Does a psychiatric diagnosis mean anything?

I have a new psychiatrist and a new tentative diagnosis. Or rather, a new additional diagnosis. So at the moment I have been diagnosed at some time by somebody with: severe depression, bipolar disorder, obsessive-compulsiveness disorder, obsessive thinking, anxiety disorder, social anxiety disorder, panic disorder, dissociative disorder, autistic spectrum disorder, narcissistic personality disorder, borderline personality disorder, and now adult attention deficit disorder. I have might forgotten one or two. Although I am certain I have depression and a batch of severe anxiety disorders, parts of all these diagnoses seem right, but none of them alone fits perfectly. I don’t think I’m special in feeling confused, even frustrated, about the problems in getting a clear diagnosis.

When you have a problem with your gallbladder or spleen, the diagnosis and treatment are comparatively obvious. Your just look at the spleen and you can usually see what’s wrong with it, and if that doesn’t work (I’m no spleen specialist) you run a few simple tests, like a blood test, and look at those results. But looking at the brain won’t help for mental illness. You can see a brain tumour easily enough, but you can’t see depression or anxiety. (I admit that this claim isn’t quite true, as there are some correlations between some structural changes to the brain and some mental illnesses some of the time, but the correlations are complex and not perfect predictors – yet – so I think my statement is essentially true.)

And then there is the pathologising of the extremes of normal behaviour. It is perfectly normal to grieve when a loved one dies, or to be upset when something important goes wrong. When does grief edge over into depression? It isn’t easy to say. When is a child abnormally hyperactive and not just rather boisterous? When is a person manic and bipolar rather than just lively and extraverted?

So at the moment mental illness is different from physical illness. Things might change in the future, with more sophisticated imaging and the means of visualising neural circuits and neurotransmitter system in real-time action. But even then we are left with the fact that the brain is a hugely complicated organ and the relation between what it does and its structure is also extremely complicated, and mental illness results from the interaction of developmental, situational, and genetic structures to the whole brain. Although we obviously have many working hypotheses, we don’t have any good complete models of mental illnesses and how exactly they arise, and how changes to the brain and its neurochemistry changes behaviour. I think this difficulty in seeing what is wrong contributes to the stigma of mental illness: with a physical illness, you can see, and therefore point to, your problem – look at my swollen spleen! – but people with mental illness look the same on the outside and on the inside.

Simple diagnoses make life easier for clinicians. You have a label, and then you also have a range of possible treatments: the label will determine that treatment. If you are diagnosed with depression and are given anti-depressants, and you respond to anti-depressants, then you must have had depression. Everything else, like poor concentration, tiredness, anger, lack of empathy, and inability to sit still, or whatever, must have been caused by the depression. But why should disorders of a very complex organ that we barely understand map nicely on to simple linguistic categories devised by clinicians in order to enable them to classify and treat people? I doubt if they do.

I don’t see that for mental illness we are in any better situation than physicians at the time of the Black Death who thought that the plague was caused by a miasma rising from the ground. But at least they could see the buboes. Just look at the mess the idea that depression is caused by a lack of serotonin is in.

In practice there is no point going in to see your doctor, psychologist, or psychiatrist, saying that their diagnosis is rubbish and unscientific. They have busy, difficult lives and can’t know everything. Do though make sure that every symptom that troubles you is taken seriously, and that you receive appropriate treatment for these symptoms. And if after a while things don’t get better you need more or a different sort of help. If your mood improves a lot but your concentration doesn’t, then you shouldn’t feel bad about trying to find out why. Good luck.

Dream a little dream

I’ve been experimenting with lucid dreaming by taking supplements last thing at night, including lecithin, choline, huperzine A (an alkaloid found in some plants that’s been investigated for treating Alzheimer’s disease), GPC (l-alpha glycerylphosphorylcholine), and galantamine (found in snowdrops), They’re all available from retailers such as Amazon and pretty harmless in terms of side effects, at least, it seems, for me. All of them in some way or another increase the amount of the neurotransmitter acetylcholine. I’ve tried taking them in isolation and in combination, and in combination is the only thing that has had any effect on me. My sleep and dreaming appears to be remarkably robust.

I still haven’t had a proper lucid dream, which as I understand it is an awareness that you are dreaming, and therefore you have an ability to influence your dream. I have though on many occasions had the curious sensation that I can only describe as that I am dreaming that I am having a lucid dream, or dreaming that I know I am dreaming, but lack any ability to influence my dream. These supplements reliably promote this “dreaming of lucid dreaming” state in me.

I also on two occasions have dreamt of what others call “the shadow” – a shadowy hostile figure who lurks threateningly close by (see here and here for examples from others). On both occasions this dream has started with a feeling that someone is in the room or outside, or outside the bedroom window. If I catch a glimpse of them, they are grey and featureless. I’ve had them for years; I remember very clearly being terrified as a young child by a grey shadow figure standing like a statue beside the bed. In my case they are not accompanied by sleep paralysis. Figures of this sort are widely described across time and cultures (in olden times it might have been called an incubus), so clearly are some fundamental, but poorly understood, feature of dreaming.

Most people love to talk about their dreams, and once you tell someone that you’re a psychologist, you’re in trouble. I have always been fascinated by my dreams – those strange images that arise unbidden with sleep, sometimes with frightful clarity, that follow complex and often bizarre storylines, and surely, surely must tell us something important about ourselves? And if you could have a lucid dream, could you not systematically manipulate some of the variables of dreams to find out more?

There are many theories about the origins of dreams, and they are covered in detail in my forthcoming book, The Science of Consciousness, to be published by Cambridge University Press (hopefully next year). Many people are familiar with Sigmund Freud’s psychoanalytical theory that dreams disguise repressed and unwelcome thoughts so that they do not wake us; hence for Freudian psychoanalysis dream interpretation is a question of interpreting the surface of the dream, particularly its symbolic nature. Hence for psychoanalysts dreams are the most important method of treating mental illness. Other depth psychologists think that dreams serve different functions (e.g. Jung thought they addressed issues to do with individuation and spiritual growth), but all these approaches share the idea that dreams have some meaning, and that interpreting dreams is a means to recovery and growth. Revonsuo views dreams as an evolutionary adaptation to dealing with threat; we can safely rehearse methods of escaping threats in dreams. Many researchers link dreams with creativity, and there are several accounts of ideas being generated and problems being solved in dreams (see here for a discussion of Kekulé’s famous account of dreaming of a worm swallowing its tail seen in flames in a dream). And then there is Allan Hobson’s idea that dreams are essentially random constructed by the cortex from random activation of thoughts and ideas by subcortical input.

I kept a detailed dream diary for a year, and still record as much of my dreams as I can. I don’t think there is any one correct theory of why we dream; I am sure all of the above are true at times. (Another thing I am sure about is that there is little merit in dictionaries of dream symbols.) I never cease to be amazed at the bizarreness, complexity, and creativity shown in my dreams, but I doubt if I am alone in this regard. The activation-synthesis hypothesis has a great deal to commend it, but I don’t think internal activity is random: some memories are stronger than others, some anxieties occupy us more than others; we desire some things more than others; and some threats are more worrying than others. The mind is always bubbling away, and some bubbles sometimes come to the surface. Dreams are the default mode network, the system that generates daydreams, running without control or censorship.

But can we learn from our dreams, and can recording and interpreting dreams help us on the path to spiritual growth and healing mental illness? I was slightly surprised that during my therapy my therapist seemed totally uninterested in my dreams (and this is in the context of that therapy being one of the most useful experiences of my life). If the idea that dream content is the interpretation of randomly generated but largely prominent memories, ideas, and emotionds is correct, you might expect an analysis to be revealing. However, when I analyse the dreams in my collection, I find there is little obvious to learn from them. They show recurring thoughts and concerns, but I am aware of them from everyday life. I dream of death, dying, and nuclear war most nights. We can’t learn much from dreams because we already know most of what they tell us.

The one surprise is how often I dream about my father, when I think about him so little in waking life – or at least did. He left when I was aged ten, and I barely saw him again afterwards. He died, alone, in 2004, 15 years after I had last seen him. This persistent dreaming makes me realise that I wish I had tried to contact him, if only to ask him why he had co up my life.

A warning though: some dreams take on a life of their own. I have for decades dreamed about watching a plane fall out of the sky, I think this idea has just become a very highly activated idea, one likely to bubble to the surface some nights. That’s why we get recurring dreams. So perhaps my dreams of my father are no more than a simple recurring dream, and reveal nothing deeper.

Note that I am giving a talk on the meaning of dreams in London on 4 July 2017. Please come along. I promise to try and answer every question I get.

Stay well, and dream on.

 

Loneliness

Lonely people tend to die younger. They have more health problems when they’re still alive, and tend to be more anxious than average. They tend to suffer more from high blood pressure. They have weaker imune systems. And I’m lonely.

Lonely people tend to die younger. They have more health problems when they’re still alive, and tend to be more anxious than average. They tend to suffer more from high blood pressure. They have weaker imune systems. Bummer.

Of course as with all findings about mental health, you must be careful talking about causes when all you have are correlations (feeling unwell might prevent you going to social events, for example), but it does seem likely that being lonely is bad news. The findings on the positive effect of social support – people with plenty of good friends and a strong social network tend to be happier and healthier – are after all just the other side of the coin.

We can distinguish acute loneliness (loneliness that persists for a relatively short period of time and that arises as a result of loss or transition, such as the death of a partner, change of job, or a geographical move) from chronic loneliness (loneliness that goes on and on and is part of a person’s life over some years). I’m currently reading Emily White’s book Lonely, about her chronic loneliness, and enjoying (or identifying with it perhaps) very much.

I think there is now more of a stigma attached to being lonely than there is to being mentally ill. Most people now accept that mental illness is a result of many factors, and that the ill person is not to blame. However, many people appear to believe that if you’re lonely, it’s your fault. You should just try a bit harder: join a club, do volunteering work, or take a dancing lesson. Or perhaps, they think, you’ve got no friends because you’re not a very nice person.

I admit it: I am chronically lonely – and I’m a very nice person.

Being chronically lonely (just lonely from now on) is related to many other things. White clearly thinks that being lonely and being depressed are very different; the main evidence for this claim is that many people report average levels of depression. I’m a bit sceptical that people have good insight into their mental states (we know from cognitive psychology that our insight is limited), but loneliness does seem to be related to social anxiety and personality factors independently of depression. I can feel lonely at a crazy party. In fact I sometime feel loneliest at a crazy party, where everyone else is obviously enjoying themselves, playing party games and singing songs. I have been in a packed football stadium where everyone else is singing and chanting and cheering and I just can’t join in; it feels false, wrong. I’m not looking down on the people who join in – although it must often look that way to other people – I just can’t make myself feel like other people. I’m an outsider (or as my mother used to say, “weird”, the irony being that she also is a lonely outsider).

I do wonder if people who think of themselves as very lonely mean “lonely” in the same way as others do. I think most people have acute loneliness in mind, whereas I think people like White and me are struggling for a word to capture a sense of alienation and otherness that pervades our lives even when others are present. A lot of what White talks about in Lonely makes me wonder if she just means “single”: a lack of intimacy, having somewhere there, the sound of voices and feet padding on the carpet at home, havint someone to touch, having someone with whom to share everything. But then I have felt lonely when with other people, including partners. Perhaps some of us are just destined to feel different. And for me it is entwined with depression.

But these are simple labels for complex experiences. I have no advice for others in the same party. I don’t want to go to a party or start dancing. Perhaps that’s why I enjoy the gym so much: I can be with other people, who vaguely share the same aim, but who don’t expect anything of me.

 

 

How to lose weight (continued)

I posted some time ago about my great success in applying science to losing weight. At one point I had lost about 30 pounds in 6 months. Most people who lose weight go on to regain it, sometimes even eventually weighing more than they had when they started, so after six months I thought it was time to revisit my diet – or more precisely, my lifestyle.

The news is mixed.

I posted some time ago about my great success in applying science to losing weight. At one point I had lost about 30 pounds in 6 months. Most people who lose weight go on to regain it, sometimes even eventually weighing more than they had when they started, so after six months I thought it was time to revisit my diet – or more precisely, my lifestyle.

The news is mixed. I have regained a bit of weight, but I am now fitter than ever before, as measured by endurance capability, maximum weight I can lift, resting pulse, and blood pressure. Most of the weight I have put back on (about 12 pounds) is muscle, not fat. My visceral fat is down to 11%, and my body fat 17%. I still feel flabby around the middle though, and would like to lose more weight there. Some of the weight gain – a few pounds – is fat, so it is a work in progress with many gains and a few losses.

So I think overall the verdict is that a version of this “diet” works, at least for me.

As with most things, life gets in the way sometimes. It’s difficult to stick to a particular lifestyle  when there are events such as Christmas come along, or when you’re travelling. I try, but relax things a bit. After all one of my greatest pleasures is eating out, and one has to have some fun. I nearly always pass on the dessert though.

I have also had time to consider what were the essential aspects of my original diet. I still think for me then the big thing was obsessively weighing and measuring food, and calculating the nutritional content of what I ate. This monitoring enabled to stick to a diet of around 2000 Calories a day, with about 75 g protein, 25 g fibre, and 50 g or less of carbohydrate (and often less than 1 g of salt a day). (I didn’t and still don’t care about the fat/oil content because I am convinced by the data showing that fat does good rather than harm.) Note again that this intake is the inverse of the traditional food “pyramid” with a large carb intake at the base. I also aimed for as wide a variety of micronutrients as possible, by supplementation and by eating as many different vegetables, and some fruit, as possible.

I stick by these things although I have relaxed the carb limit a bit. In particular I enjoy baking, and make my own gluten-free bread, which is largely seed rather than grain-based, containing walnut pieces, linseed, flaxseed, sunflower seeds, chia seeds, and pumpkin seeds. It tastes good (others say that too), but doesn’t keep well. I still try and avoid sucrose (sugar) like the plague.

I think the increased carb intake, especially bread, makes it more difficult to lose more weight. My main struggle however has been finding a way of eating that enables me to continue gaining muscle while losing fat. I don’t yet have an answer. When you work out six times a week for 45-60 minutes a day you’re going to need more calories, but what is the ideal proportion of fat, carbohydrate, and protein? How many times should you eat a day, and when, relative to the workout? I have scoured websites and books on exercise physiology without finding any answers that convince me. It is also difficult to work out how many calories you need when you have a complex exercise regime with many different types of exercise. I’m pretty certain the answer is more than 2000 though!

I recently saw a television programme that monitored someone trying to lose weight rapidly by calorie restriction over a week. At the end he had lost weight – but it was all fluid and muscle, and muscle is the last thing I want to use. On the other hand this was a television programme not a scientific study (although the measurements appeared to be taken under laboratory conditions), his diet was extreme, and he was very fit and lean in the first place.

I am sure that the principles of my diet work if you want to lose weight and become healthier. Restrict your carbohydrate intake, watch the total calorie intake, drink plenty of water, and exercise – the more and the more different sorts the better. But to become super-fit and super-lean is a further challenge. If you know anything about the science of doing so, please let me know.

The other issue outstanding is why so many people who start to diet do well at first and then go downhill. There are of course several possible reasons.

  • You don’t really like the food in your diet. I am lucky in that I don’t like the taste of sugar that much and love blueberries and fish. It would be much more difficult if it were the other way round. So you have to include as much good food that you like and also re-educate your palate.
  • You’re not really too bothered about your current weight and appearance. That’s fine, it’s your life – just remember if you’re obese it might be quite a short life.
  • Not giving yourself enough rewards. Rewards work! If you find the going tough, decide on a reward programme. You’re doing something important so the rewards should be reasonable: stay on the diet for a week and you deserve that new book you thought was a bit of a luxury. I’m not a great fan of “treats” in the diet as rewards: after all a diet with two days of cake treats is really just dieting for five days. Similarly all these points-based systems are over-complicated for many people (like me) and it’s easier just avoid the cake than working out if you can have it, and buy a trip to California instead.
  • Lack of support. It’s difficult if everyone around you is gorging all the time. It’s difficult if you’re trying to diet alone. One of the reasons diet clubs work better than other things isn’t because of the system, but because they provide social support to encourage you.
  • Yo-yo dieting. Going on a diet and then stopping and starting again, perhaps with a new system, and your weight oscillating as you diet – and don’t. You have to ask yourself why do you stop after a while. Perhaps you don’t like the food. Perhaps there is no support around. Perhaps you haven’t rewarded yourself sufficiently.
  • Thinking of it as a diet rather than a lifestyle. I know I’ve used the word diet, but that’s just a shorthand. You should realise that you’re not just eating fewer cases, but embracing a new, better way of living. You’re not going just going to lose a few pounds, but you’re going to become a healthier, happier person, with a longer life expectancy and better quality of life. And a healthy body is important for a healthy mind.

Now pass the blueberries.

Getting the words out

I’ve been silent because I’ve been busy. I have found that writing my “great work”, The Science of Consciousness, is good for my mental health – although whether I’d be able to write at all without a certain level of mental health is a moot point. Writing gives my life direction and purpose, and structures my day. The amount of work involved makes a mockery of any notion of being “retired”; writing is fulltime job. Consciousness is the most difficult subject I’ve ever written about: to paraphrase the British psychologist Stuart Sutherland “an awful lot has been written on consciousness, mot of it rubbish”; why do I think what I’m writing isn’t rubbish too? I suppose you can only do your best and then just hope. I’m not going to fall into the trap that many psychologists fall into, of equating consciousness with attention, or even just visual attention. I recognise it’s a big, difficult topic.

I have been reflecting about why I have found this writing so enjoyable and so therapeutic. Perhaps it’s obvious, but it’s because I really want to do it. I would probably write it even if I didn’t have a publisher and a contract. The only downside of a contract is often a fairly tough deadline – but if I didn’t have a deadline I almost certainly would work more casually, so it’s an advantage as well as a curse. (And usually the deadline wouldn’t be so bad if only I had started earlier.)

In the odd spare moment that I have, I wonder if my mood would be as good without this purpose. As ever there is circularity: doing stuff makes your mood better, but you have to be well enough to be able to do any stuff in the first place.

Of course in the end I will die (unless I decide to have my head frozen, and even then I expect eventually to die regardless) and eventually my books will go out of print, and I will be forgotten. At this point I envy people with children; they will live on through their genes. As others have observed, our lives are like stones thrown into a pool, causing ripples to spread out. Eventually the ripples fade and it is, for most of us, as though our stone was never thrown into the pool.

When writing a book I try not to think about it too much. I have 150,000 words to deliver before the summer. If I think of it in that way, the task is an enormous one. So I break the task down into 1000 words a day (number of words left divided by number of days left, allowing Sunday off – or rather do those jobs that have accumulated in the week) come what may. I think deciding to miss one day is a slippery slope; of course choosing to miss one day wouldn’t make much difference, but it’s easy for that one day to become two, and before I knew it, a month would have gone, and a 1000 words a day has become 1250. And then there’s reading, researching, and checking. You have to treat it like a job, or any other job I suppose, and just get on with it. I know there’s no point putting off starting to write every day because I know that it has to be done regardless, and starting at 5 pm is much more miserable and difficult than starting at 9 am. I still procrastinate a bit first thing, but I gather many writers do. I think it was Derren Brown who said something like “all self-help books just boil down to – just do it”. If you’re writing a book, writing an essay, or just have to mow the lawn – get on with it now.

Also on the positive side, I have had three outputs this week, and nothing lifts my heart more than seeing my name somewhere.

First, the second edition of my book, Talking the talk: Language, psychology, and science has just been published by Psychology Press. See:

 

 

This book is a gentle introduction to psycholinguistics, the science of how we produce and understand language. I still think the first edition was the best thing I have ever written (so far).

Second, I had a letter in the Daily Telegraph on Tuesday about futurology, robots, AI, and the implications for the economy. I’m a pessimist about these things:

 

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Rather to my surprise, it generated a great deal of interest. There were letters in reply (none of which really addressed the problem, I thought) and offers to write about the subject elsewhere. I think the future is a pretty scary place, and although I would have loved a laptop with fast internet connection when growing up, it could be that I have lived in the best of times – a rather optimistic conclusion for someone as usually as negative as me.

And third, finally, I gave a talk at Durham University on How to be successful in academia, particularly if you’re suffering from mental illness. I’m told it was very successful.

So a good few weeks. Success and achievements lift the spirits – just as you would expect. If you can, do something. But there will be times when you are too depressed to do anything. My advice, based on my experience, is to sit it out. Things will get better eventually, because they always have in the past. I promise.

 

Emptying the mind

It’s been a while since my last blog. Who would have thought that being self-employed would mean being so busy? I have been trying to focus on what’s important: my goals in taking early “retirement” from the full-time job have always been to increase my reading, thinking, and writing time.

But we live in a world of distraction. Distraction makes procrastination very easy. I even know of academics who have been encouraged by their “line managers” (what a repellent phrase) to “multi-task” their administration and research. I’m not sure at what level they’re supposed to multi-task – reading a paper while giving a lecture perhaps? – but we know that multi-tasking reduces efficiency: it just doesn’t work. Doing two things at once has a cost (which is why even speaking on the phone while driving increases the chance of an accident, let alone texting and driving). It also increases stress. And we know that doing important, creative work requires focus – you can’t carry out great research while students back their essays. I even have my doubts about one of those great sacrosanct beliefs in academic life that great teaching and research must go together: good teaching requires time, and research requires time, and you can’t be doing two things at once (see above).

I have tried to simplify my life, for peace of mind both for being mentally ill, and in order to be able to think more clearly. I have just been reading Timothy Ferriss’s excellent (if lengthy) Tools for Titans, and it is obvious that I am not alone in pursuing this strategy. Physical clutter is distracting – some of us even find it distressing. Mental clutter is just as bad, perhaps worse.

And how much mental clutter we all must have! How can you live in the moment when you are worrying about what you did wrong this morning and what you have to do this evening? How can you write well when your mind is on the telephone bill?

So here are some of the things that I’ve done to reduce mental clutter.

  1. Write down as much as possible. First I carried out a brain dump of everything I had to do, everything I was worried about, and everything on my mind. This task took a while, and I kept adding to the dump over a few days.
  2. Make structured lists. Over the years I have experimented with several types of list and time management systems. Now someone with an obsessional personality has to be careful of lists – they can easily take over and become an obsession and a distraction in themselves. I recently tried a complex system of email folders with tasks for doing today, tomorrow, the day after tomorrow, this week, waiting for, and so on … (I am familiar with Dave Allen’s Getting Things Done system and implement a simplified version of it. I have tried dedicated software but am aiming for a simple solution.)
  3. To do. Currently I am using Apple’s Reminders, with several types of list organised by location and time. I am trying to keep it simple. I have tried complicated systems and apps and remain to be convinced that a to do list can be bettered. The important thing is that nothing gets lost, and that I know everything will be dealt with by the deadline. I don’t want to have to think about peripheral things.
  4. Removing distractions. Social media distracts us and increases mental clutter. I can’t go as far as some and remove myself completely from Facebook and Twitter, and I don’t want to delete all my email accounts (and I don’t think it would be a good idea for future employment possibilities). But I don’t need to check my email every hour. Emails generate emails. I have reached the fabled “Inbox zero”, partly by moving things I can’t do now to an appropriate folder. (Actually as I write it is Inbox 1.) There are some emails I can’t do anything about just now, either because they refer to future events or because I need to do something to be able to answer them – they are moved to a “Waiting” folder. I do feel bad about several emails in my “Weather” folder that I plan to get round to when I have time. These are questions about or suggestions for or things to add to my British weather pages (http://www.trevorharley.com/trevorharley/weather_web_pages/britweather.htm). I do feel a bit bad that people have gone to the trouble of writing to me, and I always thank them, but it’s not my day job, and my time is very limited, so I can’t process them all at once. Recognising that we have limited time is a big part of the fight. WE CAN’T DO EVERYTHING. And that means MAKING CHOICES. (Apologies for shouting these statements.)
  5. Meditation. Everyone says meditation is good for clearing the mind and improving mental focus and clarity. I though with my monkey mind find the process very difficult, and probably as a result find the benefits – so far – limited. I will persevere though. I am using Andy Puddicombe’s Headspace site; I like the structure it provides and the implicit coercion. My jury is still out on meditation.
  6. Mindfulness. At all other times I am trying to be mindful of what I am doing now. If a distracting thought arises I try to push it away or if it is something I need to pay attention to add it to my list. It is easy though for obsessive people to get obsessed with clearing our minds, so we are for ever writing down minor thoughts. We all also occasionally at least need to plan what we’re going to do: living in the present doesn’t imply drifting.

Interestingly, as I was half way through writing this blog, the following landed in my inbox and caught my eye (I know, I know):

http://calnewport.com/blog/2016/12/18/on-digital-minimalism/

Finally, we should think about whether it’s even a good idea to strive for an empty mind. Life isn’t that simple. Things are always cropping up, and surprises are always happening. Rather than avoiding shit we must learn to respond to shit in the right way. The more I think about it, the more important I think this point is: we will never achieve a perfectly empty mind. It’s our responses we need to change.

Have a good Christmas and New Year everyone. It’s a difficult time of year for people with mental health problems – if nothing else it’s so dark in the northern northern hemisphere. So just hang on in there.

Commitment and commitments

Some people seem to have more time than others. There are only 24 hours, only 1440 minutes, only 86,400 seconds available for all of us each day. Yet some make more of those minutes than others; they make their minutes count more than the rest of us.

Such a perfect day – how often can we say that, even on those rare days when we are fit, well, and happy? I usually finish the day with a profound sense of disappointment, feeling that I could and should have done more that day, which means that I should have done things differently.

I have just finished reading Mark Forster’s Secrets of Productive People: 50 Techniques To Get Things Done. I enjoyed it a great deal, and there were several thought-provoking points that stuck with me. I must admit it wasn’t quite what I expected from the title; I was hoping for an analysis of how really productive people actually spend their time (see below). Nevertheless Forster’s books are ones I would recommend to anyone interested in time management, productivity, writing, creativity, or generally living a better life.

I was particularly struck by this quote:

“Don’t say you don’t have enough time. You have exactly the same number of hours per day that were given to Helen Keller, Pasteur, Michelangelo, Mother Teresa, Leonardo da Vinci, Thomas Jefferson, and Albert Einstein.”- H. Jackson Brown Jr.

I must admit I thought I hadn’t heard of H. Jackson Brown Jr. before (it turns out that he is author of Life’s Little Instruction Book, which was a bestseller in the early 90s), but I am now sure that I have seen some of his homilies on calendars and tea towels (“Drink champagne for no reason at all” strikes a particular chord with me). Of course the meaning of the quote is obvious and indisputable, but it really brings home how some people seem to have more time than others. There are only 24 hours, only 1440 minutes, only 86,400 seconds available for all of us each day. Yet some make more of those minutes than others; they make their minutes count more than the rest of us. I accept a few people appear to need less sleep than others, but most of us need around seven to eight. Currently I seem to need seven; any less and I notice I really don’t function at all well. Saving on sleep is a false economy (sadly).

So that means I have 17 hours left after subtracting my sleep hours left every day, and let’s assume that a very successful person has about the same. But even the hardest working person must eat, exercise, shower (occasionally), dress, travel, perhaps shop occasionally, keep the house maintained, clean, pay bills, maintain social and family contacts, and so on. I outsource as many of these as possible, and try and cut back on non-essential activities, but there are limits on what you can do. You might be able to prepare two meals at once, but try going out without dressing. Please, yes try it. And maybe you can multitask a bit (although being mindful means to me that when you shower you focus on the shower and enjoying the water, not thinking about something else). So you end up with considerably fewer than 17 hours a day. I also find hard work, including writing and reading tiring, and there’s a limit on what I can that pushes the limit even lower.

Ah, but some will say, the people named in the quote were geniuses: they need less time to get big things done. Maybe. But what makes a genius? Thomas Edison observed that “Genius is one percent inspiration and ninety-nine percent perspiration”, and the latest psychological research shows that he wasn’t far wrong. Success in anything takes real commitment. We now know that although native talent has a role to play in success, above a certain level of intelligence and ability, sheer hard work and the number of hours put in matters much more than most people think. Where do these hours come from?

Are you happy with what you get done? If not, then the key point that struck me after reading Forster’s book is if you want to do more of something else, you have to do less of something you’re doing now. What are you not going to do that you’re doing? I know it seems obvious, but on reflection it struck me as profound point: if I want to do more reading, writing, and thinking, I need to stop doing something else. What?

I probably do less “inessential” stuff than many people. I don’t watch much television; I don’t go shopping; I don’t play computer games; I am fortunate enough not to have to mow my own lawn; and I count writing this blog as work. I’m not addicted (I think) to email and social media, and although I enjoy food and cooking, I don’t spend too long on it, particularly since I’ve gone on my new “diet”, and I don’t spend as much time napping as I used after making substantial lifestyle changes to fight depression. What else can I give up? Perhaps it’s time for a time audit, but they’re quite a lot of effort and I doubt it will show I waste much time. My vices are reading the opinion columns of two newspaper, but that doesn’t take long, and keeps me informed, and occasional shopping on Amazon and iTunes.

In spite of all those I still feel I have too much to do and not enough time to do it all in. I am not alone: most of us feel overloaded all the time. You might be one of lucky few who think they haven’t got enough activities to fill their days, but if so you’re probably not reading this article. We should be trying to drop things from our lives, but often we take on new stuff. We say yes to things that interest us, or yes to our managers (perhaps we have no choice), or we want to write another book or take up a new hobby. These are new commitments. But we start off already over-committed! So every time we take on a new commitment, we have to ask which of our current commitments are we going to drop (or reduce) to make room for the new one? I want to get back to playing the piano. So what should I drop that I’m currently doing, when I already feel under tremendous time pressure?

So if you want to take on something new, or find more time, you first have to choose something to drop something you’re currently doing. Obvious perhaps, and easy to say, but much less easy to do.

Over-loading creates other pressures. Most people I know say they’re drowning in a sea of email. Many have hundreds (at least one chap I know is almost proud to say that he has thousands) of emails in their inbox. That’s obviously inefficient – I bet if you’re one of these people you’re wading through the same emails day after day, and often miss important, job-critical commitments. It involves handling the same piece of virtual paper more than once, often many times. And exactly when are you going to deal with the backlog? Most people say “one day”, but one day rarely if ever comes. (My favourite email tip is one I learned about some time ago – perhaps from a previous book of Forster: never answer an email the same day that you get it, unless the consequences will be really terrible – or, I suppose, unless you’re conducting a romance by email.)

Every successful person I have read about swears by their routine. I’ve talked about creativity and routine before. It’s a little tedious, perhaps, doing the same thing at the day after day, year after year, but successful people make time for their perspiration by sweating it out at the same time, every day.

Managing time is even more difficult for people with mental illness. Illness steals time. The unfairness of it all burns, but I think it has just to be accepted. We will never get as much done as “normal” people.

Finally, I am still very interested in my original idea of how some people to get so much done in a day. I would really love to interview an assortment of politicians, Nobel prize winners, Silicon Valley success stories, and business magnates, to find out what they do differently from me. Publishers and agents: if you want to commission such a book, please contact me! If you think you are particularly successful in life and have tips to share, please post a comment below or email me at trevor.harley@mac.com.

The future is bleak (updated)

As regular readers will know, I am obsessed with death, and I do not understand why everyone else isn’t too. What could be more depressing than the knowledge that it is all going to end for each of us relatively soon, and that eternal annihilation is all that lies in wait for us, whatever we do?

As regular readers will know, I am obsessed with death, and I do not understand why everyone else isn’t too. What could be more depressing than the knowledge that it is all going to end for each of us relatively soon, and that eternal annihilation is all that lies in wait for us, whatever we do? I saw a very old gent in the café last week, and he was enjoying his coffee and smiling beatifically at all around him. Was he perhaps just simple, I wondered? Why isn’t he petrified by the imminence of his extinction? I spoke to my therapist about it, and she pointed out that perhaps he was just enjoying his remaining time (how, I wondered), and was practising radical acceptance of his situation rather than thinking so catastrophically. It’s true that it seems to me that most people I talk to just don’t to give a damn about their own death. And I agree that it is bizarre that I am so afraid of dying that the existential despair sometimes almost drives me to suicide.

On the other hand, in a way I am glad I am not young in these troubled times. Life must surely be much more worrying and stressful for people in their teens and twenties than it was for me, in the good old simple days before pocket calculators. There is so much pressure on you to do this and that, so much political presence and political correctness in your lives, “free space” that are really prisons, with mobile phone cameras you can be in the public eye all the time in an instant, you have social media contributing to enormous peer pressure and perpetuating your simplest most honest mistakes for eternity. And then after working your way through university while building up enormous debts you might struggle to find a good job – or any job at all. But then there’s plenty else to worry about; the end of the world is near for you. I doubt if many of the young today will die a natural death. The things below worry me, and I think I’m rational to be scared by them, even if I am a nutter; they would terrify me if I were any younger, and probably just immobilise me with fear. Or drive me to suicide.

Terrorism. Surely top of anyone’s list of worries? I worry about being personally involved every time I fly or catch a train, drive over a bridge, or visit London, but I’m sure I’m not worrying enough. They will find a way to get to us in places and ways I can’t imagine. And that’s just in the short term. Surely in the long run terrorists will acquire biological and nuclear weapons; we only have to wait long enough for the worst to happen. So in a hundred, too hundred, three hundred years, whatever, they will lay waste to London, Paris, New York, and doubtless many other places. It’s just a matter of time. Verdict: grim.

Russia. Now even as a proud liberal I’m more pro-Russian than most people I know. I appreciate its geography and history, and therefore that they feel threats many of us can’t imagine. I can see why they needed Crimea as west Ukraine headed in the direction of even more west; Sevastopol is their only warm water port, and not a particularly good one at that. I also am a great admirer of Mr Putin, and have my own ambition to be photographed naked holding a machine gun one day. Oh those Russians. And if Russia doesn’t scare you, what about China or India? And the Middle East isn’t going to become a happy place anytime soon. Apologies to all my readers living in those countries; you’re probably worried about us (as well as each other). Yes, the geopolitical situation keeps me awake at nights. Scary.

Viruses, biological, and chemical warfare. We don’t even need people actively searching for ways to kill us; accidents and mistakes will happen. But why people would want to unleash a virus that is just as likely to kill them in the end as kill us in the short term is a mystery to me, but that’s nihilism for you. Perhaps they’re just hoping for a little local mega-tragedy. But if the terrorists don’t get us first then nature surely will; new viruses are always appearing and mutating, and even good-old fashioned bacteria are becoming increasingly antibiotic resistant. Eventually something really bad is bound to turn up. Yes, a pandemic such as the Great Plague of 2026 will wipe most of us out, probably in an unimaginably horrible way. Boils on the brain or something. Time to prep! Frightening.

Nuclear explosions. See also under terrorism. With a new cold war round the corner, and rogue states acquiring weapons, surely it can only be a matter of time before something happens somewhere. And if countries somehow manage to restrain from throwing their nukes at each other, and if mad men (and men they always are) don’t take charge of the arsenal, mistakes will happen; we’ve come surprisingly close to accidental nuclear war before. Within the next millennium it’s almost certain to happen. Megadeaths will leave humanity looking like the worst kind of survival disaster movie. I expect to see a double flash most days. Horrifying.

Nanotechnology. Now we get to future technologies that most people don’t worry about much at the moment – but they should. Nanotechnology means lots of very tiny things that may be able to replicate and might turn out not to be that controllable. Nanobots crawling around your veins and arteries scraping away cholesterol and plaque sounds wonderful, until as a result of some coding error they start scraping away at your artery walls too. Who you going to call? Perhaps we should retrain the unemployed (everyone – see worry below) as Botbusters. And nanobots munching away on rubbish and plastic bags turning them into compost is an excellent idea, until by mistake they decide that everything organic, including humans, is there to be munched on as well. Disturbing.

The disappearance of work. Jobs are disappearing all the time. Those that can be are being outsourced to countries where the wages are much lower and where they don’t have troubling legislation such as a minimum wage. Computers and online resources are claiming many other jobs – when was the last time you went to a travel agent? Robots already do much manual labour in garages, and I see that they are now taking over the jobs of at least some surgeons. What will be left for us to do in a few decades? A few high tech jobs; some teaching; creative work; maybe. Politicians, for sure. The overall effect will be to reduce the availability of work and so drive wages down. But there is a problem here that I don’t think has been much thought about: the owners of most of the computers and robots are making products for people to buy. But what will happen when the people can’t afford to buy anything because they have no money because the robots took their jobs? The whole system will collapse. We will be reduced to a nation of people working in coffee shops so that we can earn just about enough to go and buy coffee in another coffee shop in our breaks. I’m glad I don’t have to worry about starting out on a career just now. Unsettling.

AI and robots. I have recently finished reading Nick Bostrom’s Superintelligence, which talks about the threat posed by the development of artificial intelligence (and the associated robotics industry). Apparently the average prediction by “experts” of when we will develop an artificial intelligence with intellectual abilities greater than that of a human is 2040. Now of course as a professor of cognitive psychology I foresee all sorts of difficulties: our intellectual abilities and our consciousness arise because we develop from  birth, endowed with genes that prepare our brains and intellect for life that have been honed by hundreds of thousands of years of evolution, grounded in the world, surrounded by other people, and with five sensory inputs (with feedback). I think 2040 is very optimistic. But I don’t see that as “in principle” argument against the development of super-intelligent conscious artificial intelligence – just that it’s more difficult than many people image. It isn’t merely a question of developing a computer with enough megaflops. Some might be surprised that I accept the idea of a conscious computer so easily, but if it has the right stuff, I don’t that it’s possible, I think it’s inevitable. You can’t have a zombie that acts as though it’s indistinguishable from a conscious being but isn’t conscious. (More on this topic in my forthcoming book, The Science of Consciousness, due to be published in 2017.) But what reason do we have to suppose that when we develop a real AI that it will be friendly towards us? Might we not instead face a Terminator-like future where the missiles are fired and machines turn on the remaining few? I don’t find there to be much comfort in ideas such as those proposed by the science fiction writer Isaac Asimov that if we programme machines with his three laws of robotics (“a robot may not injure a human being or, through inaction, allow a human being to come to harm”; “a robot must obey the orders given it by human beings, except where such orders would conflict with the First Law”; “a robot must protect its own existence as long as such protection does not conflict with the First or Second Laws”) that all will be well. Humans live by laws, and they do a lot of people no good at all. People can’t even manage to drive without using their mobile phone. Why should a super-intelligent AI, with its own personality, life history, and at least the delusion of free will, feel obliged to do whatever we do them? We act in accordance with our own best interests (or at least think we do), so why shouldn’t an AI? I see disaster down the line. And will AIs suffer from existential despair? Will they worry about the power supply being switched off? And will they act to stop that happening? And then we’re assuming that intelligent AIs which have their own goals and personalities will be sane. Humans aren’t, so why should artificial humans? Why shouldn’t an AI become traumatised, or suffer from depression, or anxiety, or even personality disorder? Doesn’t mental illness come with the territory of being conscious? What would a psychopathic super-intelligent AI connected to the internet do? Or a suicidally depressed AI in charge of nuclear weapons contemplate? Alarming.

The network of things. My central heating is connected to the web, so when I’m in California I can play with turning the heating up to 30C back home. My pressure cooker is already pretty smart, but presumably the next generation will be networkable, so I will be able to cook my beans at a swipe of my iPhone from anywhere in the world. There are already robot vacuum cleaners, and fridges that check what you put in and take out and order food automatically for you. What happens if your fridge goes haywire and refuses to open, or if it orders a million toilet rolls instead of a nice piece of cheddar? Will you starve to death? So if terrorists, Russians, germs, the plague, nukes, tiny things, and robots don’t get you, your fridge probably will. Terrifying.

… To which I add a few weeks later:

Genetic engineering. How could I possibly overlook this one? I foresee nothing but trouble. Bring on the Daleks. Worrying.

Social media and surveillance. Isn’t Britain already the most watched society in the world? Aren’t there many calls of many people who should know better to monitor the press and curtail freedom of speech? Don’t we already have libel laws so draconian that people flock here from other more liberal counties (e.g. the USA) to press their grievances? I have just finished reading David Eggers’ “The circle”; although I think it is a flawed novel in some minor ways, it is immensely readable and thought provoking. With our obsessive use of social media, our pursuit of fame without effort and the idolisation of celebrities, and our ignorance of how our liberties are being eroded, we are sleepwalking to the sort of disaster chronicled in “The circle”. China is apparently working on a scheme that sounds like it should be left in science fiction where citizens accrue points for “good citizenship” (see this BBC article for example) – well, you can guess the sort of thing that makes you a worse citizen than your neighbours, and some of the possible consequences. Scores in the first instance might affect your credit worthiness or enable you to jump a queue for a good flat. But you can imagine a society where our Facebook posts and blogs are monitored, and all of a sudden things happen like your bin is “accidentally” not emptied one week. Or you get carted off to a gulag at dawn. Perhaps we already are monitored in this way and it was no accident that my supermarket home delivery last week didn’t include macadamia nuts. Thought provoking.

And then if we do somehow manage as a species to survive all that, and colonise space avoiding the doom of the solar system, we will eventually face the heat death of the universe. Surely anyone rational should all be very depressed.

Big baby: Taking responsibility for our lives

It’s not my fault my blood pressure is too high, manufacturers put too much salt in processed food. Let’s sue the food multinationals! It’s not my fault I tripped up, the council should have put more effort into levelling the pavement. Let’s sue the council! It’s not my fault that I’m fat because I stuff my face with chips, it’s the shops for selling them. Let’s sue the shops! Let’s appoint a government chip tsar to tell me to eat fewer chips! And a salt tsar, and a council tsar, and chip tsar, and a tsar tsar to look after them! And when anything goes wrong, let’s sue the tsar tsar!

I’ve read a lot of life coaching sites and books, and there’s a strong belief that taking responsibility for your life, mistakes, and happiness is essential for personal growth and mental health. It certainly sounds plausible, and there’s plenty of anecdotal evidence, but I’ve found experimental data hard to come by. It’s the sort of idea that would be very difficult to test in practice. We do know from the work of Victor Frankl that the people who found purpose and meaning in their lives, who accepted their situation and who took responsibility for their lives, were those who were most likely to survive in concentration camps. So taking responsibility and accepting the situation can save our lives.

Then there is the well-known related result that when we are successful, we think that it is due to our efforts, and when we fail in some way, we have been unlucky; but when other people  are successful, they’re lucky, and when they fail, it’s because they didn’t try hard enough. [If you want to find out more, the original source is Jones and Nisbett’s (1971) work on the actor-observer bias. In terms of attribution theory we generally prefer external attribution to facing the possibility that we are at fault (that is, internal attribution); this work dates back to Fritz Heider in the late fifties. The fundamental attribution error is the name given to the cognitive bias that we overestimate internal factors in explaining the behaviour of others, while underestimating their role in our own behaviour.]

The other side of responsibility is blame. It is YOUR fault that I didn’t succeed at doing this or never even tried doing that in the first place. The UK is now starting to resemble the USA in being a blame culture, full of lawyers and ambulance chasers and people taking out insurance without reading the small print and then blaming the banks, and people eating too much and blaming the food manufacturers and supermarkets and advertisers. In researching this blog I came across the following, unattributed, quotation: “When you blame others, you give up your power to change”. That rings very true to me.

It’s not a healthy situation, either for society or for ourselves.

Self-employed creatives have it harder than most. Although being self-employed as a writer (or retired, depending on your perspective) is liberating, it is also frightening. Writers are wholly responsible for their own work. If anything goes wrong, they only have themselves to blame. Employees do as they’re told, however high-level their job: in the end they have tasks they have to do, and places they have to be – and if they don’t do them, or if they’re not there, ultimately they get fired. But if I don’t write my two thousand words today I can’t fire myself or sue the council. Being responsible for your own time is also dangerous because it’s so easy to misuse it. Procrastination must surely be the writer’s biggest enemy – why do today what can be put off until tomorrow? Writers must take responsibility for their time.

When however we apply the idea of responsibility to mental illness the issues are less clear. I’m not saying we should blame ourselves for our illness. Why am I mad? The reasons are complex; it’s not one’s person’s fault, it’s just the way it is. But there’s no point feeling sorry for ourselves either – in fact wallowing will just make things worse. If we can’t blame others for our predicament, we can at least take responsibility for our mental health and trying to get better. Yes, I know there are times when you’re unable to get out of bed, or move from the chair – I’ve been there. But most of us have some better days, and then we can make a plan to live by.

The first step, which surprisingly many don’t take, is to acknowledge to yourself that you’re ill. Or, if you’d rather, that you have a particular set of problems. Life isn’t going to be as easy for you as the cheery soul at the next desk who is never faced by self doubt, never wants to spend a week in bed in tears, and who has never thought about suicide. We are, I’m afraid, different. We have it harder.

The second step is to implement the plan. I’ve talked in another blog about what we can do to improve our mental health, and how physical health is an important part of mental health.

The final step, which even fewer take, is to come out; perhaps we don’t quite have to go so dare as  to say we’re glad to be mad, but we can at least announce that we’re mad.

How are we ever going to remove the stigma of mental illness if we ourselves are embarrassed about it, or if we try to hide our problems from others? Would you hide cancer or a heart attack? Are people ashamed about having arthritis? Of course not. Unless we decide there is no shame in being depressed, or obsessive-compulsive, or schizophrenic, how can we expect other people to think anydifferently?

 

References

Jones, E. & Nisbett, R. (1971). The actor and the observer: Divergent perceptions of the causes of behavior. New York: General Learning Press.

Note: The title of this blog is a nod to Michael Bywater’s excellent book Big babies, arguing that that is what we’ve all turned into.

Oh to be an optimist

There are a number of ways of dividing up the spectrum of personality types; the Big Five model is the most popular, but there are others. Some people are born lucky: they’re optimists. How I envy them! Their glass is half full rather than half empty – when I look at my glass, I’ve just had a sip and it is already a third empty.
Although optimism-pessimism is an important personality construct in its own right, it’s unsurprising that optimism correlates with other aspects of personality. I consult my favourite book on individual differences, Maltby et al.’s (2013) text Personality, Individual Differences and Intelligence, to confirm what we might have expected: that in terms of the “Big Five” personality factors, optimism is significantly positively correlated with extraversion, agreeableness, and conscientiousness, and negatively correlated with neuroticism (see in particular Sharp et al., 2011). I’m surprised there isn’t a negative correlation with openness; how can you be open to new experiences if you expect everything to turn out badly? Better the devil you know.
Needless to say optimism is correlated with good health and well-being. Continue reading “Oh to be an optimist”