The academic life and mental illness

The academic life for staff and students defies common perceptions and is one of the most stressful jobs around. It contains many triggers for depression and anxiety.

My mother thought that being an academic was one of the cushiest jobs she could imagine – a couple of lectures a week and holidays for six months of the year. She thought students had it even easier having to go to those few lectures, take an exam or two a year, and spend the rest of the time travelling the world. She also thought they were out partying every night, finishing drinking at 3 a.m. and then trashing the town. I suspect she was not alone in her prejudices. How wrong these common perceptions are. I think being an academic, and being a student, is one of the worst careers for aggravating, even causing, mental illness. The job has the following triggers.

  1. The work is open ended. How I used to envy people with 9-5 jobs. Academics and students are never finished because there is always just one more job to do, whether it’s another paper to read or write or a textbook to go through again. When I was Dean it amused me that HR had a workload model for academics of 40 hours a week. I don’t know anyone who worked less than 50, and many did much more. What is there to stop us? We don’t leave the building and down keypads just because the clock moves on to 5, or because it’s the weekend. And if you should finish one job, there’s always another to do. There’s nothing to stop us doing more. Few things are more stressful than knowing you have an uncompleted task to do, and that you could be doing it, and that you have the time to dot it.
  2. What is work anyway? The same analysis is true of holidays as is true of the working week. I know of several academics who have booked annual leave in order to carry out research. When I go on “holiday” I read psychology articles and books, as do most people I know. When I was a student I would spend the vacation working in a factory in order to earn money as well as studying while travelling and in the evenings and weekends. Those maths worksheets seemed never ending. Christmas will find us reading and writing. For us there’s no such thing as a proper holiday.
  3. The work contains contradictory elements. We’re expected to carry out world-leading research as well as teach to the highest standard, and you get evaluated on both. I know there is some carryover between teaching and research, but time you spend teaching is time you can’t spend doing research, and vice versa. Contradiction is stressful.
  4. Giving a lecture or presentation or tutorial is stressful. Fear of public talking is one of the most common fears, being strong enough to count as a phobia for many people. Yet we have to do it all the time. Training is often inadequate. Some students find they’re not really prepared and although they might be taught how to organise their material and how to use Powerpoint I don’t know of anywhere that teaches them about the fear of speaking and how to overcome it. I’ve known of several students being physically sick before having to give a seminar. Speaking feeds fears.
  5. Deadlines. The life of the teacher and student are very similar in they they’re both full of deadlines. You have to give that lecture tomorrow or hand in that essay by 4 p.m. You can’t decide you’re going to take the day off instead. You need to be really, really sick before you call in. Deadlines are often too close together or even on the same day. Deadlines are exceptionally stressful.
  6. You have to organise your own time. One day you think you’re settling down to finish writing your 4 p.m. lecture, or finish your essay, when something happens. Your manager or supervisor wants to see you urgently (and it’s nearly always urgently). Your car won’t start. Your child or dog is unwell. There are suddenly 15 new pressing emails. Someone wants to see you and just won’t stop talking about their problem. And worse than deadlines are jobs with no deadlines because unless you’re very careful they never get done. You live from one deadline to another, one essay or lab report handed in to the next. So just when do you do that background reading, or write that important paper that could help you get promoted? When there’s no deadline and you’re tired and fed up it’s easy just to stop. And many deadlines aren’t real, anyway: do a a journal review by the end of the month? Sure, I’ll agree tot hat. Get to the 31st, and no problem, because everyone knows that if you send the review on the 1st it won’t matter, and what’s the difference between the 2nd and the 1st? When I was Dean I was always giving deadlines for jobs that I needed to follow up on, and less than half the staff would do the job before my deadline. What was I to do? Fire someone for being two days late with a document? In any case they were probably just busy with the last thing I asked them to do. The problem is that delays cascade. No-deadlines are often worse than deadlines.
  7. There is far much more rejection than praise. Journal acceptance rates are very low and grant rejection rates are very high. I’ve known people to send off an excellent grant proposal ten times before it gets accepted, and much outstanding research never gets funded. How demoralising it that? Feedback for students is mainly a long list of things you’ve done wrong. Of course that’s good in a way because you want to learn and improve, but persistent negative feedback gets to you. After a while people develop learned helplessness. Continual negative feedback is stressful and causes depression.
  8. It’s an exceptionally competitive environment for staff and students. Not everyone can get promoted every year. Not everyone can get a grant. The top journal can’t publish everything. Not every student can get an A every time. Perpetual competition is stressful.
  9. Some people are stars (but you’re not). But if you don’t succeed you sure will be aware of someone who has. You have to congratulate them through gritted teeth. Although you are struggling just to manage, you will know at least one person who seems to sail though. In every field or every department or ever class there is at least one Einstein. We admire them, we have to praise them, but really they just make us feel worse. Comparison makes us feel sick.
  10. EMAIL is evil. When I was Dean for every email I had to send I would get at least three back. It would be easy to spend all day doing nothing other than email. I am not alone: everyone I know is dreaming in a sea of email. And then there’s social media which some find compulsive. Often when lecturing you suspect every student is checking their messages or Facebook status. How demoralising is that? How do we cope when we’re striving in a sea of email that gets deeper every day? Smash up every computer or phone you see.

These triggers are more numerous than in many jobs. You might say other careers are bad too, but often they are better paid, and students aren’t paid at all – in fact they have to pay to have all this fun. And staff and students are often the sort of people who are least able to cope, having been brought up learning to expect to succeed.

I have no solutions. If you decide you’re going to take a real holiday for a month, you know that the departmental Einstein won’t, and they’ll have a stronger case for promotion than you at the end of the year. Off sick for a week and dare not to do that marking? When you come back that marking will still be there, but with another pile to join it, now with the same deadline. Oh, and whatever you do there will be two hundred emails in your inbox.

One thing we can do is face our weakness and admit we’re struggling, that we’re feeling anxious, that our agoraphobia has been triggered and we’re scared to go out, that we’re too depressed to talk, that our OCD has come back and is making us check every mark ten times (actually for me it has to be a multiple of three). To return to where I started, my mother thought mental illness, unlike physical illness, was a weakness. She was very, very wrong. Mental illness is nothing to be ashamed of, and talking about it is better than getting so bad that all you can think about is suicide.

 

I wish

I wish I had blue eyes.
I wish I had a smaller nose.

I wish I wasn’t depressed.

I wish I had brilliant blue eyes.

I wish I had a smaller nose.

I wish my thigh bones were two inches longer.

I wish I didn’t have a psycho tummy.

I wish I had had a better relationship with my mother.

I wish I had just 10 more IQ points.

I wish I had children.

I wish I had a strong jaw.

I wish I had been to Australia.

I wish I had just a bit more money.

I wish I wasn’t pigeon chested.

I wish I had tracked down my friend Carl before he died.

I wish I wasn’t crippled by anxiety.

I wish I had known my father.

I wish my mother hadn’t died last year.

I wish I had more friends.

I wish I hadn’t messed everything up

I wish I could go outside.

I wish my mind wasn’t mud.

I wish I wasn’t depressed.

I wish quite often that I was dead.

 

 

 

Student depression

University terms are starting all over the country. When I was an undergraduate, the Cambridge term started late, in early October, and our terms were only eight weeks long. That first one was seven weeks six days too long for me.

I have had several responses from students to my blog on dysthymia – low-level persistent depression, or what is now called persistent depressive disorder. The people who contacted me are just the tip of the iceberg. In your class of a hundred fellow students it could be that as many as nearly twenty of them are mentally ill, to some degree, right now. That’s a lot of sick people; imagine a class where twenty people were sneezing and coughing non-stop. Who are these people? Can you tell? Are you perhaps one of them? And a couple of lecturers are probably depressed right now, too.

What’s the leading cause of death for young people aged 20-35 in the UK? Those risky boys speeding round blind bends in their sporty cars? Drugs? Falling under a bus blind drunk? Being mugged and murdered? No, by some way, it’s suicide. Suicide is also the leading cause of death for men under 50. And most people kill themselves because they can’t take the hopelessness and pain of depression any longer. And if suicide doesn’t kill you, depression is associated with a host of disorders, such as heart disease, cancer,  and dementia, which might get you later.

Depression and anxiety are closely related, and usually go together. Epidemiological studies show that anxiety and mood disorders are remarkably common: it’s estimated that one in three people will suffer in their lifetime, and between one in six and one in ten are ill now. The reporting of mental illness has increased, but whether that’s because of better understanding of the disease, better diagnosis, reduced stigmatisation of the ill, increased pressure of contemporary life, or, most likely, all of these, is unclear.

When I was young (under twenty, say), I didn’t know what depression, anxiety, and obsessive-compulsive disorder were, although in retrospect I suffered from all of them. I was aware of something my relatives talked about in rather hushed tones called “a nervous breakdown”. I’m still not entirely sure what one of these was, but I think it was a sudden mental illness requiring some kind of treatment, and even incarceration in an “asylum”. Treatments were very limited back in the 70s; remember that chlorpromazine wasn’t released to the market until 1953, the first benzodiazepine, Librium, in 1960; and the first antidepressants in 1957 (iproniazid, a MAO inhibitor) and 1958 (imipramine, a tricyclic), although these drugs have many serious side-effects. The relatively more benign Prozac (fluoxetine) wasn’t available until 1987. I don’t think I knew about these drugs until I switched as a student from Natural Sciences Physical to Psychology. Indeed when I was a teenager, I thought of treatment as shock treatment; that’s about all there was.

Attitudes started to change when Prozac became widely available; perhaps that’s generally true – diseases only begin to lose their stigma when there is some hope. When I was young “cancer” was another dirty word, sometimes just called the “c word”. Don’t ask my younger self about swearing though; when I was ten, I thought the filthiest word in English was “pub” (where my father went Sunday lunchtime).

I was the first person in my family to go to university, and I had no idea what was involved, no idea really what a degree was (although I knew students “read” for it on University Challenge), no idea how to manage money (fortunately credit cards weren’t available then), no idea how to manage my time, no idea how to study independently, no idea how to live, no idea how to make use of what was available, no idea what a girl was, and no idea of how to cope when I was a raving loony without realising it. I was extraordinarily shy, which didn’t help. I wasn’t lazy; I tried my best, but I had no idea how to organise my time. I expected university to be like school, which of course it isn’t.

I stuck out the first year, mostly because I drift through things and staying was the easiest thing to do, and I was just clever enough to get by in spite of my deficits. The turning point was joining a society where I met other people. I still can’t say that I felt at home, and at the end of the first year I got a summer job where I did. I was earning good money, I had friends of sorts, I seemed to have some purpose, I felt like I was part of a community, and I wondered why go back to Cambridge. At that point I nearly gave up.

I don’t really know why I didn’t; it was easier to stay than not. And when I went back to Cambridge I discovered psychology, and things started to look up.

If I knew then what I know now I would have got professional help. I would have started with meta learning rather than learning. I would have been bolder about asking questions. Mostly I would have realised that I was ill, I wasn’t alone, and that I should talk to people.

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.

I’m mad, but so is BT

My blog on dealing with a typical British industry, BT (British Telecom), their surreal behaviour, and incompetence, and its toll on my mental health.

I’m going to take time out from writing about writing and madness to describe my difficulties with BT (British Telecom, the main telecommunications company in the UK – they provide the lines, but other companies can also provide the calls, which is altogether a rather bizarre situation). It is relevant to my blog though because it’s been such a distraction to me, and has taken up a large amount of time I could have spent much better doing worthier things. The problems have become something of an obsession – I find myself thinking about it a lot of the time, which is never a good sign for someone with mental health problems. At several points I have felt like giving up, but then thought damn it, if not me, whom? I suspect my difficulties in dealing with a big company are not unusual, but most don’t have the time or energy to pursue the culprits.

I think BT is fairly typical of British (perhaps most western) companies (and the public sector, including education) today: it’s too big, it outsources too much, it uses overseas call centres, and generally making it difficult for the individual customer to get anywhere with it. Its online system seems designed to sell, and not much else. The big managers, who make the big money, insulate themselves as much as possible from the customers, or “clients”. They probably have no idea what’s going on, and probably don’t want to.

It all started innocently enough just under year ago when BT phoned me, right out of the blue. Now I will swallow my pride here, and admit that it all serves me right for breaking my vow of never answering the phone to an unknown number, let alone never making a decision during a phone call. But the chap was very persuasive and informative: did I know that BT fibre optic “Infinity” broadband (very fast broadband, up to 80 mbps), was available in my area? I didn’t, and I was pleasantly surprised, because I live in a Scottish village pretty much in the middle of nowhere, so I had been expecting to get super fast broadband sometime around 2269. Furthermore, said this helpful and cheery chap, BT had an offer on, where they would give me BT TV on a special introductory offer for something like £10 a month for the first year. It would save me altogether £30 a month or so compared with what I was paying Sky just then. I was a bit incredulous: you mean I could get Sky Sports and Sky Cinema too? And all my other usual channels? I quite like Sky. They have a good range of channels and everything just works (most of the time). Yes, he said, you will have everything you have now, but it will be £30 a month cheaper. AND you will get UHD (4k) TV? Really? YES! Wow. What about Sky? He said BT would deal with Sky and sort out everything – I wouldn’t have to do anything. So I agreed. Emails detailing the contract were promised and an appointment with the engineer arranged for the near future. And BT would sort out EVERYTHING!

The engineer arrived the next week and set up the fast broadband with a new router and BT TV. Oh no he said, BT won’t sort out Sky TV; who told you that? You’ll have to speak to them yourself. BT would only take over Sky Broadband. But I had never had Sky Broadband – I’d always been with BT! Funny BT didn’t know I was their own customer. PIECE OF BT RUBBISH No. 1. I told the engineer I had never received the email contract, and he said he would have to send it again. PIECE OF BT RUBBISH No. 2.

Eventually he got my admittedly rather sophisticated television working with the set-up. Everything seemed to work and off he went. I started to explore the channels. It turns out there’s hardly anything to watch in UHD. But more importantly, where were Sky Movies and Sky Sports? I only had Freeview channels. Oh you have to order those separately said BT. I THOUGHT I ALREADY HAD. PIECE OF BT RUBBISH No. 3. But to be fair the price was as stated. But what was this, BBC News channel in standard definition? Where is the high definition version? It turns out that Sky beams everything down to you from their little satellite, while BT just sends the special stuff down the line, and picks up the Freeview channel from the air (confused yet?), and in my area I couldn’t get BBC News in HD. No one had explained that to me before. PIECE OF BT RUBBISH No. 4.  Talking of explanations, where was my promised contract? Needless to say, it never arrived. PIECE OF BT RUBBISH No. 5. But the good news was that I now had Sky Sports and Cinema. Or rather, I had Sky Sports 1 and 2, not all the Sky Sports channels, including Sky Sports News. Turns out these aren’t included, and the cinema package was similarly crippled. PIECE OF BT RUBBISH No. 6. And even worse, the channels I did get were only in standard definition, which is nearly as bad as watching black and white. It turns out that BT don’t provide them in HD. PIECE OF BT RUBBISH No. 7. So much for providing every thing I had before with Sky; I consider this PIECES OF BT RUBBISH No. 6 and 7 together to constitute mis-selling. I am tempted to use stronger words. If I had been told this at the start I would have put the phone down after ten seconds. So it was a good job BT hadn’t closed down my Sky contract after all, and that I had kept my Sky Box connected. But instead of having a perfectly satisfactory Sky contract, I now had a perfectly satisfactory Sky contract,  fast internet, and a perfectly unsatisfactory BT contract, and I instead of saving £30 with faster broadband, I am paying £50 more than I thought I would be.

And don’t get me going on the television box. I never did get the knack of the forward and rewind, but this might have been my clumsiness. It did keep on crashing though, which wasn’t me. It’s the software, not the hardware, and it will probably improve with time. I still consider the functionality to be PIECE OF BT RUBBISH No. 8.

Months passed. I seethed inwardly. I thought about complaining but as my regular readers will know, I was very ill, and had enough on my plate, as my gran would have said. After all, in the great scheme of things I haven’t been left without emergency cover, and I did have fast broadband. And TV. Two TV systems in fact, one though I never used.

But as the bills mounted up I seethed more and more, and then one day, I got a Sky Q box. And it worked just fine. Tidying up the wiring I decided I had had enough, so I packed up the BT TV box. This is crazy, I thought, so I went to the BT site to work out how to make the point that I thought service hadn’t been that great. I also wanted to find out when the BT television contract ended. The only thing I could find on their site was phoning someone up, or an online complaints system. So I filled in the complaint form.

At this point, if they had just said we’re very sorry, there seems to be some misunderstanding, and we’ll let you off your television contract a month early, I’d have been ecstatic. But they didn’t. They didn’t even understand what I was talking about.  PIECE OF BT RUBBISH No. 9.

From now on things become increasingly surreal. One has to be careful here because it turns out that the BT complaints system is nothing more than a glorified out-sourced call centre, and some people think you can’t criticise call centres based in other countries without being a racist. I have no great objection to call centres as long as they work, but the problem is that usually they don’t. I find I often have difficulty understanding what the person is saying, and they certainly don’t seem to understand me. (I don’t think that’s a racist thing to say, but these days, who knows.) I do feel slightly aggrieved that British Telecom outsources these jobs to non-British people, but that’s globalisation for you. I also feel sorry for the workers in these places: presumably they are poorly paid, crammed into a room, and spend hour after hour having to deal with irate people. No, it’s the senior managers who deserve our wrath.

I remember reading an article in the press by a BT manager saying that their Indian call centre was wonderful but some of their customers were disgustingly rude. There is no excuse for rudeness but I can see why people get so upset. I bet the head of BT doesn’t try to resolve their problems by going through their call centre. I don’t think it’s a sensible way to run a complaints system – and certainly it shouldn’t be the only way. PIECE OF BT RUBBISH No. 10.

So the first response was an email back saying that they were very sorry my equipment wasn’t working, and did I want an engineer to come out?

What? I replied saying that wasn’t the real problem. I hadn’t made myself clear. I repeated about the mis-selling.

They replied saying they’d been trying to phone me …

I replied saying my hearing isn’t that good (particularly with foreign accents on the phone, and in any case I prefer things in writing, so could they please not phone me). I repeated again that the main problem was one of mis-selling, and also cancelling my television contract. They’d told me when it ended, but I could get no one to confirm in writing that they had cancelled it from that date as I had asked. The person said they’d need to transfer me to a different department. What, I thought complaints dealt with things when nothing else worked? PIECE OF BT RUBBISH No. 11. The other department would email me.

Oh no they didn’t. PIECE OF BT RUBBISH No. 12. A few days later the phone started ringing. Guess who it was? So now I add to my list of issues that they phoned when I asked them not to phone. Guess how they tried to respond to this? You’ve got it. Let’s add poor customer service to the list. PIECE OF BT RUBBISH No. 13.

So someone was meant to write back. And they never did. PIECE OF BT RUBBISH No. 14.

I left it a while and then complained that they had never answered, through their strange complaints system again. The response was as you never CALLED back. What? PIECE OF BT RUBBISH No. 15. This person gave a lengthy apology in a very tiny font saying that BT values their customers and that people had been spoken to. Don’t they realise how annoying being told this can be when they hadn’t yet done a thing to help? This person said they had revised my complaint and identified that I had issues with BT TV. Yes but not technical issues; they didn’t address at all the point that it did nothing that I had been told it would be, and that it was working out to be more expensive, not less. And you can’t get Sky Movies and Sport HD, I reminded her. Yes you can! she (I think) replied. NO YOU CAN’T I said. Oh no, not in HD, she eventually conceded. And still no one had confirmed that they had cancelled my television contract! PIECE OF BT RUBBISH No. 15 (and I’m almost tempted to make this double rubbish given they deny themselves).

So I decided to try what seems to be the only thing that works these days: tweeting in the public arena. Again, I feel sorry for the poor individuals who are paid to reply to my rants. But at least they respond!

So then I get a bizarre email saying they are sending out an engineer. I never asked for an engineer! How on earth is an engineer going to sort out mis-selling? Their complaints department seem incapable of understanding what the problem is (another issue I have with overseas call centres). I feel sorry for this engineer. There is no easy way I can see on the email of telling them I can’t be in that time (other than phoning). PIECE OF BT RUBBISH No. 16.

I email again, and guess how they respond – yes, you’ve got it, by phoning me again. PIECE OF BT RUBBISH No. 17. I admit I get a bit irate at this point. I keep on saying that now I just want the email address of someone to talk to who understands English, but that is clearly too much to ask for with BT. The one easy thing they could they never attempt to do. By this point my blood pressure is soaring, I have dozens of emails not addressing any of my substantive points, the phone is ringing, the Twitter people seem perplexed, I am still paying £50 more than I used to, an engineer is coming out to sort out a non-existent technical problem, and the managers are still drawing their obscene salaries. And I’ve started obsessing about all this so it is really getting to me and not doing my recovery any good at all.

UPDATE: I think I’m getting somewhere with my Twitter campaign. They want me to send them my telephone number. And then a couple of hours later, I get a message back saying … they’re sending an engineer out tomorrow! I wonder about the ability of their complaints staff to read simple English. Or perhaps I don’t write simple English. Or perhaps now they’re just having a laugh. PIECE OF BT RUBBISH No. 18. I despair. I just want somebody sensible to talk to.

The engineer phones to confirm his appointment the evening before. An excellent idea, I explain the situation to him, and tell him not to come. He is very good. BT GOLD STAR!

If anyone can reduce the above to under 140 characters, please let me know. And if any of them are reading this and feel bad enough about themselves to do anything about it, here is a reminder that my email address is trevor.harley@mac.com.

FINAL UPDATE: I emailed the CEO, and his complaints department sorted it out the next day. BT GOLD STAR! But it shouldn’t have been so difficult. I just wanted someone to talk to. After a while the complain took on a life of its own because no one could be bothered to listen properly.

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.

Obsession

Depression alone is bad enough, but unfortunately it is rarely a pure affliction: people with mental health issues are usually doomed to suffer many versions of misery. Depression and anxiety go together, so much so that many researchers believe that there is a deep relationship between the two. Unsurprisingly then, both benefit from the same sorts of pharmaceutical treatment (SSRIs).

Anxiety comes in many forms, and many of us suffer from more than one. At different times I’ve had my share of social anxiety, generalised anxiety, panic attacks, agoraphobia, and other phobias. I have found that one of the most striking – I want to avoid the word distressing because all forms of anxiety are distressing to those who suffer from them – is obsessive compulsive disorder (OCD). When I was a young teenager my life was blighted by OCD, often in florid forms. In the night I would go down the stairs dozens of times to check that the front door was shut; I would get up multiple times throughout the night to check that my bus pass was still in my school jacket pocket; I would repeat things in multiples of three. I was afraid of contamination, the idea that germs and disease could spread by touching something that touched something that touched something, or even by having seen someone with a disease. I would then wash my hands several times (in multiples of three of course). I was afraid other people could read my thoughts, or would misinterpret an innocent gesture as an offensive one, so would apologise inwardly to them (in powers of three; twenty seven sorries is bad enough, but just try eighty one).

All classic stuff. I didn’t know what OCD was then, and I just suffered, alone, in misery. OCD is, to use a cliché, living hell, and it’s even worse if you think you are alone and have no idea what’s going on. In retrospect something should have been done about it, but I just grew out of it. Mostly – I still have a tendency to overcheck things, usually three times, but no more, and only occasionally, so it doesn’t bother me. We can live with some pathology. Being obsessive even has its advantages as an academic; there’s nothing wrong with checking your data a few times, or being careful about proof reading and checking your facts are right. Being a writer is sometimes obsessive; we often feel a pressure to write. I think you need to be a bit obsessive just to overcome all the negative feedback writers get. The boundary between OCD and having an obsessive personality isn’t always clear – as ever the problems start when what we do makes us unhappy, or interferes with our lives. We also have a problem if our behaviour doesn’t make us unhappy, but affects those around us.

As with all mental illness, the precise causes are unknown, but as with depression there is almost certainly there’s both a genetic and environmental component. The brains of people with OCD look different, but again whether that’s a result or cause of the illness, or whether both result from something else, is not know.

But not all obsessions involve an obvious compulsion other than one to keep the obsession going.  We all have things we worry about from time to time. Most of us are familiar with “ear worms”, tunes that get stuck in your head. I suffer very badly from these (I speculate it’s to do with my psychopathology). It can drive me mad – or more precisely even madder than I already am. They’re the strangest tunes too – I once endured a week of John Denver singing “Annie’s song” non-stop. Worst of all though are obsessive thoughts, the rumination on particular events, ideas, or people that takes over our minds. It is horrible. The compulsion, in as much as there is one, is to continue the obsession. The thoughts – bad thoughts – involve regret, guilt, and fear. When I was in my OCD phase as a teenager at the end of every school term I would struck by the idea that I had done something wrong, and the school holiday would then be ruined by the fear of punishment that would await me on my return at the start of the next term. Of course I never had done anything, and was never punished; it was all in my head. It’s impossible to reason yourself out of OCD.

I think obsessive thinking is verging on psychosis, because things really are out of control. We might refuse to accept that the obsession is irrational, and some people might even act upon their obsessions – I assume that is how people become stalkers. I just suffer though.

Obsessions without compulsion is called “primarily obsessional OCD”. I was encouraged to see that the Wikipedia entry on OCD says that “Primarily obsessional OCD has been called one of the most distressing and challenging forms of OCD”; it’s more than distressing, it’s mental agony. I almost envy people with OCD because at least enacting the compulsion provides a little relief, no matter how short.

However illogical and crazy the behaviour might seem to someone who has never experience OCD, it is impossible to reason your way out of the illness. You can’t tell yourself that it’s irrational to wash your hands so many times. First, the compulsion is stronger than our belief system. And second, there is always a grain of truth we can cling to – it is just possible that a disease might be passed on by touching something that was touched by someone who touched someone with a disease, for example. There is though a clear treatment plan for OCD that involves breaking the link between obsession and compulsion. One of the best books I have read on OCD is Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, by Jeffrey M. Schwartz. He identifies four stages in treatment: relabel (you must recognise what is obsessive and clearly label it as such); reattribute (this thought is not me – it’s my OCD); refocus (the really hard bit, where you have to shift attention, at least for a while); and revalue (to take the whole cycle as something not to be taken as face value, and to adapt the view of a more impartial observer – being mindful). He suggests gradually building up a delay between having the compulsion and having to do it – you might only be able to manage a few seconds at first, but you increase it, perhaps very slowly.

Such treatments, while effective for dealing with the compulsive actions, don’t immediately help us in being able to stop the bad thoughts coming in the first place. In a recent bout, ruminating on a mistake I had made, I tried saying internal loudly and firmly, “It was my choice”, which I eventually simplified to a loud “STOP!” in my inner speech. This approach eventually worked – or the bout blew itself out. A friend told me that a common technique is to visualise a STOP road sign, and I have since tried combining visualising the sign with thinking STOP! It is exhausting work though; bloody exhausting. At least my obsessions appear to have a natural life span, and eventually, after much pain, they eventually peter out.

The intrusiveness of thoughts is one reason why I find meditation so difficult. My thoughts just won’t go away. Even when counting breaths the thoughts overwhelm my inner voice counting. There is a paradox here because if I could just be mindful and live in the present, I wouldn’t be so obsessed by Bad Thoughts, but the Bad Thoughts stop me being able to attend to the present. Coming back to the now and trying to be present does help me when I’m being obsessive, and I think it’s a skill at which one can get better with practice.

I am grateful to and encouraged by everyone who has written to me about my blog. So many people suffer alone; it is time to stop the stigma of mental illness. For a long time I thought I was alone in suffering from obsessional thinking; if we all shared more we would be less isolated, less frightened, and maybe just a little better off. Please feel free to share this blog with whoever you might think would benefit from it.