Environmental Effects in Mental Illness Models
[Illustration by M H Evans]
William of Occam has a lot to answer for. Let me explain. Psychology bloggers are getting excited over recent research in biological psychiatry that integrates the environment into aetiological models of mental illness. While these developments are to be welcomed, they do come relatively late in the day, bearing in mind we've already got evidence for myriad environmental causes including urbanicity, child abuse, social class and so on.
Occam, of course, was the minimalist monk who thought the simplest explanation for a phenomenon was generally the best explanation*. Researchers looking for the genetic causes of such psychopathologies as schizophrenia or bipolar disorder have, or so it appears, followed Occam's handy rule, tending not to include the environment as a possible causal variable.
That's not to be critical of their approach which is perfectly logical. It makes sense to look for a genetic cause first if you think of schizophrenia, for example, within a medical model. For many psychologists, however, the environment is often the first port of call in the search for the etiology of mental illness.
Researchers working within a medical model have not had an enormous amount of success with a purely genetic approach. It's been very hard to show a direct link between genes and a psychological disorder. And so now the emphasis is turning to an interaction between genes and the environment (Gene-environment interactions in psychiatry: joining forces with neuroscience, via Mind Hacks). Bearing in mind how long many researchers have been banging on about the importance of the environment, it is hardly a surprising move.
What is even less surprising is the familiar way in which sets of researchers happily sit in their respective ghettos largely refusing to acknowledge each other. Another reason why this particular forward-looking piece of research is to be welcomed.
To return to Occam, I don't blame him for the idea that we should choose the simplest explanation for a phenomenon, but more that his philosophy has become so ingrained in those studying brain, mind, behaviour, what-ever-you-want-to-call-it. Surely the one thing we can count on is that human thought and behaviour is formed by a complex web of factors?
This is not to say that people shouldn't investigate single factors, of course they should. But, when building a theoretical model of mental illness as complex as schizophrenia it is taking Occam too literally to only include one aetiological factor.
[Hubris alert!] What psychology needs instead of 'Occam's Razor' is 'Dean's Diffuser' coming from the 21st Century philosopher and psychologist who wrote PsyBlog. This law states that if you think any psychological phenomenon can be explained by a single factor then, seriously, think again: the causes of human thought and behaviour are actually incredibly diffuse.
* Technically what Occam said was that if you have two theories which both explain the data adequately, then you should choose the simpler one as it was less likely to needlessly introduce errors. The key words in this context are: 'which explain the data adequately'.
Lobotomy Wins
Each speaker had ten minutes to convince us that their idea was the worst idea anyone had ever had on the mind. Ultimately, simple disgust won over the audience and lobotomy took the title. I voted for drug company advertising or more specifically, as explained by Joanna Moncrieff, drug company promotion of the 'chemical imbalance' hypothesis of mental illness.
What's my reasoning? Well the idea of people with depression having a chemical imbalance is such a widespread, and incorrect, idea that it needs to be challenged publicly. The problem is that it directly leads to the idea that depressed people need to take drugs to 'rectify' this so-called imbalance. Many psychologists and even growing numbers of psychiatrists would agree that this approach is fundamentally flawed and there is little or no evidence for it.
What about the other contenders? Yes, trauma counselling has now been found to be worse than useless but now we know that and so presumably we'll stop doing it. Lobotomies are almost, but not quite, extinct; so why get particularly upset about them nowadays? Freud's theory of hysteria triggered many of his later discoveries and the occassional modern misdiagnosis of a conversion disorder is a small price to pay for the foundation of psychoanalytic ideas.
I realise that my stance is utilitarian and focussed on the present, but that, I think is where we need to remain.
If allowed more philosophical leeway I would point to Cartesian dualism as the worst idea on the mind. The idea that mind and brain are separate just goes on and on and on and on to the most tedious degree. If your mind isn't your brain then what the hell is it? No, actually, please don't answer that, it'll only give me a headache.
And without further ado, the Mind Hacksters have the results for both best and worst ideas on the mind. Great Psychological Experiments of the 21st Century
It made me wonder. What will be the great psychological experiments of the 21st Century? Will there be any?
Opening Skinner's Box
Oslo, Norway
It can be difficult to see aspects of your own identity clearly without a contrast. As an Englishman amongst the English it's hard for me to understand many aspects of my own Englishness. In the same way, without comparing myself to other people, I can't accurately fathom my own personality. And so travelling is not just a chance to relax, eat out and take in the sights, but it's an opportunity to get some perspective.
Returning this week from the Norwegian capital, Oslo, I was struck by how easy it is to stereotype other cultures and assume our own is unique. There are two stereotypes about Norway: it is cold and depressing. These are often combined to arrive at the idea Norway has a high suicide rate because of the cold weather.
In fact Oslo, which is in the south of Norway, has a similar climate to London in June, July and August. Norwegian suicide rates, while higher than the UK are certainly not off the scale - they are comparable with those in the US and lower than those in Australia. Indeed Norway often comes near the top of tables for the happiness of its inhabitants.
If Norway isn't always a cold depressing country then what kind of a country is it and how can I tell? In many ways a city is a manifestation of its inhabitant's beliefs and attitudes, or at least a history of what they used to be. It's possible to read a city in the same way it's possible to read a person's expression.
It turned out that Oslo had much to teach me about Norwegian culture. After all, the city environment is an expression of culture, a way of the city's inhabitants revealing themselves. What does the city we live in say about us?
Two Legs and Two Wheels Good
The first thing that struck me was that cyclists and pedestrians rule the city rather than cars. At every corner there is a pedestrian crossing, people drive around the city slowly and, almost without exception, will stop when you want to cross the road. Back in the UK people pay lip service to sustainable forms of transport but what do we actually have? Ridiculous cycle lanes, roads jammed up with cars, a belief that it is everyone's right to drive up and over anyone else's head.
Cars
And what an acquisitive society we have in London. Looking at the cars people are driving in Oslo, I was wandering around the city for three days before I saw a show-off yellow sports car. In London the Porsches and Lamborghinis are nose to tail.
City planning
You only have to walk around Oslo or indeed any other town in Norway to realise that these people understanding something about design. There is a flow between commercial buildings, public facilities and the natural environment. I'm not just talking about an artsy-fartsy ascetic, I'm talking about practical usability, the difference between a public space being an obstacle and a pleasure to navigate.
Design
The famous Scandinavian design is in evidence everywhere. There is much more attention to functionality, simplicity and common sense. Doors, light-switches, toilets, fridges, heating and glazing. You name it, I saw better design and usability in Norway than in the UK.
Alcohol
No gangs of inebriated idiots roaming the streets - see below...
The Price Tag
Finally every English person's favourite subject: money. One stereotype in Norway that is certainly true is the high cost of...just about everything. My personal cost of living index, the price of pint of beer, broke all previous records. How does £8 a pint strike you? Hence no gangs of inebriated idiots.
But in defence of Norway, here's a culture that understands that you get what you pay for. You want to do it on the cheap? For the most part you get London: often dirty, smelly and unpleasant. You want to pay for quality? You get Oslo: clean, efficient, odourless (apart from the fish) and very pleasant.
We in the UK, however, live in the something-for-nothing culture. We want to cut the corners, make a fast buck, get there first, wherever there is. Hang the design, how cheap can you make it?
Depressed as I was, then, to return to England, I did so understanding more clearly what it means to be English. The Norwegians are people connected to their landscape, to their natural environment; people who care about design and don't think cars are the symbols of freedom their manufacturers would have us believe.
English culture is largely the reverse.
More on living in NorwayWilhelm Wundt: The First Experimentalist
- Ernest Rutherford
Morton Hunt's excellent 'Story of Psychology' helps explain why people doubt the scientific basis of psychology. Think about the famous figures in the history of the more physical sciences: Biology has Charles Darwin, Physics has Isaac Newton and Albert Einstein, Chemistry has Francis Crick and whole load of other people whose surnames are immediately recognisable: Anders Celsius, Robert Wilhelm Bunsen and Louis Pasteur. Now famous psychologists.
Think for a moment...who have you got?
If you're not a psychologist then you've probably thought of Sigmund Freud...and who else? B. F. Skinner? Maybe Ivan Pavlov and his soggy dog? Perhaps Jean Piaget's developmental psychology and maybe Alfred Kinsey because of the film with Liam Neeson? If you're a psychologist then I'm sure you came up with quite a few more but let's just consider Siggy for a moment because he's prototypical.
Freud was one of the greatest psychologist of all time. Let's not split hairs here about his legacy, many think it is incomparable, a few think he was full of it. Either way, everyone can agree that he was the kind of man you could trust to be creative. While he trained as a neurologist, a man of science, his influence pervades the arts.
And what are the things that people know about Freud? That his theories have largely been discredited (not really true). That he thought it all came down to sex (well yes: sex plus aggression certainly). And that he invented/discovered the unconscious (his greatest idea).
The point is that he's not really known as a scientist in the same way as Darwin, Newton or Einstein. He's seen more as a literary figure, a man of writing and insight certainly, but not a scientific man. How could anyone interested in dreams in these times of cold hard facts be a man of science?
By contrast, not many people have heard of one of the founding fathers of modern psychology: Wilhelm Wundt. It was Wundt who, in the University of Leipzig, carried out what some credit as the first ever psychological experiment in 1879.
The experiment was fairly simple, though it is still employed today in more complicated guises. It simply measured perceptual processing - the time it takes from hearing a bell ring to pressing a button.
Now, if Wilhelm Wundt was the first name that came to mind when you were asked for a famous psychologist, that would make a big difference to the public perception of psychology.
So, to return to today's straw man, Ernest Rutherford, while I'm not sure if Rutherford meant his statement to include psychology, he does sum up many people's attitude to modern psychology. The reason Rutherford is wrong is simply that psychology can also answer the questions: "Which ones?" "Why?" and "How?".
Unfortunately, here is a science regularly represented in the popular press by a man who has worked out a formula for the 'happiest' and 'worst' days of the year. A parody of scientific psychology if ever there was one. Instead psychology needs to remember its more prosaic, and more prototypically scientific, alumni like Wundt, Weber, Fechner and Helmholtz.