11. Tackling hooligans with a simple checklist.

Image

Your quiet reflections while driving to work are rudely interrupted by an idiot screaming past you in a small hatchback, overtaking the whole line of traffic, narrowly squeezing back in, missing a Portuguese pig lorry by inches.

Hooligan.

Your colleague interrupts his outpatient clinic with a brief diversion onto the internet only to suddenly find he has bought a 1995 Harley Davidson Fat Boy on ebay.

Hooligan.

Such events interrupt our attempts to look at the world as a sensible and logical place that only needs a few tweaks to make it perfect. The mind tends to create a fantasy world to live in more comfortably, and this explains dogs, fluffy toys, scented candles and soap on a rope.

Plenty of people will help us build the world of our dreams, not least the media.

Imagine the mind as a daily newspaper. Though the mind probably does not have an editor in chief, it has an editorial committee made up of opinionated people like taxi drivers and Irish nuns.

Yours may be different.

Plenty of space is devoted to current events, but even more is devoted to gossip and scandal. Quite a bit is devoted to food, clothes and the pursuit of food and clothes. The sports and health pages are also mainly about food and clothes.

Depending on the make – up of the committee, the mind can create very different sorts of world view. The Daily Mail mind for instance is quite suspicious. The Guardian mind feels it is being exploited. And the Sun mind is interested in sex and crime.

Since the concept of Depression as an illness calls for a change in a person’s usual world view, we have to imagine an editorial committee whose usual members – Fiona Bruce, Jeremy Vine and Hugh Grant – have been replaced by Leonard Cohen, Salvador Dali and Rev Ian Paisley.

Suddenly the world is transformed; distinctly darker, and quite unbalanced. Instead of Animal Hospital, as a change to a our usual programs, we now have live cockfighting from Wolverhampton.

CBT is an attempt to create a new committee instead of doom-mongers. The idea is to cut out the stuff about war and pestilence and put in more restaurant reviews.

It is tempting to think that resetting the mind’s information filtering system can bring about a more positive outlook, and this in turn could brighten the mood.

An old fashioned CBT technique, I think it was called Mastery of Pleasure, (or was that a sex manual?) involved creating a written timetable of your whole week, giving each activity a score between 1 and 10 depending on how much enjoyment it generated.

For example, watching Manchester City would score 6, while loading the dishwasher would score 7. This created a clear overview of the week, both in terms of quantity and quality of time.

Then, by substituting more dishwasher loading for football watching, your week would be improved, and more importantly, you would have disproved the notion that you had no control over how you felt.

It’s lucky that Mastery of Pleasure (or was it a postgraduate degree?) was not widely disseminated, as I suspect it is a technique that could easily turn our world upside down.

Imagine, calibrating everything, and finding, as we would, that 90% of our time is wasted on completely unnecessary items.

Luckily, Mastery of Pleasure (or was it a porn novel?) teaches people to rate their activities for pleasurableness rather than usefulness or necessity. Nevertheless, it calls upon them to re-evaluate what they find pleasurable, and if possible, substitute more pleasurable activities into the schedule, so that the whole average pleasure rating starts to increase.

There is some very interesting psychology involved in how people summarise pleasurable experiences, but one example is the case of the CD with a scratch on it about a minute before the end.

Has the scratch ruined the whole experience? What about the previous 49 minutes of pristine music?

Pleasure does not work like kilowatt hours, where we simply multiply power and time to sum up the energy used. Pleasure does not total up like the area under a curve on a graph, because the rating is given retrospectively from memory.

We also know that the beginning and the end of experiences carry more weight than the middle bits, which is why brevity is the soul of wit and why ‘The Archers,’ even at 12 minutes long, can get away with an absence of dramatic content between minutes 2 and 11.

What are the implications of moving the calibration system for pleasure from the automatic to the reflective mind? The danger is that certain activities may face a downgraded credit rating.

Some activities are probably best left to the automatic part of the mind. We could include sex, jazz and the tennis serve, which can all be affected by performance anxiety.

Once you start to rate pleasure, you may risk killing it.

I have already commented on the illusory joy of pets. But what about clothes and the pursuit of clothes, the activity called shopping? What about old stalwarts, like watercolour painting, banjo playing or golf?

What about photography, now that it is all digital? Techniques like solarisation and bas relief, that in the old days needed hours of darkroom work, involved getting contact dermatitis from putting your hands in developer, ruined your carpets etc, now can be achieved by moving a slider on a computer screen.

It so easy to make absolutely beautiful artwork using Photoshop or similar, that, suddenly, it loses its appeal totally. Such is art. It appears to need ingredients of toil and hardship to make it valid.

The notion of suffering being necessary to bring any value to an experience is borrowed a bit from religion, and also from the series Fame. Work is the price you pay. No pain no gain etc.

But how can we include items like suffering and pain in our Mastery of Pleasure (or was it a pirate ship?) timetable? Would it do suffering justice to simply rate it as zero?

Religions are always having to try and explain why terrible things happen, and this must be a massive burden for religious professionals. Why did God allow David Bowie to make the Tin Machine albums for instance?

Along the same lines, and probably to answer the same questions – only about world war and genocide – Freud developed the notion that people had a kind of death instinct.

Possibly this inspired Michael Winner to make the Death Wish movies. Though Freud would probably have put more effort into developing the main character, Paul Kersey, played by Charles Bronson.

As well as being a vigilante, Kersey was an architect. His building designs are only shown briefly, but he appears to encourage clients to save a lot of money by using a cheap building method just a little embellished by post-modern decoration.

These short cuts mirrored the corner cutting he brought to the criminal justice system by acting as police, judge and executioner all at once. I do hope Death Wish gets re-made with a lot more architectural referencing (see Point Blank).

Kersey has to choose between a civilised, measured and incremental approach to justice, using proper channels, or facing his hooligans head on and shooting them.

It is difficult to accommodate a drive toward death and destruction within a model that attempts to micro-manage pleasure activities, unless we just accept it as an elephant in the room we have to work round, covering it with a floral throw and scatter cushions.

Unless we try and accommodate destructiveness as a more understandable behaviour.

Kersey, like many other movie heroes, became a hooligan himself, but the audiences tended to view him as a necessary evil. People seem to want to subvert the usual processes of justice every now and again by acting completely out of character and possibly violently.

Kersey’s violence was initially triggered by revenge, but turned into a social mechanism, like pest control.

Many acts of seemingly random violence, such as ‘Running Amok’, have been construed as social mechanisms that redress some long lasting injustice.

In updating the psychoanalytic model of the mind, the ‘object relations school’ coined a character called the ‘internal saboteur’.

As far as I can understand it, object relations concerns itself with the very primitive mind and its development in the first few months of infancy. This is before the time when a person knows that he is a separate person and can correctly assign his experiences to inside the self or outside it. Conflict can occur in processing the aggression / guilt feedback mechanism. The object relations school seemed to focus a lot on breasts, so their world view was somewhere between the Guardian and the Sun.

I have trouble understanding object relations theory (you can tell), but we need to somehow include in our model of the mind a person – like Dr Zachery Smith in Lost in Space – who works behind the scenes to sabotage the ship.

(Or, even more evil, the Ian Holm character, Ash, in Alien – why is it that internal saboteurs are found mainly on space ships?).

Up to a point self – destructiveness can be explained as an attempt to get back at others or redress the balance in a power relationship. Sometimes it may be better to explain it as a short cut in making changes happen quickly.

I am reminded of recent attempts to fix small electrical appliances such as toasters. There comes a point where the attempted repair turns into a post mortem, the turning point being recognition that the appliance was never designed to – and cannot – be disassembled.

Finally, pulling the two halves of toaster apart with bare hands or hitting it repeatedly with a rubber hammer bring about the desired outcome of an end to the toaster issue. A colleague tells me that this happens a lot with motorcycle repairs and is known as ‘the berserker phase’. Luckily, he is not a surgeon.

In fact people who harm themselves by cutting make the observation that the act focuses and resolves a moment of intense mental turmoil.

Not recommended and foolish, both for toasters and people.

Destroying motorcycles is probably a good idea though, in the wider scheme of things. In fact there is quite a lot of redundant junk and clutter in most people’s houses that is crying out for some rational hooliganism. If you have a cathode ray tube television for instance, you have probably wondered from time to time about throwing it out of the window. I worry about you if you haven’t.

Which brings us back to the problem of calibration of emotional states. It is very difficult to find the right frame of reference. If we subjected many activities to scrupulous measurement, we would have to categorise them as ridiculous and unnecessary, like carrot shaped trousers.

In using CBT to re-evaluate and re-schedule activities, we begin to ask ourselves some difficult questions. Why does everyone we know seem to spend all day looking at a computer screen? Aren’t they supposed to be an engineer / teacher /artist?

If they realised how they now spend their time, might they be tempted to destroy the computer with Greek fire?

And if we had to carry out a Mastery of Pleasure (or was it a Waddington’s board game?) exercise on, say, running a marathon, or digging the garden, or training a parrot to ride a unicycle, how would we measure the area under the curve?

When we encounter a hooligan in our mind there are several ways we can react:

Hug them (as recommended by the Prime Minister)

Shoot them immediately (as recommended by Michael Winner)

Run away

Using a wider frame of reference, attempt to understand the hooligan

Attempt to slowly reform the hooligan using metalwork and batique

Cover them with a floral throw and scatter cushions

Play them some Tin Machine

Depending on your editorial panel, you can choose any of the above options.

(Or was it a steam locomotive?)

Advertisement

7. Killer Apps of the Mind.

Image

A cultural education                                                    (picture by Roland Topor)

There are several types of therapy for Depression. In one way or another they are directed at improving insight. Whether improved insight translates directly into recovery is a different matter. Also we are assuming that better insight is always a good idea. That might not suit certain vested interests and power groups who need us at the grindstone all day, in the pub all evening and shops all weekend.

There are quite a few logistical barriers to psychological treatment – finding it, getting there, sticking with it. Recently a number of computer programs, or applications, have been designed to help, with names like Beating the Blues and Fearfighter. Mostly these have been presented by IAPT therapists in health centres or GP practices. They can be accessed directly by users at a price, but its only a question of time before cheap or free apps become available for home use. These applications have been given a cautious welcome by experts such as NICE. People who are used to modern computer gaming will find them a bit pedestrian. I hope we can rely on the software industry to pump them up.

Professor Niall Ferguson recently presented an account of modern history attempting to explain the rise of western civilisation. He used the analogy of ‘Killer Apps’ to explain why certain societies had prospered.

Competition, Science, Medicine, Property Rights, Consumer Society and Work Ethic: these were the processes  that had brought about Western Civilisation, he argued.

Commentators say that Ferguson has misused the term ‘killer app’, which has, or used to have, a particular meaning in the computing world, not just an analogy for ‘vital’.

A killer app was supposed to be an item of software unique to a particular piece of hardware. So if you wanted a spreadsheet or desktop publisher you had to have a Mac.

Strange that Ferguson, an academic historian, tolerated an historical inaccuracy in the use of terminology, for poetic licence. The recent history of technology is probably more interesting, important and possibly bloodthirsty than the Tudor period. Still, the killer app analogy caught people’s attention, which was probably what he intended.

History wasn’t my favourite subject at school. In fact, school utterly killed History for me; too many dates and royals. I was glad when Francis Fukuyama published his book ‘The End of History’ in 1989, though for me History ended in 1973, with the damp squib of an O Level exam. After Fukuyama published his book I fully expected all the History departments in schools and universities to shut down like the coal mines, their job finished. Instead of which we saw the emergence of Time Team and Dan Snow.

Since apps had not been invented in the 1970s, I can’t blame my History teachers for not using this illustration, though I can blame them for never using gimmicks at all. Aside, that is, from Mr Hockenhull’s epic 8mm movie, reenacting the Battle of Hastings in Disley.

Still, it’s a slippery slope between education and entertainment, one that I personally would hurtle down on a Lidl trolley, but thats another story. The trick I suppose is using colourful illustrations to explain ideas without dumbing down the key message.

I am certain that Niall Ferguson has looked at all the information available and come up with the right processes that shaped prosperity, but does it help to think of them as Apps?

Apps, on the computer at least, are processes that run within an operating system.

There are certain aspects common to any system, operating or otherwise. There’s a whole theory of systems, which spans science from engineering to economics. So there is a whole range of analogies to be made between aspects of different types of system.

So it might make sense to use the analogy of an App in terms of processes in societies, small groups of people, or individuals, all of which are systems of a kind.

A system needs to define itself using boundaries. It needs to regulate its inputs and outputs. It needs fuel broken down to provide energy. It needs feedback control to maintain itself. The same features can be found in any type of system, large or small, with the possible exception of the Beko washing machine.

Freud had a surprisingly electrical view of how the mind worked. For instance,Freud thought the mind had a range of mechanisms to protect itself from electrical overloads, which are now called defence mechanisms. For instance a murderous impulse might have its energy directly countered, or projected onto another person, or converted into a physical disorder.

Some of these defences he thought were disastrous and some more effective and healthy, such as Humour, Altruism and Anticipation. We could regard Freud’s favourite defence mechanisms as Killer Apps (almost literally) in terms of dealing with extreme thinking. In terms of treatment options, Freud had something of a killer app in the form of Hypnosis, which he abandoned in favour of the technique of free association, which is like exchanging a Macbook Air for a Babbage Engine.

Killer Apps in the Mind? After all, the mind is genuinely a computer system, unlike society, which is a mixed bag of systems, non systems and mud.

In truth, many people have attempted to explain how the mind works, using simplistic models that involve two or three main components. Analogies like these tend to break down when we try to illustrate something so complicated.

Apps however have the advantage of being highly specific. I have one that merely turns on the phone flashlight. Yet there are others that tell me exactly where I am and how to get home. I have one that tells me my car is in Munich at the moment. Inkorrekt!

Just like Prof Ferguson introduced the idea of Killer Apps to spice up a massively complicated piece about the history of the western world, we might be able to use the concept to help us talk about mental processes without being hidebound by some overarching model.

We might be able to use the App idea to spotlight certain aspects of morbid thinking.Terms proffered by CBT therapists like ‘arbitrary influence’ and ‘selective abstraction’ never felt very user friendly.

Specifically, are there certain killer apps that could protect against getting depressed, or help a depressed person, if we could only download them to someone’s mind?

Abstract thinking, such as the use of metaphor, proverbs and analogies, helps us organise information. Using templates, such as lists, mnemonics,algorithms and ‘pathological sieves’, helps organise piles of untidy thoughts.

If we could load some of that onto a smartphone we could call it something like Meta4Works or ProverbBlaster. These are perhaps part of a larger software package we could call InsightFull.

I would also like someone to invent FrameItWider and AttributeRite to counter some common cognitive errors.

 

Mostly we need help to make better decisions. There is a growing interest in how decision making takes place, both in individuals and organisations. Books like Nudge by Thaler and Sunstein explain how the ‘choice architecture’ affects how people behave. The role of default options is surprisingly strong.

Zhan Guo, in a paper called Mind the Map, showed recently that the London tube map affects peoples travel decisions far more than their actual experience of making journeys. Sometimes the schematic map is nowhere near to scale geographically. Instead of using the map, we could use an App, putting in the destination.

Smartphones are getting smarter and people are – in some ways – getting dumber. Think of Arithmetic and Calculators. Could we not just hand over more of our troublesome thinking to a computer? Its precisely what we have done with arithmetic after all.

Already, or pretty soon for most people, navigating a car will be delegated to a GPS system. Its a set of decisions we can safely leave to an App. Now we have a computer system called Amazon, that can tell what I want before I even know myself.

Tesco know what kind of whiskey I would buy if only I had a voucher for £5.40 off the price. Not £5.30 mind you. £5.40.

Doubtless Tesco and Amazon are using a version of choice architecture to apply nudges to my behaviour. I doubt whether they employ clairvoyants or telepaths at Tesco, so I am guessing they are using a software application which clusters together things people like me have bought. Either that or I have misinterpreted that large phone mast on Tesco’s roof and those strange headaches I am getting.

Many decisions we make, particularly purchasing whiskey, should be delegated to a wiser system. When it comes to choosing a product or service, or even the way home, there are many sources of guidance.

Sadly, when it comes to the biggest decisions of all, we are often working too quickly, without enough information, without an App at all, or with a flat battery.There is a strong relationship between poor decision making and Depression, both in terms of getting depressed in the first place, and perpetuating Depression once it has begun.

That is why the Killer App we need the most is ChoiceMaker Turbo version.

I just used it at Tesco and ignored the whiskey offer. Like their trolleys, I have a mind of my own. Also, if I’m right they will soon up their offer.

I like the analogy of Apps, but it works better to illustrate a single mental process rather than model the mind as a whole, let alone whole societies. As a way of spicing up and developing CBT for a mass market, Apps could be the way forward, but we have yet to see a Killer App for Depression. Good news for therapists who don’t like anything called a tablet. The important thing is we continue to seek better analogies all round.

As Mr Hockenhull might have said, ‘the first two periods are Biology and IT, the rest is History’.

Or, after Fukuyama, ‘home early today’.