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Thinking – what works!

I haven’t blogged for a while and there are a number of issues I want to consider in this blog.

People regularly ask me why I don’t market our service more aggressively and showcase our success. Well, there are a number of reasons but first and foremost is that the success we have is not down to us but the people we work with.

I never ceased to be amazed by the things that people can achieve when they begin to recover their clarity of thinking. Every person who works in our company who works with people referred to us knows that the real work doesn’t take place in that meeting in our offices or in a café but in the rest of the week when they are back in the real world of their own lives. This is where they make changes; this is where they begin to move towards what works rather than focussing on “the problem” they begin to think about what would work; they begin to notice their successes and do more of what takes them toward their preferred future. Our role in their change is minimal and based upon questions not answers, we do not produce their answers – they do.

So we do not advertise our success – it is not ours but that of the people we work with. If they wish to offer their success in public and make a connection with our efforts then it is up to them not us. They are the experts in their own lives and it is that which we celebrate when we see them for the last time and they can then go and get on with their lives in the knowledge that we are here if we could be helpful again. We aim to have the lightest possible footprint in their lives.

I retweeted Darius Galasinski (http://dariuszgalasinski.com/2018/12/14/2152/ ) this morning after I read his “interesting patient” blog. I wondered how anyone could be far up their own backside to treat anyone, let alone someone who is in a vulnerable state, in such a fashion. To be teaching this way of being towards others just beggars belief. A little humility on the part of professionals might be a small step in the right direction. After all, one day the boot might be on the other foot.

Prior to reading Darius’ piece I read a piece from the Guardian (https://www.theguardian.com/us-news/2018/dec/15/to-take-on-climate-change-we-need-to-change-our-vocabulary?utm_term=RWRpdG9yaWFsX0d1YXJkaWFuVG9kYXlVS19XZWVrZW5kLTE4MTIxNg%3D%3D&utm_source=esp&utm_medium=Email&utm_campaign=GuardianTodayUK&CMP=GTUK_email) called, “ To take on climate change, we need to change our vocabulary”. This headline struck me as so limiting. To tackle any of the planet’s difficulties right now we need to change our language.

Ever since we began to communicate using abstract ideas we have been driven by problems; fixing problems; describing problems; categorising problems as though solving problems will provide us with a solution. Sadly, all that solving problems does is to focus us upon what we don’t want – problems. Solving problems does not focus us upon what we want. What we want are solutions.

Then I came across this, “Until you start focusing on what needs to be done, rather than what is politically possible, there is no hope. If solutions within the system are so impossible to find, then maybe we should change the system itself.” @GretaThunberg

The question I want to ask as a result of reading that is, “which system?” If we just try to change systems of government, administration, production or commerce little will change we will simply change the system for another that may or may not be better.

No, it is time we changed the way we think. The quotes above clearly indicate that people are beginning to think differently but we have a whole evolutionary process to overcome. We have been problem focused or “threatminded” since the dawn of human beings on this planet. If we hadn’t been we would not have survived in a physical world of existential threat (other animals, other humans, risk of many kinds). Today most threats, not all, are intellectual not physical. Threats are no longer threats to our physical integrity but threats to our wealth, careers, status and so on. However, our physical being has only developed to respond to physical threat and it is only since the Second World War that this has changed. We still respond physically to intellectual threat. It is called anxiety – imagined fear. We drive our bodies mad because our bodies want to respond to our imagination by trying to run away from it! It is our thinking that creates our distress. We constantly focus on problems and rarely upon what our world would look like if we had been successful. For a fuller discussion see my Blog (https://wordpress.com/post/steveflatt.wordpress.com/555 ).

It is language and the nature of our language that determines our view point in the world. For example, Abraham Maslow said in 1966, “I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.” The concept is attributed both to Maslow and to Abraham Kaplan, although the hammer and nail line may not be original to either of them. If we focus on problems or our descriptions of them then all we will see are problems.

As Einstein famously said, “We can’t solve problems by using the same kind of thinking we used when we created them.” Currently most people approach their activities in a threatminded way, attempting to reduce the difficulty instead of increasing success. Nowhere is this more apparent in mental well being. Everywhere I look I see professionals trying to reduce anxiety, depression, obsessive thoughts, traumatic memories by focusing upon them as though that will remove them. Frameworks and theories are created to identify problems and them focus on their removal – we cannot remove or forget – but we can begin to fill our heads with what is wanted, notice the times we achieve them and build upon those times, develop more helpful thoughts about what works.

This is all about language. It is not about treating “symptoms” which at the end of the day are our bodies natural attempts to respond to threat. It is not about managing our emotions better, though that can be helpful. It is about deciding what we will think about and acting on those thoughts in a way that will takes us in the direction we want to go (towards safety) rather than spending our lives running away from danger – real or imagined.

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Scientism in psychology

There continues to be a debate over the value of psychological research, the validity of particular research methods and the analysis of data. I came across a study published in “Advances in Methods and Practices in Psychological Science”. To quote from the abstract,
“The 29 different analyses used 21 unique combinations of covariates. Neither analysts’ prior beliefs about the effect of interest nor their level of expertise readily explained the variation in the outcomes of the analyses. Peer ratings of the quality of the analyses also did not account for the variability. These findings suggest that significant variation in the results of analyses of complex data may be difficult to avoid, even by experts with honest intentions”
And, further down,
“The process of certifying a particular result on the basis of an idiosyncratic analytic strategy might be fraught with unrecognized uncertainty (Gelman & Loken, 2014), and research findings might be less trustworthy than they at first appear to be (Cumming, 2014). Had the authors made different assumptions, an entirely different result might have been observed (Babtie, Kirk, & Stumpf, 2014). Silberzahn, R et all (2018)”

The question I want to raise in the light of so many arguments about data, analysis and measurement is that the “science” behind so much of psychological research is little more than ideology wrapped up in blindingly clever statistical analyses.

Despite this the ongoing debate over the value of psychological evidence with regard to policy-making makes for great reading. From my point of view, it highlights that wonderful observation that academic research trails behind the reality by about 10 years. The idea that we should be using the current accepted evidence base to inform policy seems well beyond its sell by date.

Currently, the psychological evidence that is informing current government policy is that coming from Improving Access to Psychological Therapies. The evidence that is supporting IAPT interventions now seems to be about 10-15 years out of date. This is so simply because the population has moved on from the kind of individualistic and paternalistic treatment intervention that epitomises current psychological offerings.

Psychological “truths” are not dictated by psychological researchers but by the social milieu. One only needs to read a history book mapping the development psychology and in particular that of psychological therapies to realise that there is a journey in which the nature of interventions changes over time to coincide with the changes in society and the understanding and education of the population as a whole.

I note that the authors of the paper “overrated: our capacity to impact policy” make the following claim,
“Could a focus on practices – rather than on experts, immutable clinical categories, technologies and fixed knowledges – allow us to appreciate the ways that knowledge, status, relief, atmosphere and solidarity come together effectively in informal practices? If we want to recognise the fluid and innovative nature of the many informal care practices then a future course for a psychology of distress could be to develop and celebrate methods that are sensitive to this.”

I think it is important to contrast that with the early history of caring interventions which were strictly the realm of the expert in the form of the psychoanalyst and his esoteric knowledge and just how much the laws of psychology have changed in the last hundred years.

Psychological care, psychological language is no longer the exclusive realm of the expert but is in common parlance and as the authors of the above quoted paper clearly indicate there is much opportunity for the public to become engaged in the process of psychological care whether it is at the level of the individual, the group, the community or a population.

Virchow was a pathologist in the 1800s and once said, “Medicine is a social science, and politics is nothing else but medicine on a large scale. Medicine, as a social science, as the science of human beings, has the obligation to point out problems and to attempt their theoretical solution: the politician, the practical anthropologist, must find the means for their actual solution. The physicians are the natural attorneys of the poor, and social problems fall to a large extent within their jurisdiction.” Rudolf Virchow http://www.azquotes.com/author/29202-Rudolf_Virchow

Psychology as a discipline has yet to come of age as a science. This can be clearly illustrated by question I found in an online survey being carried out by a PhD student. The question was, “what is your theoretical approach?” This is a question that if you asked an engineer, physicist or a chemist would be met with a blank look, as apart from minor variations, their theoretical orientation is based upon a single set of principles. This is far from true for psychology. In the case of therapy alone there are over 360 different forms of “therapeutic intervention”. Each with their own theoretical underpinning and often at odds with each other.

A good science can also make predictions based upon hypotheses and yet while there are some areas in which there is little disagreement in psychology, there are vast areas where hypotheses have been made, interventions been carried out that have worked initially but then not been replicable by other researchers. Richard Feynman said, “It doesn’t matter how beautiful your theory is, it doesn’t matter how smart you are. If it doesn’t agree with experiment, it’s wrong.” https://www.brainyquote.com/authors/richard_p_feynman Unfortunately far too many academics have far too much invested to be able to let go of their pet hypotheses and as Max Planck once said, “science progresses one funeral at a time”.

Part of this problem it seems to me is somewhat analogous to a discovery made during the Second World War ”Wald (found in Syed) carried out many investigations during the Second World War in an attempt to make Allied planes safer and the most fundamental thing his investigations revealed was “that in order to learn from failure, you have to take into account not merely the data you can see, but also the data you can’t” (Syed 2015). This statement came from observing and analysing bullet holes in the planes that returned from bombing raids over Germany. Initially there was a good deal of effort put into armouring the places where the bullet holes were. Then it dawned on Wald that these were the planes that came back; he realised that they should be looking to armour the places where the planes that didn’t come back got hit!

Recently a significant paper was published that says,
“We were surprised that genetic factors of some neurological diseases, normally associated with the elderly, were negatively linked to genetic factors affecting early cognitive measures. It was also surprising that the genetic factors related to many psychiatric disorders were positively correlated with educational attainment,” says Anttila (2018). “We’ll need more work and even larger sample sizes to understand these connections.” https://www.sciencedaily.com/releases/2018/06/180621141059.htm

This is the kind of data that illustrates the point I was trying to make above that currently psychology in the field of therapy is very focused, particularly clinical psychology, on trying to identify and resolve problems rather than looking at potential wider solutions. Antillia’s study gives a clear steer to looking at environmental and social factors as well as genetic factors (genetic factors are only weakly correlated with psychological/psychiatric disorder according to the study). My particular observation in this situation would be that we should be looking for environmental and social conditions in which psychological and psychiatric disorders occur less often and be exploring why that is rather than simply trying to solve the problems and reduce the distress that occur in other less benign environments. In other words, creating the conditions for good mental health rather than trying to reduce the bad conditions that produce bad mental health.

Despite a hundred years of research the holy Grail of psychology, a single unified theory, remains as elusive as ever. Perhaps this is because the human brain is evolving and changing in response to the changes in environmental conditions (and who can doubt that societal and environmental conditions have not changed in the hundred years so since Sigmund Freud) at a phenomenal rate. This ever-changing environment laying waste, in a decade or two, to each last “great theory” produced to explain human behaviour.

Perhaps it is time that psychologists started to work with what is already in place and what is wanted, rather than working with what was and what they would like it to be! There are steps in this direction, but they are being met with fierce resistance from entrenched opinions. Letting go of treasured beliefs and ideologies is not easy but at least heretics don’t suffer capital punishment any longer!

References:
Anttila V. et al. Analysis of shared heritability in common disorders of the brain. Science, 2018; 360 (6395): eaap8757 DOI: 10.1126/science.aap8757
Syed, M. (2015), Black Box Thinking, The Surprising Truth about Success, John Murray publishers, Great Britain
Silberzahn, R., Uhlmann, E. L., Martin, D. P., Anselmi, P., Aust, F., Awtrey, E., . . . Nosek, B. A. (2018). Many analysts, one data set: Making transparent how variations in analytic choices affect results. Advances in Methods and Practices in Psychological Science, 1, 337–356. doi:10.1177/2515245917747646

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Statement of Intent

Since August 2018, when a significant change of circumstances occurred, I have had many requests from case managers for therapists to work with people who have suffered trauma throughout the United Kingdom. At that time I had no intention of setting up a national trauma network.

Since then the pressure to do something that would provide a reputable and reliable service based upon accredited therapists and practitioners has become overwhelming. In response to this we have now constructed a new arm to our business called Traumaticus. Traumaticus means, “the nature of trauma”.

We chose this name for a number of reasons but first and foremost because we see traumatic responses as normal and natural behaviours that are a product of an unnatural or horrific situation that is outside of the experience of most people.

The key to dealing with trauma is not to treat it as pathologically abnormal, nor is it to minimise the person’s experience but we believe that recognising that the person’s response and behaviour to trauma is both understandable and normal and a way of coping with a horrific situation whatever it is.

We also consider that the most important aspects of any help and support that might be given is helping the person to understand their own qualities, abilities and resilience in managing to survive.

Trauma does not occur in a vacuum. Trauma occurs in an environment that is toxic in some way. Whether it be a car accident, battlefield experience, personal injury or abuse (physical, sexual or emotional). A person who has suffered trauma of some kind does not need to be told that they have now developed some kind of pathological response to normal life. They may well have developed a different response to the one that they had prior to the trauma but that response is their way of coping and surviving. For many their response to trauma does not become unhelpful until such times as they are in a new environment. It is then that their behaviour becomes “out of step”.

At Traumaticus, we use minimal interventions to gain maximum beneficial change. As far as possible, we try to avoid using technical language as a person who is struggling with distress is often also struggling with comprehension as a result of what has occurred to them. As many trauma specialists note, memory is often apparently compromised. Asking a person who is still in the grip of the aftermath of a trauma, (whether it is single or prolonged), to learn a new language and to comprehend a whole set of new ideas about themselves is just plain unreasonable. Therefore, we work with what the person is already capable of, can comprehend, and help them to build upon that and explore what might be possible for them in the future.

For a referral form: adminone@psychological-therapies-unit.co.uk

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Walls

Walls have been in the news a great deal over the last couple of years. Walls have been a fundamental part of human activity since the dawning of civilisation. David Frye has written a great deal about walls. About how walls define civilisation, about brick walls, stone walls, walls going up, walls coming down, metaphorical walls but one of the observations he makes is, “No invention has played a greater role in shaping our societies” (Frye 2018). He goes on to observe that walls are rarely ever mentioned in our histories, yet more than ever walls, particularly metaphorical ones, are defining today’s world. Whether they are firewalls, security walls or the walls of siloes they are used to attempt to define limits and boundaries in a way that our primitive ancestors building walls around their settlements could have never imagined.

Walls are built because of fear. Fear of invasion, fear of insecurity, fear of loss of face, fear of loss of control. Powerful people talk of building walls to keep immigrants out; corporations build firewalls in order to prevent information loss and subsequent commercial disadvantage; professions build walls to prevent others encroaching upon their territory.

It is ironic that there are so many people in the world who now seek to break down these walls. Whether it is politicians, professionals or just ordinary people fear an incursion by the “other”. It seems everyone is fearful of change, and thus build walls of one sort or another in order to prevent change.

In Cavafy’s poem, waiting for the Barbarians, the Emperor sits by the gate enthroned, waiting for the Barbarians to come. They have opened the gates (so the Barbarians don’t need to breach the walls) to allow the Barbarians in because they “are kind of a solution”. It seems to me that the world fears radical solutions, political leaders hide behind the walls of rhetoric hoping that no one will notice the lies that they tell. They build walls that obscure the truth. Walls built of lies that temporarily make people feel safer until the walls begin to collapse and cannot longer be sustained in the face of truth and reality. Yet we need radical solutions to help us manage the problems of the world and our seemingly self-destructive species.

Fear is a powerful driver. Harari (2016) “Subjective experiences are essential for our survival, because if we didn’t feel hunger or fear we would not have bothered to chase rabbits and flee lions.” Fear has shaped our evolution; fear enabled us to survive; fear drove us to build walls to protect ourselves and fear continues to drive our behaviour today. Yet if we listen to people like Pinker, Harari and others they claim that the world is now safer than it has ever been!

The point I am working my way towards is that in order to move on as a species we cannot just go on solving problems. Problems are based on fear, problems drive us to avoid, problems cause us to procrastinate, problems drive perfectionism, problems drive obsessions and compulsions. But we need to solve our problems before we can move forward – or do we?

Einstein once said, “we can’t solve our problems with the same kind of thinking that created them”. There is a profoundly mistaken assumption that we have to solve problems before we can move forward. However, solving problems does not lead to new solutions. Solving problems merely solves problems! This conundrum is clearly illustrated by a recent article written by Douglas Rushkoff called “survival of the richest”. In it he was describing how he was asked to speak to a small number of the ultra rich elite about how they might survive what can only be called a dystopian future that they believe will happen. Their questions to Rushkoff were about problems. Questions like “How would we pay our security guards when money is worthless?” “How do we guarantee loyalty of those who work for us?” “How do we avoid the carnage that is to come when the world economic systems fail?”

These ultrarich men (for they were all men) saw only problems in their future and were asking a futurologist about how to solve them. He provided them with an answer but according to his narrative they smiled gently and dismissed his suggestion. That suggestion was a solution not to solve the problem but to actually think what a better world would look like and how these ultrarich elite could achieve that before the problem even developed.

Rushkoff suggested that perhaps these men should be good to their employees now, create security for those who work for them, provide them with a view of the future that they could subscribe to and look forward to.

These men were thinking with their fear, a way of thinking has been with us for millions of years and is deep in our DNA. There is no doubt that most of the world’s leaders are currently using fear as the lens through which they do their thinking. As a result, they spend their time attempting to avoid a disaster which, as a result of their avoidant behaviour, brings the very result they are trying to avoid.

William Ophuls makes the point very clearly,
“Moreover, even if people sense that something is not quite right—civilization has gotten too big, too complex, too hard to manage—they may still not see that the problems are caused in large part by exponential growth and that the solution therefore lies in controlling that growth, not in programs or technologies designed to allow it to continue. For if you remove one constraint, renewed growth quickly pushes the civilization up against the next one, and so on, until it buckles under the strain.”

If human beings and to seriously begin to consider our long-term survival it is not problems that we need to solve but a view of the future that is a solution in itself. That view of the future has to be cooperative not competitive or combative; that view of the future has to be sustainable on so many levels, whether economic or ecological. That view of the future will not be achieved by solving problems but by creating a vision and taking small steps towards that futuire then we will be moving towards safety rather than running away from danger. That change in thinking, small and insignificant as it may seem, is the paradigm shift that people are seeking.

In my work with people in distress and in my community work I apply this “simple but not easy” approach and it achieves good results quickly and sustainably. We don’t teach, the people we work with, learn. They learn through their own small steps, their own changes in behaviour and discover what works for them. I need to know nothing about them, to help them make changes. Indeed, knowing their history can slow the process down for it gets in the way of their future.

History mostly teaches us what not to do next time. Edison once famously said, “I have found 599 ways how not to make a lightbulb”. His solution was not based upon 599 failures but a new vision of what might work.

The current world situation is a product of people attempting to solve problems in the same way that we did in the past, rather than trying to create a new common vision through cooperation, consensus, sustainability and community. This will not come easily for a creature that is fearful and constantly others those that are not known to it.

While we continue to build walls, whether they be literal or metaphorical between different groups, whether they be professional, societal or national and international we will continue to make the same mistakes, review the same problems and recycle the same behaviours. It is not so much that we need to solve problems but that we need to think about what the world would look like when it is more like the way we would like it to be. And therein starts a whole new philosophical argument about whose vision it should be. Or perhaps if we begin to think about a solution to that question now and begin to consider those aspects of the future that we can all sign up to!

I will leave the last word to Matthew Syed, extracted from his book Black Box Thinking, “When we are confronted with evidence that challenges our deeply held beliefs we are more likely to reframe the evidence than we are to alter our beliefs. We simply invent new reasons, new justifications, new explanations. Sometimes we ignore the evidence altogether.”
References:
C. P. Cavafy, Waiting for the Barbarians, https://www.poetryfoundation.org/poems/51294/waiting-for-the-barbarians
David Frye, (2018), Walls, a history of civilisation in blood and brick, Simon & Schuster, New York https://medium.com/s/greatescape/the-history-of-civilization-is-a-history-of-border-walls-24e837246fb8
Harari, Yuval Noah. (2016) Homo Deus: A Brief History of Tomorrow (p. 129). Random House. Kindle Edition.
Ophuls, William (2012). Immoderate Greatness: Why Civilizations Fail (pp. 18-20). CreateSpace. Kindle Edition.
Rushkoff, D. (2018) https://medium.com/s/futurehuman/survival-of-the-richest-9ef6cddd0cc1
Syed, Matthew (2015). Black Box Thinking: The Surprising Truth About Success (Kindle Locations 1437-1440). Hodder & Stoughton. Kindle Edition.