Category Archives: Ethics

Psychiatry: A New Understanding

Having been interested in psychiatry for a long while, I have now embarked on several months training in the discipline. And although mental health is never far from the public eye, it seems to be that a general understanding of mental health and disease is vastly lacking. But in my fledgeling understanding, I have begun to know things just that little bit more.

Psychiatry and the Mind

To begin with, the concept of normality, whether it is physical or mental health, is debatable. When it comes to physical health problems, like chest pain, we are quick to recognise what is ‘abnormal’ and would require action, how much action and the mode of action. It is not a necessarily binary situation, but we know enough about the natural history of a disease, biology and treatments to make a workable approach.

Psychiatry, however, is less clear-cut. Although science has, for a long while now, explained mental health problems in terms of physicality, biology and chemicals, the understanding of the human aspect of the disease still warrants expert judgement. Phenomenology, that is the study of words, has attempted to categorise mental health complaints within recognisable schema; what one may describe signposting depression should be generalisable.

My sadness and your sadness should be understood in a similar way, and their approach into depression more so.

This has had some success, and within the streams of both biological and psychoanalytic models of mental health, has allowed us to recognise disease in a functional way. By understanding the language of disease, as expressed by our patients and selves, we can learn to spot patterns in the same way we may read an ECG. To an extent. However, a psychiatric disease is not as simple as an ECG*.

The issue with psychiatry, which has been long debated, is the suggestion that, including psychotic beliefs (those not grounded in reality or truly understandable by doctors,) we do not classify disease purely on biology, but on their proximity to social norms. This is quite foolhardy philosophically since all of our norms are prescriptive and based on a shared belief, which when applied to metaphysical understands of the world is rendered mute.

Put simply, we have created the goal posts by which we measure psychiatric abnormality, and unlike physical problems (if treated as separate,) there is a great discordance between people on what disease actually means.  To some, their core beliefs may seem entirely rational and healthy, but to others, a clear indication of being unwell. And how do we make these judgements?

Apart from CT scans, biochemical markers and agreed diagnostic categories, we fray on the fringe of relative value.

And when you review popular media, for example blaming massacres on the mentally unwell, regardless of whether this is the truth (which it rarely is,) you can see how a moral value has been ascribed to behaviour, and how it can be used to suggest a diagnosis. You need to look no further than the ‘luny left’ and ‘liberalism is a mental disease’ to recognise this shortcoming of human understanding.

So when I meet my patients, I cannot fully assess them without realising that my diagnosis is shining a thin light on a large area, where the boundaries of normality are hazily defined. Does this mean that all psychiatry is value assessed, not necessarily, there is clear science and patterns, but we must be aware of where the evidence ends.

Evolutionary antecedents and Art.

We have known for a long time that the human brain is vastly imperfect. We also know that morality, that is our measure of the ‘goodness’ of things, is a relative concept. In fact, some philosophers such as Freidrich Nietzsche have gone as far as to claim there is no such thing as good and evil, and others have renounced all understanding and attributed such judgements to God alone.

What we do know is that behaviour is not unpredictable. We know those common traits are common because they are either useful to survival, non-affective or tied to something useful. For example, we know that running fast is useful alone, won’t tend to get you killed directly (unless you run off a cliff,) and works best with good hearing and reactions (for more on this, see co-adaptive genetics.)

Herego, mental health problems do not escape the scrutiny of evolutionary explanation, and this is where the science of anatomy, genetics, sociology, psychology, behaviour, chemistry and anthropology meet the human disciplines of art, literature, history, speech, song and expression. The human mind is a result of its best compromise and survival, and with it, mental health problems have shared a journey.

So when we interview our patients, we see the humanity of disease, etched through eons of evolutionary history, expressed in the contemporary terms of our sociocultural understandings. A psychotic belief is amoebic, and will likely include tenets of that person’s popular culture, as opposed to one of the ancient Egyptians. This cannot be avoided but can give us clues to an underlying constant process.

Psychiatric disease is likely part of our survival, for better or for worse.

The history of psychiatry and philosophy is intertwined, and before such things as brain imaging, it was the brain and its wake light pondering that allowed us to conclude the nature of things. Logic, experiment and results were used across a vast arena of disciplines, from which arose different schools of thought such as Freudian Analysis.

The later schools of medical models have all but usurped the philosophical and analytic, but the latter still play a vital role in our understanding. It is likely that with further science we may be able to pin psychiatric disease, or at least its base aetiology (ie cause,) on something purely biologic and explained through measurable variables, but until then, we rely on our interpretation of behaviour to guide us to the scan.

Diagnosis and Detention

So with the somewhat hazy and complex architecture of the interplay between evolutionary explanations of psychiatric disease, medical explanations, sociocultural norms, variable and diverse human expression and the legal system, the idea of diagnosis and treatment becomes one of great importance. And one that can cause great contention.

We can mostly all agree that someone at risk of suicide due to severe depression may need to be sectioned. We can also all agree that it is in their best interests to do so. This is because we value life, but also claim knowledge that psychiatric disease renders one incapable of deciding what’s best for themselves. At the extremes, we tend to agree, but in the middle ground, there is less commonality. We agree on death, but sadness is a different issue.

And when it comes to issues that have a socially contentious element, such as gender and health, we must listen very carefully.

I work in an acute psychiatric unit, which means the patients that I see are on the more severe end of the spectrum, that is that they very rarely occupy the middle ground of disease severity. I see patients who believe they are being monitored by government agencies (which arguably, we all are) or can see ancient ghosts wandering the halls.

My view of psychiatry is within the deep end of the human mind, the echoes of our ancient brains pushed to their limits. And as a growing student of the evolutionary explanations for psychiatric phenomena, it is becoming abundantly clear to me that a full understanding of the subjective nature of the disease is probably beyond pure science, it will be found in expression.

So how does this translate to sectioning a patient, or indeed, deciding if and when someone should or will be treated? To give a general answer to this is difficult, but I will give it a try, based on when the patients own subjective view of the quality of their life is jeopardised by their disease.

But for those actively psychotic, i.e who have left reality behind, such subjectivity is lost, and we must use our own sociocultural norms and understanding of reality to make sense of their experience. And we do our best. Sometimes that means bringing people in against their will, and believe me, that is rarely an easy decision.

Treatment and Life

So having trawled, on a surface level, some of the complex themes that goo into diagnosing and deciding to treat a psychiatric illness, what of treatment? From my experience, the variety of methods out there provides hope. Whether it be medication (which addresses biological and chemical causes of disease,) ECT (which, as far as we know, derives its role in chemical and anatomical methods,) and therapy, which helps us to understand and correct aberrant thinking, we do see changes.

Sometimes these changes are drastic. I note one man who came in severely depressed, paranoid, almost catatonic, who after a few weeks of ECT is now back to shopping with his wife. His subjective view of the world and his disease has changed drastically as if some great mist has disappeared. Others are less pronounced, where a persistent delusional belief is still present, but less concerning.

In each case, our measure of success is built through understanding the subjective view of our patients, either phenomenologically through an interview, or objectively through an analysis of behaviour and biochemical changes. This is a far cry from the newspaper headlines and personal accounts that litter the blogosphere, but good is being done. Psychiatry, a discipline of the old and new, saves lives.

Placed in context, however, we must always remember that our view of success is based, at least in part, on prescriptive sociocultural norms, derived through evolutionary behaviours and limited by our own bias and cultural beliefs. The solution to the malady of psychiatric disease is one that may never be fully answered, but until then I find myself in a world where I can make a difference.

So far this has been an enlightening journey. But to be a good psychiatrist means truly understanding your patients, their views, expectations and dreams based upon their understanding of a world that we may not agree on. We must be prepared to listen more than talk, read more than present, understand that we know little.  Crucially, we must know ourselves to know our patients.

It means understanding history, evolution, biology, neuroscience, art, writing, speech, religion, social causes and much more. It is by no means simple. I hope to be starting to get to grips, but I can always improve.

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The opinions expressed in this article are those of Dr Janaway alone and may not represent those of his affiliates. Featured image coutersy of Flickr.

*Note, the interpretation of an ECG is far from simple. However, in relative scales, the number of clear diagnostic changes available comparing ECG to phenomenology is vastly disproportionate. This is an academic and rather histrionic comparision, so apologies to the Cardio Reg.

 

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‘Increasing prevalance’ of PTSD in UK Veterans after recent conflicts.

New results published in the British Journal of Psychiatry suggest that post-traumatic stress disorder (PTSD) may be on the rise in service personnel. The condition, associated with exposure to trauma, has long been long linked with combat. But this new study highlights just how much Veterans may be at a higher risk than active soldiers.

But to really show what this means, I also talked to a veteran, who was kind enough to explain what PTSD feels like beyond the data.

I knew that something was different after my six-month tour of Afghanistan. It was really difficult to go from an environment where I fighting in close quarters with the enemy on nearly a daily basis, to an extended Christmas break with my family in a quiet suburb. At new year we had guests and I didn’t even go downstairs to see them. It was tough interacting with people who had no idea what I had gone through. I just couldn’t understand why people would get so angry over the little things or first-world problems; I still don’t today. – Soldier X

Worse mental health outcomes

A cohort study compared over 8000 personnel either deployed to Afghanistan and/or Iraq, with those active but not deployed, and those newly active since 2009.  The study reviewed the participants in three phases, collecting data on mental health symptoms and level of alcohol use during the study period.

The first phase examined soldiers deployed to Iraq, then the second followed these up and added those deployed to further conflict, and a third to new soldiers as well as those already under review.

The study found that, overall, 21% of those reviewed displayed symptoms of common mental health disorders (such as depression,) and that those who had been deployed to the conflict were at a higher risk. 6.1% of those surveyed showed signs of probable PTSD, with a significantly higher risk in those who had seen active duty.

I was in a close-combat role for six months, which was really intensive both physically and mentally. I was also responsible for the lives of 28 soldiers and I had to make tough decisions daily; which at the time was a lot of pressure for a 25-year old. I know the decision-making really affected me because its something I still think about a lot and often run the scenarios through my head with “what ifs”.  – Soldier X

All in all, the overall risk was 9% for veterans and 5% for those still serving, and higher in combat roles and support roles such as logistics and medical personnel. However, the study also showed that alcohol abuse rates have dropped during the same time period.

Post Traumatic Stress Disorder

PTSD is a mental health condition characterised by the emergence of unsettling or traumatic symptoms from short months to years after a severely troubling event. Those who develop the condition may report a combination of symptoms, either ‘reliving’ the event in some way such as through flashbacks or nightmares, or through ‘numbing’ by avoiding emotional subjects or addressing their symptoms.

It took me nearly three years to talk to someone about it and get some help. I still don’t talk to my partner or family about it; I find it easier to talk to professionals or put it in writing. The hardest part about asking for help was that I didn’t think I needed or deserved it, there were plenty of other soldiers that I knew of who had been through far worse experiences and were not seeking help – so why should I?  – Soldier X

The link with military work has been long known and likely due to the intense and terrifying experiences. And the legacy is one that is unfortunately predictable. But this new study sheds light on how PTSD may develop, not as something that primarily affects soldiers, but preferentially affects those who have survived and come home.

It may very much be that the evolutionary antecedents to our survival, forged long ago in the heat of prey vs predator, have become maladaptive. Or indeed, never had the chance to become adaptive over time. Repeated exposure to life and limb trauma is not a natural state which can be readily traced back beyond tribal warfare, as survival was much less guaranteed.

Perhaps a study like this, which highlights the true cost of war to the victor, can help us learn that suffering is ubiquitous in theme, just different in nature.

PTSD is always going to happen in war. There will always be traumatic events, but I think we could deal with them a lot better. Mental health became the elephant in the room in my Battalion, with some soldiers suffering from horrific cases of PTSD. One of the reasons it took me so long to talk about it was because it took 13 months to see a mental health professional after I requested it. – Soldier X

What’s next? Join our wonderful community!

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The opinions expressed in this article are those of Dr Janaway alone and may not represent those of his affiliates. Featured image courtesy of Flickr. Full informed consent was gained for interview and distribution of content obtained during the interview. All profits from this article will go to the Poppy Appeal.

 

 

 

 

‘Mental health myths you wouldn’t believe still exist’

myth mental heath care

Mental health issues are more common than you would think. And in fact, mental health problems are amongst the leading causes of disability worldwide. Astoundingly, 1 in 4 of people in the United Kingdom alone will experience mental health issues a year.

So when you look at the world overall, that is an awful lot of people.

Regardless of the universality of the problem, many people still labor under false beliefs. So we hope that by breaking some of these myths down that we can not only eliminate some undeserved stigma, but encourage a community driven empathy toward those who ask for it.

And with that in mind, I have invited some wonderful friends along with me to spread the message of what we have learned. I have also talked to psychiatrists and other medical professionals who have been kind enough to lend their time.

It is my belief that through knowledge we can really make a difference and, hopefully. together we can shine some light.

mental health depression compassion

By correcting misunderstandings we can build a community around empathy. Image courtesy of Flickr.

1. Mental health problems only affect ‘weak people.’

Being diagnosed with a mental health problem, be it depression or any other, can make one feel fearful and insecure about themselves and their future. This is a natural response, as any drastic change to our lives and sense of structure will influence our emotions.

‘Everyone can have a mental health disorder. If I were to lose someone, I would suffer and could get depression. I would not consider myself a weak person. We are all human, we are all built the same way.’ – Scott McGlynn, Present and LGBT+ Activist.

But let’s not confuse sadness with weakness, it is simply human. And since we know that the commonality of these issues is so great, it’s fair to say that just about anyone can suffer.

And from what we know about the causes of these problems, be they social, biological, psychological or a combination, we can say confidently that a ‘person’ is only part of the recipe for developing a problem. Some predisposing causes include childhood abuse, social issues and adult trauma, as well as genetic or biological antecedents

myth mental health

Even those that society elevate as heroes can feel the same pain as the rest of us. Image courtesy of Flickr.

And although there are many more factors prevalent in developing a disease, you would be hard pressed to conclude that a personal ‘weakness’ is solely to blame for somebody becoming unwell, or that a mental health issue is a sign of that weakness.

These issues can strike anyone, from military leaders to doctors, from artists to authors and beyond. Much like any disease, the human at the centre of it is who matters, not their job or what society demands. And many with mental health issues become world leaders. This is despite what society tmay wrongly consider a flaw.

Incredibly, they do this knowing that some members of society would reject them simply for their diagnosis. Former US President Abraham Lincoln and War-time UK Prime Minister Winston Churchill both presided over tumultuous times, but both were alleged to have suffered with mental health issues. 

depression stigma myth

Winston Churchill famously battled depression whilst leading the British war effort during WW2. Image courtesy of Flickr.

So instead of considering those with mental illness as ‘weak’, we would better reconsider what we define as making a person ‘strong.’ I think you would agree that Churchill’s tenure was one requiring a tremendous personal strength.

And on a personal note, living with depression requires more resilience and strength than you would realise.  And to make a difference in the world, to enrich the lives of others, whilst battling every day, that is true strength by any definition.

2. People with ‘mental health problems’ are a ‘drain on society.’

A particularly uncomfortable idea, some believe that those with mental health issues are simply faking it. Or worse still, doing so with the intention of sponging ‘off the state.’ This is a particularly divisive attitude worsened by some social media commentators going as far to claim that depression isn’t a real condition.

depression stigma myth welfare

To some, Depression is not considered a real disease. But to the patients, the story is very different. Image courtesy of Flickr.

Although it is true that in acute episodes of some mental health issues people may require time off work, it is important to note that the vast majority of patients work regularly. In fact this can be as high as 70% in those with anxiety or depression.

Furthermore, the idea ignores the very fact that: patients want to get better and businesses have a legal obligation to provide ‘reasonable adjustments’ to ensure an unwell employee can return to work. It is clear that many wish to return to a relative normality, and work with their employers to facilitate this. According to the Health and Safety Executive UK (HSE);

‘Most people who have ongoing mental health problems continue to work successfully. But when someone needs support, managers can work with them to ensure flexibility to suit their health needs.’

Being unwell is as simple as being unwell, and it seems that ‘mental health issues’ are viewed as a less legitimate to need time to recover than a more obvious physical illness. And where those with conditions like cancer are given worthy encouragement, those with depression may not be extended the same courtesy by the public.

medicine chemo depression mental health myth

It seems that ‘mental health’ problems are viewed as less legitimate than other ‘more medical’ problems. Image courtesy of Flickr.

By comparing the statistics we can see the bigger picture. Although the total number of work days lost to mental health was around 40% of the total during 2016/17, the vast majority of time off was due to other problems. So, we are forced to ask why the minority cause of time off receives such disproportionate stigma.

Are people with cancer a drain on society? What possibly makes people think that an illness of the mind makes you lesser than anybody else? We need to realise that mental health is not a failing. The connotation is that these problems are some sort of societal betrayal. – Mike Stuchbery.

Instead of considering those with a mental health issue as a ‘drain on society,’ the truth is rather different. Like patients with all diseases there will always be a relative loss of work, and this is necessary to their recovery.

Even better, since most with mental health issues do choose to work, it is clear that the problems are taken in hand where possible. So you may ask why people would attack those with mental health issues when the evidence is so clear?

work myth drain on society mental health

Despite the myth, the majority of those unwell continue to work. Image courtesy of Flickr.

Personally,  I think it’s because content creators recognise just how financially powerful encouraging that stigma can be for their channels, or perhaps that because stoking division is an effective political move. If this is true, then the problem does not lie with the patients themselves.

“Cinema, radio, television, magazines are a school of inattention: people look without seeing, listen in without hearing”  – Robert Besson.

If society can be so easily hoodwinked, then combatting the stigma is that much more important.

3. ‘All people with mental health problems are dangerous’

Another dramatic misconception is that ‘all people with mental illness’ are dangerous, and when the public are repeatedly told that those committing mass shootings are ‘mentally ill,’ you can understand why there is a concern.

But the fact’s don’t support the sensationalism. In fact, the Canadian Mental Health Association reassures us;

Mental illness plays no part in the majority of violent crimes committed in our society. The assumption that any and every mental illness carries with it an almost certain potential for violence has been proven wrong in many studies.

Although it is true that some people may commit a crime while unwell, only 1% of people in a recent survey believed that individuals with mental health issues pose a threat. There is something lost between the public and some of the papers here.

But thankfully, many in print media are very aware of the misconception.

In my time as a journalist I met a good number of people who could be described as violent. Some were guilty of some shocking deeds. Yet, I cannot recall a single one who had a recognisable, distinct mental health issue. But I think when it comes to misconceptions, it’s not just journalists making the leap but society as a whole – Andy West, Broadcaster and Writer.

crime myth mental health

The majority of violent crimes committed in the UK and US are not committed by those with Mental illness. Image courtesy of Flickr.

Given that an estimated 7 million people in the UK have a mental health disorder, the average homicide rate is just between 50 -70. And over 2016-2017,  this represented a tiny fraction of the 790 homicides in the UK (8.9%.)

This means that 91.1% of UK murders are committed by those without a mental health issue, and when it comes to acts of violence,  those with mental health problems are responsible for only 3-5 % of crime compared to 96% (approximately,) within the general population in the United States.

In addition, within mental health overall, those with schizophrenia have a only slightly higher risk, mostly associated with substance abuse. But in the same vein, the vast majority will never commit a violent crime.  But what of psychosis itself?  During a psychotic episode, where in some psychiatric conditions a patient may lose contact with reality, only 6% may present any risk.

What about mass shootings? Well, less than 1% of all gun related deaths in the United States are due to those with a mental illness, and in that small number, the majority are suicides.

suicide harm

Contrary to popular belief, those with mental health issues are more likely to harm themselves than someone else. Image courtesy of Flickr.

So, why the overinflated preoccupation with risk? Perhaps misconceptions about serial killers being insane, the vilification and over-dramatisation of mental health in movies and television, and most insidiously, the use of mental health patients as scapegoats.

Let us consider the US, where gun laws are under constant scrutiny. It is much easier to blame a mass shooting on a ‘mentally unwell lone wolf’ than admit that you may have a culture problem and access to firearms. For some gun advocates, perpetrating this horrible myth serves them well.

So all in all, those with ‘mental health’ problems commit less violent crimes than the rest of the UK (and US,) and are a greater risk to themselves than others.

scapegoat mental health violence

It seems sometimes that those with mental health problems are made scapegoats by those who should know better. Image courtesy of Flickr.

Although there is some risk, the data bears out nothing significant beyond specific cases to a population level. The very idea that everyone with a mental health issue is dangerous is demonstrably false, stigmatising and worryingly, seemingly deliberately sold.

‘The only thing we have to fear is fear itself.’ – Franklin D Roosevelt

4. There is ‘no getting better’

‘People succumb to an idea that things don’t get better. You can’t see mental health, it’s not like a broken leg. There is an ‘end point.’ It’s clear, but with mental health its a lot more difficult for people to believe that there is a definitive fix.’ Ralf Little, Health Advocate and Actor.

For some, a mental health problem can last a long time, but for others, they may only brush with it briefly, once in their lives. Everybody’s experience of life is different and with that comes a different experience of mental health issues. It can be easy to feel trapped in disease, only to wonder why you felt so helpless months later.

Mental health disease future

A mental health problem can seem like the end of the world. But for most, if not all, the veil is lifted with time. Image courtesy of Flickr.

It is often with the benefit of hindsight that the truth becomes clear. When it comes to mental health, this often shows us that recovery may require lifelong treatment to maintain. or nothing at all – it all depends on the person and their journey. In fact mild to moderate depression may need drug treatment for no longer than a year, if at all.

The misconception that these issues are ‘permanent’ or ‘inescapable’ is very much hyperbole, and does not take into account how different people define their quality of life. Or indeed, what people consider being ‘unwell.’

It is up to the patient to decide when they have escaped the disease, which for many is the cessation of its symptoms, and for others, never feeling them again.

Personally, I view my depression as companion who raises it’s head from time to time, and during those periods inbetween I consider myself ‘better.’

For me, its about assigning value to the moments and realising my choice in doing so. Perhaps many of you will understand this.

myth value life

Sometimes a mental health problem can reveal what is truly valuable to us. Image courtesy of Flickr.

Yet somehow, society forces a double standard when comparing mental health issues with more physical ones. A cancer remission is treated as ‘getting better’ whilst many would say recovery in a depression is ‘only temporary.’ Both have a chance of returning, but we consider the time without illness as being ‘healthy again.’

While appreciating the complexity of the comparison, its fair to say that both have periods of being unwell and less unwell. Or not unwell at all, with a potential with recurrence or not. But in most cases, there is some level of improvement.

Have faith that on the other side of your pain is something good. – Dwayne Johnson

Whether this improvement is enough is up to you, but from personal experience and the stories of others, life can be just as good, if not better than before, when a condition is well managed. For me, my depression has added such value to my life that I appreciate living it all the more.

So, by using a medication, therapy, or lifestyle changes (or some combination of them), we can have great success in treating a wide variety of conditions. And, although many years ago these conditions could be something lifelong and debilitating, today’s patients can live rich and fulfilling lives.

life mental health myth

It is up to us as individuals to decide what matters to us, and when life is worthwhile. Image courtesy of Flickr.

What is important is realising that each patient is an individual, that treatments may need to change over time and that each step back can be regained. To suggest that there is ‘no escape’ poses only one limitation, on how well you understand human life.

5. ‘Mental health only matters when you are unwell.’

If you are reading this through twitter,  you may have already seen the ‘I have mental health’ campaign. And for those who haven’t, the grassroots movement included people from all walks of life holding up a sign with the statement.

But why?

The idea was to make normal what many do not consider reasonable: that mental health is a constant and ongoing entity, one that we all share and one we can all lose. This idea is uncomfortable to some. But why?

mental health myths all of us

All of us have mental health, and it can waver just like our bodies. Image courtesy of Flickr.

Perhaps because of the idea of ‘weakness’, some societal expectation, or fear, many do not like to entertain the idea that their mind is like the rest of their body. Something that can become ill, and requires maintenance to work well.  Just like our skin that can become itchy and red, things can change in an instant.

‘Mental health isn’t all of me, but it’s a massive part of my journey and a massive part of my whole being.’ – Adwoa Aboah

It seems that many only realise the fragility of our minds when something breaks. But unlike a precious vase, we rarely handle our minds with care. We expect them to be indestructible, when in fact all of us have our limits.

Since 75% of mental health problems begin before the age of eighteen,  it is clear just how beneficial teaching people how to take care of their mental health can be.

When we consider the theories around mental health disorders, we can see that many explain problems as the result of misbalance. Either too much work, too little sleep, a significant life event, a loss of purpose or one of another million things. It can take just one extra thing to tip the scales.

myth mental heath care

Mental health can be fragile, so it must be valued and taken care of. Image courtesy of Flickr.

In addition, when we consider treatment, the same can be said. Whether it be medication or therapy, a change is made to tip the scales back to equal. Mental health is an ongoing and organic process, the sum of our experiences and way of thinking.

It deserves as much kindness as our greatest treasure. And with that, it may be of huge societal benefit for all of us to embrace our own mental health, learn how to manage it and ensure that this is done from an early age.

6. You can ‘just snap out of it.’

I am sure many of you reading this will have heard a statement just like this, and for many, it will be very frustrating. There seems to be a belief that you can just ‘buck up’ and ‘snap out’ of mental health issue.

‘The idea that you can ‘positivity your way out of it’ is ludicrous. Its strange to believe that those unwell are just ‘being silly’, there is a real issue happening. Why do we collectively believe that such issues can dismissed so easily?’ – Ralf Little.

Almost as if its something flippant, volitional and subject to change at your whim.

From what we know about mental health conditions, this is not true, and often problems like depression can be pervasive, and take some time to sort out. This is also true for anxiety and a wealth of other issues.

clock mental health

Mental health issues may not be solved quickly. They can develop over a long time, so treating them may take a while. Image courtesy of Flickr.

The very complexity and individual nature of these conditions dictates that the right amount of time be taken.

The primary misconception lies in the general understanding of the problem, and that comes from familiarity. But if you have never had a disease, you simply don’t know as much about it as someone who does. That is forgivable, I wouldn’t personally understand how it is to live with heart disease.

However, there is information out there, it is just a process of making it available. I feel rather than ensuring everyone experiences a mental health issue first hand (although 1 in 4 do,) we can explain the problem instead. Most people are incredibly empathetic once talked to, it is the silence between conversations that breeds misunderstanding.

“I’m here to tell you that if you get broken, it’s possible to put yourself back together. I’m here to tell you that if you get lost, it’s possible that a light will come, dancing, on the horizon, to lead you home.”  – Nick Lake

According to Health Communities, depression itself can take weeks to truly manifest and if untreated can last up to 18 months on average –  and with treatment, can still take a number of weeks or more to even out.

therapy time treatment

Therapy can take a number of weeks to months. But the time is important. Image courtesy of Flickr.

When it comes to anxiety, those with generalised anxiety disorder (GAD,) the treatment process can take up a number of months before you see results. After that, continued treatment may be necessary. These are just two examples, but the same is true across the spectrum.

So, if we can help others to understand that mental health issues are not a quick fix, we can change their expectations. I feel that this would help both those with a mental health issue and without.

7. ‘Everyone will think I am crazy!’

 ‘People with mental health conditions are worried that others will judge and be afraid of them just because they are ‘different.’ Awareness needs to be brought forward that people with diagnosed conditions should never be ashamed of who they are. And just because someone is different doesn’t mean that they are dangerous in the form of being ‘crazy’. Never judge a book by its cover. – Paul Manners, Recording Artist and Influencer.

There is a lot of confusion around ‘psychosis’. But what is psychosis? According to the National Health Service (NHS);

Psychosis is a mental health problem that causes people to perceive or interpret things differently from those around them. This might involve hallucinations or delusions.

Put simply, and it isn’t quite as simple, psychosis is a loss of touch with reality manifest in either some hallucination (seeing, hearing or otherwise sensing something that others cannot,) and/or delusion (believing in something that is in conflict with reality.)

media misconception drama

The fear of being seen as ‘crazy’ is one based in hyperbole and insensitive media portrayals of mental health issues. Image courtesy of Flickr.

Psychosis can occur alongside numerous psychological issues when they become severe, including depression and schizophrenia. It can also be caused by medications, other organic illnesses such as dementia, and can relent when treated. Insanity is not necessarily permanent and resolves when the cause is dealt with. In each case it is important to not that a trigger can precipitate an episode, or that something can come on gradually. 

So, now we know what ‘actual medical insanity’ is, we can remind ourselves that the symptoms of a depression or anxiety disorder (amongst others,) do not mean that you are ‘crazy’. The fear is very much in the mind, but that is understandable.

“Perfect sanity is a myth propagated by straitjacket salesmen. – Rebecca McKinsey

Given that society is so demanding, and that mental health issues are so emotionally depicted in media, people often associated mental health problems with psychotic symptoms. However, this is only relevant in the small fraction of people with psychosis. 0.7 % of those over 16 years old in 2016. And, unless you work in a psychiatric facility, your chances of meeting a psychotic person are vanishingly low. The issue lies with expectation, not reality.

fear crazy myth

Most people who are mentally unwell would not stand out from a crowd. So you shouldn’t worry about it. Image courtesy of Flickr.

So, when you compare this 0.7% percent with the number of those with active mental health problems (25% approximately,) you can see how rare actual ‘craziness’ is. It’s up to us to convince the public that the 25% are not the 0.7%.

If you perceive crazy as ‘abnormal’, i.e to exhibit the symptoms of a mental health issue, then it is worth reminding yourself that we all experience mental health symptoms. It is the duration and strength that differs, and how they affect our lives.

By realising that, the idea of others judging you can go away rather quickly, all it takes is a conversation to correct a misunderstanding.

8. It’s ‘all made up’

‘Nobody thinks that the pharmaceutical industry is completely above board. But problems with big pharma do not equal that everyone is lying. The idea that psychiatric diagnoses are made up is incredibly dangerous.’ Ralf Little.

One of the more insidious claims made is that ‘mental health’ conditions are not real, and worse still, they have been invented by ‘Big Pharma‘ or ‘government agencies’ to control people and make money.

Having already dealt with the logical fallacies inherent in conspiracy theories in my work on climate change, we can surmise that conspiracy relies on misconceptions and fiction to be believed. Where science relies on evidence, conspiracy relies on imagination.

conspiracy big pharma fake

Conspiracy theories rely on fantasy and the ignorance of evidence to persist. Image courtesy of Flickr.

Instead of accepting any evidence to the contrary, a conspiracy theorist will say that ‘it’s all part of the conspiracy.’ There are simply some people that are harder to convince. But when asked to provide evidence of their conspiracy, it often falls apart. As journalist and author Christopher Hitchens once said;

What can be asserted without evidence can be dismissed without evidence.
To truly understand why people purvey this myth, we need to consider motivations. Some may have had bad experiences with the pharmaceutical industry (and rightly so, it needs improvement!), and others may wish to manipulate the unwell to offer them some ‘alternative’ treatment for money.

Others may point to the apparent difference between psychiatric diseases and more ‘common physical ones.’ They claim a paucity of verifiable evidence for these diseases, and when comparing them to the more easily believed metrics of physical disease, that the proof simply isn’t there.

This is what we call an argument from incredulity, the idea that the complexity of an explanation undermines its truth. And within psychiatry, there are physical changes in certain conditions we can demonstrate objectively, but diagnosis is a complex process looking at behaviours over time.

diagnosis psychiatry

A psychiatric diagnosis is made on a patients behaviours, as well as other factors. Image courtesy of Flickr.

But those changes are real, and to suggest that things are being made up is quite a leap. Whilst we hazard to claim that Einstein’s equations are untrue,  most of us won’t understand them. So why the double standard?

Personally, I suggest that when it comes to psychiatry there is a huge personal and societal stake involved. When emotions are riding high, people are more likely to make snap judgments, and when it comes to identifying with an idea, or joining a group, the idea becomes a sense of identity.

Being part of a movement fulfils basic psychological needs.

group identification myth

Being part of a group, or one believing in an idea, is a powerful and comforting thing. Image courtesy of Flickr.

For many, their belief in a conspiracy becomes part of who they are – they may think they are ‘in the right’ and ‘helping’, so don’t judge them too harshly. But there are those who knowingly manipulate, and they are a different story.

So in the end it comes down to which is most plausible;

  1. Psychiatric conditions are complex and individual problems require expertise to diagnose and treat. There are replicable behavioural and physical changes that can be used to aid this process. There will always be some financial gain to those producing medications, but that is a separate issue to the truth of the disease.
  2. Psychiatric issues are made up, the evidence is ‘false’ and it’s all done to ‘make money’ or ‘control people.’

I think when you view the two side by side, one looks rather less believable.

9.  Mental health issues are ‘simply biological problems’

‘There are reams of papers and journals dedicated to the idea that things like upbringing and trauma can have a remarkable effect on health. To say its just ‘chemicals whizzing around in your brain’ is just ludicrous. Demands on life are often unworkable, and this can lead to problems. It is important to realise that environment and behaviour factor heavily in mental health disease.’ – Mike Stuchbery, Writer and Broadcaster.

From what many understand about disease, this myth is an understandable one. We are brought up to only recognise diseases in terms of physical problems (a sneeze, runny nose, a painful stomach,) and it makes sense that we would attribute biology to their causes too.

These ideas are developed early on in our lives, and are hardwired.

With a move within psychiatry to reconcile behaviour with neurology, one could be forgiven to treat the two as one – but it is a little more complicated than that.

biology mental health

Although it may be tempting to reduce mental health issues to purely biological problems, the fact’s say otherwise. Image courtesy of Flickr.

What we know from medicine places a larger influence on psychological and social factors than you would realise. For example, we know that patients with depression are more likely to suffer from heart disease, and that mental health problems find some cause in social factors.

Disease is the result of an interplay between biology, psychology and the environment. Some diseases are a tad more ‘biological’ in nature, and others seem to be purely ‘genetic’, but most fall between the categories, where one factor is just part of their makeup.

‘To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all.’ – William Osler.

To dismiss mental health issues as ‘purely biological’ sells them short. Crucially, it means we are missing vital information in helping us treat them. If we can recognise the psychological and social determinants of disease, and understand their contribution, it gives us more avenues for treatment.

As such, psychiatrists and other doctors use a ‘Bio-psycho-social’ model of disease in their diagnoses.

freud mental health

Sigmund Freud was one of the first to popularise the idea of past experiences being part of mental health issues. Image courtesy of Flickr.

With depression for example, although there are genetic factors and talk of biological antecedents, we know that stress, sleep deprivation and trauma are highly predictive. And for anxiety, childhood experiences of fear and hopelessness play a role.

So when we treat psychiatric issues we combat each domain, where therapy and medication can be just as important as each other. To separate psychiatric diseases from biology is incorrect, just as saying that they are ‘only’ biological.

‘Doctors and patients need as much data as possible to make an informed decision about what treatment is best’ – Ben Goldacre.

The truth is somewhere inbetween, and with it, our best chance of making people’s lives better.

10. ‘Mental health issues are rare.’

The final myth is particularly pervasive, and you may have already been convinced otherwise of its assertions. Mental health problems are extremely common, it is the severity that differs.

global burden disease

Mental health problems are a global issue. And extremely common. Image courtesy of Flickr.

All in all, 1 in 4 people in the UK will suffer from a mental health issue at some point in their lives.

Depression is the leading cause of disability for women across most of the world and will be the lead the world in disease burden by 2030.

The very idea that these issues are rare can be traced to a misconception about what they are. Many consider mental health issues to be exemplified in rare cases of psychosis, or those dramatised in media. But mental health problems are not always as dramatic.

I don’t think it’s a healthy way of living to assume mental issues are a rarity, everyone will probably stumble across a mental issue at some point in there life, it’s how we deal with it that determines our outcome and if we’re prepared to accept it. ‘ – Charlie Parsons.

But they are worth knowing about. Considering just how common they are, and that they are becoming more common, we can build a community that wants to recognise why and do something about it.

learning mental health

By learning the truth of mental health problems, we can become wiser and more empathetic as a society. Image courtesy of Flickr.

By correcting the idea that ‘mental health’ issues convey only the extremes of behaviour, we miss the vast majority of people who suffer. We owe them the time to recognise not just how common mental health issues are, but how they affect each and every one of us.

There is no standard normal. Normal is subjective. There are seven billion versions of normal on this planet.” – Matt Haig.

One in four is a big number, so next time you are out shopping consider just how many around you are suffering in silence.

Let’s end the stigma.

For small creatures such as we the vastness is bearable only through love.”  – Carl Sagan

I hope that this work has explained why some of these myths exist, and what the real truths actually are. And I hope that by taking the time to explain them that we can correct some of the harsh inequalities experienced by those with mental health problems.

Crucially, we can see that whilst each myth can be debunked,  there is always some believable idea behind it. It is what happens next that builds a misconception into a commonly held belief.

stigma learning together

Learning is the first step in ending the stigma that drives us apart. Image courtesy of Flickr.

Stigma against mental health problems, like any stigma, is founded on misconception and fear. And like any stigma, it disappears as the truth of the matter becomes well known. We have seen it time and time again, but it takes work from the ground up.

When it becomes clear that the public will no longer tolerate the abuse of the mentally unwell, (and why should they?) the financial and political motivations will die along with the stigma itself.  People are generally good, so if we can respect each other and work together the sky is the limit.

‘Mental health stigma is killing a lot of people, especially men. This is not addressed in dialogue, men try to ‘power their way through.’ Mental illness is ‘not a challenge to be overcome’, it’s a whole load of added pressure. It’s an illness.’ – Mike Stuchbery.

I hope that in some way I have given you something  that you can discuss and share. Together we can end the stigma, so here is as good a place as any, So please help by sharing, and let me know your thoughts in the comments below.

In memory of R.O

If you wish to reproduce this article, in full or in part, please get in touch.

What’s next? Join our wonderful community!

The opinions above represent those of Dr Janaway alone and do not necessarily represent his affiliates. Any quotation or contribution made by a third party (signposted in text,) has been done under volition and without financial compensation. There is no direct financial gain to either the author or contributors from the publication of this work, it is all done for free in our own time to help others. All text has been discussed and reviewed with senior mental health professionals to ensure accuracy. There are no concerns of breaking patient anonymity or confidentiality.

Several twitter posts were originally going to be used, but due to the confusion noted of others in questioning the users intent these have been omitted out of courtesy. Apologies to those wishing to be featured, but your responses were incredibly valuable. And to those I was not able to get back in touch with, I appreciate your willingness to help and look forward to new opportunities to work together in the future. If you are concerned about your health please see your local healthcare provider. Featured image referenced above.

A special thanks to; Scott McGlyness, Paul MannersAndy West, Ralf Little, Charlie Parsons, Mike Stuchbery, Ayden Callaghan , Stephen Ritchie and Chloe Whichello and my twitter community for providing such great feedback. And not forgetting Ashleigh Howells for her patience in reading and editing, as well as much needed encouragement, as well as Dr David Denton for his keen insights.

Ten Incredible Pearls of Wisdom From Great Minds

ten wisdom dawkins

The world can be a confusing place, but academics, authors, artists, poets and philosophers are just some of the many who have tried to explain things. In my wanderings through scientific texts, popular non-fiction and and documentaries, there have been a few stand out comments.

Whether it be Malcolm Gladwell’s keen insight into human nature, or Carl Sagan’s prophetic view of the world, all have resonated in some way beyond comprehension. They seem intrinsically correct, and universally true.

So here are ten incredible pearls of wisdom from the great minds.

1. On The Origins And Nature Of Human Behaviour

‘Let us understand what our own selfish genes are up to because we may then at least have the chance to upset their designs.’ – Richard Dawkins, ethologist, evolutionary biologist and popular-science writer.

As the current face of evolutionary theory, Dawkins’ is no stranger to controversy. And although his work has revolutionised our understanding of the natural world, his opinions about how we must overcome our nature have caused the most conversation.

ten wisdom dawkins

The nature of life is conservative, selfish and driven by unconscious forces. Dawkins’ understands that to ‘be good’ you must understand our basic urges. Image courtesy of Flickr.

Dawkins’ is very aware how our evolutionary history, and how the selective pressures of the environment and each other, have shaped our behaviour. And in his book ‘The Selfish Gene‘, gives us to pause to consider the true morality of nature.

What is ‘natural’ isn’t inherently ‘moral’, and what we consider ‘moral’ is not inherently survival.  So Dawkins’ asks us to understand our primal natures if we are to best them.

2. On The Power Of Words

‘To acquire immunity to eloquence is of the utmost importance to the citizens of a democracy. ‘ – Bertrand Russell, Philosopher, Logician and Nobel Prize winner.

Although Russell is best known as a philosopher, his life of work reached deeper into the shared mind of society than we realise. By studying and writing on the academic disciplines of logic, mathematics and epistemology (the study of knowledge,) he became a strong advocate for peaceful societal reform.

A man’s words may make beautiful the macabre. Russell relied on logic to unify humanity toward a common good. Image courtesy of Flickr.

And most noteworthy are his observations of how people can be manipulated by words. The use of eloquent language, a flowery vocabulary or poetic arrangement can make the terrible seem empowering.  You need only read the words of Nazi spokesperson Joseph Goebbels to see how language can betray human decency.

We must understand a man’s motivation, and place it in the context of the sociopolitical climate, to truly understand what may be hiding behind the words.

3. On The Risks Of Virtue

‘Whoever fights monsters should see to it that in the process he does not become a monster. And if you gaze long enough into an abyss, the abyss will gaze back into you.’ – Friedrich Nietzsche, Philosopher, Author and culture commentator.

As the central reference to ‘Nihilism‘, Nietzsche examined the purpose of life without purpose. His infamous quote ‘God is dead‘ instilled the idea that the concept and role of any God is limited, and that through pain and suffering we may choose a virtuous path.

wisdom nietzsche

Nietzsche warned us not to become monsters in the pursuit of greatness. Image courtesy of Flickr.

Whilst an avid skeptic of religion in general, his infamous parable ‘Thus Spoke Zarathustra‘ presented, in humbling terms, the true insanity of zealotry. He warns us not to lose ourselves in purpose, and to recognise how a belief in achieving ‘the good’ can lead to evil.

And in a world where popular influencers claim a moral authority, his words could not carry greater weight.

4. On The Importance Of Responsibility

‘Man is condemned to be free; because once thrown into the world, he is responsible for everything he does.’ – Jean Paul Satre, Philosopher.

Regarded by many as the father of ‘Existentialism‘, Satre believed that existence precedes essence, and that we must find our own way in a meaningless universe. But in accepting this freedom in action, we cannot ignore our role in what comes next.

wisdom star ten star

Satre  believed that with action comes responsibility, and with freedom comes the same. Image courtesy of Pixabay.

Many existentialists reject the concept of ‘good’ or ‘bad’ behaviour being an inherent natural motivation, and instead suggest that we make our decisions based on complex (although often incorrect,) contextual interpretations.

Not only does this mean we must be aware of our own limits, but take responsibility when they are exposed.

5. On The Stoicism Of Knowledge

The older I get, the more I understand that the only way to say valuable things is to lose your fear of being correct. – Malcolm Gladwell, Author and Journalist.

Famed author of ‘David And Goliath’, ‘Outliers‘ and ‘The Tipping Point‘, Gladwell explores the interconnectedness of humanity with the world around it. In his poignant prose he unravels what may seem miraculous, often challenging widely held beliefs.

wisdom pearls gladwell quote

Gladwell has exposed and explained the hidden reasons behind cultural success and individual power. To question convention is as useful as it is risky. Image courtesy of Flickr.

His work tells us not only to dig deeper to explain the world, but that explanations may exist beyond the obvious. He also extols the value of expressing new ideas, fearlessly with no regard for your own ego.

We must challenge convention to find the truth, even if it risks our reputations.

6. On The Insights Given By Friendship

‘You can learn something about a person by the company she keeps.’ – Sam Harris, Philosopher and Neuroscientist.

Although more likely to be a figure of repute for his views on religion, Harris is a distinguished author and surveyor of the interface between neuroscience, morality and the world at large.

A fierce critic of authoritarian dogma, Harris asks us to take responsibility for building our knowledge toward creating a better world.

wisdom harris quote ten

Sam Harris is a vocal critic of authoritarian regimes and their numerous abuses. Image courtesy of Flickr.

He also asserts that morality itself exists independently of religious doctrine, and empowers a human approach toward a coalescence of society. And as a neuroscientist, he is all to aware of how our behaviour may make us, or betray our intentions.

So if  you want the measure of a man, consider who they value as friends.

7. On The Illusion Of Simplicity.

‘I think you’ll find it’s a bit more complicated than that.’ – Ben Goldacre, Physician and Author.

The namesake of his popular book tells us a lot about Ben Goldacre. An academic and scourge of pseudoscience and ‘folk wisdom’, Ben uses evidence to expose the lies many are sold by the few to the many. He also tells that what is made simple, or appears so, may not be.

wisdom goldacre bad science

Ben Goldcare makes it his mission to challenge misleading beliefs, expose bad science and explain the misunderstood. Image courtesy of Flickr.

What is claimed to simple may be complex, and what lies between may be inaccurate, underhanded and deliberate.

And with that, we should try to understand the motives behind simplification, and why it is so easy for us to be sold a lie. Amongst his many targets is Homeopathy and the risks involved in being misled.

8. On the Arrogance Of The Human Mind.

‘See that the imagination of nature is far, far greater than the imagination of man.’ – Richard Feynman, Theoretical Physicist, Nobel Prize winner and  Science Communicator.

Whilst it may seem odd that a theoretical physicist is so humble about uncertainty, Feynman shows us just how wonderful the universe is.

Although a pioneer in our understanding of the nature of our reality, he recognises that there is simply more we don’t know.

feynman physics quote wisdom

Feynman studied and revealed some of the most hidden secrets of our universe, but in doing so realised that was is unknown is our greatest teacher. Image courtesy of Flickr.

The intricacies of our reality, currently hazy between the infinitesimally small and unimaginably large, appear to us through rigorous questioning and often teach us that our presuppositions are not just wrong,  revealing a drastic flaw in human understanding.

We claim to be intelligent, and yet this intelligence often blinds us to our own folly. We must revel in the wonder of whats left to wonder about, and not be afraid to look stupid doing so.

9. On The Value Of Choice And Humility

‘I was never born to write. I was taught to write. And I am still being taught to write.’ – Atul Gawande, Surgeon, Research and Author.

If you are a doctor, you no doubt are aware of Gawande. Whilst a strong advocate of evidence and comprehensive approaches, Gawande has also ventured into a philosophical musing of the human condition.

gawande life wisdom

As a surgeon, Gawande not only saves lives, but has taken it upon himself to understand what the true value of life is. Image courtesy of Flickr.

In his best-selling book, ‘Being Mortal’, Gawande examines the true value of human life, and what we lose and gain as we age. And true to his nature, he treats himself with a level of skepticism coherent with his humble world view.

We are born with a choice in a difficult world, expertise is only a measure of dedication tempered by self criticism, and arrogance undermines greatness.

10. On The Size Of Our Influence

‘The Earth is a very small stage in a vast cosmic arena.’ – Carl Sagan,  Astronomer, Astrophycist and Pulitzer Prize winner.

To reduce the works of Sagan to one sentence would vastly sell him short. Not only did he lead the way in popularising science, but housed a mind so in tune with the human condition that his loss is truly universal.

Having inspired legions of scientists, including protege Neil deGrasse Tyson, Sagan’s holistic approach to science and its delicate implications toward society rings as true today as it did years ago.

sagan quote wisdom science

Carl Sagan was not just a pioneer of knowledge, but arguably one of humanity’s greatest teachers. Image courtesy of Flickr.

He was exceptionally kind, humble and patient, expressing the very tenets he postulated as a universal ideal.

Sagan reminds us that the true beauty of the universe is not just in its nature, or its creation, but in our pursuit of explanation and the inherent ability to use this knowledge to better ourselves and future generations.

And that perspective matters, for the universe is much greater than such complex molecular machines as we. We are so very small, but in that there is much to be learned, gained and valued.

So Much Left To Learn

Ten quotes simply isn’t enough to even scratch the surface of the grand insights accumulated in the wealth of human knowledge, or beyond it. And with each quote, you may have taken your own interpretation of meaning and purpose.

Perhaps you disagree with some, or worry that they are incongruent with each other. But I am willing to contend the opposite, that each shares a unity in placing the pursuit of knowledge through humility, truth and beneficence as a true virtue.

So what are your favourite quotes? What and who has changed your life? Let us know in the comments. And if you believe, like I do, that knowledge is best shared, then help us by sharing this article with your friends and family.

What’s Next?

The opinions expressed in this article are those of  Dr Janaway alone and may not represent those of his affiliates. Featured image courtesy of Flickr.

Note from the Author: Upon writing this article I became very aware of just how much I don’t know, and how much I can learn. I feel it only right to follow up on this article with more information about the works and lessons of the persons featured. There are many greats not featured on this list, but don’t worry, I will find ways to include them. I do not value my opinion of what is great  above any others, I only wish to signpost what is already there.

Should We Message The Programmer? The Ethics Of A Simulated World

Having discussed how you should generally approach living in a simulated world in our last article, we can now enquire a little further into specific acts. And, don’t worry, we will cover a fair few. So lets talk about Genocide through knowledge. In fact, let’s ask the question a different way. If you ran the risk of destroying the entire simulation universe simply through sending a message to it’s creator, should you? Or would the potential benefits of talking to it’s ‘creator’ outweigh the risks? And how even may you contact them, let alone convince them either way? Today we will consider an automatic message, i.e ‘universe.exe’ realises that ‘entity x’ has become aware. Let’s take another trip into a simulated universe through a thought experiment.

‘Why does the eye see a thing more clearly in dreams than the imagination when awake?’ – Leonardo Da Vinci.

Messages and Knowledge

Firstly we must consider why, not how, we have come to be in a simulation. And the two main theories, based on why we ourselves would create one, would be either ‘for entertainment’ or ‘for experiment.’ Although both seem simple, each is full of a multitude of ethical concerns and open questions. So lets start by saying what we can, that is logical and valid, for both. Firstly, there is significant evidence that we are living in a simulation. Simulations are built on some sort of code, that is readable and checkable. Certain actions of the simulation may prompt review by its creator and user, much like an ‘Error’ on your PC. And that prompt can be automatically or manually dealt with. For example (in a manual response;)

Observation: Entity no. 3216732178 has become aware of ‘universe.exe’

Warning: Universe.exe ”experimental” parameters now biased. Terminate program Y/N?

science philosophy dream simulation

The Universe may be beautiful, but can we destroy it with knowledge?

We can be assured logically that since you are reading this, there is no automatic action to destroy the simulation if one person becomes suspicious of, or convinced that, they are living in it. You can also logically conclude that the realisation of ‘Entity no.3216732178’ has not been deemed enough concern to terminate the program manually. The creator is okay with it, at this level of penetrance at least. But imagine that the program running the simulation has an in-built threshold, by which the program offers a new prompt for manual decision making, or worse automatic. It may go something like this;

Observation: 51% of known ‘Human’ entities (and Parrot No. 321132892190) have become aware of ‘universe.exe’

Warning: Universe.exe ”experimental” parameters breached beyond tolerable levels. Terminate programme Y/N?

User: N

Warning: User override denied. ‘Universe.exe’ has breached operable parameters. Data corrupted. Terminating in 10 seconds.’

As scary as this thought may be, it makes a number of assumptions. The first is that there is a tolerable level by which the simulation could operate whilst entities were aware of it. For The Truman Show, that was 0. Day to day many of us labour under delusional beliefs, and yet the universe does not shut down. So it can be inferred that it is the specific belief that matters to a creator. They are happy to let millions believe in Thor as it doesn’t effect the purpose of the simulation in a negative way. So be it an experiment or entertainment, the simulation runs on. The eventuality that concerns us here is in which circumstances would a creator click ‘Yes’. (Note, this ignores an automatic deletion.)

‘Good morning, and in case I don’t see ya, Good afternoon, good evening, and goodnight.’ – Truman Burbank, The Truman Show.

Messages And Response

For the sake of argument let’s first consider that we live in a simulation designed for ‘entertainment.’ In our last article we discussed how this may be bad news for the world if we realised it. So much of our top TV shows rely on violence and shock to stay alive, it could be argued that we should do the same to ‘stay switched on.’ But lets consider what may happen ‘naturally’ if the simulation hypothesis was not just proven, but widely accepted. There are two extremes of outcome that are immediately apparent, each with a multitude of potential responses by the creator.

  1. We lose our minds. The Universe is a joke and there are no repercussions, as long as we stay on air we will stay alive. Prep the nukes.
  2. Okay, perhaps the watchers want peace, lets go with that.

We cannot predict exactly how the creator would respond to either (1) or (2), suffice to say that as long as its entertaining enough to stay watched, they will not terminate the simulation. But remember, reality TV either adapts, becomes a circus act, or dies.

simulation ethics science philosophy

A Circus Is Entertaining? But what of Humanity?

A second argument, that we are an experiment, offers both concerning and reassuring extremes. The first option is that a clear realisation that the test subject has become aware of the experiment and it’s potential hypothesis may have three obvious outcomes;

  1. The experiment is terminated as any new data is no longer reliable.
  2. The experiment is left running as ‘knowledge’ of the experiment is just another variable.
  3. The experiment will continue until x percent of test subjects become aware.

In (1) the creator relies on the ignorance of ‘us’, the ‘test subjects’, for the experiment to succeed. We cannot know that we may be in a simulation, and therefore cannot bias the test. But since I am sitting here typing this piece, the presence of my frontal lobes and ability to use information renders the ‘cannot know’ irrelevant. We clearly can. So we are left with option (2), which is that realisation in the experiment is not a contrary to its operational parameters. This could be for a number of reasons, including that the creator is interested in what may happen with this specific realisation, or is running a study of a populations response to chaos. And since we can consider this option, the experimenter has enabled us to do so.

So, since I am still here, option 2 or 3 can be argued as reasonable deductions.

‘A place where we all go can’t be bad, can it girl?’ – Chris Nielsen, What Dreams May Come

Should We Send A Message?

Well, we already have. The first time a scientist, or more likely an author, even briefly considered the ‘simulation’ then that data became available. The question here is when does that information become troublesome to the creator, at what level of penetrance? And do we risk a universal genocide? In the entertainment hypothesis, it depends what we do with the information, how we react and whether the watchers are entertained. If it is an experiment, the stakes are higher.

If option 2 is to be believed (The experiment is left running as ‘knowledge’ of the experiment is just another variable,) then we are probably fine. This is not a new idea, and has been atlas considered by thousands. But if its option 3 (The experiment will continue until x percent of test subjects become aware,) then we may approach a point of no return.

So, in that sense, this may not just be a ‘thought experiment’ after all.  And hypothetical creators up there, please retweet and comment.

‘I find myself exposed, tapping doors, but irritate, in search of destination.’ – Damien Rice, Eskimo (O)

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The opinions expressed in this article are those of  Dr Janaway alone and may not represent those of his affiliates. Featured image courtesy of Flickr.

Note: Once again, as per with the previous article, the subjects discussed are not done so exhaustively. There are many other intermediate conclusions that can be drawn between the extremes presented, but for the sake of discussion I have chosen polarising outcomes. You may also be able to fairly debate my inferences and deductions, and it would be useful to do so. Furthermore this entire article has been a rather meta experience. If we are iliving in a simulation, I have broken the fourth wall and rendered the Universe susceptible to the conclusions drawn. If not, then this may provide an entertaining discussion alone.  Awaits ‘Mad Scientist’ badge.

Media credits

  1. Lake and Trees, Flickr.
  2. Circus Performer, Flickr.

 

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