All posts by dhoward@cyg.net

Is It Just About Belonging?

Blame it on the oxytocin — with its magic spell,
Blame it on the oxytocin — that it spins so well,
It begins with just a bit of hype,
But ends with reversion to a type,
Blame it on the oxytocin,

. . .The neuropeptide of in-group bonding, affiliation, self-preservation, and perceived safety.

So much for appropriated lyrics — as Eydie croons about the ‘dance of love’. It’s been a long and relentless search for the why’s. Why did Patty Hearst rob a bank? Why did Charlie Manson’s Helter Skelter vision hold such compelling and homicidal thrall? And why does a significant chunk of US citizenry continue to cling to a narrative with no basis in reality — again with lethal result?

No shortage of explanations on offer. Brainwashing. The Stockholm Syndrome. Cognitive dissonance reduction. Identification with the aggressor. Maybe all of the foregoing!

A recent New Yorker article (What Makes a Cult a Cult, July 12, 2021) had caught my attention. In particular, the author, Zoe Heller’s citations from The Delusions of Crowds (Bernstein, 2021). She quotes as follows:

People do not deploy the powerful human intellect to dispassionately analyze the world (choosing instead) to rationalize how the facts conform to their emotionally derived preconceptions. . . Humans understand the world through narratives (and) however much we flatter ourselves about our individual rationality, a good story, no matter how analytically deficient, . . resonates emotionally, and persuades more than the most dispositive facts or data. (bolding added)

In short, convincing and compelling ‘evidence’ is no match for what we want to believe — no matter how fantastic, far fetched, farcical, and frankly false. We find a narrative — then search for ‘facts’ (alternative and otherwise) to support it.

As I read, I was reminded of Daniel Kahneman’s excellent treatise on thinking, fast and slow. Fast thinking, System 1 as he labels it, is where we spend most of our day — ‘the secret author of many of the choices and judgments (we) make’. As it turns out, this is an efficient and expeditious way to drive the bus; but equally biased and often unsupported by data. . . frequently wrong. System 2, the slow, methodical, fact-checked alternative is ignored and resorted to with grudging resistance. To rework Plato’s aphorism: Don’t confuse me with facts . . . I’m in thrall to my lizard brain.

And just maybe that’s the underlying mechanism by which all those intriguing, psychological (but inferred) ‘explanations’ are driven. It’s less about the Svengali of the moment’s hugely persuasive message, less about restoring a balance to our cognitively conflicted state. And more about flat out safety, more about instinctively, viscerally measuring the options, doing a gut-level cost / benefit analysis — and going with the most available group.

Brain biology (surprise, surprise), with its expanding understanding of neurochemicals and their figural role in the choices we make, has something to say about those elusive ‘why’s’. In (very) reductionist terms, just as Dopamine surges when we feel rewarded, Endorphin release helps us manage and mask pain, Cortisol readies us to deal with threat — so Oxytocin has its signature triggers. Access to a familiar ‘herd’, confirmation that we’re safely ensconced amongst the like-minded, opens that particular sluice. Conversely, distancing from said group, socially, physically is, by and large discomforting — and may lead us to make some pretty counter-intuitive calls.

So when Jim Jones says it’s Kool Aid (it’s always good to hydrate fully before a long, inter-stellar flight); or Tucker Carlson goes on about the risks that attach to Covid vaccinations (I’m always losing my car keys anyway. . . how useful to have them stuck to my upper arm!); or the hours of beyond distressing video of January 6th are framed as a normal tourist day at the Capitol — let’s be charitable. The hundreds to millions of adherents are not stupid or mesmerized or deluded. They’re just loyal. They’ve just checked their respective cortexes (cortices?) at the door and slid down the evolutionary scale to lizard levels. They’re actively grooming the alpha of the moment, ducking the principled, critically thinking risk that attaches to moving away from the crowd and pulling a Liz Cheney or a Mitt Romney. They’re just having a little oxytocin shower — and movin’ to the beat. Bless the Boss(a Nova).

Where It All Starts

Screen Shot 2021-07-04 at 4.06.03 PMIs it remotely possible that we are double parked around the corner from the TOE (aka: The Unified Theory of Everything) — and just have to make that final turn? My own Hammond’s Road Atlas has been the various iterations of the DSM, the Diagnostic and Statistical Manual, currently in its fifth go-round. This compendium has valiantly, comprehensively (so we hope), and sometimes mistakenly catalogued mental disorders. And evolved over the past 70 years from what, by today’s standard, would be an ‘extended pamphlet’ to the DSM-5’s bulky near 1000 pages. Its editions have ebbed and flowed, reflecting the ‘current wisdom’ on what constitutes a ‘disorder’. The general direction, one hopes, has been an evolution toward a kinder, gentler (and certainly more informed and inclusive) catalogue.

One constant, however, has remained. Diagnosis, the cornerstone of psychological and psychiatric treatment and intervention, has remained slavishly dependent on checklists of clinical symptom clusters — ‘observables’ if you will. Tote up the tick boxes and, if the criteria are met, you have a ‘diagnosis’. With the 2013 advent of the DSM-5, the somewhat cynical, but not wholly undeserved criticism, was that it represented a ‘reshuffling of the deck chairs’. The long-awaited tome that would focus on, or at least include the collecting of genetic, imaging, physiologic, and cognitive data in formulating a diagnosis, had failed to materialize. As one Scientific American article from that year put it: ‘New DSM-5 Ignores Biology of Mental Illness’. The curtain was pulled aside and the same wee wizard revealed — dressed in a nice, new aubergine suit (distinguishing it from its blue predecessor), updated font and numbering in the lapel pin (5 vs. V), but echoing Macbeth’s lament: ‘a tale told by an idiot, full and sound and fury — but signifying nothing’.

Well that’s a bit harsh. But it certainly seems to have contributed to a pretty seismic shift in momentum. Biology, more particularly neurobiology is increasingly the bar to be at when seeking ‘points of origin’ of any number of ‘conditions’ that for decades saw the search end with a tally on the scorecard of diagnostic criteria. Although dedicatedly toiling on in the labs and academic institutions for eons, these ‘rat-runners’ were under-recognized, while their ‘applied’ counterparts garnered centre stage. Just as the mind and the body had remained separate entities (thanks Descartes!), so the researcher and the clinician occupied functionally opposite corners of the ring. The former picking methodically away at esoteric connections between this behaviour and that tiny region of the brain; the latter, confidently trotting out fifty-year old wisdom from the most recent iteration of the Titanic. Happily, fundamentally that is changing.

I have long been interested in psychopathy, that most heinous villain of personality disorders. Somewhat coincidentally in 2013, I was seated in an auditorium at Penetanguishene, a facility, part ‘jail’, part treatment venue where many such individuals are housed. The keynote presenters were Robert Hare and his team, widely acknowledged as the leading experts on psychopathy and the diagnosis of same. His PCL-R is the instrument almost universally utilized in identifying and rating levels of this disorder. In keeping with the scorecard protocol, Hare’s exhaustive research has centred on the 20 elements that define the psychopath. Each scored 0, 1, or 2, in a trained clinician’s opinion, a tally (generally) of 30 or more is pretty much a slam dunk.

The conference participants included corrections officers, police, and mental health practitioners from all walks. When Hare began to introduce his neurological research, I’m pretty sure I saw a large chunk of the attendees start to glaze over. The fMRI results, response times to ‘emotionally-charged’ words, and relative sizes of various brain structures seemed to have scant application to the parolee who failed to show for an appointment or the guy who regularly got busted for assault or fraud. But Hare persevered, introducing a nascent interest of his: Is the psychopath a criminal who chooses to act out against societal norms; or is he a product of his wiring? Should he be incarcerated or treated? He was straying into the moral minefield of culpability, choice, and societal response.

A core ‘deficit’ in the psychopathic tool box — and one of Hare’s 20 — is empathy. Fast forward a half-dozen years. I was listening to a podcast built around a relatively rare condition, in its various forms collectively referred to as synesthesia. In this particular instance, a Mirror-touch manifestation of the ‘disorder’ was being described as experiencing what another might feel, but on multiple sensory levels, at high levels of intensity, and involuntarily — in short, an ‘excess of empathy’. The disorder is being traced to a tiny cortical region, the temperoparietal junction, the TPJ (say that ten times quickly!); and specifically the level of ‘gray matter volume’ present. I began to wonder if one end of the empathy stick saw wildly increased levels of sensitivity to others, perspective taking, interdependence, etc., could the other end of said stick (all those nasty antisocial’s) see the structural opposite. A little digging says, yes. This is not to say psychopathy is bred in the bone, but certainly the wiring — however, it’s shaped and established — plays its part.

So here we are. The marriage of mind and body is slowly being reconciled. Those sacred clusters of symptoms continue to be figural focuses in intervention; but the causes are steadily being revealed — and with them a true paradigm shift in treatment. The art and the science can, will, indeed must play together in the same sand box.

Don’t Just Do Something. . . Sit there!

Don’t just sit there, do something!
(Aphorism, rightly or wrongly attributed to televangelist, Robert Schuller)

Sit there. . . the admonition levelled at the shiftless, the lazy, the unfocussed, the unmotivated. Capturing the essence of the Western idyll, elevating the list-makers — or more properly, the list-completers. And vilifying the ‘Type B’s’ (if there was ever such a ‘personality type’, characterizing the non-Type A’s), as the laid back, feet-up-on-the-porch-railing folk who seem content to just watch the world pass them by. In short, if you’re not moving, preferably forward, there’s a problem. A restlessness, agitation even, a kind of culturally sanctioned ADHD has come to be the norm.

Let’s try another one: For every action, there is an equal and opposite reaction. Basic, grade 11, Newtonian physics. And, so it would seem, basic social psychology as well.

My sometime running coach opened our first conversation with a simple question: ‘What’s your distance?’ Scraping away the obvious, he wanted to know how to shape a training program so it best served the mileage at which I intended to compete. I reasoned, from my modest (very modest) success in the dozen or so years I’d already logged at the sport, that marathoning was an open invitation to injury. Equally, I was never going to be a successful miler. So it was down to what is affectionately known as ‘middle distance’ — the space between endurance and sprinting. He exhaled, clearly relieved at my decision. Metaphorically, I’ve spent much time in this same space in the years since. Or at least tried!

This middle middle ground is indeed a challenging and challenged place to live. Sometimes dissed as fence-sitting, equivocating, ambivalent, passive, uncommitted . . . the list goes on (and on). Sometimes lauded: balanced, equanimous, neutral, considered. Generally elusive and unsustainable . . . and almost always preferred to the polarities that lie to either side.

The maxim of the quick hit, do it . . . and move on to the next (preferably as soon as possible), that so informs our culture in this era of the compelling need for instant gratification, is further complicating the process. The usual whipping boy (person?), digital distraction, heartily supported by myriad, internet-spawned algorithms and their wee squirts of dopamine (aka ‘Likes’, thumbs-up and their emoji kin) and immediate access to endless rabbit holes, may as much be a reflection and symptom as a cause. Automaticity, reactivity have been around for a very long time. A resistance to taking the ‘long way round’, ‘sitting with’, savouring, steeping is the norm. Goal attainment over process.

I’m currently slogging (??) through the 500 pages of Daniel Kahneman’s Thinking, Fast and Slow, a wonderfully detailed review of the research of the past several years of cognitive process — and how we do it. The title is a very succinct summary of these findings: we spend most of our time ‘thinking fast’, using our intuitive takes on things, our ‘knee jerk’ (often factually unsupported) responses to navigate our day. He points out that this is frankly the only way to deal with the multiple decisions, needs for quick action that face us. But at a cost of ‘slow thinking’, where time is taken to weigh and measure, to consider the evidence, to make truly informed and thoughtful choices. He neither lobbies for nor picks a preferred mode. Both are necessary and have a role to play. But his writing is a (relentless) reminder that critical (considered, slow) thought may be being further eroded, less valued, and just too time consuming.

The case for ‘the middle way’ is both simple and ancient. Just not easy! Practice, repetition, noticing and embracing incremental, gradual change occupy a place both in long established wisdom and in an increasing canon of modern research as the mysteries of the mind are progressively married to the workings of the body, our physiology. The benefits of pausing, ‘staying present’, reflecting and reshaping our neural pathways (aka, neuroplasticity) are rooted neither in speed nor ‘one-shot deals’. Both require patience and many iterations. And neither happen without intention and purposeful choice. Auto pilot serves us well — until it doesn’t. . . when life gets too complicated to just push back, to move on to the next rabbit hole, to dance to the limbic urgency to fight or flee.