Monday, 30 November 2015

An Illness of Thought

Today's post is by Jonny Ward who tweets as the Anxious Fireman and has also blogged for the Stigma Fighters. 

Hello to all reading this. My name is Jonny Ward. I’m 31, male, straight, white and a firefighter with Greater Manchester Fire and Rescue Service. I can grout the shower, chop logs, I have an anxiety disorder, I have travelled a lot of the world and I enjoy mountain biking.

If you had to ask me about any one of my interests or traits from that list, which would it be? And why?

If this had been someone else and it was three years ago, I would have picked the anxiety disorder part. Because back then I was just as naive to mental ill health as most men. I would consider it unusual, a strange thing to say or admit too.

But over the last two years my mind-set has changed tremendously. I suffered with anxiety and panic attacks. It happened after a long period of stress. I was doing too much work, too many projects, trying to please too many people. All of which meant I burnt out, blacked out in a restaurant and woke up anxious. I started having panic attacks and in classic panic attack form became afraid of having more panic attacks around people and looking stupid.

It’s taken me a while to really understand what made me ill. It wasn’t the situation, the work load, the “stresses”. These were all purely material and circumstantial. It was my own thoughts. My cognition if you will.

Every thought I had was becoming negative, was I good enough, was I pleasing others, was I achieving enough! Was I! Am I! What if! What if! WHAT IF!!!

A negative thought affects your health, as any thought in the mind does. If it’s positive you feel slightly better, negative, slightly worse. Just like drinking alcohol, a little doesn’t kill your liver, but drown your liver in alcohol every day and eventually it will become very sick.

This is what I was doing. I was becoming a negative thoughtaholic. My self-belief, confidence all became undermined and I made myself ill. I managed to turn things around but it was difficult. I had CBT and counselling and medication.

I have recently buried a second friend (who was also fireman) who completed suicide. He had been very poorly in his head for a while and, in my opinion (I have no medical knowledge) had been thinking very negatively about who he was, his relationships, his standing in life, how he was seen for a very long time. His thoughts were very poorly. What really killed him though I think is his fear of getting help and “coming out”.

His ego, or pride would not allow it, his thought process would not allow him to accept he was human and not a ‘man’.

When I told my watch at the station, friends and family I was suffering and vulnerable, I got closer to them than I ever thought possible. I wish my friend had taken that step.

My love to you all

Thursday, 26 November 2015

‘Pathologizing Mind and Body’ Workshop in Leuven

What is the relation between mental disorders and physical disorders? Is it possible to find a biological basis for mental disorders? What purpose would a reduction of mental disorders to physical disorders serve? These are some of the questions addressed at the workshop ‘Pathologizing Mind and Body’ organized by Jonathan Sholl and Marcus Eronen. Philosophers, psychologists and psychiatrists approached this topic from different angles and highlighted problems and recent developments.

In the first talk, Ignaas Devish stressed the distinction between suffering and pain, claiming that suffering is not a phenomenon that is amenable to diagnostic operationalisation and medicalization. He argued that because of this, victims of traumatic events should be offered an ethical debriefing in addition to psychological debriefing, which allows them focus on their suffering and the existential problems they face from a non-medical perspective.

Arantza Exteberria talked about ‘Interactive Bioloops and Pathology’. She pointed out  that biolooping is a common phenomenon, with social levels thoroughly influencing biological levels of functioning. Because of this, there is no clear mental/physical distinction when it comes to pathologies. Furthermore, the complex and dynamic nature of individual-organism relations suggests that personalized medicine will be a fruitful way to proceed. 

Denny Borsboom introduced the audience to the network approach to mental disorders. Rather than searching for a unified cause that underlies a variety of pathological symptoms in a certain disorder, this model focuses on the network of pathological symptoms as a mutually reinforcing structure. On this model, high connectivity between the different network nodes or symptoms is the hallmark of a disordered mind. Denny concluded that according to this understanding of mental disorder, a disorder as an entity is more analogous to a flock of birds than to a unitary thing.

In his presentation ‘Fat or Obese – What Difference Does it Make?’ Andreas de Block considered objections to the medicalization of fatness by proponents of fat studies. He criticized the link fat studies scholars often make between pathologizing and moralizing and discussed studies which show some potential benefits of pathologizing obesity. Andreas also explored the possible effects of labelling obesity as a mental disorder analogous to addiction.

Tuesday, 24 November 2015

The Erotetic Theory of Delusional Thinking

This post is by Matthew Parrott (pictured above) and Philipp Koralus (pictured below). Here they summarise their recent paper ‘The Erotetic Theory of Delusional Thinking’, published in Cognitive Neuropsychiatry. 

We thank Lisa and Ema for the invitation to introduce our recent paper. In this paper, we appeal to the recently developed erotetic theory of reasoning in order to explain three patterns of anomalous reasoning associated with delusion: mistaking a loved-one for an impostor (as in the Capgras delusion), the well-documented tendency to ‘jump to conclusions’, and surprising improvements in a certain reasoning task involving conditionals (Mellet et. al. 2006).

According to the erotetic theory, the aim of human reasoning is to answer questions as directly as possible (for further discussion and for a formal account of the theory, see Koralus and Mascarenhas 2013). More precisely, according to the erotetic theory, reasoning proceeds by treating an initial premise or set of premises as a question and then treating subsequent information as a maximally strong answer to that question. Here is an informal illustration:

Suppose you are given a premise: there is either beer in the fridge, or there is wine and cheese in the fridge.

Informally, the erotetic theory holds that this premise will be cognitively processed by reasoners as the following question, or issue, that needs to be addressed: Am I in a beer-in-the-fridge situation or in a wine-and-cheese-in-the-fridge situation?

Now suppose the next piece of information you get is that there is cheese in the fridge. If you process that information as a maximally strong answer, resolving the issue you were trying to address, then you will conclude that you are in a wine-and-cheese-in-the-fridge situation

Of course, it would be a fallacy to draw this conclusion based on the information available. Interestingly, it is a form of reasoning that most people are naturally disposed toward (Walsh and Johnson-Laird 2004). The erotetic theory captures this pattern of tempting fallacies, along with various others documented in the experimental literature, and predicts new ones. Crucially, according to the erotetic theory, what allows human reasoners to avoid fallacies is to raise enough further questions as the reasoning process progresses. What characteristically leads us astray when we succumb to fallacies is a lack of inquisitiveness (for details see Koralus and Mascarenhas 2013).

We were curious whether, with the help of the erotetic theory, we could make sense of seemingly outlandish thought patterns associated with delusions as extreme cases of tendencies that are present in all of us. The idea was to explore a model of delusional thinking as being like ordinary thinking except lacking inquisitiveness of a crucial sort.

According to the erotetic theory, delusional thinking is conceptualised in terms of the way individuals ask questions or in terms of how they go about answering those questions. In the paper, we propose that relevant patients entertain roughly the same default questions that most people strongly associate with various external stimuli, but that they either envisage fewer alternative possible answers to these questions or raise fewer follow-up questions as they proceed to try to answer them. This chiefly has a negative effect on the quality of conclusions drawn, but we argue that it can also yield some surprising performance advantages.

In the paper, we describe how lack of inquisitiveness can make sense of various thought patterns associated with delusion. We hope this brief introduction sparks interest in renewing efforts to understand reasoning, both ordinary and delusional, more systematically than we do at present.

Thursday, 19 November 2015

Legal Fictions in Theory and Practice

In this post Maksymilian Del Mar (in the picture above) presents the recent book Legal Fictions in Theory and Practice (Springer 2015), co-edited with William Twining.

Treating Menorca as if it is a suburb of London, or a ship as if it was a person, or pretending that persons who form contracts are made by rational agents with knowledge of the commitments they are making, or that states who take over other states find a land empty of life (as in the doctrine of terra nullius) – or, positing the existence of consent, malice, notice, fraud, intention, or causation when evidence clearly points to the opposite conclusion (or to no conclusion at all)…

All these are example of legal fictions. They fly in the face of reality. And, in the literature on theories of law and legal reasoning, they are not very popular. In this new collection – Legal Fictions in Theory and Practice (Springer, 2015, co-edited by William Twining and Maks Del Mar) – 18 chapters explore another view: that not only are fictions pervasive in legal practice (and in very different legal traditions), they are also considerably more valuable cognitively than we have hitherto appreciated.