Why would a book that gives you evidence that the things that you worry about are not such a big problem irritate you?
Okay, that's easy. It's because you are worried about certain things, and yelling at yourself that it's not such a big deal only reduces that a touch, so you feel lectured to. Secondly, you have expended resources, physical or psychic, into problems that now seem small, so you feel a bit foolish, a little ripped off, a little sheepish, at having this pointed out.
Daniel Gardner's The Science of Fear has some minor flaws, I'll touch on those, but they shouldn't dissuade you from reading the book. We are hardwired for certain types of fear, which, once activated, we have trouble turning off. A whole lot of other people get resources from the tribe by exploiting our fears, so they have an interest in keeping us on tenterhooks.* Politicians, nonprofit advocacy groups, companies that produce safety goods or services, government agencies...
Okay, that's adding up to a lot of people who need us to be anxious in order to sell us alarms, foods, programs, wars, medicines... We spend a lot of our precious resources on things that we might not, hope not, ever use or need, in order to reduce our anxieties. And we do this within the context of western society which provides unimaginable wealth and safety. My theory is that a certain amount of worry is built into us, because the ancestors who worried lived to perpetuate their DNA. We may be able to redirect our worry to things that actually have a fair chance of harming us, and which we have some control over. But I propose that we cannot, at present, reduce the amount of worry in our lives without specific intervention, such as medication, therapy, or radical life change. Sumus quod sumus, we are what we are. You will always be this nervous. Your job is to direct the anxiety to the best targets.
Note: As you get older, what you worry about will change automatically, and you will be absolutely sure you are wiser. Uh, maybe so
Worried about the environment? A dozen medical conditions that aren't actually life-threatening? Crime? Terrorism? Gardner will give you the numbers, reminding you how small the danger is. And, he will demonstrate how misplaced fear costs us not only money, but lives. After 9-11, people drove instead of flying. But driving is dangerous, and the most likely number is that 1,595 people died because they drove instead of flying - about five times the number who died in the planes on Sept 11. We spend money to protect ourselves from extremely unusual risks, and don't protect ourselves against more common ones.
The Amazon reviews say that some people found the book too long, and the statistics a bit much, but everyone basically liked it. I vaguely see that, but thought the book was great. The readers of this blog are not going to find the numbers daunting. I thought it was about right. Additionally, he gives a good summary of the research into our fearful and risk-evaluating minds, and this fits very well with our "May We Believe Our Thoughts?" discussions. Some of the research, in fact, we have already covered here. The Science of Fear covers a lot of ground on confirmation bias, our attraction to certain narratives, and a half-dozen smaller brain quirks you had no idea were influencing you so much. Yet Gardner also demonstrates how we can override these tendencies with thoughtful risk assessment.
The quibbles: Despite his clear explanation that we perceive greater danger from cancer because we are living longer, and have greatly reduced other causes of death (many who face cancer today would not have lived to face cancer in the old days, having died in childbirth, or of diphtheria, cholera, or smallpox), Gardner still counts all deaths as equal in some other calculations. He contrasts deaths from terrorism with deaths from diabetes, smoking, and obesity, for example. But the lifestyle deaths occur later in life, taking 5, 10, 15 years off our total. Deaths which take fifty or eighty years off our expected longevity should be counted higher. (Historically, the opposite was sometimes true. So many children died before the age of five, and this was so expected, that these were counted - not very consciously - as of lesser value. We were habituated to 20% of all children dying, and thought it sad, but not a greater loss than an adult's death. This has shifted over the last 50-100 years). Secondly, Gardner does not weigh in on the less-measurable goods of justice, fairness, and culture. While this may be scientifically reasonable, seen as outside his purview as a risk-evaluator, it results in his setting these values to zero. This becomes important in his discussing risks in crime and terrorism. He undervalues all other possible benefits of deterrence, social pressure, and foreign policy in his number-crunching. He tips his hand as a Canadian of the center-left in some of his assumptions as well, but he is even-handed enough that these should be passed over without additional mention. He tries extremely hard to be fair, and few conservatives could match him in this.
Your politics will shift just a bit after reading this book, wherever you started from.
*WTH are tenterhooks, anyway? Ah. Mildly interesting.
Showing posts with label trusting our thoughts. Show all posts
Showing posts with label trusting our thoughts. Show all posts
Sunday, September 04, 2011
Thursday, September 01, 2011
Changes
We think of St Paul as having a single, pivot-point change. There is certainly reason for that, but the Scriptures don't actually say he was consistently X before conversion and consistently Y after. In fact, a close reading reveals a long stay in the desert that seems important in the biography as well. Yet because the most important thing about him changed on a pivot, we automatically impose that narrative on every other part of his life as well. Perhaps he was similar in personality at 16 and 60. Perhaps personality went through slow changes over his life. We don't know.
I had a born-again experience in 1975. But even at the time, I was aware of a similar private experience just two months before, and related promises and resolves to be a good Christian and follow Jesus extending back to age 12, when I wrote in to a Billy Graham TV crusade after hearing him preach and got some material back. There were also renewals, some of them dramatic, after 1975. Which one was the "real" one? And given that I was baptised as an infant perhaps that...
Or, as the Scripture also says, Jesus called me before my own creation and the creation of the world.
I have changed my mind about things more often than most people, I am sure. Seldom have those changes been rapid. I left socialism/liberalism one issue at a time. Yet every time I would think "Hmm, I am probably better defined as a conservative now," I would run across some further issues or intense declarations that would keep me out. Postliberal really is the best descriptor. I have an automatic brain tic that reverses polarity when someone is too insistent or strident. Liberals chased me out with that, and conservatives fenced me out in similar fashion.
The science says that most of us acquire our faith and our politics as teenagers and then change little. Church camping advocates point to numbers that show the prominence of camping in the histories of adults currently in church, and I don't doubt that. Politically, the adage is that we look at what was happening in the world when a person was 18 to discover his or her politics. That can go many ways, however, as yearly cohorts do not all go green, communitarian, or libertarian. Yet it does seem to often be true that the die is cast then, with the shape changing only mildly thereafter.
I had a born-again experience in 1975. But even at the time, I was aware of a similar private experience just two months before, and related promises and resolves to be a good Christian and follow Jesus extending back to age 12, when I wrote in to a Billy Graham TV crusade after hearing him preach and got some material back. There were also renewals, some of them dramatic, after 1975. Which one was the "real" one? And given that I was baptised as an infant perhaps that...
Or, as the Scripture also says, Jesus called me before my own creation and the creation of the world.
I have changed my mind about things more often than most people, I am sure. Seldom have those changes been rapid. I left socialism/liberalism one issue at a time. Yet every time I would think "Hmm, I am probably better defined as a conservative now," I would run across some further issues or intense declarations that would keep me out. Postliberal really is the best descriptor. I have an automatic brain tic that reverses polarity when someone is too insistent or strident. Liberals chased me out with that, and conservatives fenced me out in similar fashion.
The science says that most of us acquire our faith and our politics as teenagers and then change little. Church camping advocates point to numbers that show the prominence of camping in the histories of adults currently in church, and I don't doubt that. Politically, the adage is that we look at what was happening in the world when a person was 18 to discover his or her politics. That can go many ways, however, as yearly cohorts do not all go green, communitarian, or libertarian. Yet it does seem to often be true that the die is cast then, with the shape changing only mildly thereafter.
Recent Conversations - May We Believe Our Thoughts
The full discussion on how reliable our thoughts, beliefs, and opinions really are.
Paranoia
Unawareness Versus Denial
Anosognosia
Paranoia
Unawareness Versus Denial
Thursday, August 04, 2011
Presentation
My team presented at Schwartz Center Rounds today. We discussed compassionate care of the homeless. The format is that an individual case is presented, and the general issues of compassionate care that the patient presents are discussed. We presented a young man who came to the hospital suicidal, identifying the fact that his girlfriend kicked him out and he was homeless as one of the things that "made" him suicidal. There were plenty of reasons to dislike the fellow. He doesn't seem particularly depressed, and in fact was cheery and social with the other patients, especially the younger, vulnerable females who he attempted to cuddle up with. He was rude, threatening, and insulting to staff, while reminding them that they had to be polite to him because he's a patient. He is trained as a welder but has not worked since 2003, collecting disability for depression, though not being treated for depression all that much. He drinks too much, but resists efforts to get him into any sort of treatment or lifestyle that would address this. I could go on, but you get the idea.
The unit staff had a great deal of trouble remaining objective, of course, as they w4ere the ones in the thick of it. But even those of us with more distance seethed, not so much for the sneering and insulting attitude, but the interfering with others' treatment.
Yet we are also trained to recognise that things are not always as they appear on the surface, and to be alert for what our own feelings tell us about the patient and the world he likely inhabits. The idea of countertransference is never supposed to be far from our thoughts. As one of the psychiatrists mentioned in the discussion "When I start blaming everything on the patient, it's time to take a vacation. Or get out of this field." Very true.
He did very little to find himself any housing, despite my supplying him with lists and offering to pay the first month's rent. The nurses became increasingly rude in demanding that I find him a place and get him out. They kept making suggestions of what I should be doing, rather obvious suggestions which I had long since tried. They wanted him gone because they didn't like him, and the fact that he was homeless because everyone else didn't like him - well, they didn't want to hear that.
They were quite happy to send him out without shelter, but I am not allowed to do that. Or rather, it happens all the time because the patient is discharged, but I am regarded as having failed because they don't have housing. It's unpleasant, and it still bothers me after all these years to work with people who regard me as a failure. But that's what the job is.
I batted cleanup in the Schwartz presentation, and highlighted the enormous conflict we feel in not wanting to blame the patient for things that they have little control over, but also want them to have natural consequences for their actions, as that is often the last teacher when all others have failed. I talked about volition, and recent research, and some of the issues we have discussed in my May We Believe Our Thoughts series.
I was nearly brilliant. I suspected it, but it was confirmed by those who came up to discuss for the rest of the day. Many comments were simply the polite affirmations of nice people, very nice to hear but not to be taken too seriously, but others were complimentary in a deeper way, referencing exact quotes, which they had even copied down. That sort of thing.
Here's the problem, which I am reminded is the great discouragement of all preachers and teachers who look for insight: everyone seemed to hear the part they already agreed with, while being completely unaffected by consideration of the competing value. Those who felt that irritating patients were being pampered altogether too much by the hospital, and we had to recognise the limits of compassion and take a firm hand yada yada yada... thought I expressed very clearly the need to move these people on and take the consequences of their behavior, and glad that administration had heard me say it so bluntly. Others felt enormously vindicated that I had spoken out about how much countertransference was allowed in current hospital culture and how wrong that was, and our need for...well, whatever. Something that will fix bad staff attitudes.
And a third group felt gratified that I had highlighted the recent research on volition and how indeterminate agency and self-control can be. They wanted references.
All that in eight minutes of presentation, plus about three thirty-second answers to questions. I was brilliant, I tell you. So why do I weep?
I posted the song because of the "Still a man hears..." line, but it's appropriate for the later verse as well:
The unit staff had a great deal of trouble remaining objective, of course, as they w4ere the ones in the thick of it. But even those of us with more distance seethed, not so much for the sneering and insulting attitude, but the interfering with others' treatment.
Yet we are also trained to recognise that things are not always as they appear on the surface, and to be alert for what our own feelings tell us about the patient and the world he likely inhabits. The idea of countertransference is never supposed to be far from our thoughts. As one of the psychiatrists mentioned in the discussion "When I start blaming everything on the patient, it's time to take a vacation. Or get out of this field." Very true.
He did very little to find himself any housing, despite my supplying him with lists and offering to pay the first month's rent. The nurses became increasingly rude in demanding that I find him a place and get him out. They kept making suggestions of what I should be doing, rather obvious suggestions which I had long since tried. They wanted him gone because they didn't like him, and the fact that he was homeless because everyone else didn't like him - well, they didn't want to hear that.
They were quite happy to send him out without shelter, but I am not allowed to do that. Or rather, it happens all the time because the patient is discharged, but I am regarded as having failed because they don't have housing. It's unpleasant, and it still bothers me after all these years to work with people who regard me as a failure. But that's what the job is.
I batted cleanup in the Schwartz presentation, and highlighted the enormous conflict we feel in not wanting to blame the patient for things that they have little control over, but also want them to have natural consequences for their actions, as that is often the last teacher when all others have failed. I talked about volition, and recent research, and some of the issues we have discussed in my May We Believe Our Thoughts series.
I was nearly brilliant. I suspected it, but it was confirmed by those who came up to discuss for the rest of the day. Many comments were simply the polite affirmations of nice people, very nice to hear but not to be taken too seriously, but others were complimentary in a deeper way, referencing exact quotes, which they had even copied down. That sort of thing.
Here's the problem, which I am reminded is the great discouragement of all preachers and teachers who look for insight: everyone seemed to hear the part they already agreed with, while being completely unaffected by consideration of the competing value. Those who felt that irritating patients were being pampered altogether too much by the hospital, and we had to recognise the limits of compassion and take a firm hand yada yada yada... thought I expressed very clearly the need to move these people on and take the consequences of their behavior, and glad that administration had heard me say it so bluntly. Others felt enormously vindicated that I had spoken out about how much countertransference was allowed in current hospital culture and how wrong that was, and our need for...well, whatever. Something that will fix bad staff attitudes.
And a third group felt gratified that I had highlighted the recent research on volition and how indeterminate agency and self-control can be. They wanted references.
All that in eight minutes of presentation, plus about three thirty-second answers to questions. I was brilliant, I tell you. So why do I weep?
I posted the song because of the "Still a man hears..." line, but it's appropriate for the later verse as well:
After changes, we are more or less the same.
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