Monthly Archives: January 2014

51. Feeding Fivepences into the System.

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Durer had a problem drawing the female upper body, which was why he was dropped from the Tomb Raider team.

No-one in the post office queue seems to be talking about Expressed Emotion research. Perhaps that’s because, like the post office queue itself, the concept belongs to the seventies. That’s why I prefer Hermes Mail, where the drop off point is across town, in a corner shop heavily frequented by substance mis-users.

The idea that behaving like a character from Eastenders can bring about psychotic relapse in a family member is devastating. The key ingredients of Expressed Emotion, or EE as we used to call it before the telecoms company stole the name, are supposed to be Critical Comments, Hostility and Emotional Overinvolvement. The same conditions have been achieved on shows that feature hysterical and random harsh judgements, like Strictly or the X Factor.

At the corner shop, a lady in front of me has counted out a large number of copper and silver coins onto the counter and the shopkeeper helps to count them. The customer is an ex punk rocker by the look of her attire, though a quick mental calculation tells me that she was already aged at least 40 in 1978, when punk was at its height, so that her wardrobe consultants may be at fault. Nevertheless, torn tartan trousers are pretty much fine for any occasion, from the Savoy Grill downwards, let alone a trip to the corner shop. There are people in pyjamas behind me in the queue.

The problem seems to be related to the Lottery – she has brought the wrong ticket, or it is not her own ticket, or possibly it is a dry cleaning receipt. She glances back at me conspiratorially and says that she isn’t going to tell the person whose ticket it was supposed to be. I confirm to her that her ethical position is sound, but also that I have no idea what she is talking about.

I observe that everyone in the queue is very calm, despite what seems like a pretty serious delay in proceedings. And I attribute this to a very particular body language on the part of the salesperson. She is a tall Asian lady with an excellent upright posture and a steely gaze.Yet even within the steel, there is a glint that says, ‘make time in your life for an elderly person who cannot cope with the modern world’. This is a low EE shop, I decide, and no-one is relapsing into a psychosis here this morning.

If you like low EE, one of the best shops is called Boyes. It’s hard to explain the ambience. The lighting is soft and the aisles are wide, but in no way confusing. Towards the back of the shop, there are piles of haberdashery and materials, including a large selection of foam blocks. None of the items are brash or tawdry; every item is just the kind of thing you might need one day, if you were turning over a new leaf from a former life as a contract killer.

The public library used to be low EE but things have really changed. In the centre is a ring of PCs which are occupied by students, all of whom are looking at facebook. In the foyer two old blokes are talking loudly about the bets they have placed that day. The atmosphere is tense, because everyone knows the librarian should exert some kind of authority and enforce silence, but this doesn’t happen. And then people arrive to collect free condoms from the help desk, and I wonder how they are filed and coded in the library system. The librarian says they have run out of condoms and apologises profusely. The two customers, who are teenage boys taking the mickey, burst into a fit of giggling . I appreciate the distraction, which allows me to feed handfuls of 5p pieces into the self service machine. So I can rent DVDs and pay fines effectively free, in that I can mobilise coins that were, up till now, beyond use.

EE was one of the most cumbersome tools ever developed by modern mental health researchers. It has fallen out of fashion not just because it is a thing of the seventies, but because it could never be cost effective compared with drug therapy.

It takes a panel of specially trained academics hours to decide if a family is high EE or not. EE can be reduced by special family education programs, the feasibility of which ranks with ‘rolling out’ DIY SOS nationwide.

Otherwise psychotic people shouldn’t spend more than 35 hours a week with their high EE family. That leaves a lot of time to kill. First day centres closed, then Woolworth’s closed, then the library repealed the decibel law. Employment is increasingly high EE, and so is television.

That probably explains why we ‘find ourselves’ in Boyes so much, trying to remember why we wanted foam blocks. And why people trying to avoid a psychotic relapse spend a lot of time in the Hermes queue.

EE is a good name for a business, even if they can’t really provide ‘everything everywhere’. In community mental health care its more a case of Nothing Anywhere, just shops to go in.

Also, its only £3.60 for your parcel, instead of £12.60 with Royal Mail.

50. Taking Canadian Living more seriously.

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First, cement each of the six guitar strings to the guitar. Then, cement the guitar to the James Blunt figure. Now, cement the James Blunt figure to the tank controls…

When I was about 7, I had a book called ‘365 Things to Make and Do in Nature and Science’. To be honest, many of the projects were frustrating, as it was difficult to obtain the necessary parts and materials, some of which were quite exotic. In our town it was very hard to obtain, say, an old altimeter from a WW2 German bomber, or a tin of gunpowder. There was also the obvious problem of leaving one day relatively unstructured during a leap year.

Until now, I have never questioned the idea that Doing Something is a worthy use of time, as compared with Reading Something, or Watching Something. But now, typing with a bandaged thumb from an unfortunate slip of the Stanley Knife, tennis elbow on both sides, from excessive screwdriver and spanner activities, and lower back pain from heavy lifting, I’m forced to ponder whether it’s time to say goodbye to B and Q and that new yellow brick road I was planning.

The Nike slogan, ‘Just do it’, is now 25 years old. People were tougher in the eighties – if coined now,  that slogan would come with a number of provisos and safety warnings, such as adding: ‘once you have checked with your cardiologist’ or  ‘providing you are Corgi Registered’.

Though Nike do not state this overtly, their motto asserts a behaviourist stance on life which I interpret as follows – you are what you do. There is a worthy theory underpinning this outlook, stemming from the psychology of self – perception. From what we find ourselves doing, we infer who we are and what we stand for. I am sitting at a computer, wiping blood off the spacebar, so I am a dedicated writer. If I had a Scotch, a full ashtray and a loaded revolver on the desk I’d be even more dedicated.

Last year, as further evidence of a shift from behaviourism toward ‘cognitivism’, Nike took the ‘just do it’ campaign in a new direction: Possibility.

‘With ‘Possibilities’ we’re taking ‘Just Do It’ to a whole new place, showing people a new way to set goals and think about their own athletic potential’

Thinking about our athletic potential is quite cognitive. If you are taking a penalty shot or serving at tennis, the last thing you want to do is think about possibilities. Probably the one time David Beckham thought about possibilities was the time he shot the ball twenty feet above the crossbar.

Apple’s campaign ‘Think Different’, invented in 1997,  also seemed to pursue a cognitive path. 29 famous ‘thinkers’, such as Albert Einstein, were included in the campaign posters. But if we look more closely at the list, we see that many if not most of the ‘thinkers’ were actually artists or musicians, i.e. people who held tools in their hands, made grooves in vinyl or canvas and left a legacy of artefacts and occasionally accidentally cut their fingers. In fact, none of those featured in the ads were Philosophers, unless you count Kermit the frog.

‘Here’s to the crazy ones’, ran the script,  ‘The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They’re not fond of rules. And they have no respect for the status quo’.

The script seems to owe something to Top Gun, where, rather lazily in terms of character development, the hero was named Maverick.

We probably know many such mavericks, but they have never become well known or achieved much, because they thought too much and didn’t do enough. In Britain they would mainly be described as harmless eccentrics. On the other hand, those who made it into the ranks of Think Different were prolific doers. Alfred Hitchcock made over 60 movies for instance; Bob Dylan made over 40 albums.

Maverick couldn’t wait to get catapulted off an aircraft carrier and frighten the MiGs.

I just collected a Depression Leaflet from the doctors while I had my finger looked at.

In the ‘what can be done?’ section there is a bit of practical advice as follows:

‘Vary your normal routine, get out and about if you can, keep occupied if possible, if you can’t sleep, try watching TV or listening to the radio.’

In search of useful things to do I turned to ‘Canadian Living’ magazine. I found an article called ‘Fifty good deeds for fifty days’, which borrows a little from the Random Acts of Kindness movement.

Like ‘365 things to make and do’ however, some of the materials are hard to find. For instance I have no ‘well behaved dog’ to take to visit elderly people, nor any fresh cut flowers to leave at a nursing home. If I happened to buy some pet food at the supermarket to take to the local animal hospital, I’d probably buy something they weren’t allowed, like cream buns.

I’ve come up with these ideas instead, which I’m hoping Canadian Living will publish:

  • Wearing a salvation army jacket and carrying a clipboard, feed parking meters that are about to expire – not for Audi drivers though
  • Get everything out of your food cupboard and throw away any packets with a sell by date before you were born, or 1963, whichever is more recent
  • At Tramshed, in Shoreditch, try and make a citizen’s arrest on Tony Blair.
  • Find a pothole in the road, chalk round it in yellow and report it to Fillthathole.org
  • Place a small whiteboard in your toilet, headed: ‘This toilet was last checked at…’ Then sign with a fictional name and date, such as Attila the Hun, 453 AD.
  • Install Windows 8.1, but first say goodbye to everything you have on your computer, it’ll be like new
  • Phone up Santander Bank at 5.30pm and ask them to answer a short feedback questionnaire, regarding your performance as a customer
  • Phone up the bursar at the University of Leicester and ask for a cash donation towards your holiday in the Bahamas

In other words, don’t just think different – do different. Or differently, if you prefer .

49. Saying no to Mister Kipling.

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My new laboratory

Outside Ladbrokes, it occurs to me that behavioural psychology, one of the greatest discoveries of the twentieth century, has fallen, like that other great Russian invention, the Kalashnikov, into entirely the wrong hands.

Clinicians have neglected behaviourist explanations and treatments for mental health problems, leaving these dark arts to commerce.

Though still called cognitive behaviour therapy, CBT has edged out the behavioural aspects, such as facing feared situations in real life, or reducing unwanted repetitive actions like texting during mealtimes.

The move towards Mindfulness has taken things even further in this direction. Whereas behavioural techniques can be applied successfully to animals, mindfulness cannot. Herein lies the problem. Therapists are most reluctant to regard the human being as an animal, whereas it suits some commercial interests for people to act like plankton.

In fields such as gambling, shopping, advertising and food, simple behavioural strategies have proven to be devastatingly effective. By placing rows of sweeties either side of the checkout in supermarkets, or sending a tinkling food cart slowly but surely up and down planes and trains, we are made to drool. Our sense of scale is disrupted, by selling massive chocolate bars for £1, next to tiny versions for 65p and three-for-two offers. Greater consumption seems to make sense.

Behavioural interventions like graded exposure and exposure response prevention are too dangerously similar to common sense to warrant an exorbitant fee in clinical practice. Whereas a gambling machine or a chocolate bar has no problem reducing you conceptually to the role of laboratory animal.

I’m just dreaming up another screenplay, which is for a re-make of Traffic, but with people addicted to sugar instead of heroin, with fat actors instead of thin.

I’m hoping it’ll get funded before the current moral panic about sugar dies down. The idea is to examine ‘the sugar problem’ from different perspectives, from politicians and big business on the one hand, to the crowds of diabetics camped outside Clinic 16 on the other, via the sticky pavements outside KFC.

Here’s the background theory as I understand it, simplified for the movie:

1. For some reason, the USA has a big corn syrup industry and puts corn in all kinds of food products.

2. Fructose, made from corn, is sweeter than glucose and has less feedback effect on the brain, leading to over-consumption and frequent trips to the Spar shop.

3. People get more tolerant to sugar, increasing their consumption progressively.

4. They may experience craving and withdrawal effects similar to chemically addictive drugs, leading to sugar addiction

5. Sugar tweaks the dopamine and endorphin pathways in the brain. These are shown diagrammatically as massive cables connected to the addiction box, which is sited just behind the nose.

6. Recognising they have an addictive product on their hands, the food industry takes advantage, increasing the sugar concentrations, fructose content and portion size. 500ml becomes the new 330ml. We are asked at food shops if we want to ‘go large’ and we say yes. Shouldn’t there be a consent form for such a far reaching decision?

7. Big Sugar runs a clever diversionary tactic, blaming Big Fat for everything.

8. The insulin manufacturers get richer.

9. Politicians propose a Sugar Tax, forgetting it was an OMD album and they probably still have copyright.

10. Grand Designs features an edible house made of Glacier Mints.

Did the mental health industry play its part in the great sugar rush? At first sight, it looks as though our hands are also sticky. Mainstream psychiatry demonised the use of amphetamines, barbiturates, benzodiazepines and antipsychotics as tranquillisers, while promoting ‘atypical antipsychotics’ that were strongly associated with weight gain. Psychiatrists promoted the concept of addiction and started applying it to things increasingly difficult to compare to heroin, such as chocolate, sex, darts and embroidery. As a result, the concept of addiction has become a metaphor for any repetitive pleasurable behaviour that has a downside.

The mental health industry is buying into the idea that drugs and even foods have power over us and may enslave us if we weaken. In terms of reducing the crowds at clinic 16, will it help to regard sugar as an addiction? More likely it will prove counterproductive to empower sugar by deeming it a chemical of substance. There’s no denying that sugar is a powerful ingredient – the taste for sugar is hard-wired. After all, it’s only competing with three other tastes, two of which are bitter and sour. It’s a taste that children seem to love, but that many grow out of. But in the end it’s just a molecule, not a mystical power. Food and drugs are tools for us to use, not the other way round.

I’m pretty sure, in a double blind trial, I could not tell Coke from Diet Coke. Yet everyone I ask assures me there is a massive difference. There’s an urban myth that sugar intake creates a ‘rush’ or increases energy, even risking overexcitement. Who planted that idea in popular consciousness? Mars, perhaps.

As a debunking exercise, I did a small field trial on the so-called Death By Chocolate. Suffice it to say I survived. Should I have asked for my money back?

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The Death By Chocolate, before the experiment

Maybe the marketing men did not envisage how strongly sugar would catch on, given a combination of chemical and social reinforcement and low pricing. Companies say they have increased portion size and fructose content because people are demanding larger and sweeter products. A kind of forward feedback has occurred, and the moral is, conditioning is a powerful motivator.

How to end this movie then? One idea is to have all the dark psychologists who manipulate our food preferences arrested in a raid on Tate and Lyle? Or an upbeat ending with scientists discovering Baking Canderel? Or a line of addicts at the sugar clinic, receiving treacle in little pots, instead of methadone?

Incidentally, please do not attempt the Death By Chocolate challenge without medical advice. Sometimes these urban myths have a grain of truth in them.

48. Tuning in to the sound of sharpening knives.

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An architect taking a quick personality test

It’s a clear, bright evening in Yorkshire. A man in a Volkswagen Golf stretches both hands behind his head, steering for a while with his knees. He is observed by police safety cameras and later charged with dangerous driving. Not only does he get a year’s ban, 100 hours community service and a fine of £685. In addition he is vilified on the evening news by a sanctimonious policeman. In a moment he has gone from ordinary bloke to public enemy number one. The moral of the story is that any pretence that Yorkshire had to be ‘the Texas of England’ has completely evaporated.

The deeper moral is that sanctimonious people are much more dangerous than careless drivers. It’s not that long ago – the eighties? – that people were put in pillories and stocks and burned as witches. More recently the tabloids have taken over the hunt, bringing down celebrities whenever they can.

I am sure the bible covered this very issue, in the episode about casting stones at the adulterous person. Clearly, hypocrites have always existed. The practice of scapegoating existed in Ancient Greece, where they used to throw a beggar or a disabled person out of town whenever there was a natural disaster. They could have used a goat, like the Israelis, but maybe it suited them better to exclude a person, in terms of reducing the social security budget.

If the storms and floods continue I suspect we will have to blame a football (or cricket) manager and cast him out. It would be all too easy to mention a name or two.

It probably suits the police to pretend they are fighting crime by video. But a casual inspection of the local town centre reveals significant criminal activity. Lots of drivers are using mobile phones, parking on yellow lines, eating sandwiches and smoking cigarettes. All at the same time, in some cases. It wouldn’t take me long, if you made me a crime-fighter, to find people riding bikes without lights, on pavements, or even without hands on the handlebars.

Higher up the criminal food chain, complex laws are also enforced selectively, from drug possession to tax evasion, depending on the whim or policy of the CPS. The EU Commission even has an article in its constitution stating that it will pick and choose what it wants to enforce.

Suffice it to say, there seems to be a lot of luck involved in falling foul of the law, certainly more than your history teacher explained on the Magna Carta field trip.

I suspect the recent legislation banning fox hunting with dogs reflects an acknowledgement that all of us might have a deep rooted and nasty tendency to join a baying mob, which must be guarded against.

Scapegoating is a process found in dysfunctional groups and families. It is viewed as an unhealthy defence mechanism that, nevertheless, serves some purpose in preserving the group’s existence. Scapegoating often seems to occur in group therapy, where it can be interpreted, or even better, treated. With jazz.

Today’s paper reveals that jazz has infiltrated the public sector and has been applied to NHS managers, senior policemen and the department of transport. Alex Steele, musician and founder of ‘Improwise’, states that the NHS, in need of radical change, has called in his jazz quartet several times ‘to help with leadership’.

A police chief is quoted as saying the situation in his organisation was best explored through ‘parallels with the world of jazz’. Comedian Alexei Sayle famously observed that Jazz had no natural enemies or predators, but it seems he was wrong.

The Department of Health ’rounded furiously’ on the jazz workshops, stating that taxpayers will be ‘rightly appalled’.

So, jazz, intended to help groups function better, itself becomes the scapegoat. But Jazz cannot be blamed for careless driving. Hands off the Wheel was grunge, not jazz, and Asleep at the Wheel are Country. From Texas, not Yorkshire.