PDA

View Full Version : blink: Thinkin,' Even in Therapy, Won't Get You Anywhere


James Brody
February 22nd, 2005, 10:27 PM
"Never argue the content of a psychosis." My first psychiatric nurse, 1963.
----------

Malcolm Gladwell tells us that the more we reason about an event, the more likely we are to make mistakes: most of our decisions rise from "thin slices" of experience. We judge marriages, teacher competence, dating choices, combat strategies, criminal suspects, wine and foods, and even fine art works without telling a consistent story for why we make a particular choice. Judgments about a teacher in 2 seconds agree with those made after 3 months. Prospective dates announce one set of standards but fall in love with people who don't match them. Pentagon analyses of combat scenarios can be defeated by a gifted nonconformist commander.

Gladwell follows his insight and gives thin slices from research and from high-risk occupations. He also introduces us to a fascinating cast that includes Timothy Wilson (psychology of decisions), John Gottman (marital), Wendy Levinson (malpractice suits) , Bernard Berenson (art criticism), John Bargh (priming), Iyengar & Fishman (speed-dating), Paul Van Riper (military strategy), Lee Goldman (heart attack assessment), firefighters, and the police who shot Amadou Diallo are examined according to insights from two sons of evolution, Sylvan Tomkins, and Paul Ekman.

The disconnect between memory and action is an old story. In 1933 Penfield told us that when stimulating exposed neocortex in surgery, he elicited memories of events that never happened (Bloom, 2000). Students will remember details from a movie and be shocked when they see the film a second time and find that their memory does not match the film (Gladwell, 2005). According to David Cohen (1999), ABC television found many small children to confabulate "abuse" stories during the three weeks after a pediatric exam! Gazzaniga's research found the left cortex to lie about what the right did and to become angry when disbelieved. (Bloom, 2000; Gazzaniga, 1992). (Even that inspired narcissist, Sigmund Freud, noticed these things!) And Loftus and Ketcham (1994) debunked memories of early sexual abuse and suggested that memories reform according to suggestions from an interviewer. Our dreams appear when we watch the consolidation of memories from the prior day. Our pasts are as contrived, crafted, and imaginary as our futures and memories are perhaps changed most easily whenever they are retrieved. Relive an event and you change the record...

Our magnificent neocortex transforms into an agent of reversible construction: it makes Quonset huts and tents, not castles. Your most durable memories, fun, nonverbal, learned easily, and retrieved often, are usually those that match your genetic propensities. The neocortex is also an agent of shared environment: a layer of inhibition, arranged by culture and a buffer, an exploratory system, between instinct and environment. And it can feel good to get drunk and put the damned thing to sleep! We can also understand why the lobotomized will be less suicidal and why the mildly depressed more realistic (Bloom, 2000; Ratey & Johnson, 1998).

Did Sylvan Tomkins Have Aspergers?

Rachel Gur reported 15 years ago that males can't recognize when a woman is mildly upset; females can. I know guys fired by women, the guys "never saw it coming." Many little boys make the same complaint about their mothers and teachers; the little girls all see the attack build, the guys are stunned and scream "unfair!" Along these lines, Gladwell sees the cops who shot Amadou Diallo as becoming "too male" in a crisis, unable to respond to subtle emotional cues, and achieving a state of transient Aspergers.

Clever fellow, this Gladwell!

Aspergers Syndrome, a disorder that impairs socialization but sometimes delivers a gift for sorting and classifying, seems to be a male trait and perhaps associated with high levels of maternal testosterone. Estrogen, on the other hand, mediates learning, it also appears to mediate cooperation. According to Gladwell, Sylvan Tomkins was a classifier and a talker, sometimes for hours at parties, on the mosaic tiles of human facial expression and the classification of expressions. He was also a resource for Paul Ekman who eventually refuted anthropology's fantasy that culture dictated facial expression. Rearranging these possibilities suggests that Tomkins may, paradoxically, have had Aspergers! Was Tomkins really an awkward, energetic guy who labeled expressions but could not respond to them empathetically or a "warm-fuzzy" empathic guy who also classified facial movement? This dilemma might intrigue Baron-Cohen...

"blink" and Thorazine

My first state hospital was home to 3000 creatively confused souls who, like the spider who spun her web inside a matchbox, arranged new lives for themselves inside a country retreat of bricks, bars, locked doors, and white suits. It was a lost time before community mental health centers and a long time before lithium and a longer time before Prozac.

Redneck nurses, escaping their six kids and truck driver husbands, collected gossip from the aides and used it to guide their smiles, frowns, cigarettes and coffee. Medication adjustments were used for sustained control: do it once and change someone for months! Each nurse managed 60 patients, each psychiatrist about 700. One psychiatrist came to us from Cuba but spoke no English: the nursing supervisor wrote his orders. Another, a Cambodian, spoke less English than he understood and wanted a fence to separate the men from women so they would not breed. A third from the UK was blessed by all the staff for his warmth and hard work and no one asked how he got lost at the asylum. A fourth, a Greek, tut-tutted the staff and implied promises that were neither made nor kept. And the fifth, hyper and mildly irritable, tended his cases like a mother hen. The most effective administrator was a Turk.

And there was no data that any one of these characters less effective in the prescriptions that he wrote.

This odd network was perhaps stable for controversial reasons that Gladwell might appreciate: (1) A large overlap exists between medications and an equally large overlap between symptoms (systematic use of behavior therapy was nonexistent within that agency). Patients and staff were fundamentally the same but there was often too much or too little of an essential trait in a patient and we needed to adjust their volume. (2) No one, according to Gladwell, sues the physician that he likes. (The Cuban had a gracious smile. The Greek appeared to mediate, the Brit was loved. We hated only the unsmiling Cambodian...call the lawyers!)

Thus, clinical effectiveness cannot be assured by elaborate plans: it may, in fact, be compromised by them. If you're any good, intuition generates a few simple decisions that let the client once more arrange his world without annoying other people. At the same time, the client protects himself and his doctors: each partner is an exploratory system that repeats what works and avoids what does not. Our job, like that of a good parent, is to discover contexts wherein liabilities become assets and to nudge our collaborator toward them. We can attribute good outcomes to our patient's resilience, bad ones to his stubbornness, but they are the same. As a great pediatrician remarked 20 years ago: "I want to be the last doctor to see the patient before he gets well..."

Implications: Trashing the Wrap from Bloomingdales

Twelve years of public education chisel verbal information into butter that melts in summer heat: all is forgotten. The fun-to-do, easy-to-learn adaptive things such as kicking, hitting, kissing, and forming gangs appear on the school yard. No one has to pay a kid to throw rocks at a rabbit! No one takes away videogames if he doesn't practice throwing those rocks! Further, home-schooled kids do not show social impairments and they do better than the public kids on aptitude tests although their mothers do not have masters degrees, high salaries, or cushy benefits. (Public education is a spiteful cancer: it now wants mothers to file lesson plans!)

Psychotherapy is another instinctive, good thing cocooned in plans, assessments, 12-page social histories, defense mechanisms, early trauma, and insight. (In this case, however, quality review teams assure that the butterfly never escapes!) I suspect that hookers, nurses, and diner waitresses stabilize hyperactive males and frightened females: the data will remain uncollected. Words become a means to keep the client and healer sitting together while more important communications take place! And it may be that language and rules more often stabilize cultural practices than change them.

Whether in education or psychotherapy, or even in the fact that our neocortex looks so impressive, the wrappings are from Bloomies and the contents from WalMart. Some kid once made the same comment about a king's wardrobe...

Bottom Lines

"Couple of guys sittin' around drinkin'
"Down at the starlight bar
"One of 'em says, you know I've been thinking
"Other one says, that won't get you too far..." "The Secret of Life," sung by Faith Hill
----------

Buy Gladwell's new book even though Faith said it first...she said it best. He provides anecdotes without mechanisms but even with mechanisms such as those described by Barabasi (2002) or by Watts and Strogatz (1998), he would not convince rationalists, cursed with too much estrogen and serotonin and by attention surplus disorder (See Ratey and Johnson, 1998). Gladwell will sit on a pin or on a comma in a fly box or history, entombed under the blather that he debunks. The good news is that evolutionists and deists can be friends even if the first finds the second psychotic and the second finds the first damned. So long as they don't argue their reasons!

Perhaps it's not such a bad thing that we burned the library at Alexandria...
---------

References:

Barabasi, A-L (2002) Linked: The New Science of Networks. NY: Perseus. (Introduces emergent networks, organizational arrangements that occur widely and have the speed and scope to support Gladwell's collection.)
Bloom, H. (2000) Global Brain: The Evolution of Mass Mind from the Big Bang to the 21st Century. NY: Wiley.
Cohen, D. (1999) Stranger in the Nest: Do Parents Really Shape Their Child's Personality, Intelligence, or Character? NY: Wiley.
Gazzaniga, M. (1992) Nature's Mind. NY: Basic Books.
Gladwell, M. (2005) blink: The Power of Thinking Without Thinking. NY: Little, Brown.
Loftus, E & Ketcham, K. (1994) The Myth of Repressed Memory NY: St. Martin's Press.
Pinker, S. (2002) The Blank Slate: The Modern Denial of Human Nature. NY: Viking.
Ratey, J., & Johnson, C. (1998) Shadow Syndromes. NY: Bantam.
Watts, D. & Strogatz, S. (1998) Collective dynamics of 'small-world' networks. Nature. 393: 440-442.

Copyright 2005, James Brody, all rights reserved.

Fred H.
February 23rd, 2005, 06:49 AM
The more we reason about an event, the more likely we are to make mistakes: most of our decisions rise from "thin slices" of experience.

The good news is that evolutionists and deists can be friends even if the first finds the second psychotic and the second finds the first damned. So long as they don't argue their reasons!
Enjoyed your review of blink, JimB, but I’d say that most deists are evolutionists. You must be referring to the male evolutionists that have reasoned too much from thin slices of evolution and mistakenly concluded that it’s all directionless and accidental . . . guys that don’t quite recognize Mother in Nature.

Fred H.
February 24th, 2005, 11:25 AM
. . . the more we reason about an event, the more likely we are to make mistakes: most of our decisions rise from "thin slices" of experience. We judge marriages, teacher competence, dating choices, combat strategies, criminal suspects, wine and foods, and even fine art works without telling a consistent story for why we make a particular choice.
So true JimB. Which explains my lack of respect for cognitive therapy, even though I myself seem unable to stop cognitiving, and still naively believe I have some limited free will. Amygdalae (and other sub-cortical stuff) rule. As you say: Thinkin,' Even in Therapy, Won't Get You Anywhere.

ToddStark
March 2nd, 2005, 12:29 PM
Nice review. I'm just finishing this myself. Let me add my perspective.

Half of Gladwell's book is about how and where thin-slicing (what most of us simply call "intuition") works. Klein in "Sources of Power" and "Intuition at Work" does a much more thorough job with the topic, but his examples are more clinical and less interesting. He found that firefighters only remember considering one option under stress and that chess masters consider the same number of candidate moves as simply strong players (but much better ones!) and analyze them about just as deeply. Gladwell on the other hand has a way of finding really relevant examples and pulling out just the bones of them to create a general impression.

The other half of Gladewell is about why thin-slicing works and when it doesn't work so well. Biases, stereotypes, and superstitions are thin-slices. Thin-slices are often mutual reinforcing with motivated beliefs of commitments that defy reason and defy evidence. Also, experts rely on expert thin-slices aquired through experience, much of which involves systematic, formal methods in the past. Novices rely on novice thin-slices and of course are far less competent. Intuition doesn't come magically from heaven, it comes from experience and training. That's Klein's major point as well. And it often must be refined to be of much use.

The case of Gottman makes particularly clear that people, even experts, often don't have very good intuition unless someone has bothered to go through very exhaustive, systematic, scientific analysis of data to find the salient signature in the situation, and then train their intuition to find that pattern. Other experts could not match Gottman's predictive success because their own thin-slicing wasn't picking up the appropriate pattern to make the prediction needed. The data they needed for their daily work was overwhelming for making the simple prediction of long term marital success that Gottman could make from the tiniest signature of marital contempt.

The example of Lee Goldman's cardiac assessments is also an excellent case in point. The reason for him creating an algorithm for assessing cardiac patients was because he found that expert assessments were essentially arbitrary, to the surprise of everyone. Two different experts would assign the same patient to opposite risk groups much of the time, and none of them was much better than chance at predicting immediate serious cardiac problems, the goal of the triage. The algorithm, derived in part from analyzing data carefully and systematically, provided ER triage specialists with a more reliable way of thin-slicing their patients.

The discussion of the Milennium Project results imply the same thing. Van Riper acknowledged that the kind of systematic data gathering done by the Blue Team was potentially invaluable for planning, but it failed them in the heat of battle because individual commanders had no way to focus on what was really important at each moment from that wealth of data.

This is not a minor point, half of Gladwell's examples argue directly against the interpretation that the burning of Alexandria was a good thing because "we think too much."

Gladwell is a very good popular science writer and was pretty careful to make this clear, but from the reviews I'm seeing, I think most people who read it are missing half of his message. A lot of them, and I think Fred often falls into this camp, are looking for a rationale for a kind of anti-intellectualism, and Gladwell can only provide it if you read Blink! very selectively.

kind regards,

Todd

Fred H.
March 2nd, 2005, 08:10 PM
Todd
A lot of them, and I think Fred often falls into this camp, are looking for a rationale for a kind of anti-intellectualism.
You think this camp looks for a rational, which is a kind of anti-rational? Perhaps your thinking lacks much rational. Maybe you should read Gladwell's book again—I think your reasoning’s too thinly sliced.

Intuition doesn't come magically from heaven, it comes from experience and training.
Many great discoveries of science, are magically by men in their twenties—so much for experience and training.

ToddStark
March 3rd, 2005, 09:45 AM
Hi Fred!

1. "Anti-intellectualism" - a disclaimer, not an insult

First, I didn't mean the comment as an insult but to frame my point of view. When I use the term "intellectualism" what I mean is the attitude of love of so-called "book learning" and philosophy for their own sake. Jim is anti-intellectualist to a moderate degree (I suspect) in this sense that he values knowledge but mostly considers it instrumental to scientific theory, and finds philosophy for its own sake rather pointless. That's an attitude, not a matter of being rational or irrational.

I'm an intellectualist in the sense that I consider "book knowledge" and philosophy intrinsically worthwhile pursuits, somwhat akin to the value of seeking truth for its own sake rather than just for its pragmatic results. We may agree on the latter but differ on the former value. I will often seek a *rationale* for intellectualism, even though it is really a pre-established attitude I have had since I was very young. Seeking a rationale to me simply means looking for a way to explain and justify something we already believe. We all do it, I just want to make it explicit.

I was setting the frame by pointing out that I differ fundamentally from some of the reviewers of that book in that I have faith in knowledge and learning for their own sake, while some of them clearly have contempt for it. As a result, I will be likely to find aspects of the examples that show how the people relied on their learning, and those who are anti-intellectual will be equally likely to focus on only the aspects that show the limits of learning. I don't wish to belabor the point, but I didn't want to leave you thinking I was being contemptuous with my use of the term.

2. Gladwell and Klein on intuition and expertise

All of Gladwell's examples of thin-slicing are also great examples of cases where people previously amassed considerable expertise and also usually made a very systematic study of the data. Expertise was neccessary in each case but not always *sufficient*, and THAT was also an important point in the book, I contend.

The key concept is that for a particular problem at hand there is often some subtle signature pattern to be found in the mass of data available to us. This signature pattern lets us make a prediction that seems almost miraculous because of its speed and efficiency. Yet on closer inspection (which Klein does more than Gladwell, although Gladwell refers to the research in passing) we see that the firemen, chess players, researchers, doctors, nurses, military commanders, and so on, all recognized the signature pattern because of their experience.

The conclusion is important, that in many action situations we need to create the conditions where we can make good use of our thin-slicing rather than dumbing ourselves down with slow and less efficient reflection. Gladwell goes farther with his example of a faked statue and shows that even in cases where immediate action isn't needed, thin-slicing is important for setting the initial frame for data-gathering. "Thinking outside the box" problems show this particularly well.

If you take a problem with a highly counter-intuitive twist to it, and force people to write down all the facts and examine them systematically, you actually make it less likely that they will see the twist neccessary to solve the problem.

3. Ok, now *my* point on intuition and expertise.

I was just pointing out that the value of thin-slicing doesn't neccessarily support the anti-intellectualist attitude in any straightforward way because intellectualism strongly reinforces the information gathering process needed to accumulate the experience required for thin-slicing.

4. Fred's counter-example: young scientists

You offer the case of scientists who make remarkable discoveries at a relatively young age as a counter-example. It isn't a counter-example for a number of reasons:

a. Rate. Talent has much to do with the rate at which we accumulate useful experience in particular domains. People very talented at mathematical thinking for example can accumulate more useful expertise and real understanding of general principles for solving math problems by the time they are 9 years old than others have amassed in 40 years of effort.

b. Sufficient time. When you make the domain very specific but the database very huge, like chess expertise, researchers find that 10 years is often enough to go from novice to expert. Bobby Fischer was a very good player at 9 but a hell of a lot better at 23. Do you have trouble believing that Einstein and other people who have made remarkable contributions to theory could have amassed a lot of expertise in math and physics by their 20's?

c. Evidence. It would be pretty hard to find a scientist who didn't have previous experience in the domain where he made the discovery, or a domain similar enough that the insights transfer, and that is what is needed to demonstrate your counter-example. For example, if Einstein had never thought about math or physics prior to imagining the concepts of special relativity.

d. Limits of application. Formal training and educational practices are always going to be a contentious issues if we try to extract general principles because expertise is very domain-specific and even meta-cognition (our beliefs and attitudes toward learning that help us learn better) can be largely domain-specific.

e. Naked creativity. There seems to be a widespread belief that important discoveries are often made by people outside the field where the discover it made. This is not entirely false, but very misleading. My experience is that while the germ of new ideas surely does come from the crossroads between different fields (like Schroedinger's contribution to biology), the final principle really only becomes workable when experts within fields closer to the domain at hand (Watson and Crick) do the leg work to flesh it out. Narrow domain-specificity in science can't be taken *too* far, but it seems to me that it clearly does have to be taken into account. I'm a big fan of interdisciplinary science, but I only see it being really productive when people are legitimate experts in various fields, not when they simply read widely and guess wildly at new principles.

f. Prepared learning. Our talents for learning aren't themselves learned. We come into the world with talents for learning in various ways, giving a huge head start to amassing experience in certain practical domains. Language may be the most interesting example, but there is good evidence for prepared learning abilities in biology, physics, and psychology as well.

kind regards,

Todd

Supporting and Recommended Sources:

"Blink : The Power of Thinking Without Thinking (http://www.amazon.com/exec/obidos/ASIN/0316172324/qid=1109859449/sr=2-1/ref=pd_bbs_b_2_1/002-4764302-3046412)," Malcolm Gladwell, Little Brown, 2005.

"How People Learn: Brain, Mind, Experience, and School (http://www.amazon.com/exec/obidos/ASIN/0309070368/qid=1109859508/sr=2-1/ref=pd_bbs_b_2_1/002-4764302-3046412)," National Research Council, National Academies Press, 2000.

"Sources of Power: How People Make Decisions (http://www.amazon.com/exec/obidos/ASIN/0262611465/qid=1109859750/sr=2-1/ref=pd_bbs_b_2_1/002-4764302-3046412)," by Gary Klein, MIT Press, 1999.

"Simple Heuristics That Make Us Smart (http://www.amazon.com/exec/obidos/tg/detail/-/0195143817/qid=1109860951/sr=1-2/ref=sr_1_2/002-4764302-3046412?v=glance&s=books)" by Gerd Gigerenzer, Peter M. Todd, Oxford University Press, 2000.

Fred H.
March 3rd, 2005, 03:53 PM
Todd—Houghton Mifflin definition of intellectual: rational rather than emotional.


If experience and training are so critical, then why don’t those who’ve made great discoveries in their twenties go on to make even greater discoveries in their forties?

Other than his lackluster performance in school, schooling also utilized by his peers, where did Einstein’s get all this “experience and training” that contributed to the great discoveries he made in his twenties? That Swiss patent office? Innate talent and drive are what’s critical. Your “experience and training” could well be a negative.

On the other hand, I’m inclined to agree that experience and training probably are somewhat more important for mediocre folk, like you . . . and me.

Nevertheless don't forget where we're from,
Women from Venus, men from Uranus.
Therefore we rarely think outside our boxers.

ToddStark
March 4th, 2005, 04:10 AM
If experience and training are so critical, then why don’t those who’ve made great discoveries in their twenties go on to make even greater discoveries in their forties?

I would say simply because expertise is neccessary but not sufficient for scientific discovery. Having expertise is neccessary to make fundamental contributions to science, but isn't enough, and more experience doesn't neccessarily increase the likelihood of making a more significant discovery. In fact, as I already pointed out from the research quoted in several of those books, additional domain-specific expertise can even hinder cross-domain flexibility and flexibility in thinking about initial conditions for a problem.

Other than his lackluster performance in school, schooling also utilized by his peers, where did Einstein’s get all this “experience and training” that contributed to the great discoveries he made in his twenties? That Swiss patent office? Innate talent and drive are what’s critical. Your “experience and training” could well be a negative.

This is just a misunderstanding between us. I would say that "drive and talent" are what make it possible to train yourself and gain the right kind of experience. I would add that "talent" is probably not strictly essential for gaining expertise, beyond a certain minimal amount, but it certainly makes a difference in what kind of training and experience helps you, how much you need, and how you will eventually apply your expertise to problem solving.

I'm the last person who would argue to you that formal schooling builds expertise. In fact, I have the opposite viewpoint, that formal schooling does NOT typically train people or provide appropriate experience for building expertise. There are several possible reasons for this, and it is discussed in some detail in one of my previous references ("How People Learn").

When I say training and experience, I am talking about exactly what Einstein did, trained himself by exposing himself to principles and problems in his domains of interest and thinking about them over a period of years. That's how I learned most of what I learned as well. I typically bought the texts, worked on solving problems, and often skipped class. And from the results, I probably earned a lot more expertise than most of the people who attended the classes. I call this experience and training.

Many brilliant people have lackluster performance in school. They are usually bored.

On the other hand, I’m inclined to agree that experience and training probably are somewhat more important for mediocre folk, like you . . . and me.

Fred, I've witnessed you learning all sorts of things yourself that required you to engage in self-training and producing your own learning experiences. I don't think you give yourself enough credit. We rarely change our previous conceptual model as a result of new knowledge aquired in this way, but I think that's just a matter of learning the domain-specific meta-cognitive skills for evaluating when we understand new things. I don't think meta-cognition is entirely or primarily a matter of talent, although it may play a role.

I attended very few classes in college, and the fewer I attended the better I did. I don't think I had a special talent, but I do think I had a knack for self-training, that I had learned naturally what is known formally as "active learning." According to current research, this is an attitude and a set of skills and some domain-specific knowledge about how to learn each domain, it is not primarily talent.

Nevertheless don't forget where we're from,
Women from Venus, men from Uranus.
Therefore we rarely think outside our boxers.

Here is where "mediocre" people can be easily distinguished from exceptional ones. The exceptional ones do manage to think outside their boxers from time to time. As long as they're gettin' enuf. When you're not gettin' enuf, everything distracts you. Great thinkers (at least the male ones) have to have good partners or else they'd devote all of their great thinking to getting laid.

Thanks !

Todd

Fred H.
March 4th, 2005, 10:03 AM
Todd--I've witnessed you learning all sorts of things yourself that required you to engage in self-training and producing your own learning experiences. I don't think you give yourself enough credit.
You are, I think, too enthusiastic, giving us more credit than we merit; we learn only what our neurons permit—products of a mindless evolution, or a low entropy when time began.

As long as they're gettin' enuf. When you're not gettin' enuf, everything distracts you. Great thinkers (at least the male ones) have to have good partners or else they'd devote all of their great thinking to getting laid.
Risking political incorrectness, I doubt “great thinkers” are ever female, nor that they think much about getting laid; plus if "gettin’ enuf" is on your mind, most likely you’re no Newton nor Einstein.

James Brody
March 4th, 2005, 03:59 PM
The library is gone...

We're doing OK, not sure that we'd do better with all those stories...Murray's books argues "no."

But, you have your psychoses, I have mine
:p

Jim

Fred H.
March 5th, 2005, 08:00 AM
JimB—Speaking of psychosis, the other night on Letterman, Dan Rather—referring to his infamous and obviously forged memos supposedly written by Bush's National Guard commander—made the following statement: "Although they [the independent investigation] had four months and millions of dollars, they could not demonstrate that the documents were not authentic, that they were forgeries."

Some rather substantial denial I’d say. Surprised he didn’t add, “I am not a crook.”

Somewhere Richard Nixon is smiling.

James Brody
March 13th, 2005, 07:44 AM
Fred disrespects the only legitimized tool in psychology. Nurses, waitresses, social workers, preachers, and hookers use our instinctive hooks, strings, and levers, the things that Fred possibly respects, and their so doing turned most psychologists into bottom-feeders! It becomes important, because Fred is a zanier and often better writer than I, not to change Fred (his wife gave up!) but by changing the connections that he makes with CBT. This means using a little CBT on him!

First, someone (Dawkins? Wallace Austin?) observed that popular belief goes through phases: the earth cannot possibly be round; it's round but so what?; and we knew all the time that it's round. CBT has a similar career: first, it can't possibly do anything; next, it works only when applied by experts to those developmentally enhanced by estrogen; finally, it can be used by medical residents, nurses, caseworkers, or computers behind a screen and works just like we always knew it could! Fred is still in Phase 1 but, no surprise, he's an older guy!

CBT researchers, the offspring of Aaron (Tim) Beck, are now in Phase 3 and claim statistical victories for treating anxiety, depression, schizophrenia, bipolar disorder, OCD, and even some of the personality disorders. Tourettes and Aspergers are probably next on the list and, perhaps someday, we may use CBT to make a wife love her husband after he takes a pay cut!*

Second, I am suspicious of any faith, exercise, or weed that treats everything. Serotonin regulators, for example, have landed and mutated and, like any exploratory system, pill-makers target ever-smaller segments of the pill-takers for their next mutation. Serotonin, however, adjusts our reactivity to external stimuli, changes sleep and dreaming patterns, regulates appetite and digestion (90% of it is in your gut!), and interacts with social experience. Lose a woman, take a pill, and change your whole body so that you don't care if you ever get another one (woman or body!). Chemicals also help you to hear whispers instead of shouts when you hallucinate but you also lose some of your working memory and initiative. (What a deal!) CBT can amount to a very specific numbing of your dominant reactions: it helps you buy a little time and find options that you otherwise miss. You can be selectively depressed and use that emotion as a tool in accord with its original design.

Networks and the rest of my story about CBT:

The CogSquad distinguishes "core beliefs" from "automatic thoughts," the private conversations that we each have: core beliefs and automatic thoughts nicely overlap with the concepts of hubs and nodes as defined by network theorists in physics. Nature, for example, (Song, Havlin, & Makse, 2005) has a drawing of an emergent network: a very large core surrounded by a hundred tiny balls, each one connected to the core and often to two or three other balls. The big thing is a "hub," the smaller ones, "nodes."
Core beliefs can overlap with the network concept of hubs and automatic thoughts, the thoughts that derive from core beliefs, align with the concept of nodes. Network theorists sometimes argue that early nodes become hubs because they are more "fit," that is, they are more successful at recruiting new nodes. More primitive instincts eventually collect specialized tools that can be thoughts, habits, or a cellular phone. Let thought grow from instinctive, brainstem and cerebellar sequences that get warmth and a full belly. Also that get beer and a full tank of gas in the car. Broads appear just like fundamental particles do from total vacuum. "Evolvability" applies! (See Kirschner & Gerhart, 1998.)

Cognitive therapists are ahead of the physics types who have not yet considered that some nodes may connect to more than one hub! Swap your thought, one of your nodes, and activate a different hub and everything connected to it! (They also haven't tied network structure to resource availability!) Nodes possibly take on adaptive functions and allow their network to have greater access to novel resources and to early warnings. Human minds can trigger a particular node, reinterpret an automatic thought, and elicit a connection to a less troubling hub. Examples:
A smiling baby might love you, it might have gas.
A rude clerk might think you're poor and ugly: she may also be coming down from cheap cocaine and, evicted by her parents, not have a place to sleep. In the first case, you frown and walk away, in the second, you lock up your money and offer a door key!

More subtly, a lady has intrusive thoughts about harming her children. She dislikes her thoughts but cannot control them. I ask, accidentally, about several scars on her face. When an adolescent, she had unpredictable, uncontrollable acne that kept her away from proms and beer parties. The overlap between her inability to control either her acne or her intrusive thoughts is striking, one that she had never noticed, and tied perhaps to core beliefs that possibly emerged from helplessness and hopelessness more than 360 million years ago...What we now dream about network behavior allows us to imagine tactics that might bring some of her thoughts under rein...

Hope this helps!

JimB

* Doubtful that even CBT can overcome this kind of dispair: probably need a generation of antidepressants that manipulate not serotonin but oxytocin and vasopressin. Imagine: pee less, swell up, and smile through your divorce!

James Brody
March 13th, 2005, 07:59 AM
"...half of Gladwell's examples argue directly against the interpretation that the burning of Alexandria was a good thing because "we think too much.'"

I didn't want to commit more work to a fun but not a deep book.

Yep, Malcolm slides around and you have to watch carefully to notice his seams and appreciate his ambivalence.

His position(s) are also defined by market: smart people buy books and most of them, perhaps for reasons of prenatal estrogen, hang on to some instinct that their stories count for more than drawing attention from mates and allies.
I just went through "Tipping Point" in a blink and found a similar difficulty...

Thanks for your thoughts!

Jim

Fred H.
March 13th, 2005, 10:44 AM
My bottom line on cognitive therapy is that it’s really not much more than religion and/or faith—“As a man think in his heart, so is he"—Proverbs 23:7. (And I don’t know that the behavior in CBT is necessarily a whole lot more than works, as in, “Faith without works is dead”—James 2:14.)

As you know JimB, I’m a big fan of religion and faith, but I suppose I tend to get a bit skeptical when folk attempt to sell cognitive therapy as something more than it is—after all, there’s nothing new under the sun (Ecc.1:9 . . . my, my, aren’t I religious today?)

On the other hand, if therapists explain the primacy of emotion—subcortical biology—then perhaps they’re providing something more than their clients could get from Church. So I say screw the cognitive therapy—I get mine at Church. What we really need is sub-cognitive therapy.

ToddStark
March 14th, 2005, 01:00 AM
Hey Fred,

One of the classic contrasts with cognitive therapy is suggestive therapy ("hypnotherapy") because it presumably targets "unconscious" rather than explicit thinking processes. The empirical data show that it changes the relapse characteristics of other things, like cognitive therapy, and so probably does work on different hooks in us.

It does make an interesting contrast because it deals in conviction, which is your point as well. One of the most innovative theorists regarding hypnosis is Ted Sarbin, who looks at it in terms of immersion in role taking. This essentially translates to our conviction in our beliefs at the time and how these convictions relate to our thought and behavior. Our convictions follow through to behavior and physical effects. That's where it involves the "subcortical" aspect, getting beneath the surface of thinking to get at what turns it into action and relates it to our body.

I've always been impressed by the similarities between the way faith healers and successful hypnotherapists work.

kind regards,

Todd

James Brody
March 15th, 2005, 06:53 PM
"I've always been impressed by the similarities between the way faith healers and successful hypnotherapists work."

I smell a war....

JB