International society removes ‘schizophrenia’ from its title

Woohoo! First it was a joke that was taken seriously only in the post-psychiatry movement. Now it’s a mainstream opinion. Soon the only discussion will be how anyone could ever have believed in the syndrome of schizophrenia.

Hard wired 12: Heuristics

Heuristics – the amazing mental shortcuts that lead us into trouble

“A heuristic is a mental shortcut that allows people to solve problems and make judgements quickly and efficiently. These rule-of-thumb strategies shorten decision-making time and allow people to function without constantly stopping to think about the next course of action.”

We all use heuristics. We have to. The alternative would be ‘paralysis by analysis’. We’d be too busy thinking through our every action actually to do anything. From a smile or a handshake to how to cross the road or even boil a kettle. Without heuristics life would be exhausting and probably very short. After all – by the time you’d thought through how to respond to the speeding car hurtling toward you, you’d probably be dead. Heuristics are the psychological shortcuts that keep us going in a complex world.

Some of our heuristics are learned. That’s why experts are so good at what they do. Years of experience has taught them the heuristics of their work.

In my own field for example, I remember as a novice psychiatric nurse spending hour upon hour wondering how to approach each individual, trying to be aware of their every characteristic as though all that information, somehow would tell me what to do. With experience I learned that not every piece of information is important in every situation. I can ‘cut out the irrelevant’ and take appropriate action based upon only the important things. In a very real sense the study of ‘heuristics’ is the study of ‘the relevant’.

So I know that depressed people need motivation; I know that anxious people need a way to problem solve; and I know that psychotic people need a way to assess their perceptions and beliefs. These are the shortcuts, the heuristics that allow me to be effective. But they’re not foolproof.

In choosing to ignore irrelevant information and act according to pre-conceived patterns of need psychiatric nurses run the very real risk of ignoring ‘the individual behind the distress’. By focussing only upon the depression and working to motivate a service-user I might fail to notice their suicidal ideation. That would be a serious omission and working too hard on motivation without addressing the underlying desire to die could result in the person actually killing themselves rather than just thinking about it.

Of course experienced nurses know this and work hard not to limit their attention only to motivation without understanding what might come next but the point is clear. Mental shortcuts are useful but they are also, by definition, superficial. They make us prone to mistakes.

The good news is that we can learn to take account of these pitfalls. The bad news is that most of the time heuristics just take hold of us and we carry on in our own sweet, superficial way because that’s what we evolved to do.

Like all evolved tendencies, heuristics favoured survival of the fittest in the Environment of Evolutionary Adaptation (EEA). They are so embedded in our evolutionary journey that they are a universal trait among humans. We act without thinking. That’s what kept our ancestors alive. It’s also what keeps us alive today. Whether the threat was a predatory tiger in the Pleistocene or a speeding car in the present we act instantly to keep ourselves safe. Natural selection kept the gene pool viable and the evolution of heuristics was assured.

Instinct

When we talk about ‘instinct’ we often really mean heuristics. A newborn human has only two instinctive responses:

1. Suckling;
2. Fear of falling.

Everything else has to be learned. The more effective the heuristic shortcut the more likely it is that we confuse the lesson with instinct. But it’s not instinct. The tendency to develop learned heuristics is an evolutionary trait but often the heuristics themselves are the products of experience and of culture. They develop as we learn from experience and, as we have seen, they can lead us astray.

In a sense, evolutionary psychology might be thought of as the study of heuristics. It’s the study of those ingrained mental shortcuts that mould our basic drives even (although not necessarily our specific behaviours). Protection of children, for example or a general commitment to justice (at least justice so far as other people are concerned) seem more hard wired than a healthy respect for road safety. That’s because although the need to survive is hard wired the rules governing traffic have to be learned.

As already noted, one of the aims of this blog series is to understand the role of determinism in our evolutionary make up. I suspect that if we are to embrace free will (the opposite of determinism) in any meaningful way then attention to heuristics will be the way forward.

Hard wired 6: The meaning of human nature

Disclaimer: As I made clear at the beginning of this series I’m writing this blog because I want to learn. I don’t profess to be an expert in evolutionary psychology and I don’t pretend to have an absolute understanding of human nature either. So if you read something here that strikes you as really, really, silly, pretentious or just downright inaccurate – please tell me. And please tell me why you think I’m mistaken – that’s how I’ll learn.

Throughout my career I’ve met all sorts of people from many different ‘walks of life’, some with serious mental health problems and some who swore that their mental state was nothing short of perfection. I’ve met people with money and also those who struggle to find the next meal – actually I’ve met many more of the latter than the former.

But no matter what their circumstances, class or lifestyle many, and quite possibly ‘all’ of them, have a tendency to justify their ingrained behaviours by describing them as ‘human nature’. They spoke as though everyone behaves that way and there really isn’t any option. Interestingly the same argument about ‘universal’ behaviour is made by the ‘dog eat dog’ con artist who sells his second-hand car without declaring the fact that it’s good only for scrap and the sympathetic nurse who seems to live only to help others in need. Both would tell you with equal certainty that their behaviour is the result of universal human nature.

But if human nature means anything at all it must be consistent – it must hold true for all people. Otherwise it’s just a collection of preferences that people justify by claiming that they’re more widespread than they are.

One of the most important issues addressed by evolutionary psychology is this very question – what exactly is ‘human nature’? What are its components and why, if such a thing as human nature exists at all, do we see such widely differing behaviours from human beings ‘in the wild’, so to speak?

I confess that for many years this concept confused me. It seems that whatever aspect of ‘human nature’ I came across there was a contradiction waiting in the wings to knock it down again. It was as though human nature became nothing more than a myth – a widespread illusion that people use to justify whatever they like without so much as a grain of truth behind it. And then, just within the last few months, I read ‘The Moral Animal’ by Robert Wright (1994) – a fascinating book that suddenly helped me to make sense of the whole notion of human nature. You can get hold of the book here

Wright describes the way that human nature, far from being a collection of hard and fast, inflexible rules, is much more like a set of choices, alternatives that are turned on or off in response to opportunity and circumstance. To illustrate this I’ll take only one of these alternatives – the dichotomy between dominance and submission.

I know many very successful people who claim that the drive to dominate, to be in charge, to have authority over others is something that exists in all of us. They justify their behaviour, their often cruel and uncaring behaviour, by asserting that if they didn’t take charge of others, others would take charge of them. In the past I’ve dismissed this reasoning as just so much posturing intended to excuse their abuse of those around them. But now I’m not so sure.

To make sense of this I’ll begin with an assumption:

In evolutionary terms, dominance is preferable to submission!

This is because dominance is likely to result in more opportunities for procreation. Remember that the driving force of evolutionary adaptation is to get your genes into the next generation and the only way to do that, at least for primates like ourselves, is via sex.

Yes, of course, it’s possible in the modern world to produce offspring without sexual intercourse but that wasn’t the situation in the evolutionary environment. For most of our history (human and pre-human) sexual intercourse was vital to genetic survival.

So – the default is to strive for dominance. Our nearest relatives on the evolutionary family tree, chimpanzees and bonobos demonstrate this correlation remarkably well. The dominant males get most (if not all) of the sex. Their genes make it into the next generation. The submissive males are much less likely to procreate and so their genetic lineage dies out. Usually.

There is then, a great drive to dominate others, especially for males. But what of those who find themselves lower down in the ‘pecking order’ – the hierarchy of sexual opportunity? What choices do they have.

Well essentially they have only three choices….

 1. They can risk injury or death (often amounting to the same thing) by challenging the dominant male;
 2. They can support the dominant male in the hope that they will be allowed some limited access to females (this really happens);
 3. They can accept submission and stay alive with the possibility of the odd sneaky liaison when the dominant male isn’t looking.

If the male in question has realistic designs on dominance (or supporting the dominant male) they are likely to bide their time and make their own ‘power play’ when they’re mature enough to do so.

If the male in question is weak they tend to accept submission and the occasional liaison because this affords their genes a greater chance to be transported into the next generation. After all – there’s no evolutionary prospects at all if you’re dead. Staying alive by submission at least gives your genes a slight chance of making it through.

We can see then that dominance isn’t an ‘all or nothing’ strategy. It’s a sliding scale that prompts individuals to assume more or less dominant roles depending upon the circumstances that they find themselves in. In short it’s a hard wired, genetically determined, psychological ‘module’ that helps us to ‘play the odds’. We’ll hear more about psychological ‘modules’ as the series progresses.

For now let’s compare this principle to human behaviour…..

We all play different roles depending upon our circumstances:

 1. The bullying office manager is dominant when surrounded by underlings but assumes a submissive role when called to explain the accounts to the chairman of the board.
 2. The pompous professor is less domineering when surrounded by more respected academics;
 3. The violent criminal may be quite prepared to assault his (weaker) victims but assumes a much more submissive role when sent to a prison populated by real ‘hard men’.

Of course – in the modern world these choices about dominance don’t always relate directly to opportunities to procreate but that’s not the point. They did during the Environment of Evolutionary Adaptation (EEA) and so the tendency to be dominant when we can and to submit as a form of self-preservation when we must is hard wired. That’s why ‘human nature’ seems so variable. It depends upon complex social and circumstantial cues to fine tune behaviour.

As we go through this series the theme of circumstantial adaptation will be integral. Nothing about human nature is quite so ‘cut and dry’, so ‘black and white’ as many of us – myself included – used to believe.

Hard wired 1: contents

Every year I teach myself something. But this year is different. This year will account for only half the project. I have turned my attention to the fascinating subject of ‘evolutionary psychology’ and it will take more than a single year to get my head around this remarkable topic. I estimate that it’ll take at least two years (and possibly longer) to get even a basic grasp of this complex but fascinating topic. So….

I’ve been planning this for a while. Now I think I’ve got enough ‘down’ to begin. Undoubtedly this series will change a lot over time, it’s as much a way for me to aid my own study as anything else (I have no tutor to set assignments or mark my work here) so the chances of this outline being truly representative are slim. But, from my perspective today, 4 months in to my self-imposed studies, this is what I expect to cover.

Do feel free to comment and to criticise (constructively please) as that’s the next best thing to a tutor marking my work. This is very definitely my attempt to distil new information. I make no claims to expertise here – so please view each entry as a student’s essay trying to make sense of it all.

I plan to include…

Contents list

Introduction

Why evolution is true
Some things are hard-wired because they result from our evolution in the Environment of Evolutionary Adaptation (EEA)
What evolution by natural selection means
The big brain
Psychological ‘modules’
The deceptively simple lure of determinism
Know thy enemy

Mental modules:

Why Freud was nearly right
The unthinking mental module
Pattern recognition
Gambler’s fallacy
The power of previous investment (can’t stop now)
Images and other unconscious cues
The power of a pair of eyes (even when drawn or photographed)
Stupid men – the power of printed pornography
Stupid women – the power of written pornography
Ease of remembering
Group conformity
Story-telling vs statistics
Percentages vs natural numbers
Deception
Self-deception
False memory
Consistent behaviour
Risks – How easy is it to think of examples?
Cognitive dissonance
Gut versus reason
Emotion versus intellect
Placebo
Group conformity and group identity
Reversion to the norm
Social hierarchy
Children believe easily
Deference to authority (strength)
Pride, saving face and an aversion to appearing weak
Disgust
Pain/pleasure
Confirmation bias
Selective abstraction
Reciprocal altruism
Gossip
Tit for tat
The drive to punish (including punishing non-punishers)
Sexual priorities – men
Sexual priorities – women
The evolutionary necessity of fear
The modern (political and commercial) exploitation of fear

Modern movements

A small world brain with big world problems
Radical feminism
Mens’ Rights Activists (MRA)
Marxism
Theism
Libertarianism
Socialism
Conservativism
Utilitarianism
Judicial bias
Science versus (human) nature

Mental disorders

Anxiety
Depression
Psychosis
Personality disorders

I wonder if this is true

Faith healing GP Accusations have come forward that a Staffordshire Dr. told his patient God would heal her & to stop taking her psychiatric medication. The GP denies any wrongdoing and claims that the allegations represent an attack on his Christian faith.

Whether or not this particular GP is guilty of such serious misconduct is a question yet to be answered. However it wouldn’t be the first time such medieval recommendations have been made in UK. The last few years have seen UK psychiatrists like Rob Waller refer psychotic patients for exorcism, several deaths resulting from exorcism worldwide and an Archbishop calling for exorcism of ‘the mentally ill’ in the House of Lords.

It’ll be interesting to see how this plays out.

Tiddles, ATOS and the Dept of Health

ATOS, the hated French firm responsible for denying benefits to more disabled and incapacitated people than you can shake a stick at, have done it again. This time they’ve come up with a money-saving scheme that looks set to save the Department of Work & Pensions a veritable fortune without having to deny the health needs of claimants.

Previous attempts to victimise seriously ill and disabled Britons involved declaring them fit for work so that they could be denied benefits. The basic idea was that once these unfortunate former taxpayers had starved to death the government would save a few quid looking after them – money that would be better spent elsewhere. After all – relieving hard-pressed multi-millionaires of their financial responsibilities to the welfare state is far more important than keeping their less fortunate compatriots alive to leech off the wealthy.

Recently it has become clear that ATOS’ original approach of denying medical evidence and just ignoring the hardship of claimants has been more bother than it was worth. Thousands of claimants have appealed against their judgements and the subsequent exposure of ATOS’ cynical cruelty has been damaging not only to the French firm of venture capitalists but to the beleaguered UK government as well. So ATOS has come up with another, less obvious suggestion and the government has been grateful enough for their inspiration to pay them handsomely. ATOS executive Pierre Le Chat has been paid an undisclosed 6 figure sum for the idea which the government claims will save billions of pounds for the independent health providers now profiteering in the newly privatised NHS.

Instead of merely pretending that people are healthy ATOS suggests that the mode of treatment changes. A classic example of this is the newly recommended treatment for cardiac patients. Previously such people have been treated with a range of drugs and exercise-based physiotherapies, none of which come cheap. And yet, as Le Chat pointed out in familiarly superficial style, they all do essentially the same thing. They are all intended to lower blood pressure.

Lowering blood pressure isn’t particularly hard to do. Exercise works. So does stroking and cuddling pets. So the solution is easy – at least so far as the Dept of Work and Pensions is concerned.

From tomorrow, new cardiac patients will not be prescribed medication at all. Instead they are to be given a kitten to stroke. The kitten will be provided free on the NHS although it will be the responsibility of the individual patient and their family to feed it and pay any associated veterinary bills. It is expected that patients will have their kittens sterilised as soon as they are old enough but should this not happen and more kittens are produced they can be returned to the NHS for redistribution to other workshy malingerers.

Obviously some patients will need more than just a new pet cat to resolve their physical health needs. Monsieur Le chat wasn’t available to comment on provision for these people but junior health minister, Kitty Laville, perhaps in a bid to rise above her hitherto obscurity has been prepared to comment. In a truly stunning illustration of her government’s callous stupidity this inept Lib Dem turncoat, a latter day version of Judas Iscariot, told the BBC:

“When there’s no money for health care some people will die. That’s a shame but at least it’ll be the undeserving poor that leave us. That will save precious resources for those who are prepared to work for a living.”

Oh well. So long as the nice Tory and Lib Dem voters stay around to vote for their right wing heroes next time who cares? I mean really, who cares? Do you?

Laville was equally unsympathetic when asked about cardiac sufferers who also experience pet allergies, itself a major contributor to elevated blood pressure. In the now familiar style of this callous, divisive government she replied:

“All medical interventions have side effects. We have to accept that not everyone will respond to treatment. However the new regime won’t start until after the bank holiday.”

Click here for more information.

Public speaking

One of the things I’ve missed the most about my new role is the lack of public speaking engagements. I just love speaking at conferences. The price of entering a corporate world is that it’s hard to be an individual (at least at first).

That was the bad news …. now the good ….

This afternoon I spoke with my line manager, the divisional head of quality. We spoke about a range of things including conference speaking and he’s agreed that I can start representing the company publically. I can speak at conferences again.

So this is me letting you all know that I’m available to speak once more. If you want someone to witter on about mental health and social care related issues then I’m your man. Please get in touch via my work email: stuartsorensen@priorygroup.com

For the record then, my new role (well newish) is Quality Development Lead (mental health) for a large, nationwide social care provider. My role entails several functions including:

Devising and impementing a long-term mental health strategy throughout the company;
Training and supporting staff to implement the strategy;
Ensuring quality throughout the company;
Advising upon and dealing with mental health related issues throughout the division.

The company is a national organisation covering the whole of UK so wherever you are in the British Isles I’ll have something to say to you and your delegates.

I’m experienced in a wide range of mental health and social care related topics and am also very happy to run workshops and speak in panel sessions. I’m a pretty good networker too.

Go on – get in touch. you know you want to!

Scary shit! I mean really scary!

I’m no stranger to driving. I cover around 1000 miles in my car on an average week and it’s not always in ideal conditions. In fact, over the years I’ve come to think of myself as pretty skilled behind the wheel – maybe that was the problem.

Last Friday night I found myself working in Poole, Dorset. For those that don’t know the geography of UK that’s a town on the South coast (the bit that looks out toward France). That’s about as far as you can get from my home in Cumbria without getting wet. I live in the North West of England, about 30 miles South of the Scottish border in a town on the edge of the English Lake District called Workington.

Normally it would take me around 7 hours to drive home from Poole. not such a big deal, even accounting for rush hour traffic. So I left work at a little after 4pm to travel back to Cumbria. I knew that there were bad weather warnings but I’d dealt with that stuff before. I’m a Cumbrian – we’re used to bad weather. Bring it on!

The snow hit when I was at about Warwick and it did slow the traffic down a bit. By the time I left the motorway (Jct 36 of the M6) it was midnight. That was a bit behind schedule but hey ho – no problem.

I had planned to follow the M6 motorway to Jct 40 and take the main road from Penrith. It’s a bit further to drive but it’s a better road. However the M6 was blocked at Shap summit according to the ‘matrix signs’ so I came off at Kendal instead. The plan was to stop at the Kendal travelodge because my good lady, Gill had already called to warn me about impassable lake district roads and I didn’t want to push my luck.

Alas – the road to the Travelodge was closed but there was a diversion into Kendal so I kept going. I could always double back to the travelodge from Kendal town centre. However the diversion took me to a dual carriageway with no way to double back. Oh bugger!

By now there was so much snow on the road that I couldn’t stop the car – I’d never have got it moving again. I was committed. I couldn’t stop and I couldn’t turn around. I just had to drive on. To stop would have meant a night in a freezing car with drifting snow and no telling how long I’d be there. Not a sensible option.

Of course a wise man would’ve stopped in Kendal but I’m no wise man.

So with 55 miles still to travel I soldiered on through the A591 – The ‘Lakes Road’. The Lakes Road is normally a beautiful, scenic route that takes in lakes, meres, quaint little towns and villages and, of course, stunning mountain passes. Stunning so long as you can see the bloody road!

With nobody but myself (and my own stupidity) to blame I soldiered on. I drove through Ings and Ambleside without incident. Admittedly I averaged around 15 miles per hour (and slowed down for the corners) but I got through. I even passed a deer on the road. I was going so bloody slowly it didn’t even run – it just stood there and watched me drive past. I passed the mini roundabout at Grasmere easily enough (yes even a mini roundabout feels like an obstacle in those conditions) and then I began to climb. I was driving up Dunmail Raise – the largest and steepest mountain pass on the Lakes road. And I still couldn’t see the road for the thick carpet of fresh snow that obscured my path.

Of course a wise man would’ve stopped in Grasmere but I’m no wise man.

Going up Dunmail wasn’t so bad. It was going back down toward Thirlmere that was the problem. The picture below shows you the view from Dunmail top to Thirlmere (the lake in the distance) but it doesn’t give you any hint of what it was like in the early hours of Saturday morning as I drove down the steep, narrow, winding road into the valley below.

Then came the long road past Thirlmere – a terrifying combination of sliding tyres, sharp corners and dry stone walls. Not fun at all but nothing to the delights of Thirlspot hill to come. Another short climb out of the Thirlmere valley and the car literally slid down the next hill to Thirlspot. I had already decided to pull into the car park of the Kings Head Hotel at Thirlspot and wait until morning but there was so much snow I couldn’t see the bloody entrance. So on I went.

Next came Castlerigg – a beast of a climb that took every ounce of my driving ability. If I’d lost traction only once I’d have slid right back to the right angle bend at the bottom of the hill and a really memorable ‘prang’. Not a good plan.

But I made it to the top and started the descent into Keswick. Guess what I’d forgotten…. the right angle bend half way down the snow covered hill with the sheer drop to the lake below. Oh bugger!

‘Gingerly’ doesn’t describe the tentative way that I applied the brake until by the time I reached the corner I was doing a full 5 miles per hour and still sliding. Now that really was scary! As a young man I’d worked behind a hotel bar not far from that particular corner and I still remember the story of a tourist who took the bend too fast and effectively ‘flew’ into the fields below – hundreds of feet below. He died, of course – torn and twisted (as Meat Loaf would’ve put it) at the end of his undoubtedly spectacular ‘flight’. That memory was vivid in my mind as I wrestled the car around the tight corner and continued down the hill toward Keswick. Only another 25 miles to go.

I won’t bore you with the rest of the drive but it wasn’t pleasant (although the solway plain does have a somewhat more temperate climate once you leave Keswick). Suffice to say that I was glad to get home after 55 miles (and two and a half hours) of the scariest drive of my life.

The next day was Saturday and I slept until early afternoon before spending the day more than a little preoccupied. I had to do it all again on Sunday. Fortunately though about half an hour before I was due to leave for another 200 mile trip my boss Emailed – the meeting had been cancelled. To say that was a relief really doesn’t describe the sense of reprieve I felt. but that left me with another problem. I didn’t want to get back in the car at all. That’s how phobias start but there it was – I was really scared.

Then Monday came – today – and another 170 miles to South Yorkshire. I checked the weather (and the traffic reports) and all seemed OK so reluctantly I set off. And here I am in Rotherham – 4 hours from home and happy to have driven over the Pennines to get here. I’m not scared any more but by ‘eck – perhaps I should be.

The old (archived) blog content

If you were wondering where all the blog’s content has gone it’s here (well most of it is) in downloadable PDF and other formats.

You’ll find loads of stuff on mental health, human rights, and a few other topics as well. Go and have a look. You know you want to

Enjoy

The new lunar society

What a brilliant response!

I’m really chuffed that so many accomplished and undoubtedly knowledgable people have said you’d like to join the New Lunar Society. I really do think this could become something truly special. That was the good news.

Now the not so good news….

At least six of the New Lunar Society’s members can’t make the 23rd (when we’ll be defining terms of reference etc) and so, rather than start without some ‘key players’, We’ve decided to rearrange.

So we won’t be meeting in Birmingham this weekend. I’ll be sending out a new date and venue shortly. If you’d like to be involved and haven’t already been in touch let me know by Email: stuart.sorensen@googlemail.com

I’m really looking forward to getting started with this but there’s no point setting off ‘half-cocked’.

Watch this space…