Language That Is Person-First

An editorial in the Canadian Medical Association Journal by Roger Collier highlights the problem of Person-first language: Laudable cause, horrible prose

Person-first language (or language that is person-first, as it prefers to be known) is the nice idea that rather than calling someone, say, "blind", we should call them "a person who is blind", so as to remind everyone that they're not defined by their blindness but are a person first... clever, eh?

No. For one thing, it's just bad English. As Collier puts it: "There’s a reason Ernest Hemingway didn’t call his novel The Person Who Was Male and Advanced in Years and the Sea."

He goes on to quote linguist Helena Halmari who highlights a number of problems with the approach:

In English, emphasis naturally occurs at the end of sentences... so by pushing mention of a disability or disease deeper into a sentence, adherents to person-first language may actually be adding stress to those words. “What you have at the end of a sentence is the new information that gets the most attention,” says Halmari.

Worse yet...

Tucking the disability behind the noun may contribute to stigma rather than reduce it. After all, most adjectives with positive connotations precede nouns. We do not typically say a “person who is beautiful,” for instance, or a “person who is intelligent.” Sticking a word in the shadow of a noun can create the impression that there is something inherently wrong with it - that it should be hidden.

As a 'person with mental illness', I entirely agree. I am a man, a neuroscientist, a blogger; I'm not ashamed of those things, so I don't feel the need to erect linguistic fences between them and my person. I am also a psychiatric patient, a depressive, mentally ill; I'm not ashamed of that, either, and I resent the implication - however well-intentioned - that I should.

To me that's the really troubling part of this: the should aspect. The only reason you should not call someone something, is because they ask you not to.

Person-first advocates claim to be speaking on behalf of the 'group' who are harmed and offended by the current use of language - but who gave them that right? They don't speak for me, or anyone but themselves. I don't see 'the mentally ill' as a group at all, but even if it is one, they're certainly not our  elected representatives.

So non-person-first language doesn't offend me. In fact, I'm more worried by the idea that people will assume that, because I'm mentally ill, I want them to use person-first language. Now that's offensive.

How To Respond to Criticism

People argue. On the internet, especially. Here's some tips on how best to respond to criticism of your ideas or writing - in my experience (the fact that I've often failed to follow these rules myself is part of that experience.)

Be Nice

Aggressive and insulting responses are a sign of weakness, and readers know it. If you're confident in your position, you can afford to be nice, and it makes your whole case look more convincing. Quite apart from the fact that it's just, well, nice.

Don't call out people for not being nice, though. The Three V's - "vitriolic", "virulent" and "violent" - seem to be especially common complaints. The trouble is that just as remarking on someone's faux pas is, itself, a faux pas, proclaiming that your opponent is using nasty language lowers the tone of your response.

It's natural to feel hurt by insults, but keep your feelings to yourself. Even if the criticism really is appallingly vicious, let it speak for itself: just slip a quote of the worst bits into your response, by way of making a separate point, and don't lower yourself by commenting on it.

Complimenting critics shows strength. It shows that you're confident that, despite the praise you're heaping on them, you're still right. So be generous. It only works if it seems sincere, though, so no outright brown-nosing.

Be Fresh

Don't just defend the ground you've already occupied - take the offensive (without being offensive). Bring new arguments to the table. New facts are always good - if a critic tries to debunk an example you used to prove a point, don't bother to quibble with them: produce three more.

Make your response readable. A reply is a piece of writing like any other, and it should be as concise and as clear as possible. Exhaustive replies are counterproductive; they're unlikely to be read. Just identify the key criticisms, and respond to those.

Stick to the point. Readers want you to engage with the issues. You may feel that you know all about your detractors' beliefs, character, motives and so forth, and that these are interesting. They rarely are.

Be Right

Often forgotten, this one.

If you're not sure whether you're right, find out. Take your time. If you have to say something right now, say you're working on it. Better a late reply than a bad reply.

If you're wrong, admit it. People will forgive an honest mistake, if you hold up your hands and ask them to. A reputation for admitting your mistakes and correcting your views is actually a point in your favor

If you've done something wrong, apologize. And nothing more. Don't try and justify yourself; it never works. Don't try and get people to pity you; it'll ensure no-one does. Just say sorry, and then keep quiet until the whole thing cools down.

Why (And How) To Write Less

I said a couple of times during my recent trip to UPenn that "Most writing is too long". People seemed to nod appreciatively at this, so here's some more on that topic...

Most writing is too long and the most common reason is that it's not written for the reader's benefit. Readers want the important stuff, as clearly as possible, in the shortest possible space. If you remember that and let it guide your writing, you won't go far wrong. The reader's favourite bits are the ones you don't write.

The problem is that it's tempting to write for your own benefit, not the reader's, and this almost always ends up making things too long. This can take many forms:

Some write to help themselves understand the material, such that the end product is a record of their learning process. Others will insert details that the reader doesn't need, because it's a topic the writer's fond of. Other fear making tough decisions about what to include, so they say everything and hope some of it's good: "Write it all and let God sort them out."

This is common because formal education teaches you to write poorly. Specifically, it encourages people to overwrite. Teachers and professors give assignments and they set a minimum word count. This sends the message that where writing's concerned, more is better.

Teachers have their reasons. They want a brain-dump to show that the student's done the homework, pretty much the opposite of good writing. That's fair enough for school, but if you internalize that philosophy, you will end up writing to show off rather than for the reader's benefit.

Once you put the reader's interests first, you'll naturally start to find your own ways to achieve that. Everyone's style is different, but here's a few I've learned:

• If it starts "On that note...", "Also...", or "Furthermore...", you should probably cut it.
• Join Twitter - writing to a 140 character limit is a great form of discipline. Then imagine that every paragraph you write must become a tweet. You may find you can compress that paragraph into one sentence.
• Just as Twitter is good, other artificial constraints are good. Set yourself a word limit; if you're blogging, make it 500 words.
• Unless the article's about you, sentences that include the word "I" or "we" can usually be cut.
• Think of your piece as a nuclear missile: it has a payload, the message you want the reader to grasp, and a rocket motor, the introduction and other stuff you need to ensure it reaches the reader. Every missile needs a motor, but designers try to make the payload as big as possible, given the size of the motor. Identify what your payload is, and what your motor is. Then think, is my motor too big? (It probably is.) In this paragraph the missile analogy is the motor.
• As a rule of thumb, by writing it better, you can cut it down by half.

The Onion Makes Mental Illness Ridiculous

Despite being entirely fictional, The Onion offer some of the most perceptive political analysis anywhere.

Less well known, but likewise brilliant, is its coverage of mental health. The Onion's approach is to satirize the beliefs and perceptions that characterize psychiatric illness. The result is hilarious, but also insightful and, in a weird way, empathetic:

Local Anorexic Still Way Too Fat

Despite years of intense dieting and vigorous exercise, local anorexic Lisa Kimmel is still way too fat, it was reported Monday... Though Kimmel could stand to lose a few pounds in nearly every area of her body, worst of all are her arms. "I've got this totally disgusting flab on the back of my arms that swings back and forth when I move," said Kimmel, wearing an oversized Champion sweatshirt to conceal her obesity. "My arms totally look like my grandmother's."

Making matters worse is the fact that Kimmel's mother wants her to be overweight, constantly trying to get her to eat fatty foods like ravioli, mashed potatoes and broiled chicken with the skin still on. Other family members, as well as Kimmel's friends and doctors, also entreat her to eat because they want her to be fat, repulsive and unliked.

Pharmaceutical Company Says Its New Anti-Depressant Is 'Worthless And Dumb'

At a press conference Monday, Peter Cafazzo, CEO of Brunley-Hunt Pharmaceuticals (BHP), introduced his company's latest anti-depressant, Cyntrex, a product he described as "a totally stupid waste of time that probably nobody will ever want ever." ...

According to reports, top BHP researchers began having doubts about the drug during the early development stages, when they realized they couldn't do anything right ever ever ever, and that none of the pharmaceutical-industry leaders cared whether they lived or died. But work on the project continued, despite BHP's growing conviction that Cyntrex would be the worst product in pharmaceutical history.

Is The Government Spying On Paranoid Schizophrenics Enough?

Panelists discuss ways to care for the nation's paranoid schizophrenics, such as hiding cameras in their homes or audio transmitters in their ears. e.g. "We need to hide cameras everywhere they go, in the street, in their homes, in the eyes of people at the stores where they shop."

Some people might see this as making fun of the mentally ill, but I don't: it's making fun of the illness.

Suffering from a psychiatric disorder is a tragedy, but the disorder itself, and the distorted cognitions associated with it are, well, ridiculous. It's ridiculous to see yourself as fat when you're dangerously underweight. It's laughable to think you're worthless when you're successful and respected.

Coming to realize the absurdity of such beliefs is an important part of recovery, and an explicit goal of cognitive behavioural therapy although therapists don't tend to emphasize the funny side, it is certainly there.

The Small World of Words

I've been asked to encourage people to take part in an online psychology study called The Small World of Words

I get a lot of this, and I usually don't respond to such requests, but this one looks pretty interesting.

The project aims to collect the world's biggest word association database. You see a series of words and you just have to type in the first three words that pop into your head.

Here's some more about it:

On average, an adult knows about 40,000 words. Researchers in psychology and linguistics are interested in how these words are represented mentally. In this large-scale study we aim to build a network that captures this knowledge by playing the game of word associations. You can help us with this project by participating in this short and fun study.

The study consists of giving the first three words that come to mind for a list of 14 items.
All ages and nationalities are welcome, but please note that we do require all participants to be fluent English speakers.

It's the sheer scale of this that makes it cool. They've got some 60,000 participants, and over a million associations already, but they're aiming for almost 300,000 people - which would make it not just the biggest word association study ever, but the biggest psychology study of all time, as far as I know.

It only takes about 2 minutes to complete and it's actually quite revealing. Out of 14 words I managed to associate a full 3 of them with 'pain', which disturbed me somewhat.

So take a look and spread the word (associations)...

Beyond Self-Report

If you want to learn about someone, should you ask them?

Two bits of research published recently cast doubt on the validity of self-report as a tool in psychology and psychiatry. The first found that teens who reported that they suffered from bullying experienced more mild 'psychotic-like' symptoms. That correlation would be consistent with the idea that these symptoms arise as a response to stress.

However - the same study found that there was absolutely no correlation between peer ratings of whether someone was bullied, and their psychotic symptoms. Only self-report was associated.

The second study looked at whether a crisis intervention program - intensive mental health care - helped people who'd recently attempted suicide. The results showed that, compared to a control condition, suicidal patients who got crisis care self-reported fewer subsequent suicide attempts.

But a trawl of hospital records painted exactly the opposite picture - the intervention group were more likely to end up in hospital with a second attempt.

Remarkably few studies in psychology and psychiatry compare self-report to other measures of behaviour. This is because self-report is typically a lot easier. If these papers are anything to go by, however, this is a serious limitation. Self-report can be radically at odds with other measures of behaviour.

Which raises the question - who's right? Are the self-reports right, when they clash with other sources? I don't think there's an easy answer. In the bullying case, it might be that self-report is more accurate, because the peers doing the peer-report are the bullies. In the suicide study, maybe the self-report was more accurate, because the patients knew about attempts that never made it to hospital.

But on the other hand you could argue exactly the opposite. Maybe the self-reports of bullying just reflected whether the kids thought their classmates liked them. Maybe the patients were ashamed to admit that they'd reattempted suicide even though they'd got all this special crisis care. It's hard to tell.

One thing's clear though: self-report is not the whole story.

Gromann PM, Goossens FA, Olthof T, Pronk J, and Krabbendam L (2012). Self-perception but not peer reputation of bullying victimization is associated with non-clinical psychotic experiences in adolescents. Psychological medicine, 1-7 PMID: 22895003 

Morthorst B, Krogh J, Erlangsen A, Alberdi F, and Nordentoft M (2012). Effect of assertive outreach after suicide attempt in the AID (assertive intervention for deliberate self harm) trial: randomised controlled trial. BMJ (Clinical research ed.), 345 PMID: 22915730

Love Truth? Wait.

Britain may be hosting the Olympics, but that hasn't stopped us indulging in our own national sport of complaining. Many of the complaints in the past 24 hours or so have been about this chap:

Rileyy_69 attacked a celebrity on Twitter, who called him out on it, rileyy_69 attacked him more, thousands of fans of said celebrity attacked him, he attacked some of them back, then he apologized, but then attacked again, and eventually someone reported him to the police, and he was arrested on Tuesday morning for malicious communications or something.

All very exciting, but so what?

Should we pity this guy, or did it he bring it on himself? Were the thousands who attacked him jumping on the bandwagon, or justifiably outraged? Should he have been arrested, and if not, why? Because the law in question ought to be repealed, or because it's a fine law but was wrongly applied in this case?

Good questions. We don't know enough yet to answer them. We don't know this person, his life story, his mental health situation, etc. Some details have now started to emerge, but generally the early, fragmentary reports in cases like this only add to the confusion.

It's too early to tell. I don't think anyone can dispute this. Unless you i) know Rileyy69 in real life and ii) are an expert in the relevant areas of law and iii) have read all his Tweets, not just the ones that made it into the newspapers, you are probably not in a position to judge.

It's too early to say, but that's never stopped anyone.

Newspapers and blogs are full of definitive, final judgements on these questions. Both those broadly in favor of the arrest of Rileyy_69, and those opposed, are equally premature. If there is a difference, it's that the latter group also include hypocrites, who swiftly took to Twitter to criticize the knee jerk mob mentality of the Twitterati.

One who really cared about Rileyy_69, the law, the media, or whatever else they claimed to, would above all want to establish the facts before commenting. The truth will out; we can but wait, or try to help it along. But we should not try to outrun it.

The truth is slow.

And that's fine. There's rarely, and certainly not in this case, a need to form your opinions within minutes and to nail your theses to the door of the cathedral within a day of the event. Just wait! You'll be in good company; few of the great minds of history measured time in hours.

"Ah", you might say, "but those who attacked Rileyy_69 on Twitter were, themselves, doing what you're criticizing!". They were, actually, but that's what Twitter is for. Tweets are about speed and in its place, that's fine. The human brain responds to stimuli within about 100 milliseconds; you give people the chance to type that response, and they will. To criticize that is to criticize human nature.

No, the problem is not those who use an avowedly instant communication service as intended. It's those who try to export that mode of thought into the ancient and higher medium of prose longer than 140 characters.

For everything there is a time, a time to Tweet and a time to think. Just don't mix them up.

Why Blogs Fail

I can think of several new neuroscience blogs that started out with some really nice content, but then they disappeared after a few weeks or months. I'm sure the same must be true of other genres. This is a shame.

Thinking back over the early days of Neuroskeptic, my advice to new bloggers is: it gets better. The early days of any blog are psychologically tough because almost inevitably, your first posts are not going to get the recognition they deserve.

That's because people tend to really pour their hearts into early posts - these are the ones that express thoughts you've been mulling over for ages and are finally writing about - and then inevitably, hardly anyone reads them, because it's a new blog and no-one even knows it's there yet. Certainly that was my experience.

Luckily, it doesn't stay that way. Your first posts will flop, at least in relation to your own expectations, but remember that a) it's nothing personal and b) no-one except you cares. Only you can see your traffic stats and whatever, but even if everyone knew them, they wouldn't mind. You need to push on through that stage and once you do, you won't care about it either.

To get past the first stage, you need to "sell" your blog. I think a lot of new bloggers forget this, or think it somehow won't apply to them, which sets them up for disappointment. Of course, good content is essential - no matter how hard you try, you can't sell crap. But great writing alone is not enough. No, not even yours.

Promotion is part of blogging, but once you get into the right mindset, you'll realize that it's not a chore so much as a natural extension of writing. You write something, and then you go and find people who'll be interested in it, and who might have interesting comments about it, and try and get them involved. Or you get involved in conversations about the topics you're interested in.

Sell, don't beg. Outright asking more established people for links, retweets etc. rarely works and it looks bad. Get people interested in it. If that's a chore, then it means you're not really interested in your own stuff, in which case that's a problem.

If you've done this for, say, a year, then I'd say you've given blogging a good shot and you can make an informed decision as to whether or not it's for you. But if you quit after just a couple of months because "I tried blogging and it didn't work out" or "I had a blog but no-one read it" then I'd say you're probably making a mistake. You haven't experienced all of blogging, only the start of it, which is the toughest and least rewarding part. It gets better.

Politics: A Dialogue

"There's no point in voting. All the parties are the same."

"Hang on. Are you saying the Communists are the same as the conservatives? And that they're both the same as the Nazis?"

"Well, I meant all the main parties are the same."
"OK. But what's a main party?"

"A party that gets most of the votes, of course."

"Right. So by saying the main parties are the same, you're saying that most people broadly agree about politics."

"Erm... yes, but when you put it that way it seems much less fun. Anyway, I for one reject the discredited status quo and support..."

"...the Nazis."

"No! How dare you call me a Nazi?"

"You effectively are behaving as one. You're not voting against them. Which has the effect of helping them."

"That's ridiculous. I like Schindler's List as much as the next guy. I hate Nazis!"

"Just not enough to do the one thing they don't want, to vote against them."

"Erm... look, don't blame me. Blame mainstream politicians. They're the ones who've made people disillusioned. They're out of touch, and don't understand everyday people like me."

"They understand you well enough to convince you to vote for them, or at least not against them. Well enough to make you believe that they'll always be in power, that they are the natural leaders. I think they understand you all too well."

"That's not what I mean. I want people like me to be in power."

"Well, run for office then."

"Ha! I'd lose."

"Why?"

"Because..."

"Because people like you, wouldn't vote for you."

"That's crazy. Of course I'd vote for me."

"Would you? Someone like you was probably on the ballot, as an Independent or a minor party candidate, but I bet you didn't check. You just decided there was no point, because he would never win."

"And I was right!"

"Don't you see the problem? You're only right, because people like you think you're always going to be right. It's a self-fulfilling prophecy that you'll lose. That's the problem with your party!"

"My party? I'm not in a party!"

"You are, you just don't know it. A party is a group sharing common interests and beliefs. There are lots of people like you. Everyone is in a party; some of the parties are just badly organized, and don't get any votes or representatives."

"Because we don't want power!...wait...or do we?"

More Depressed Than Average?

Whether we think of ourselves as "depressed" or "anxious" depends on what we think about other people's emotional lives, rather than our own, according to an important paper just published: Am I Abnormal? Relative Rank and Social Norm Effects in Judgments of Anxiety and Depression Symptom Severity

The work appears in the obscure Journal of Behavioural Decision Making, which is downright criminal. It deserves to be in the British Journal of Psychiatry ... and it's not often I think that about a paper.

In the first experiment, the authors quizzed people how many days per month they felt “depressed, sad, blue, tearful” or had “excessive anxiety about a number of events or activities.” They then asked them a series of questions designed to work out how they thought other people would answer than question. So they could work out where each individual thought they ranked within the general population, in terms of depression or anxiety symptoms.

Take a look. The top panel shows someone who felt depressed on 5 days a month, but believed this put him in the most depressed 70% of people. The second person felt depressed twice as often, but she thought she was below average.

 

They found that perceived rank was strongly correlated with whether people thought they "had depression" or "had anxiety" - much more strongly than actual frequency of symptoms. "Having depression" meant "being more depressed than other people".

That's just a correlation and doesn't prove causation, but in the second experiment, they randomly assigned people to get different versions of a survey which manipulated perceived rank, and they confirmed that rank was indeed associated with how "disabling" they felt a given level of symptoms would be.

Now, this is just common sense, in a way. Of course whether you think of yourself as abnormal will depend on what you think of as normal - that's what "abnormal" means. We understand ourselves in the context of other people.

But this common sense is maybe not so common nowadays; you can read a hundred papers about the chemistry, genetics or causes of "depression" without a consideration of what "depression" (i.e. "abnormal" as opposed to "normal" mood) is.

The implications are big. Here's my main concern. Right now a lot of people think that promoting the idea that mental illness is very common is a good idea. Their stated goal is that by 'normalizing' mental illness, we'll destigmatize it. This will both help the mentally ill to cope, and encourage people to talk about their own mental health and get help.

All very nice. I've accused such campaigns of being based on dodgy stats, but this paper suggests that such campaigns could end up having exactly the opposite effect from that intended - they could lead to under-diagnosis, and increased stigma.

Suppose being depressed or anxious becomes seen as more 'normal'. According to these data, this will make people who are depressed or anxious less likely to seek help, for any given level of symptoms. Change people's perceptions of other people, and you'll change how they see themselves.

Worse, normalizing distress could - paradoxically - make those who do seek help seem more abnormal. Think about it: if depression and anxiety are normal, surely only an abnormal person would need special help to deal with them.

It's a small step from this to the idea that mental illness is mere personal weakness, laziness, attention-seeking, or scrounging. 'What's your problem? Everyone feels down or worried sometimes... most of us just deal with it.' If everyone is mentally ill, then no-one is really mentally ill... so the "mentally ill" must have something else wrong with them. Not very nice.

I'm not sure if this has happened, or will ever happen, but it's something to think about.

Melrose, K., Brown, G., and Wood, A. (2012). Am I Abnormal? Relative Rank and Social Norm Effects in Judgments of Anxiety and Depression Symptom Severity Journal of Behavioral Decision Making DOI: 10.1002/bdm.1754

You Are Not "Your Brain"

Best-selling mysterymonger Deepak Chopra announces Good News: You Are Not Your Brain.

We are not our brains. We are "conscious agents"... It's very good news that you are not your brain, because when your mind finds its true power, the result is healing, inspiration, insight, self-awareness, discovery, curiosity, and quantum leaps in personal growth. The brain is totally incapable of such things. After all, if it is a hard-wired machine, there is no room for sudden leaps and renewed inspiration...

Chopra is saying that you are a conscious agent, with the power of self-awareness and curiosity etc. Which is true. He then says that "The brain is totally incapable of such things", but you are, therefore, you are not your brain.

The problem is that Chopra has a concept of "the brain" which is essentially a passive, "hard-wired machine". He's right that we are not such a machine; his mistake is to call that machine "the brain", because brains aren't like that either.

But this is not a mistake unique to Chopra. As I wrote previously, the concept of "the brain" is inherently misleading -

What do we mean when we talk about "the brain"? Easy, right? It's this (picture of a human  brain). But this is not an image of a brain. It's an image of a dead brain. In a living brain, all kinds of interesting things are happening. Things we literally can't begin to imagine. Because these are hard to visualize, they can't enter the mental picture.

To picture the living brain as just a yellowy lump is like picturing Wikipedia as a disc. It's accurate as far as it goes, but it misses the whole point. You could download Wikipedia onto a BluRay disc, and then you could describe that disc as "Wikipedia" and you wouldn't be wrong, but Wikipedia is much more than a silver circle.

"The brain" brings to mind an inert squishy lump of a certain size and color. This mental image corresponds perfectly well to a dead brain - which is all the proof needed, I think, that it fails to capture the essence of a living one.

"The brain", in other words, is a mere simplified caricature of the brain.

So when Chopra says "You are not your brain", he is right, in the sense that you are not what Chopra (or anyone else) understands by "your brain", but that doesn't mean you're not your brain.

This mistake also crops up in more serious discussions. There are philosophical arguments that go something like this: the human mind can do things that it is inconceivable for a brain to do. Therefore, the mind is not the brain. But couldn't it be that it is the brain, itself, which is inconceivable?

Broken Hearts and Broken Livers

In a new paper, Beyond the Blues, German psychologists Postert et al discuss how the Hmong people of South East Asia talk about sadness - or rather, how they don't, because they don't really have a word for it.

Based on anthropological fieldwork in a number of Hmong communities in Laos, the focus of this article is on the Hmong term tu siab, literally "broken liver". This is usually translated as "sadness" in the dictionaries, but the authors say that, although it is certainly the closest thing the Hmong have to a word meaning sadness, it is not the same because:

The instance of becoming ‘sad’ in Western contexts is that ‘something bad happened’... This may involve disappointment in personal relationships, but also other afflictions beyond the social realm. At the core of the emotional experience of ‘sadness’ are basic violations of values deeply embedded in Western conceptions of the individual. The afflicted individual feels resigned, passive, out of control...

In Hmong language, the concept of ‘broken liver’ has a strong emphasis on kin relations. It pertains very often to social situations of isolation and neglect from one’s kin including consanguines, patrilineal ancestors, or affines or their unmarried daughters in cases of romantic love. Persons with a ‘broken liver’ may have been voluntarily offended, excluded, or separated from these persons by bad fortune...

One of the highest Hmong values, a person’s vital social integration, is at stake here. However, a state of ‘broken liver’ is usually far from resignation. Contrary to the assumed passivity of a ‘sad’ individual, a ‘broken liver’ is an affective marker highly mobilising social relations and interdependencies ... having a member in one’s group whose liver is ‘broken’ appeals to the collective commitment of all relatives...

[like the English "guilt" and "shame", but unlike "sadness"] ‘broken liver’ demonstrates characteristics of a socio-moral emotion in everyday pragmatics of Laotian Hmong villages. It is typically evoked in a – conscious or unconscious – transgression of an important sociocultural rule. When a man is assumed not to accord to basic principles of social reciprocity by keeping substantial gains from an opium sale for himself, close relatives may develop signs of a ‘broken liver’ signalling their disapproval...

In short, the argument is that the Hmong "broken liver" differs from our "sadness" in being an active response rather than a passive reaction, a social statement rather than an individual feeling, in having a moral dimension, and so on.

But isn't that much like our "broken heart"?

"Breaking someone's heart" is a moral issue. It's not good to be a heartbreaker. If someone broke your friend's heart, you'd be angry. It's a specifically social emotion in the sense that it generally results from betrayal, abandonment, or disrepect. It's true that while the Hmong's "liverbreak" seems to extend to all close relationships, "heartbreak" often has a romantic connotation; but we do talk about "breaking your mother's or father's heart", so even that's not an absolute rule.

Consider this recently broken heart. Doesn't Tulisa's heartbreak fit the tu siab bill?

If so, then the main difference between Hmong and English terminology is that they only have a concept of 'heartbreak', and lack a general concept of 'sadness'. That's quite interesting, but I'm not sure how much to read into it. English doesn't have a word for 'déjà vu'; we had to borrow it from the French, but surely that doesn't mean that no English people ever felt it until the French explained it to them.

I'm no expert but judging by this paper, Hmong emotion terminology is really very similar to ours. The big difference is that the Hmong (in common with other East Asian cultures) link emotions to the liver, which to Westerners sounds silly, but it's no more silly than our talk about emotions being in the heart. They're both just metaphors.

Replace "liver" with "heart", and the following Hmong terms (listed in the paper) look very familar -

• zoo siab  ‘pleased, happy’ (lit. ‘good liver’)
• siab npau  ‘angry’ (lit. ‘liver boiling’)
• chob siab  ‘inwardly offended’ (lit. ‘pierced liver’) etc.

Don't those all make sense? We talk about being "hearty" or "heartened", "taking heart" or having our "hearts lifted" when we're happy or confident; our "blood boils" when we're angry; we talk about feeling "cut", "stung", "pierced" by criticism or insults, and we suffer "heart-rending" traumas.

This is certainly a very interesting paper, but it didn't leave me feeling that the Hmong's emotional life is all that different to ours.

Postert, C., Dannlowski, U., Müller, J., and Konrad, C. (2012). Beyond the Blues: Towards a Cross-Cultural Phenomenology of Depressed Mood Psychopathology, 45 (3), 185-192 DOI: 10.1159/000330944

Personality Without Genes?

According to a paper just published (but available online since 2010), we haven't found any genes for personality.

The study was a big meta-analysis of a total of 20,000 people of European descent. In a nutshell, they found no single nucleotide polymorphisms (SNPs) associated with any of the "Big 5" personality traits of Neuroticism, Extraversion, Openness to Experience, Agreeableness and Conscientiousness. There were a couple of very tenuous hits, but they didn't replicate.

Obviously, this is bad news for people interested in the genetics of personality. But I wonder if the implications are even wider -

We know that there are SNPs associated with physical traits like height, weight, hair colour, eye colour, and the risk of various diseases. If none of those SNPs are associated with personality, then none of those traits are causally associated with personality.

"Short man syndrome"? A myth. Rod Stewart was wrong about blondes. There's no such thing as a "fat personality". And so on. Maybe that's not surprising, but more generally, the implication would be that the genes we inherit have no direct or even indirect influence on our personality, which is a pretty radical conclusion when you think through it.

I'm making some assumptions here. Maybe some genes are correlated with personality, but the currently popular "Big 5" approach is just a poor way of measuring of personality. It could also be that there are so many interacting genetic and environmental effects on personality that any given effect is tiny by itself, and even bigger sample sizes, or multivariate data analysis, would be needed to detect such effects.

de Moor, M., et al. (2010). Meta-analysis of genome-wide association studies for personality Molecular Psychiatry, 17 (3), 337-349 DOI: 10.1038/mp.2010.128

Do You Have Free Will?

I mean you, specifically.

I'm not asking whether people have free will. I think they do - except you. You're the one person on earth who doesn't have it.

If you disagree - how would you convince me that you do have it?

Alternatively, if you're one of the people who doesn't believe in free will - I agree with you, people don't have it... except me. I'm special.

-

This might seem like one of those thought experiments that only philosophers could care about, but it's of more everyday importance than the general question of 'whether we have free will'. That's an interesting debate, but really it doesn't change anything. If we have it, we always have, and if we don't, we never will. Either way, here we are, and we'd better get on with our lives.

On the other hand, the question of whether an individual has free will has real consequences. It can even be a matter of life or death. It comes up in court cases. Lawyers and psychiatrists don't use the words "free will", they'll talk about responsibility or capacity or sound minds, but what they mean, in essence, is what the rest of us mean by the term free will.

In some of these cases, free will is what you want - if, say, psychiatrists want to confine you to a hospital, and you say you don't want to be there. Other times it's the reverse - if you've committed a crime, and your defense is that some kind of mental or neurological illness made you do it, then you're arguing that you don't have it (or didn't, at the crucial moment.)

But while lots of people have opinions on the abstract "Free Will" question, I don't think many people pay attention to the issue of their own free will or lack of it - until they end up in court. We just assume that if everyone else has it, so do we, and vice versa.

Yet how can we be so sure? Everyone accepts that people differ in regards to how much free will they have. Wwhen people say "I believe people have free will", they don't really mean all people - they surely make an exception for babies, people in a coma, people having a seizure, and probably children, people with dementia, people with severe mental illness... Likewise, people who don't believe in free will recognize that there's a difference between a normal adult and one of those people.

But where do we draw the line, and how do you know which side you're on? This seems to me the most important questions to be asking about free will.

Confused

What is confusion?


According to Collins English Dictionary, the main meaning of the word "confused" is:

confused [kənˈfjuːzd] adj

1. feeling or exhibiting an inability to understand; bewildered; perplexed

That sounds about right. But hang on. Isn't there something odd about this: "feeling or exhibiting an inability to understand..."?

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.

The 30something Brain

Brain maturation continues for longer than previously thought - well up until age 30. That's according to two papers just out, which may be comforting for those lamenting the fact that they're nearing the big Three Oh.

This challenges the widespread view that maturation is essentially complete by the end of adolescence, in the early to mid 20s.

Petanjek et al show that the number of dendritic spines in the prefrontal cortex increases during childhood and then rapidly falls during puberty - which probably represents a kind of "pruning" process. That's nothing new, but they also found that the pruning doesn't stop when you hit 20. It continues, albeit gradually, up to 30 and beyond.

This study looked at post-mortem brain samples taken from people who died at various different ages. Lebel and Beaulieu used diffusion MRI to examine healthy living brains. They scanned 103 people and everyone got at least 2 scans a few year years apart, so they could look at changes over time.

They found that the fractional anisotropy (a measure of the "integrity") of different white matter tracts varies with age in a non-linear fashion. All tracts become stronger during childhood, and most peak at about 20. Then they start to weaken again. But not all of them - others, such as the cingulum, take longer to mature.

Also, total white matter volume continues rising well up to age 30.

Plus, there's a lot of individual variability. Some people's brains were still maturing well into their late 20s, even in white matter tracts that on average are mature by 20. Some of this will be noise in the data, but not all of it.

These results also fit nicely with this paper from last year that looked at functional connectivity of brain activity.

So, while most maturation does happen before and during adolescence, these results show that it's not a straightforward case of The Adolescent Brain turning suddenly into The Adult Brain when you hit 21, which point it solidifies into the final product,

Lebel C, & Beaulieu C (2011). Longitudinal development of human brain wiring continues from childhood into adulthood. The Journal of Neuroscience, 31 (30), 10937-47 PMID: 21795544

Petanjek, Z., Judas, M., Simic, G., Rasin, M., Uylings, H., Rakic, P., & Kostovic, I. (2011). Extraordinary neoteny of synaptic spines in the human prefrontal cortex Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.1105108108

Filters

At TED, Eli Pariser, author of the The Filter Bubble, talks about how:

As web companies strive to tailor their services (including news and search results) to our personal tastes, there's a dangerous unintended consequence: We get trapped in a "filter bubble" and don't get exposed to information that could challenge or broaden our world-view. Eli Pariser argues powerfully that this will ultimately prove to be bad for us and bad for democracy.

His point is that the web is, technologically, a fantastic system of giving the consumers of information (i.e. you) exactly what they want, when they want it. It's enabled a degree of personalization which old media could never come close to. But this isn't necessarily a good thing, because people tend to pick and choose information that fits with their existing views and interests, and filters out everything else.

The problem is not entirely new. Back in the days when everyone read their daily newspaper, the newspaper editor was your filter. And because there were maybe a dozen newspapers in your region that you could buy, you'd choose the one that best fitted with your world-view.


Indeed, in the UK, what newspaper you read says considerably more about you than what party you vote for. There are only 3 main political parties, but there are about 10 main newspapers, and in my experience people are more likely to change their vote than to change what they read.

But the internet allows people to cherry-pick far more effectively. The Guardian, for example, regularly prints articles that annoy, or at least challenge, many Guardian readers. That's inevitable, because no two people have exactly the same tastes: what one reader loves will have another reader tearing up his paper in frustration.

Nowadays, it's quite possible to get all of your news and views from blogs. Blogs are specialized: they cover a particular kind of stories, with a particular slant. Many of them do that extremely well. If you don't quite agree with a given blog, there's plenty of others with a slightly different approach to pick from. And you can pick as many blogs as you like until you've got a full set - exactly how you want it. Clearly, the potential to only find out about what you already want to hear is much greater.

New or not, it's certainly a problem. The good thing is that the internet makes it extremely easy to snap out of the filter bubble. A completely different perspective is just a click away: that's new, as well. All you need is to want to do that.

Why should you? Always reading stuff that you already agree with isn't the best way to get informed about something. Actually, it's just about the worst way to do that. If you're serious about wanting to learn the truth about something, you need to (critically) read different sources. But beyond that, it's just boring to always do the same things. There are a lot of cool things going on that you've never heard of.

Finally, if you're a blogger, remember that you're not just telling readers your opinions, you're helping them to filter out other people's. You don't have to feel bad about that, it's inevitable, but remember: if you really want to help your readers understand something, you need to tell them about the areas of disagreement.

I don't just mean linking to stupid people and then explaining why they're stupid. That's fun, but if you're serious, you need to link to the best examples of alternative views and give them a fair hearing. This is something that I feel I could do more of on this blog, and I hope to do it more in future.

Duck or Rabbit?

Ambigous figures are drawings that seem to flip from being one thing to another.

Psychologists Melissa Allen and Alison Chambers recently showed these images to teenagers with autism in an attempt to find out whether they were able to perceive the effect normally: Implicit and explicit understanding of ambiguous figures by adolescents with autism spectrum disorder

A leading theory of autism is weak central coherence - the idea that autistic people tend to be focussed on details, rather than the "big picture". This might predict that autism would interfere with the perception of these figures because the ambiguity is all about the global, gestalt meaning: the details are fixed, but you can see them as adding up to two different things.

The autistic teens and a control group were showed the images and asked to copy them using a pen and paper. Then their drawings were rated for "duckness" or "rabbitness", or equivalent, by a rater who wasn't told which diagnosis the drawer had.

The results showed that the autistic group were able to perceive both interpretations of the figures, and were equally likely to report experiencing the "reversal" phenomena in which the image seems to flip. However, when it came to the drawings, they were less biased by being told which interpretation to use. When the instructions said "Draw this rabbit" as opposed to "Draw this picture", controls tended to make their copy more rabbity, but autistic people copied it faithfully.


Beyond their relevance to autism, these kinds of pictures are interesting because they tell us something important about perception.

You can't see these images for what they really are. They really are ambiguous - they're neither duck, nor rabbit. They're both. However, our brains insist that they are one the other, at any one time. They're duck, rabbit, duck, rabbit. But they never seem to be a "duckrabbit". Not for me anyway. Even though I know, in an abstract sense, that this is what they really are.

Both "duck" and "rabbit" are things we've encountered a thousand times before. So we seem to be drawn to see them in those familiar terms. "Duckrabbits" are unheard of, outside psychology. Rather than sit on the fence, our perceptions fall into the well-worn grooves of our preexisting categories.

Allen ML, & Chambers A (2011). Implicit and explicit understanding of ambiguous figures by adolescents with autism spectrum disorder. Autism : the international journal of research and practice PMID: 21486897

Turn That Off, I'm Writing

I listen to a lot of music.

Music is playing in the background most of the time whether I'm on the computer or not (thanks to my old, poorly-designed but still faithful Shuffle). However I've noticed that I find myself turning off iTunes when I'm writing.

Right now, for example, I have just put this song on pause because I'm writing this post (a post about why I paused that song - bit of a chicken-and-egg situation there.) I can't write with a song on, because the lyrics would be distracting.

However, I don't always do this when I'm typing. With some songs, and some kinds of writing, it's OK. I think this is how it works:

Instrumental songs are obviously OK. But I don't listen to many.

More interestingly, songs I've listened to many times are fine. I've just put on this which, according to iTunes, I have listened to no fewer than 140 times over the last three years. And this is fine. No distraction. I think the reason must be that I'm so used to the lyrics that the language part of my mind no longer needs to work out what they mean.

Some kinds of writing are compatible with songs. Blogging isn't and writing "important" emails aren't but a lot of emails are. Which I guess means that I'm not really putting much effort into writing them. I must be typing on auto-pilot, just repeating stock phrases ("Sounds good") rather than actually using my language areas, or at least, not using them very hard.

Psychologists are fond of using these kinds of selective distraction tasks to map out the architecture of the mind e.g. verbal ones distract verbal working memory but not spatial, and vice versa. So this is all pretty standard stuff, but what's interesting is that it's not intuitively obvious.

It doesn't feel like sometimes when I'm writing my language faculty is hard at work, and other times it's not. It feels like I'm thinking about what I type all the time. It's just typing. Sometimes I'll be replying to a bunch of emails, music on full blast, and then I'll find myself putting it on pause when I get to one particular email; but I couldn't tell you in advance which one it would be. It just feels right. Better turn the music off for this one, this one's serious - though even that's putting it too strongly. It doesn't feel serious, it just feels like the music needs to be off.

Our concious experience is smooth and seamless even though we're constantly switching between using different parts of our brains. This becomes all too evident in the case of brain lesions, which can rob us of capacities we never knew we had, because they were always there when we needed them. Some lesions, for example, render you completely unaware of anything that happens to your left. It doesn't seem like we're using a different part of our brain when dealing with stuff on the left as opposed to the right - but we are.

The Web of Morgellons

A fascinating new paper: Morgellons Disease, or Antipsychotic-Responsive Delusional Parasitosis, in an HIV Patient: Beliefs in The Age of the Internet

“Mr. A” was a 43-year-old man...His most pressing medical complaint was worrisome fatigue. He was not depressed...had no formal psychiatric history, no family psychiatric history, and he was a successful businessman.

He was referred to the psychiatry department by his primary-care physician (PCP) because of a 2-year-long complaint of pruritus [itching] accompanied by the belief of being infested with parasites. Numerous visits to the infectious disease clinic and an extensive medical work-up...had not uncovered any medical disorder, to the patient’s great frustration.

Although no parasites were ever trapped, Mr. A caused skin damage by probing for them and by applying topical solutions such as hydrogen peroxide to “bring them to the surface.” After reading about Morgellons disease on the Internet, he “recalled” extruding particles from his skin, including “dirt” and “fuzz.”

During the initial consultation visit with the psychiatrist, Mr. A was apprehensive but cautiously optimistic that a medication could help. The psychiatrist had been forewarned by the PCP that the patient had discovered a website describing Morgellons and “latched onto” this diagnosis.

However, it was notable that the patient allowed the possibility (“30%”) that he was suffering from delusions (and not Morgellons), mostly because he trusted his PCP, “who has taken very good care of me for many years.”

The patient agreed to a risperidone [an antipsychotic] trial of up to 2 mg per day. [i.e. a lowish dose]. Within weeks, his preoccupation with being infested lessened significantly... Although not 100% convinced that he might not have Morgellons disease, he is no longer pruritic and is no longer damaging his skin or trying to trap insects. He remains greatly improved 1 year later.

(Mr A. had also been HIV+ for 20 years, but he still had good immune function and the HIV may have had nothing to do with the case.)

"Morgellons" is, according to people who say they suffer from it, a mysterious disease characterised by the feeling of parasites or insects moving underneath the skin, accompanied by skin lesions out of which emerge strange, brightly-coloured fibres or threads. Other symptoms include fatigue, aches and pains, and difficulty concentrating.

According to almost all doctors, there are no parasites, the lesions are caused by the patient's own scratching or attempts to dig out the non-existent critters, and the fibres come from clothes, carpets, or other textiles which the patient has somehow inserted into their own skin. It may seem unbelievable that someone could do this "unconsciously", but stranger things have happened.

As the authors of this paper, Freudenreich et al, say, Morgellons is a disease of the internet age. It was "discovered" in 2002 by a Mary Leitao, with Patient Zero being her own 2 year old son. Since then its fame, and the reported number of cases, has grown steadily - especially in California.

Delusional parasitosis is the opposite of Morgellons: doctors believe in it, but the people who have it, don't. It's seen in some mental disorders and is also quite common in abusers of certain drugs like methamphetamine. It feels like there are bugs beneath your skin. There aren't, but the belief that there are is very powerful.

This then is the raw material in most cases; what the concept of "Morgellons" adds is a theory, a social context and a set of expectations that helps make sense of the otherwise baffling symptoms. And as we know expectations, whether positive or negative, tend to be become experiences. The diagnosis doesn't create the symptoms out of nowhere but rather takes them and reshapes them into a coherent pattern.

As Freudenreich et al note, doctors may be tempted to argue with the patient - you don't have Morgellons, there's no such thing, it's absurd - but the whole point is that mainstream medicine couldn't explain the symptoms, which is why the patient turned to less orthodox ideas.

Remember the extensive tests that came up negative "to the patient’s great frustration." And remember that "delusional parasitosis" is not an explanation, just a description, of the symptoms. To diagnose someone with that is saying "We've no idea why but you've imagined this". True, maybe, but not very palatable.

Rather, they say, doctors should just suggest that maybe there's something else going on, and should prescribe a treatment on that basis. Not rejecting the patient's beliefs but saying, maybe you're right, but in my experience this treatment makes people with your condition feel better, and that's why you're here, right?

Whether the pills worked purely as a placebo or whether there was a direct pharmacological effect, we'll never know. Probably it was a bit of both. It's not clear that it's important, really. The patient improved, and it's unlikely that it would have worked as well if they'd been given in a negative atmosphere of coercion or rejection - if indeed he'd agreed to take them at all.

Morgellons is a classic case of a disease that consists of an underlying experience filtered through the lens of a socially-transmitted interpretation. But every disease is that, to a degree. Even the most rigorously "medical" conditions like cancer also come with a set of expectations and a social meaning; psychiatric disorders certainly do.

I guess Morgellons is too new to be a textbook case yet - but it should be. Everyone with an interest in the mind, everyone who treats diseases, and everyone who's ever been ill - everyone really - ought to be familiar with it because while it's an extreme case, it's not unique. "All life is here" in those tangled little fibres.

Freudenreich O, Kontos N, Tranulis C, & Cather C (2010). Morgellons disease, or antipsychotic-responsive delusional parasitosis, in an hiv patient: beliefs in the age of the internet. Psychosomatics, 51 (6), 453-7 PMID: 21051675