AI News, Training the Brain for Happiness
Training the Brain for Happiness
Four years ago, the public radio program “This American Life” broadcast a remarkable show it called “Switched at Birth.” It described two families—two mothers that one day in 1951 gave birth to baby girls within hours of one another in the same hospital.
For a bunch of different reasons, the mistake went uncorrected until one mother came forward 43 years later with her suspicions, and then genetic testing was done.
In the great debate about nature versus nurture, we accept that whether you’re blonde or brunette, need glasses or don’t, are genetic traits we can’t do much about.
She writes, “These differences—whether we turn toward the bright side of life or the dark—can be traced to specific patterns of activity in the brain itself.”
But she also writes that “subtle variation in how we see the world—our biases and quirks of mind—can reshape the actual architecture of our brain, pushing us toward a more optimistic or pessimistic take on life.
All of the participants in the study were about three years of age when the study started, and they were followed and interviewed very extensively every year for the following 25 years.
Now, the researchers were interested in whether people with the short version of a gene called the serotonin transporter gene would be at high risk of depression.
We know that the short version of this gene has particular effects in the brain, so there was good reason to think that people with the shorter version would be at higher risk of depression than those with the longer version of the gene.
And initially when they looked, they found, much to their surprise, that those with the short version of the gene didn’t actually seem to have any higher risk of depression.
And what they found was that those people who had the short version of the gene and also had had three or more really negative life events, really adverse life events, their risk of depression was far, far higher.
So in other words, people who had had three or more pretty nasty things happen to them, they weren’t actually at any higher risk of depression unless they also had the short version of the gene.
So really what the study showed was that a particular combination of environmental events and a particular genetic makeup absolutely formed a kind of a toxic combination.
But you write that our sunny brain is rooted in the pleasure centers, while, and here I’m quoting, “The roots of our rainy brain lie deep among the ancient brain structures that alert us to danger and threat, our fear brain.” So it sounds to me like it’s more like a car with two different pedals, one for acceleration and the other for braking.
So what I’m really talking about is on the one hand we have the rainy brain system, which is the system that kind of underlies a more pessimistic attitude or an anxious kind of personality style.
Now, what happens over time is that nerves and fibers link up that ancient amygdala, the fear system, with areas in the frontal cortex, so the more recent areas of our brain in evolutionary terms.
So that while the amygdala might fire and say, “There’s danger here, we’d better run,” the higher areas in the cortex will tend to dampen things down and put on the brake a little bit.
So they’ll often live for weeks or months in a particular role or in a particular lifestyle to really try and get into the head of the person they’re acting.
So that’s a nice demonstration of how if we really kind of almost like mimic a particular mental condition, that can actually start changing in our own heads and in our own behaviors.
And the other kind of thing that comes into the mix in all of this—well, first of all, I suppose I should say, I mean, a lot of my research is about looking at the fundamental biases that underlie a lot of these rainy brain or sunny brain circuits.
But by using particular techniques, using computers, for example, we flash up pairs of images, say a very nasty image and a very positive image, and then we ask people to search for a target.
And I think that’s one of the fascinating things, I think, is that often we find that events happen, and good and bad things happen to all of us, but it really does make a huge difference in terms of how we interpret that event.
If we start off with a slight tendency to interpret something in a negative way, over time we’re actually training our brain more and more and more to develop that kind of mind-set.
So the example I think I used in the book was it’s a little bit like a—if you think of how water runs through sand, gradually if the water keeps running in the same direction, it will carve out a trench in the sand.
Steven Cherry: And you think that really most events in life, I guess some are absolutely bad and some are absolutely good, but most events in life can be looked at either optimistically or pessimistically without there being any difference to the event itself.
And I think one of the issues is, just to kind of step back a little bit, one of the things I really tried to argue in the book is when I’m talking about optimism, I’m not just talking about positive thinking.
This is one of the problems, that there’s a whole kind of positive-thinking movement, if you like, or a lot of self-help books really put forward this theory that, you know, all you need to do is think happy thoughts and think positive thoughts and everything will be fine.
And just as an example, if you imagine you walk down the street and you pass by somebody, you notice somebody you haven’t seen for a long time, so an old friend you haven’t seen for a long time.
So while there are some good randomized control trials that have been done, there’s still a lot more work to be done to really see whether we can really shift biases, particularly over the longer term, and whether that will really have a big impact on particularly clinical conditions.
Well, I don’t know that there’s a more important problem in science than figuring out the nature of happiness, so thanks for your research, thanks for writing this book, and thanks for joining us today.
Design Thinking is Kind of Like Syphilis — It’s Contagious and Rots Your Brains
Hell, the folks at Singularity University — a cult of technological utopians who hoover handfuls of vitamins and believe we’ll all upload our minds to servers in a few decades — think Design Thinking may be your “Secret Weapon for Building a Greater Good.” No doubt, many others have also heard from people excited about Design Thinking — a state of being known as “having a bad case of the DTs.” As the designer Natasha Jen explains, Design Thinking can be traced back to foundational thinkers like the polymath Herbert Simon and the designer Robert McKim.
Design Thinking is also an approach that can be used to consider issues, with a means to help resolve these issues, more broadly than within professional design practice and has been applied in business as with as social issues.” If you’re confused, don’t worry.
In 2005, he approached the software billionaire and IDEO fan-client, Hasso Plattner, with, as Miller writes, “the idea of creating a home for Design Thinking.” Plattner donated $35 million, creating the d.school, or “IDEO.edu.” Kelly became influential at Stanford, particularly by getting the ear of the university’s president, the computer scientist John L.
Kelley pushes this view, arguing for “incorporating Design Thinking into existing courses across the humanities and sciences.” Hennessy and Kelly think the goal of education should be “social innovation,” which makes you wonder how earlier “innovators” ever managed without getting the DTs.
The d.schoolers believe Design Thinking is the key to education’s future: it “fosters creative confidence and pushes students beyond the boundaries of traditional academic disciplines.” It equips students “with a methodology for producing reliably innovative results in any field.” It’s the general system for change agent genius we’ve all been waiting for.
Miller fawns over the d.school and notes that its courses are “popular” and often “oversubscribed.” He writes, “These enrollment figures suggest that whatever it is the d.school is doing, it’s working.” We will see that popularity is a crucial marker of success for Design Thinkers.
Miller struggles to define Design Thinking in the article, “It’s an approach to problem-solving based on a few easy-to-grasp principles that sound obvious: ‘Show Don’t Tell,’ ‘Focus on Human Values,’ ‘Craft Clarity,’ ‘Embrace Experimentation,’ ‘Mindful of Process,’ ‘Bias Toward Action,’ and ‘Radical Collaboration.’” He explains further that these seven points reduce down to what are known as the five “modes”: Empathize Mode, Define Mode, Ideate Mode, Prototype Mode, and Test Mode.
What Miller, Kelly, and Hennessy are asking us to imagine is that design consulting is or could be a model for retooling all of education, that it has some method for “producing reliably innovative results in any field.” They believe that we should use Design Thinking to reform education by treating students as customers, or clients, and making sure our customers are getting what they want.
The version above is full of Silicon Valley buzzwords and jargon (“fail fast”), but it’s missing what Jen calls “Crit,” the kinds of critical thinking and peer criticism that designers do all the time and that forms the foundation of design and architecture education.
Later, she argues more forcefully, if Design Thinking is really that great, “Prove it.” Jen puts forward a definition of Design Thinking today: “Design Thinking packages a designer’s way of working for a non-design audience by way of codifying design’s processes into a prescriptive, step-by-step approach to creative problem solving — claiming that it can be applied by anyone to any problem.” Design Thinking is a product — a Stanford/IDEO commodity.
It’s even getting worse and worse now that [Stanford has] three-day boot camps that offer certified programs — as if anyone who enrolled in these programs can become a designer and think like a designer and work like a designer.” She also resists the idea that any single methodology “can deal with any kind of situation — not to mention the very complex society that we’re in today.” In informal survey I conducted with individuals who either teach at or were trained at the top art, architecture, and design schools in the USA, most respondents said that they and their colleagues do not use the term Design Thinking.
In afew cases, respondents said they did know a colleague or two who was saying “Design Thinking” frequently, but in every case, the individuals were using the DTs either to increase their turf within the university or to extract resources from college administrators who are often willing to throw money at anything that smacks of “innovation.” Moreover, individuals working in art, architecture, and design schools tend to be quite critical of existing DT programs.
Reportedly, some schools are creating Design Thinking tracks for unpromising students who couldn’t hack it in traditional architecture or design programs — DT as “design lite.” The individuals I talked to also had strong reservations about the products coming out of Design Thinking classes.
A traditional project in DT classes involves undergraduate students leading “multidisciplinary” or “transdisciplinary” teams drawing on faculty expertise around campus to solve some problem of interest to the students.
The students are not experts in anything, however, and the projects often take the form of, as one person put it, “kids trying to save the world.” One architecture professor I interviewed had been asked to sit in on a Design Thinking course’s critique, a tradition at architecture and design schools where outside experts are brought in to offer (often tough) feedback on student projects.
One OpenIDEO user enthused that the PlayPump highlighted how “fun can be combined with real needs.” Thom Moran, an Assistant Professor of Architecture at the University of Michigan, told me that Design Thinking brought “a whole set of values about what design’s supposed to look like,” including that everything is supposed to be “fun” and “play,” and that the focus is less on “what would work.” Moran went on, “The disappointing part for me is that I really do believe that architecture, art, and design should be thought of as being a part of the liberal arts.
They provide a unique skill set for looking at and engaging the world, and being critical of it.” Like others I talked to, Moran doesn’t see this kind of critical thinking in the popular form of Design Thinking, which tends to ignore politics, environmental issues, and global economic problems.
In a book I’m writing with Andrew Russell, The Innovation Delusion, we examine the origins of our culture’s current obsession with “innovation.” We make a distinction between actual innovation, the introduction of new things and practices into society, and innovation-speak, the empty-headed and misleading ways people have come to talk about technological and social change in the past few decades.
Since the 1990s, innovation-speak has grown into an entire Silicon Valley-centered lexicon of newspeak, including terms like disruption, disruptive innovation, angel investors, thought leaders, entrepreneurship, change agents, startups, incubators, Regional Innovation Hubs, smart this or that, unicorns, STEM education, pivot, lean, and agile as well as dead or dying faddish jargon, like killer app and Big Data.
In The Innovation Delusion, Andy and I examine how innovation-speak has led us to neglect many essential aspects of our culture, including maintenance, our infrastructure, essential cultural traditions, and the ordinary, humdrum, mostly anonymous work that keeps the world going.
I have asked many professional historians this question, and they believe this increasing complexity claim is unsupportable.) This manufactured general perception of “crisis” creates opportunities for change from two directions — from-above and from-below — though in practice these directions often work together hand-in-hand.
From above, university presidents and provosts introduce new initiatives, funding streams, and incentives to encourage, or even force, faculty to model themselves on the current image of “innovation.” From below, the perception of crisis provides openings for faculty members to create new programs, centers, institutes, and other initiatives that promise to make the university more innovative and transform students into little innovators and entrepreneurs.
McKenna emphasizes repeatedly that consultants had to create the perception that they were experts with legitimate knowledge, especially by leading others to believe that the consultants had access to esoteric systems of thought, or “sciences.” Natasha Jen and others complain about how schematic and “linear” Design Thinking’s self-representation, but as a tool for hucksterism, turf-grabbing, and bullshit-peddling, this seeming-systematic is precisely what makes the DTs attractive.
are always haunted by the notion that Latin and Greek words are grander than Saxon ones.” Fittingly, Design Thinkers prefer the three-syllable Latinate word “ideate” to the one-syllable Germanic word “think” and even more the four-syllable word “ideation” to the simpler words “thought” or “thinking.” IdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeationIdeation If you reflect for even half a second, you realize how vapid Design Thinking is.
(With tears in my eyes, I recall the heart-breaking moment when I realized that Design within Reach meant design-within-physical-proximity and not design-that-could-ever-be-grasped-by-my-income.) What’s more, anyone who has studied the history of capitalism knows how important design and style have been to the diffusion and reshaping of products.
Economists and historians who study innovation, like Nathan Rosenberg, David Mowery, Steven Klepper, and David Hounshell, often write about the genesis of entire industries born around new fundamental technologies, like steel, railroads, automobiles, electricity, airplanes, pharmaceuticals, chemicals, petroleum, electronics, computers, and the Internet.
Fellows are creating a global movement to ensure that all students gain the necessary attitudes, skills, and knowledge to compete in the economy of the future.” You’ll notice this statement presumes that students aren’t getting the “attitudes, skills, and knowledge” they need and that, more magically, the students know what “attitudes, skills, and knowledge” they themselves need for . . .
The UIF was originally funded by the National Science Foundation and led by VentureWell, a non-profit organization that “funds and trains faculty and student innovators to create successful, socially beneficial businesses.” VentureWell was founded by Jerome Lemelson, who some people call “one of the most prolific American inventors of all time” but who really is most famous for virtually inventing patent trolling.
Students can leverage their peer-to-peer marketing abilities to create a movement on campus.” Meanwhile, the UIF blog posts with titles like, “Columbia University — Biomedical Engineering Faculty Contribute to Global Health,” that examine the creation of potentially important new things mostly focus on individuals with the abbreviation “Dr.” before their names, which is what you’d expect given that making noteworthy contributions to science and engineering typically takes years of hard work.
As one participant recounted, “I just learned how to host my own TEDx event in literally 15 minutes from one of the other fellows.” The UIF has many aspects of classic cult indoctrination, including periods of intense emotional highs, giving individuals a special lingo barely recognizable to outsiders, and telling its members that they are different and better than ordinary others — they are part of a “movement.” Whether the UIF also keeps its fellows from getting decent sleep and feeds them only peanut butter sandwiches is unknown.
After the presentation, a female economist who was sitting next to me told the UIFers that she had been a professor for nearly two decades, had worked on the topic of innovation that entire time, and had done a great deal to nurture and advance the careers of her students.
The author refers to Fasihuddin as a kind of guru figure, “If you participated in the Fall 2013 cohort, you may recall Humera repeating a common statement throughout session 5, ‘By connecting to other campuses that have been successful, and borrowing from those ideas you hear from your UIF peers, it removes the fear of the unknown for the faculty.” Where does the faculty’s fear come from?
But in the UIF, Rogers’ vision becomes connected to the more potent ideology of neoliberalism: through bodies of thought like Chicago School economics and public choice theory, neoliberalism sees established actors as self-serving agents who only look to maintain their turf and, thus, resist change.
It’s what led billionaire Ayn Rand fan Peter Thiel to put $1.7 million into The Seasteading Institute, an organization that, it says, “empowers people to build floating startup societies with innovative governance models.” Seasteaders want to build cities that would float around oceans, so they can escape existing governments and live in libertarian, free market paradise.
Sure, if while you are talking someone’s body tightens up or her head looks like it’s going to explode or her voice changes or she talks down to you and doesn’t treat you as an equal, it could be because she is a demonic, laggard-y enemy of progress, or it could be because you are being a fucking moron — an always-embarrassing realization that I have about myself far more often than I’d like to admit.
In computer programming, there is an idea called “Chesterton’s Fence,” which is “the principle that reforms should not be made until the reasoning behind the existing state of affairs is understood.” Or as Burke again put it, “We are but too apt to consider things in the state which we find them, without sufficiently adverting to the causes by which they have been produced, and possibly may be upheld.” These principles challenge our impatience and overweening estimation of our own genius.
Burnett is the Executive Director of “Stanford’s innovative Product Design program.” As his bio explains, Burnett has a “Masters of Science in Product Design at Stanford and has worked in start-ups and Fortune 100 companies, including seven years at Apple designing award-winning laptops and a number of years in the toy industry designing Star Wars action figures.” No one is really clear what made Burnett break.
it works in creating a cool life.” They also poke fun at DT’s habit of overselling its promises, “A well-designed life is a life that is generative — it is constantly creative, productive, changing, evolving, and there is always the possibility of surprise.” (italics in the original) The book mauls Design Thinkers’ oversimplification of the world through absurd diagrams and formulas, like this one: Problem Finding + Problem Solving = Well-Designed Life.
We can challenge “I am a fat turd” with “I’m good enough, I’m smart enough, and gosh darn it, people like me.” This CBT rubric has formed the basis for hundreds, thousands, maybe even hundreds of thousands of self-help books for the last three decades, but Burnett and Evans make nary a mention of this fact.
They just call negative thought patterns “dysfunctional beliefs” and challenges “reframes.” In a gorgeous example of meta-commentary, what they are pointing out is that Design Thinking is the act of taking ideas that already exist, sexing up them up with a bit of rouge, and putting them in other words.
Typically, people with a bad case of the DTs do this without recognizing their predecessors but instead claim to have done something new, to have made some “innovation.” As the historians David Edgerton and Will Thomas have argued, such bogus novelty claims actually produce ignorance because they hide the true nature of social reality from the speaker’s audience;
Now, you can pay Burnett and Company $950 or more to take trademarked “Life Design” workshops — like this one, Designing Your Life for Women — though it’s not clear if the rumors are true and these are actually improv comedy classes or if Burnett just decided to take advantage of people who are stupid enough to believe that self-help banalities put in other words as Design Thinking could somehow improve their lives.
Just read this description: “We will focus on balance and energy, use ideation techniques to help get you unstuck, build Odyssey Plans for three potential futures, and define ways to prototype the compelling parts of these futures.” Burnett has become the first comedian of the emerging and uncertain Post-Innovation-Speak Age.
Pain is Weird
Pain is not just a message from injured tissues to be accepted at face value, but a complex experience that is thoroughly tuned by your brain.
In this article, I get specific about what’s realistic and practical with “mind over pain.” There’s bad news, but there’s also good news — if you understand how pain actually works.1 Many discoveries about the physiology of pain23 have been painfully slow to reach the public, or even health professionals.
Mostly we need to stop thinking of pain in terms of single causes or cures: “It’s all coming from the ____, I know it!” It almost never is.4 Pain is not reliable sign of what’s really going on.
This passage is mainly known for the first few words, a pithy statement of the modern understanding of how pain works: Pain is an opinion on the organism’s state of health rather than a mere reflective response to an injury.
There is so much interaction between different brain centers, like those concerned with vision and touch, that even the mere visual appearance of an opening fist can actually feed all the way back into the patient’s motor and touch pathways, allowing him to feel the fist opening, thereby killing an illusory pain in a nonexistent hand.
The mere appearance of his phantom hand opening and closing normally cured his agonizing “spasms.” He felt better because of the illusion that he was better — because he thought he was better.
A good quality 2007 study showed that mirrors aren’t actually necessary to achieve this effect.5 Mirror therapy is probably just a “fun” way to visualize healthy movement — which also works quite well without a mirror!6 Stranger still are tales of severe pain without injury, illustrating that pain can be entirely in the mind.
JP Fisher, senior house officer, DT Hassan, senior registrar, N O’Connor, registrar, accident and emergency department, Leicester Royal Infirmary7 His pain was a “nocebo” — the opposite of a placebo.8 Extreme examples like this are rare, but probably not as exotic as you might think.
And indeed there is evidence of this: in a 2012 experiment, for instance, fear of pain made people more sore for longer after a workout.9 Happily, it also works the other way: people may feel much less pain than they “should” when they are confident for any reason, such as not realizing how bad the damage is.
Health care professionals everywhere still believe that the nerve is “sending pain,” that the signal is pain — and therefore these nerves are habitually called “pain fibers” and their messages are called “pain messages,” an equivalence between signalling and pain baked right into the language.
The relationship of perceived pain to afferent nerve impulses, by Patrick Wall and SB McMahon, 254–255 For several decades now, it’s been clear to pain scientists and neurologists that this simplistic, pain-fiber model is hopelessly inaccurate.
In fact, they call it “the naïve view”!10 Even microscopic worms with only two trouble-detecting nerves, compared to our billions, have richer pain experiences than that, with ways in which their pain is an “opinion” — an interpreted experience, with some surprising sensitivity to context.11 And of course it makes complete evolutionary sense.
This principle was demonstrated early in the history of pain research by a famous paper about wounded soldiers in WWII, which showed that they experienced surprisingly little pain considering the severity of their injuries — probably because they were so glad to be off the battlefield.12 Ever since, researchers have been trying to understand just how that actually works.
Once a danger message arrives at the brain, it has to answer a very important question: “How dangerous is this really?” In order to respond, the brain draws on every piece of credible information — previous exposure, cultural influences, knowledge, other sensory cues — the list is endless.
Pain really is in the mind, but not in the way you think, Moseley (TheConversation.com) As if that didn’t complicate things enough, once your brain has made up your mind, it also sends messages downwards that actually affect the sensitivity and behaviour of the nerves.13 Thus everything that hurts involves a conversation, a sort of debate between the central and peripheral nervous systems.
To extend the analogy, this isn’t just twiddling the volume knob, but changing the equipment, changing the signal before it even gets to the “amplifier.” (Just for fun, have a look at the complex version of that diagram.
Unmoored from physical reality, however, they can become a nightmare … hundreds of thousands of people in the United States alone suffer from conditions like chronic back pain, fibromyalgia, chronic pelvic pain, tinnitus, temporomandibular joint disorder, or repetitive strain injury, where, typically, no amount of imaging, nerve testing, or surgery manages to uncover an anatomical explanation.
Scratching an itch through the scalp to the brain, by Atul Gawande Many moons ago I started trying to understand and explain pain, gradually producing this article, only dimly aware as I worked that I was re-producing some much more mature ideas.
I knew that modern pain science and treatment has deep roots, insights and research going back to the 1960s and Melzack, gate control theory and cognitive behavioural therapy, but my explaining was eerily similar to a recent and popular “packaging” of pain science known as Explain Pain (EP), from Drs.
Lorimer Moseley and David Butler: “a range of educational interventions that aim to change one’s understanding of the biological processes that are thought to underpin pain as a mechanism to reduce pain itself.”14 There’s a book of that name — Explain Pain — and many other interpretions and riffs on the key ideas (like this article).
Explaining Pain according to Dr. Moseley is about “wanting people to actually understand how and why they can be in horrible pain yet not in horrible danger.” According to me, explaining pain (might) help to reduce it, and it’s inherently fascinating even if it doesn’t do a lick of good.
(There are still plenty of unanswered scientific questions, too.) And because Explain Pain as a “brand” might be a little bit of an over-hyped upstart, maybe given too much credit by too many people too soon — especially the idea that it actually reduces pain, which remains highly speculative.
As Todd Hargrove put it, “Pain is sometimes immune to logic,” because pain is handled by a part of the brain that is not easily over-ruled by other brain “modules” — like an optical illusion that you can’t “un-see” even when you understand it.19 As he put it elsewhere: Humans don’t get to decide what they find threatening, stressful or painful any more than a cat does.
Romance: Thanks to a quirky 2014 study, science has confirmed that that being in love relieves pain — a wonderful example of the potential power of the mind over pain.20 Falling head-over-heels is not exactly a convenient solution.
Although it is technically the brain’s prerogative to ignore painful signals from your tissues, that doesn’t mean that there’s any way we can convince it to do so — if there is a destructive disease process going on, for instance, the brain will usually not ignore those signals!
It’s certainly extremely important to emphasize the psychology of pain, but the video comes dangerously close to advising patients to “don’t worry, be happy” and the dreaded “all in your head” — and that’s really not what we want here.
Most people with chronic pain aren’t just a little stressed, they are a lot stressed, and often by major life challenges and social problems that they literally cannot solve.26 Even when their problems are theoretically more manageable, most people find it extremely difficult to troubleshoot their own mental health.
So while it’s correct to tell patients to “learn to reduce stress” and “consider how your thoughts and emotions are affecting your nervous system,” that advice is impractical without more and better information.
I understand what they were going for, and it’s the tip of an iceberg of an important concept — healing by “growing up” — that I will discuss below, but the video simplifies it to the point of absurdity.
A key conceptual shift that we think is really important is that you can understand that pain is the end result, pain is an output of the brain, designed to protect you … it’s not something that comes from your tissues.
Unless you have a known serious aggravating factor — a major trauma, for instance — there is almost never any reason to fear that recovery from any chronic pain problem is impossible.
There’s been a lot of indirect evidence about this for a long time, but one of the first really good, direct scientific tests was finally published in 2013 by Vibe-Fersumetal.27 Classification-based cognitive functional therapy (CB-CFT, or just CFT) for low back pain is a “body/mind approach to understanding and managing this complex problem” that “targets the beliefs, fears and associated behaviours” of patients (what I have called the “confidence cure” for many years).
The big idea of CFT is that the cycle of pain and disability can be broken by easing patient fears and anxieties, specifically “reframing the persons’ understanding of their back pain in a person-centred manner, with an emphasis on changing maladaptive movement, cognitive and lifestyle behaviours contributing to their vicious cycle of pain.” Translation: pretty much anything strategy that restores confidence.
Three months and a year later, the CFT group was much better off.28 CFT was “more effective at reducing pain, disability, fear beliefs, mood and sick leave at long-term follow-up than manual therapy and exercise.” As the authors put it for BodyInMind.org, “Disabling back pain can change for the better with a different narrative and coping strategies.” There were some blemishes on the study methods, but nothing dire;
Create new social contexts by doing something as simple as playing a team sport — because other people are counting on you, the painful consequences of intense exercise are usually re-contexualized as tolerable, even desirable, and you can put up with quite a lot more.
This explains lots of interesting results in pain research (not to mention clinical observations), like the cognitive functional therapy results in the last section, and the fact that the most powerful factor predicting how soon people return to work after an episode of low back pain is whether or not they expect to return to work,29 and the fact that education alone probably helps to resolve neck pain.3031 So do not let health professionals get away with any fear-mongering.32 Seek out as much information as you can find, because nothing causes more anxiety than uncertainty.
Early intervention is critical to prevent acute pain from turning into chronic pain.33 It is clear that chronic pain involves significant neurological changes, both in nerves and in how pain is processed in the brain.
Do it in general ways (soak the whole system in a hot tub), but also more specifically: pleasantly stroke a sore knee, give a screaming shoulder the “comfort” of a sling for a while, or cautiously but thoroughly move a troubled joint to demonstrate to your brain that it’s okay.
In fact, this probably explains why many treatments for pain problems are popular and seem to help sometimes, despite being unreliable and generally minor.34 Classic examples: taping, bracing, strapping, splinting, salving, vibrating, heating, icing.
Regardless of how they supposedly work — there are many overly complex explanations — most of these methods mostly just change how a body part feels.35 The benefit of novel sensory input is probably not much more profound than being distracted by a loud noise … but we can add it to the toolkit, with reasonable expectations.
There are many examples of difficult problems that can usually be fixed with some hard work and maybe some leaps of faith: bad marriages and toxic friendships, bad jobs and bad bosses, a house or city or climate you don’t like, poverty, addiction, insomnia and many more.
The ability to weather emotional storms — being unflappable in the first place, or recovering relatively quickly — probably affects pain levels.37 The pain scale is the imperfect replacement for flaming, poisoned swords.
If you have chronic pain, you’ve probably been asked many times to rate your pain, and probably on a scale of 1 to 10, and maybe with a visual aid like this: On the one hand, the pain scale is an essential pain research and clinical tool, with proven value — it’s the main way that we measure the effect of therapies, to see if they really work.
Having a baby, yikes, that was like a 19 with spikes to 38.” The irony is that the pain scale is supposed to help you think more objectively and rationally about your pain, but it often just creates another opportunity for melodrama.
Unfortunately, it’s tricky to tell patients “sometimes pain correlates poorly with tissue damage” without them hearing “it’s all in your head.” It’s a hazard baked right into modern pain science, and I think it’s a serious problem.
For example, here’s the beginning of an amazing, uplifting back pain story, told by Dr. Jerome Groopman in his book, The Anatomy of Hope, about his own experience with super severe chronic low back pain: Dr. Rainville planted the MRI scan of my spine on a lighted box on the wall and systematically inspected the film, vertebra by vertebra.
So here’s the difference: The ideas presented in this article are so clinically important and interesting that, in many discussions, they have begun to drown out the boring-but-basic fact that tissue trouble still usually leads directly to pain.
I’m speaking both professionally and personally here, because I suffered exactly that fate in the last year: a persistent pain with no apparent cause, so much so that I was told by a few professionals that my only problem was “pain dysfunction,” or experiencing pain without tissue damage.
It is becoming clear to me — if I look at it with my left eye, anyway — that we need to know the basics of pain neurology quite well indeed in order to acquire the confidence required to see through those illusions.
It’s noteworthy that it didn’t hurt for decades — because if that’s possible, just imagine how unpredictable the symptoms of a little arthritis can be — but it’s also noteworthy that it did start to cause trouble eventually.
8 Subconscious Mistakes Our Brains Make Every Day–And How To Avoid Them
The reason we can’t ignore the cost, even though it’s already been paid, is that we wired to feel loss far more strongly than gain.
They asked subjects to assume they had spent $100 on a ticket for a ski trip in Michigan, but soon after found a better ski trip in Wisconsin for $50 and bought a ticket for this trip, too.
So like the other mistakes I’ve explained in this post, the sunk-cost fallacy leads us to miss or ignore the logical facts presented to us and instead make irrational decisions based on our emotions–without even realizing we’re doing so: The fallacy prevents you from realizing the best choice is to do whatever promises the better experience in the future, not which one negates the feeling of loss in the past.
People who hear voices in their head can also pick up on hidden speech
Serial killer David Berkowitz, also known as the “Son of Sam,” famously claimed that he heard voices in the form of a dog telling him to commit murder.
“And there's an idea,” adds Alderson-Day, “that the people who hear voices might have brains that are a bit more primed to look for meaningful patterns in the environment around it particularly in unusual or ambiguous situations.” To see if priming might play a role in hearing voices, Alderson-Day and his colleagues including researchers from University College London, and the University of Porto in Portugal, took two groups of people—those who claimed to hear voices but were otherwise mentally healthy and those who were also healthy but didn't hear voices—and placed them into functional magnetic resonance imaging (fMRI) machines.
Because a lot of us have some experience hearing voices—if you’ve ever heard a voice (your mom perhaps) calling your name in an empty house you’ve experienced some level of auditory hallucination—only people who had recently and relatively frequently heard voices were included in this group.
- On Tuesday, April 23, 2019
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