sarcastic against the French adult psychiatrists as a specie for ignoring as a group how to make a first diagnostic of high level autism in an adult when I praised the surgeons who were able not to be frightened by an aspie who happens - in his case and some aspies don’t – to possess a different sensitivity to pain that your usual Frenchman.
I praised them for remembering that the army surgeons and the surgeons without borders had reported not infrequently of clients walking for hours on a broken leg without crunches to reach the closest medical facility for several miles sometimes instead of calling the shrink on duty before accepting to come closer than a few meters distance from my patient unless his life would be immediately at stake.
And to add a belt to suspenders as the French old saying goes, I want to make clear that I don’t think that the vaccination of any child can cause his autism traits because the mutated genes inherited from grand-parents or the do novo mutations appear before the vaccination calendar of a child.
ivana: Sorry, your comments got caught in a filter (because the filter doesn't work) but I've restored them now.
Peter: I had another think about privileged access to our own emotional states. Maybe a good analogy is that each of us has access to a box. Only we can look into the box and see what's in it at any time. But we may not recognize the object (emotional state) in the box. And we might mis-label it. If I had a private box and someone put, say, an apple into, I'd be able to recognize it as an apple; but only because I've learned what an apple looks like. If I'd never learned about apples I wouldn't know how to describe it - or I might mistake it for something else, like a pear, that I had encountered.
However someone else could help me. Even though they can't see into the box, I could describe the apple ("it's about the size of a tennis ball, green with red patches, little stem on top...") to someone who did know what that was.
So while I may be the only one with direct access to my emotional states, that doesn't mean I "know best" what they represent.
This post and discussion concern the mental status issue of insight. NS correctly notes that a confused person cannot at the same time possess insight – ever observed someone in a delirium? In the domain of mood disorders, complete or partial loss of insight is a hallmark of the manic episode, certainly once it gets a head of steam up.
On the depression side the same thing can occur, as NS described. As a matter of fact, Max Hamilton included loss of insight as one of the 17 items in his original scale for rating the severity of depression. Leaving aside psychotic features, Max described loss of insight as failure of the patient to recognize that s/he had a nervous illness; attribution of symptoms to virus or overwork or climate or to physical concerns. Presentation in general practice settings with physical complaints is well known and sometimes goes by the term masked depression.
Anon@14:27 made a point unintentionally. (Perhaps because his own thinking isn't especially well advanced? ;-) I'll go out on a limb and make some unsubstantiated guesses: The vast majority of depression sufferers have no psychological training (past perhaps what they've gleaned from the internet), so, like the general population who are unsophisticated in the scientific method, etc., these people need Really Smart People relaying Really Important Points in ways (often analogies) that they can understand.
If all of us "real" scientists did our part educating The Masses we'd have better debates on everything from climate change to drug trial results. And perhaps we'd help a couple of folks along the way, too. NS, you probably did more for a larger number of people with your post than hundreds of "serious" articles could ever do. All of which leaves me with no residual confusion whatsoever. Bravo!
practiCalfMRI
You wrote:
these people need Really Smart People relaying Really Important Points in ways (often analogies) that they can understand.
Anon@14:27 was jusqt saying the same thing.
Only Anon@14:27 just told us that Neuroskeptic was not qualified in "psychological thinking" whatever that can be, "theorie of emotions" may be.
He maight have been angry at NEUROSKEPTIC being just a sufferer and not a RSPrRI
(Really Smart People relaying Really Important Points).
practiCalfMRI
Also, a personal true story.
NEUROSKEPTIC is a RSPrRI and I found him at his best on the three parents metaphore for the de novo mutations in SZ.
Braving Anon@14:27 I send the link to this blog and the nice metaphore on a French blog and a protestant and psychologist of some sort (pseudo Pierre-Antoine) just thought I was insulting his mother because he had never known a father.
I swear I have no idea who the man under the pseudo pierre-Antoine is.
(Really Smart People relaying Really Important Points).
Ivana, it appears you misread my post. I was actually saying that Anon@14:27 had implied that only scientist-to-scientist communication is useful on this blog, and I vehemently disagree. My contention was that, by aiming for a lay audience, there would be more relevance to more people in NS talking as a qualified scientist to a non-scientific audience. There are surely more depression sufferers with no scientific training than there are depressed scientists, so NS is doing a much bigger service by talking to Joe Public than doing what Anon@14:27 seems to want, and restrict it all to hard core science. In other words, NS is the Very Smart Person making a Very Important Point. Make sense now? :-)
Since I received on my mail Subject: [Neuroskeptic] New comment on Confused the information:
practiCalfMRI thinks I missed his point.
He accused me implicitly of having made up my true story.
related in Ivana Fulli 2 September 2011 18:15.
I think no matter how much a considerate and good friend NS he has the moral duty to publish my answer:
NB: Beware I am deeply ashamed of the stupid antiamericanisms in that French very Big Judge blog commentaries to say the least:
http://www.philippebilger.com/blog/2011/08/et-cest-reparti-.html
A “Pierre-Antoine” thought I was attacking him under the belt using the fact that his mother couldn’t or did not want to tell him who his father had been.
The enraged man wrote to me through the blog many many insults starting with
"thanks to the attention you devoted to the humble me, I had no father, just a provider of genetic material who has known my mother (...)I am qualified as a psychotherapist (family therapy and mystic delusions)
"@Ivana Fulli
Merci de votre attention à mon humble égard, je n'ai pas eu de père, juste un géniteur qui a connu ma mère (...)
j'ai une formation de psychothérapeute (familial et délire mystique). (…)
Rédigé par : Pierre-Antoine | 30 août 2011 à 09:29 "
What I had dared to post on the French top judge blog was NS blog link twice and :
"Pierre-Antoine
I am sorry I had not send you yesterday the shortest link to gain acces to a post of NS who was commenting 2 recent and troubling scientific publications. To reused his smart expression you don't have two parents Pierre-Antoine but 3 and the honor of your mother is intact.
(NB I used a French idiomatic expression the honor of your mother is intact, very very often used by the chatting classes when you want to state that a man doesn't share many charateristic with his brother)
Pierre-Antoine
Désolée, je ne vous avais pas donné hier le lien le plus court pour accéder à un billet du blogueur NEUROSKEPTIC qui commentait deux publications scientifiques récentes et troublantes. Pour reprendre sa brillante expression : vous n'avez pas génétiquement deux parents Pierre-Antoine mais trois au moins et l'honneur de madame votre mère ne s'en trouve pas entaché car votre troisième parent génétique ce sont les mutations qui différencient les gènes qui ont produit vos parents de ceux qu'ils vous ont transmis
I hope that some of you guys see my point.
See for yourself what I receive and couldn't locate on NSblog
( must be a woman thing not being able to navigate on the very clear NS blog).
practiCalfMRI has left a new comment on the post "Confused":
Ivana, it appears you misread my post. I was actually saying that Anon@14:27 had implied that only scientist-to-scientist communication is useful on this blog, and I vehemently disagree. My contention was that, by aiming for a lay audience, there would be more relevance to more people in NS talking as a qualified scientist to a non-scientific audience. There are surely more depression sufferers with no scientific training than there are depressed scientists, so NS is doing a much bigger service by talking to Joe Public than doing what Anon@14:27 seems to want, and restrict it all to hard core science. In other words, NS is the Very Smart Person making a Very Important Point. Make sense now? :-)
practiCalfMRI
I wrote on 2 September 2011 13:29:
"Only Anon@14:27 just told us that Neuroskeptic was not qualified in (...) "theorie of emotions" (...)
He might have been angry at NEUROSKEPTIC being just a sufferer and not a RSPrRI
(Really Smart People relaying Really Important Points)."
practiCalfMRI answered me today at least through my mail box:
"Ivana, it appears you misread my post."
I already answered this that afternoon on that blog that we shall agree to desagree on my misreading his post and that I felt accused of having made up my "Pierre-Antoine" true story.
But I have another point to make - and a very important at that:
practiCalfMRI wrote to me
" (...) Anon@14:27 had implied that only scientist-to-scientist communication is useful on this blog (...)
I couldn't fully agree because it is possible but Anon@14:27 can also be a NS indignant of NEUROSKEPTIC disclosure of depression suffering.
practiCalfMRI wrote to me:
"so NS is doing a much bigger service by talking to Joe Public than doing what Anon@14:27 seems to want, and restrict it all to hard core science."
Sorry, darling, but there is a very big body of good research and papers and books on "theory of Emotion" although strangly enough not so much of emotional disorders.
Actually on the academic scientific point of view NS attempt was, well, trying to reinvent the wheel I am afraid.
See the popint now sweet practiCalfMRI or do I have to elaborate ?
better to be safe than sorry and I will add that Anon@14:27 might be an academic psychologist best equipped to do a much bigger service than NS by talking to Joe Public about the theory of Emotion and of psychological thinking theories in general
It remains that I thought that NS lay person and very ignorant at that post on Emotion theory increased my esteem for him as a human being and as a neuroscientist.
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