Tag Archives: dreams

103. The Optimism Crash.

I spent all morning trying to set up Mesh wifi (fail) and all afternoon trying to mirror my phone onto the TV (epic fail). Yesterday I spent an afternoon editing a pdf document to help someone apply for a UK pension (pass, barely). 

And then my HP printer had a seizure of some kind and went into a gobbledygook printing frenzy. HP detected this and immediately sent me an email to say they are really pleased I am having fun with my printer and look forward to more printing in the future, possibly a golden age of print. It’s 1476 all over again.

This is all fine, first world problems, but it’s not quite the future we expected when Tomorrow’s World was on TV. After the moon landings, Velcro and Pot Noodles we looked forward to free energy and a working week of 1 hour when we went in to feed the robots.

Finding that people tend to be optimistic is one of the most important and far reaching discoveries in Psychology. It explains why people keep on buying lottery tickets, electing pathological liars to Downing Street and hitting 3 woods out of fairway bunkers.

People are more optimistic than they really should be.The human spirit is seemingly hard-wired to be indomitable. 

Though it must be said, a lot of optimism research was carried out in the USA, often using samples of college students and arguably during a more optimistic period of history.

During that era, post war, the cultural vibe was an expectation of progress, that each generation would become more prosperous and happy than the one preceding. According to historians* ‘the belief that things are going to get better was already connected to a figurative America even before European settlers set out for the New World’. 

The American Dream preceded D:ream and their song ‘things can only get better’ by 3 centuries at least. 

A word of caution about the American Dream, regarding nomenclature. Call me a pedant, but we need to separate out the differences between Dreams, Daydreaming and Wishful Thinking. People who like to think wishfully fall into the ‘two biscuits later’ category, instead of the ‘one biscuit now’ group who end up in prison. Wishful thinking overlaps to an extent with positive thinking, which can be helpful to the positive thinker, if detrimental to everyone around that person.

The new wishful thinking in politics is to bring back an imaginary world where the map was mainly coloured pink, ambulances arrived within 2 minutes and your GP had a housekeeper called Janet who could mainly solve your problem herself with a shilling’s worth of homespun wisdom. Otherwise a GP would visit before the kettle had even boiled.

Such imagery was perfected by John Major who put it thus: ‘long shadows on county cricket grounds, warm beer, invincible green suburbs, dog lovers and – as George Orwell said (he didn’t) – old maids bicycling to Holy Communion through the morning mist’ (He said ‘hiking’ not ‘bicycling’; call me a pedant again).

Choosing to embrace nostalgia instead of optimism led to Major’s Conservatives being eclipsed by Labour in 1997, who deployed the above mentioned anthem ‘Things can only get better’, by D:ream. Featuring TV scientist and Professor Brian Cox, D:ream were probably the only band ever to use a colon in their name, a device that artfully referenced the computer language underpinning electro-pop.

Dreams, daydreams, nightmares, flashbacks, are all different mental experiences. But they are quite interchangeable in the context of popular music. We are not expecting artists to use psychological terms accurately, (especially as most psychiatrists use them inaccurately too).

Daydream is a Mariah Carey album from 1995, featuring the singles ‘Fantasy’ and ‘One Sweet Dream’. Daydreaming, unlike Mariah Carey herself, is only of limited interest to psychiatrists, since it is a normal mental experience. Daydreaming is a normal mental event, ditto Fantasy and having One Sweet Dream. Or so we thought, until the concept ‘maladaptive daydreaming’ was invented in 2002 by Eli Somer, by which time Mariah Carey had moved on to her ninth album, ‘Charmbracelet’. 

The diagnosis of maladaptive daydreaming was never accepted mainstream. There’s always a backlash against attempts to medicalise aspects of normal life, though anyone could see that daydreaming might be a problem, say, for a fighter pilot or the person who inserts pins on a grenade assembly line. 

Daydreaming is more usually counted as a positive and constructive mental experience, where ideas can flourish. Nevertheless, Somer thought that daydreaming could be problematic if it became excessive or morbid in content. 

Somer was a daydream believer but we are left with the philosophical question first raised by The Monkees: Oh, what can it mean? 

Daydreams are what we do when boring people are giving long speeches. If they are maladaptive they can equally be adaptive. Some of my best thinking, such as planning the list of plumbing parts I will need for a new drain, has taken place as my mind drifted during a long sermon (sorry Father Chris).

The American Dream, which never was really a Dream, somewhere in recent history, seemed to reverse its mood polarity. As Billy Joel put it in the song ‘Allentown’, ‘every child had a pretty good shot / to get at least as far as their old man got’. The lyrics go on to say that, ‘something happened on the way to that place / they threw an American flag in our face’. The song marks roughly the time when the optimism curve started to trend downward.

(That time was emphatically not 1982, which was the year I got married. Allentown was written a few years before that, but yes it was released in 1982. Apologies to Mrs EP).

The life expectancy curve took longer to start declining, but by 2020 most countries, other than New Zealand, Taiwan and Norway, (the smug countries) were predicting reduced average lifetimes. 

Something has gone a bit wrong, but who can we blame? In ‘Allentown’ the problem was the decline of the steel industry, or more accurately its export to Asian countries.

The obvious suspect is the onward march of so-called neo-liberal economics and its fellow apocalyptic horsemen: war, climate change, plague and library closure.

Social division has increased and people are more unhappy in countries with higher levels of wealth inequality. Commentators have linked neoliberal economics to general dissatisfaction and anxiety and to a huge increase in the prescribing and consumption of antidepressants. 

Children in the UK, especially girls, were particularly unhappy compared with other European countries, according to a 2015 study, being made to feel inadequate in one way or another.

Schools continued to overload both students and teachers with assignments and assessment despite the finding that during the plague year, when schools were closed for months on end, the students got better exam results than they ever had when the schools were open.

Social media companies are helping to fuel the fires of envy and self loathing. They are essentially advertising agencies, though more artfully targeted than billboards and posters.  

The targeting still seems erratic, which is why I keep getting adverts from HomeStoreandMore for Patchwork Posie Kitchen Textiles. Or, today, ‘how to make it look like you have abs in every photo’. Instagram is trying to ab-shame me now. And that’s right on top of being cholesterol-shamed at the health centre.

The internet has a lot to answer for and is routinely blamed for every type of disruption. The internet wasn’t a thing in 1982 when Allentown was released, and it wasn’t a thing during most of the 20th century’s wars and genocides. But one has a feeling that the IT revolution exaggerates every social trend, from redefining the ideal female eyebrow to closing small shops and is probably making wars even more deadly than they ever were.

Despite very difficult times ahead, as we collect our thermal pyjamas and hazmat suits from HomeStoreandMore, can we rely on people to stay cheerful? 

Hard-wired optimism is one reason why all of us are not depressed all of the time. Is this resilience being gradually overwhelmed by a tide of damaging online experiences? Yes, clearly, for some, such as adolescents who use Instagram and have been presented with ‘the bleakest of worlds’**.

There is evidence to suggest that Optimism Bias, though basically an incorrect prediction, leads to better outcomes than seeing the future realistically:  

‘that the mind has evolved learning mechanisms to mis-predict future occurrences, as in some cases they lead to better outcomes than do unbiased beliefs’***

This raises a problem for therapists, at least those whose system is based on countering cognitive distortions. This probably explains the recent trend of therapy morphing into Coaching. Check out your therapist’s footwear next time around. If the Clarke’s cornish-pasty loafers have been replaced by Air Max, you may be predicting a ‘better version’ of yourself in the world to come. New Balance might be better. 

According to Wikipedia, Billy Joel is still only 73, so ideally placed for a future presidential run.

*‘Things are going to get better: the American dream in contemporary young adult chicano literature’ Marlene Roider and Stefan Brandt, Graz, 2017.

**Now we know that big tech peddles despair, we must protect ourselves; Zoe Williams, Guardian, 7 Oct 2022

***Sharot, 2011, https://www.sciencedirect.com/science/article/pii/S0960982211011912

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101. Manchego Nights

I’ve had a lot of dreams recently. Most of them I can’t remember. Analysts used to like interpreting dreams, but now I think dreams are viewed as a kind of mental Pilates, rehearsing possibilities and dangers ahead.

I knew a patient once who thought that we were recording all his dreams and sending them to Disney to be made into cartoons. DIsney never replied to his letters. With medication and therapy he stopped believing his dreams were stolen, but sadly when this happened he also stopped dreaming altogether. I’m sending some of my new dreams to Disney right now before I forget them or get my medication increased.

Driving the bus

This one comes up quite frequently. I’m driving a double decker but from the upper deck, looking down the little periscope window at the right front corner. Sometimes it changes into a Volkswagen Variant station wagon which I drive from the back seat. The bus very nearly topples over round corners. Probably one for the Freudians.

Quantum of Amnesia.

In this one, no-one can remember anything about the Bond movie Quantum of Solace, even though everyone has seen it at least once. Even straight after watching it on TV I cannot remember any of the plot or characters. I find that others have noticed the same thing. Some anaesthetists in China are showing the movie in operating theatres instead of using gas. A news article finds that Quantum of Solace is the favourite movie choice for date rapists. The Alzheimer’s Society calls for the film to be banned.

Wisconsin Shuffle.

I am a professional gambler, working the Mississippi river boats, dealing the Wisconsin Card Sort Test. The other big players are all psychologists, some of whom I recognise, though now they all have moustaches and one of them wears the uniform of a Norwegian navy captain. 

The dream suddenly moves to an appraisal meeting where I am facing the Trust Board. They demand a share of my winnings and suddenly the medical director produces a Derringer from up his sleeve and the chairwoman comes at me with a tiny dagger. I protest that my gambling takes place in my own time and not one of the Trust’s programmed activity sessions. ‘We’ve changed the paradigm,’ laughs the chairwoman. As she lunges forward I see the little NHS Trust logo on her stiletto and then I wake up.

Prince Andrew

Prince Andrew arrives for his CBT session. He’s upset because he’s going down in the line of succession. He was eighth in line to the throne, now he’s ninth, overtaken by baby Lilibet Diana. How badly upset should he feel? Ninth out of sixty million, surely not too bad? 

‘In line to the throne’ is Andrew’s best top trumps suit, even though he’s now overtaken by a tiny girl.

As consolation I remind him he’s still Earl Of Inverness. ‘They can’t take that away from me’ he nods, though in his homework assignment he has found that some residents of that city are trying to sack him. It’s a title that’s been created several times, in 1718, 1801, 1892, 1920 and 1986. I make a note of the sequence to put in a pub quiz one day.

Ward twenty something

In this one I’m admitted to a hospital in Scunthorpe, left in A and E for 12 hours without any water or food, wrongly diagnosed and sent to an inappropriate ward. The other 3 patients in the 4 bedded bay appear to be zombies. Mrs EP visits me and asks if there is any food available. The nurse shakes her head sadly. ‘A long time ago we had vending machines but they have all been taken away’. On her way out, just outside the ward, my visitor sees an enormous bank of vending machines full of chocolate and pepsi. She has enough change for a Twix bar and Ribena, which she brings back for me. I try one finger of Twix, but the effect is like the wafer thin mint in Meaning of Life and I vomit till I explode.

Tower of Babel

This one is like a biblical epic movie, in letterbox format and starring Kirk Douglas. It’s meant to be a comment on the modern world, where there are too many words being uttered or written. But Kirk keeps saying things like  ‘I know there is huge merit in talking about your issues and the only thing about keeping it quiet is that it’s only ever going to make it worse’ and the director just keeps saying ‘cut’.

Be mindful

Its mental health awareness week yet again. I learn that stress affects exactly 74% of people. I take the Perceived Stress test and am surprised to find I score 16, which is described as moderately stressed. Apparently I could reduce it to 10 by taking a Be Mindful course.

After a cup of tea, I take the test again and score 8. Apparently I could reduce it to 5 by taking a Be Mindful course. I open up the Be Mindful course on a web page and a giant shark comes out of the screen and I wake up.

Spacey is exonerated

In this one the actor is totally cleared of any wrongdoing. As a recompense, the movie All the Money in the World, for which he was replaced by Christopher Plummer, has to be re-shot frame by frame with Spacey CGI’ed back in place. I wake up when Spacey seizes the Oscar from Plummer’s cold dead hands.

Learning points

Are any of these dreams food-related? Scrooge, in Christmas Carol, attributed his ghostly night fantasies to tyramine-rich products:

‘You may be an undigested bit of beef, a blot of mustard, a crumb of cheese, a fragment of underdone potato. There’s more of gravy than of grave about you, whatever you are!’, he yells at the ghost of Jacob Marley. 

Dickens was quite advanced in suggesting a molecular basis for psychopathology, even though later Scrooge found plenty of meaning in his dream.

Scrooge changed his whole life around but I came up with two small changes from my dream work. 1. Avoid the combination of Manchego, Chianti and Amitriptyline before bed time. 2. Don’t go to ward twenty something ever again.

    86. Setting food on fire: not really politics and not really science.

    New Image

    Warning: hair fires are getting more common.

    Behavioural activation is one thing, but most therapists wouldn’t recommend attacking a breakfast cereal cafe in Shoreditch with fire torches, even if such action seemed to strike at the heart of the neoliberal orthodoxy. As a child, I remember putting various kinds of food on to an open fire to see how well they burned. Result: cereals burn extremely well. Discussion: a packet of Ricicles with the top torn off is virtually a Molotov Cocktail. Have people learned nothing from the great fire of London?

    There must be better ways of challenging gentrification. Karl Marx spent years in the great reading room at the British museum, working out how to win the class struggle. Possibly he over-thought the whole thing, but direct action against muesli wasn’t on his agenda.

    As the person next to you in the waiting room might say, let me tell you about my latest hallucination. I was half asleep at the time, so the experience would be of no interest whatsoever to a psychiatrist. ‘Hypnagogic’ or ‘hypnopompic’, both suitable names for an electropop band or a small disco in Albufeira, are words to denote an experience that occurs when you are just dropping off or waking again. Such things are firmly in the ‘that’s- yawn-normal’ category and would only rate a single line on page 119 of a psychopathology textbook, even if anyone was still writing those.

    Anyway, here’s what it was like. It was a circular image, on the lower half of my left visual field. It was brightly coloured but hard to make out. There seemed to be a mountain and on top of the mountain something like a person. There was no sound, but somehow the words ‘good works’ became associated with it, though the words were not spoken.

    That’s it. But what to make of it? A trip to the slightly-over-intimate optician at Specsavers, or start a new religion?  One explanation of why we dream is to allow the rehearsal of potential responses to feared scenarios. Primitive peoples would have dreamt of being attacked by wild animals but now we dream about how we would turn the water off if the pipes burst – you may have different nightmares, but you should still install service valves for each appliance.

    In the dream scenario, we appear to be paralysed and unable to take necessary action. This is supposed to be because these dreams occur in REM sleep, when the body’s motor system has been taken off-line for maintenance. But this is not helping me interpret my vision. It’s unlikely that a man on a technicolor mountain will give me instructions, if only because there are no mountains where I live, unless you count the coal tips at the power station.

    Good works could mean a number of things, but I’m sensing the gist of it as behaving more constructively or generously or just more usefully. At the very least ‘good works’ means I’m not going to pursue my latest business idea, which is a range of homeopathic soups, provisionally titled ‘Memories of Heinz’. And it probably means stopping putting opportunistically low best offer bids on ebay items, just in case the seller is desperate to raise money.

    Decades ago, I remember Father Higgins causing a stir when he seemed to go against the idea of Prayer. I think what he said was that you are judged on what you do, not what you think or say. Looking at that now, it doesn’t seem too controversial, following all the scandals that hit the churches. People were clearly behaving badly yet talking sweetly to the boss.

    At a meeting this week I found myself in the coffee queue, behind an eminent colleague. I noticed him place his cup just slightly off beam below the dispensing nozzle, so that he got the full quota of frothy milk, but none of the squirt of coffee, which comes out about an inch to the left of centre. I watched the coffee spurt to the side of the cup and I watched him not notice. I watched him take a slurp of his coffee and complain it didn’t taste of anything. Why didn’t I say something? Answer: too much thinking and not enough behaviour, just like Karl Marx.

    Getting the balance right between thinking, emotions and behaviour is what therapists do – on diagrams. The point of my dream, I think, is that behaviour comes first and we should help colleagues operate coffee machines even if they work for NICE.

    Lots of strands of information feed into our dreams. If ‘good works’ means something to do with behaving better, then it does chime with some of the stuff I wrote about last year. I suggested that behaviourism had been abandoned prematurely in favour of cognitive approaches. I suggested that Art and Music and other skills therapies had been neglected in favour of talking. And I praised hunter / gatherer activities, or pottering, which is the natural human condition. I attempted to steal Nike’s slogan ‘just do it’ to symbolise putting the B back into CBT.

    People are abandoning old assumptions about how to protect against sadness and anxiety. They are resorting to eclecticism and mixtures of lifestyle improvements and increasingly, to apps connected with social contact and fitness. Not to mention the people who are connecting batteries to special hats to improve their exam performance, or using Nitrous Oxide to make TV more enjoyable.

    This is heretical, but merely running for miles is not a good work. That is why athletic activities have to be artificially and laboriously associated with charitable causes before they acquire a moral value. This is even more heretical but I venture to suggest that neither knitting nor chatting nor a combination of the two are intrinsically valuable activities. It’s easy to say what isn’t a good work; much harder to say what is. Here are my first thoughts on the matter, in the form of a multiple choice question.

    Which of the following is a Good Work?

    Donating one of your spare copies of Songs about Jane by Maroon 5 (statistics show there are on average 2.6 copies per household) to Cancer Relief.

    A mindfulness based breathing exercise, such as blowing up a balloon, pausing to enjoy the pleasing tension in the larynx and the slight dizzy sensation caused by lowered pH.

    One short burst of primal screaming followed by a cigarette

    Writing down a negative thought using lemon juice as invisible ink, revealing it with a hair dryer and then burning it

    Playing the Killers’ song ‘Everything will be alright’.

    A friend tells me the man on the mountain sounds like Moses, the person who probably invented bullet points and coined the word ‘covet’. Moses set fire to lamb at times but not I think as part of an informal science experiment.

    75. Feeding jokes and riddles into Multivac.

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    Because I’m worth it.

     

    Obviously I can’t say anything about it, but I’ve been on Jury Service. I’d love to tell you all about the case but I can’t. Suffice it to say, as a spectator experience, this beats soaps and reality shows and probably boxing too.

    There are some things I just have to write down. There’s a lot of time hanging round in the jury waiting room, which is about as comfortable as a Ryanair departure gate. Though they do have daytime TV, it keeps being interrupted by the How to Be in a Jury DVD. Luckily one of the ushers is a stand up comedian and keeps popping in to try out material on the captive audience.

    For some reason, jokes, like dreams, don’t seem to bed themselves into the memory banks very well. When it’s time to remember a joke to tell, the memory just vanishes. Isaac Asimov based a whole short story, ‘Jokester’, on this premise, concluding that jokes were part of a psychology experiment carried out by aliens.

    This time I resolve to write them down straight away.

    A man comes into the doctor’s surgery.

    ‘Doctor, I think I’m a moth’.

    ‘You really need a psychiatrist rather than a GP’

    ‘Yes, I know, but your light was on’.

    No-one laughed apart from me. That’s a bit worrying, since the jury is one of the very few occasions where a random sample of the population has been assembled. Is my sense of humour, statistically, a bit odd? Everyone seems very normal, at least compared with the people I normally meet. Perhaps they have heard it before, or perhaps its because I like psychiatrist jokes more than the average person. Perhaps I am tuned in to contrasts: here’s an ultra sober setting, a Crown Court where people are being tried for sex crimes and murder. And here’s one of the court officers, dressed in a gown, telling gags. Humour often arises out of adverse situations, but why exactly? Why do people make sick jokes about Princess Diana or Fred West?

    The usher announces further delays. We see one of the judges arrive in his Impreza and a flunkey goes out to open his door and hold an umbrella over him as he walks five yards to the court entrance. That would never happen in the NHS, not even for Lord Winston.

    A man comes into a doctor’s surgery.

    You should know I’ve got a rather unusual congenital problem

    Tell me more about it

    I was born with five penises

    Hmm. That must make it difficult to get your trousers on

    Actually, they fit… like a glove.

     

    I laughed more than the others again, but I like stand up and even pay to see comedians live, which probably places me in a small minority of the population.

    The usher pauses ever so slightly between the words ‘fit’ and ‘like’ in the punchline. For some reason that bit of timing is critical in adding humour, the split second somehow priming the laughter pump, like turbo lag. As he finishes the last line he turns and swoops out of the room in a grand exit.

    Jokes and dreams. Why can’t we remember them? Is it a lack of concentration, which stops us filing them away properly, or do they just belong to a different part of the brain from the usual memory, like singing uses a different system from talking? Is there an equivalent of a Save command in the memory system, that somehow doesn’t always get pressed?

    There are many psychological theories about joke memory, including a rule that the very best jokes are the most difficult ones to remember. Maybe it’s because jokes are inherently discordant and can’t be processed into patterns. And perhaps humour offers a defence mechanism against discordant experiences, like horrific crimes.

    I have a friend who races snails. He takes it very seriously. In fact he has one extremely fast snail that he enters for national competitions. For the snail Olympics, to make it even faster, he decided to improve the snails power to weight ratio by removing its shell. After this, it won its next race easily.

    I asked my friend how he felt about it.

    He said, great performance, although somehow… just a bit sluggish.

    I’d like to think that a sense of humour is an asset in working with people with mental health problems. I used to think it was a moral imperative to state a witty remark if it happened to come into your mind. Nowadays though, especially with regard to some people’s interpretations of political correctness, the smart move is to keep it to yourself. No-one would be allowed regular comedy slots in an NHS department, not even dermatology. Even though you can buy a book called ‘The best ever book of dermatology jokes’ on Amazon.

    Here’s a joke I found sent into a forum. You are meant to answer the question: Why does no-one trust a dermatologist? The answer is supposed to be ‘he keeps making rash decisions’. Instead someone has responded, in capitals:

    BECAUSE THEY SAY YOU NEED A MOLE REMOVED WHICH CAUSES NO PROBLEMS AND INSTEAD LEAVE AN UGLY AND EVEN BIGGER SCAR

    I don’t know why that’s funny, but it is. Discordant notes again I suppose. It doesn’t pay to overanalyse it.

    At the end of ‘Jokester’, once it was revealed that jokes were nothing more than part of an experiment, humour was simply ‘turned off”. Was Asimov anticipating the PC movement, or was Jokester just a true story?