Psychology

Competitive Under-Eating: That Harmful Thing You are Probably Doing and Why You Have to Stop

Joey Chestnut stands at 6 foot 1inch tall but in the world of competitive eating his figure looms much larger. In 2016 he regained the championship belt by consuming 70 hotdogs and buns in 10 minutes. Two month later he held on to the US Chicken Wing Eating Championship by eating 188 wings in 12 minutes. Joey trains for his feats with a combination of fasting and stretching his stomach by drinking gallons of water. It’s a dangerous ‘sport’ as the legal disclaimers attest. The harms of competitive eating are obvious and well-documented so I am not going to talk about them here. I’m concerned about a competitive eating behaviour that happens towards the other end of the spectrum.

Competitive Undereating doesn’t draw the same crowds as Joey and his rivals – though it does require an audience of sorts – and there is isn’t any prize money. There is nothing in it but a misguided sense of triumph, the creation of tension at mealtimes and the risk of psychological harm. Competitive Undereating is a subtle and complex behaviour where a person strives to demonstrate that they have or will eat less than someone else. It can be used to signal that eater isn’t ‘greedy’ or ‘bad’ or that they have superior ‘control’ over their appetites. It is linked with maladaptive perfectionism (the unhealthy kind) and can trigger more serious eating issues in the eater and those around them.

Shared student houses are a hotbed of dietary restriction and I think it is linked to Social Comparison Theory. This theory states that to manage our self-esteem we are driven to make comparisons between ourselves and others. A downward comparison means we look for someone who is ‘worse’ than us to make ourselves feel better. For groups where academic achievement is on a par (such as medical students, for example), physical appearance and attractiveness are the next best targets for comparison. Moving out of home and having to manage budgets and meals for the first time is stressful and can lead to the development of harmful behaviours in those vulnerable. Being thrown in to a group living situation can raise worries about whether you or the way you eat is ‘normal’. Do you eat the ‘right’ foods? Does the way you eat seem weird to other people? Added to that is the unconscious drive, when we are in groups, to establish a hierarchy to see who is the ‘Alpha’. Now the conditions are set for the flourishing of anxiety-driven competition.

But it is not just in unrelated groups. It is common to find Competitive Undereating among households. Siblings do it against each other, especially if one child has already been dubbed ‘The Thin/Small/Skinny One’. Mothers do it with their daughters more than society would like to admit.

Competitive Undereating is not an eating disorder, though it is a sign of disordered eating. I am sure, though, that most people who engage in this harmful, unproductive behaviour don’t even realise it. Simply, they have been around it, and doing it for so long that they do not even notice anymore. Worrying about what someone else thinks of our eating instead of what we ourselves want has become automatic. To understand whether you, or someone around you, is a Competitive Under-Eater, you need to first know what it looks like. Family or group mealtimes are where this kind of behaviour is most obvious. Let’s imagine you and your housemates/friends/colleagues/family are going out for dinner…

Preparation

The competition begins long before arrival at the chosen eatery. Perhaps the choosing of typically low calorie cuisine (e.g. Thai, Japanese or vegan) is an attempt to minimise calorie consumption from the outset. For a Competitive Under-Eater the venue can be the first signal of status. ‘I’m choosing the healthy option because that’s better. I don’t allow my cravings to determine my choices’. If not, if, say, the choice is pizza or burgers then the menu is scanned beforehand, not for efficiency, or in excited expectation, but to find the lowest calorie, healthiest item. The ‘best’ choice.

At The Restaurant

At the restaurant or dinner table we begin to see the different types and strategies of Competitive Undereating. I call them The Proclaimers, Surveyors, Sirens and The Compensators.

The Proclaimers

Sadly, I am not talking about the cheerful Scottish duo (but now the song is in your head). These Proclaimers take two forms, but both involve making an announcement about previous eating.

‘I haven’t eaten anything all day!’ It is less important whether this is or is not a factual statement. The point of the proclamation is set the Proclaimer out as the most ‘controlled’, the best denier of hunger. In a world where being thin is the sign of success, not eating all day is an achievement.

Of course, not everyone who turns up at dinner saying they are starving is competitively undereating. What’s we’re talking about here is the meaning, the intent behind the statement.

The alternative proclamation is something along the lines of, ‘I’ve already eaten’ or ‘I had a big lunch’. This is incredibly common in restrictive eaters and serves to legitimise later under-eating. It is a pre-emptive strike aimed at stopping others from enquiring why they are eating so little.

The Surveyors

Surveyors take an audit of the menu choices of the rest of the group.

  • What are you having?
  • How many courses are you going to have?
  • Are you going to have bread?
  • Are you going to get dessert?

Again, this is less about the specific behaviour. There are plenty people who are so excited by the whole menu that they just want to talk about. In the mind of a Competitive Under-Eater, though, the value of the survey is to inform their own selection. ‘Well, I don’t want to be seen to be having more than anyone else. I don’t want to look greedy. I don’t want them to think that I eat ‘too much’.’ For this person finding out what everyone else is having is driven by the anxiety of not wanting to stand out or seem different.

The Sirens

I call this group/behaviour the Sirens because, like the mythological creatures, they lure others in to a trap. For example, they may talk about how delicious the dessert menu looks, how they have been craving cheesecake all week. When it comes time to order, feigning indecision, they insist that everyone else order first and then, at the very last moment, decline. The satisfaction here is knowing now that others will be eating more than they have and again signalling their superior ‘control’.  

The Compensators

Whether it comes at the start or the end of the meal Compensators make a public statement about ‘working off’ their food, of the need to undo the harm of eating. Comments like:

‘I’m gonna have to go for the longest run in the morning!’

‘It’s a good thing I did spin this afternoon!’

They may not have under-eaten but this kind of comment makes clear that the speaker has or will have a calorie deficit compared to the other diners and suggests that everyone else should emulate their behaviour.  

What’s The Problem?

The reason this kind of behaviour concerns me is because of the psychological repercussions. Imperceptible at first, with time the behaviours can bed in to become an established pattern.

To start with Competitive Undereating habitualises the judgement of self and others. Silent disapproval becomes second nature. It means that even (or especially) when sitting down to eat everyone at the table is being quietly assessed and critiqued. It creates anxiety (which in itself impairs digestion) and prevents full enjoyment of the meal. It gets in the way of real, healthy social interaction. Competitive Undereating comes between people because, ultimately, the attention is focused back on the self. Whatever the other people are doing or eating you are always thinking about how it relates to, reflects on or affects you.

Secondly, it consumes thinking and is a colossal waste time, energy and creativity.

Third, Competitive Undereating can trigger and perpetuate eating disorders, and hinder recovery. It can be incredibly difficult for someone in recovery to start to rebuild a healthy relationship with food if they continue to be exposed to Competitive Undereating or judgement about their food choices. Not least of all because comparing your food intake to someone else’s ignores biological, metabolic, genetic, hormonal and lifestyle differences between you.

Competitive-Under-Eating looks harmless but it can lay the foundations for deeper problems with food, eating and self-esteem. If you recognise yourself or someone close to you as a Competitive Under-Eater it can be helpful to remind yourself that what you eat does not affect other people and vice versa. It’s dinner. It’s not a competition.

 

If you think you might have a problem with your relationship with food it may be helpful to talk to a professional. Psychologists and registered nutritionists who specialise in Intuitive or Mindful Eating can help you develop a more relaxed, natural relationship with food.

Depression is a Whole-Body Disorder. Why Don’t We Treat It Like One?

Today marks the start of Mental Health Awareness Week in the UK. In previous years the campaign has explored the experiences of living with mental illness, social stigma and support resources. This year the focus has changed from living with illness to asking why so few of us are thriving psychologically. Why are so many of us in ‘survival mode’? It’s an approach that invites us to look at the wider factors influencing mental health on a sub-clinical level. When most of the people who experience depressive or anxious symptoms will not or cannot access treatment it is important to understand other viable and effective avenues for intervention.

This broader theme of what it means to ‘thrive’ reflects a growing appreciation that disorders such as depression are not simply ‘brain-based’ but are biological and psychological responses to social, environmental and lifestyle factors. Just a few days ago a review of 20 years of depression research concluded:

“…one thing is for sure: depression, and mental health problems in general, can no longer be seen only as disorders of the mind, or indeed only as disorders of the brain. The strong impact of the immune system on emotions and behaviour demonstrates that mental health is the health of the whole body.”

Two years ago the Lancet Psychiatry released a statement editorial highlighting that ‘nutrition is as important to psychiatry as it is to cardiology’ and advocated that nutritional status and dietary intervention should be considered when assessing a person’s mental health condition. The recent publication of the ‘SMILES’ Trial was the first study to elucidate diet as a causal factor in depression. Mood improvement in this study was not a factor of weight loss and while this particular study did not assess these parameters it is likely that the improvement was due to a reduction in systemic inflammation, as has been highlighted by a number of observational and RCT trials.

Inflammation is the immune system’s response to illness or injury, which, amongst other things, involves the release of small molecules called cytokines by immune cells. Typically, the inflammatory response is brief and begins to recede when the tissues start to heal. However, a number of stressful external factors also induce inflammation and the secretion of pro-inflammatory cytokines including: early life adversity, traumatic events, chronic work stress, poor diet, obesity and a sedentary lifestyle. When stress is sustained so is inflammation and this state of low-level chronic inflammation is implicated in a range of diseases including heart disease, Type 2 diabetes, Alzheimer’s Disease, and depression. Blood levels of inflammatory cytokines correlate with the severity of depression that patients report. In one trial non-depressed participants were injected with a substance called endotoxin, a toxin found in the cell walls of bacteria that the immune system recognises as harmful. The participants who were injected with endotoxin not only saw an increase in their levels of cytokines but reported significantly increased anxiety, depressed mood and loss of pleasure (a symptom of depression). The participants who received the placebo did not report these mood effects.

As well as improving diet, exercise has been shown to be effective in reducing levels of inflammation, improving mood and increasing the levels of a substance called BDNF. BDNF is a growth factor that promotes the growth of new brain cells, as well as protecting the ones we already have. Low levels of BDNF have long been associated with depression and other mental illness. Exercise mimics the action of antidepressants by raising levels of BDNF and improving the availability of the neurotransmitter serotonin, which is associated with good mood. Exercise has the additional benefit of improving heart health and general brain structure and function, and improving sleep (sleep disorders are a common factor in depression).  Taking a similar position to the Lancet Psychiatry report, a recent editorial in the journal General Hospital Psychiatry makes the case that the evidence for the beneficial effects of exercise on mental health is so compelling that it is time to start thinking about how to apply it as treatment.

Other lifestyle factors have also been shown to be effective in improving mental health including meditation, learning, fasting and even sauna use. Combined, these factors present us with the best cost-effective opportunity to reduce and prevent the development of depression and associated disorders. Sadly, few people will have access to this valuable information and support. Conducting a thorough assessment into what might be causing one person’s depression takes more time than the ten minutes GP’s are allotted per person. Psychological therapies are effective but can be difficult to access. Thus, antidepressant medication remains the most cost-effective treatment available in Primary Care. The problem is that rates of treatment-resistance (patients not responding to antidepressants) are increasing. The lifestyle factors outlined above provide opportunities to both improve the efficacy of standard treatments and as standalone options for those with mild-moderate symptoms.

Hopefully, this year’s campaign will make the case for considering lifestyle interventions in the treatment of depression. For my part, my clinical practice starts with a comprehensive assessment of both psychological and lifestyle factors including: work satisfaction; relationships; childhood illnesses, exercise; diet and nutrition, and sleep habits so that the client and I can come to as clear an idea as possible of what might be causing their distress and illuminate a number of areas for intervention to give us the best chance for a positive outcome.

To increase the availability of this valuable information I am launching a series on online seminars on a range of topics including Stress Management, Sleep, Nutrition and Obesity. It’s times for us to move away from a model of symptom management to one of illness prevention, and all change starts with awareness.

http://www.monumentalhealth.co.uk/seminars/

References

Dantzer, R., O'Connor, J. C., Freund, G. G, Johnson, R. W, Kelley, K. W. (2008). From inflammation to sickness and depression: when the immune system subjugates the brain. Nature Reviews Neuroscience, 9(1), 46–56. doi:10.1038/nrn2297

Ekkekakais, P. & Murri, M. B. (2017). Exercise as antidepressant treatment: Time for the transition from trials to clinic? General Hospital Psychiatry. Doi 10.1016/j.genhosppsych.2017.04.008

Miller, A. H., & Timmie, W. P. (2009). Mechanisms of Cytokine-Induced Behavioral Changes: Psychoneuroimmunology at the Translational Interface Norman Cousins Lecture. Brain, Behavior, and Immunity23(2), 149–158. http://doi.org/10.1016/j.bbi.2008.08.006

Pariante, C. M. (2017). Why are depressed patients inflamed? A reflection on 20 years of research on depression, glucocorticoid resistance and inflammation. European Neuropsychopharmacology. In press.

Sarris, J. et al. (2015). Nutritional medicine as mainstream in psychiatry. The Lancet Psychiatry, 2(3), 271-274.

New Year's Resolutions Worth Making: Week 1 - Sleep

The decision to embark on a New Year’s Detox is a frothy mix of nonsense and lunacy. I discuss why that is – at length – here. The TL: DR version: It’s not a real thing and will do you actual, quantifiable harm. If you want to make a manageable, sustainable improvement in your physical health this year you would be much better off taking 10,000 steps per day (1-2) and maybe delaying your breakfast by a couple of hours(3). So, for those of you who are sufficiently convinced that a ‘detox’ is a giant waste of time, energy and life I offer an alternative health resolution. I’ve compiled a list of the top five things you can do to improve your brain function and mental wellbeing in 2017 (based on non-frothy science) because there is no health without mental health. The fantastic five are: Sleep, diet/nutrition, rest/meditation, exercise, and learning. I was originally planning on creating a top ten but small, incremental changes are the ones most likely to stick so get these under your belt and you will be well on the way to a happier, healthier 2017.

Sleep

There’s supposed to be something very impressive about getting by with very little sleep. We hear urban legends about highly successful people who require only four or five hours per night. They are described as ‘superhuman’ rather than just ‘different’. Corporate law firms and big banks provide beds in their buildings and newly-qualified and graduate trainees fight it out to demonstrate how productive they can be, how much sleep deprivation they can tolerate.

But there is nothing big or clever about surviving on very little sleep. For people who are not natural short-sleepers (and maybe only 2% of the population are) poor and disturbed sleep is a serious problem. The American Centre for Disease Control and Prevention describes insufficient sleep as an ‘important public health concern’(4). According to a recent YouGov poll only half of people are happy with the amount of sleep that they get(5). Psychologically, we know that poor sleep:

  • Increases risk of depression
  • Impairs decision making, including around risk
  • Makes you more easily distracted
  • Makes you less able to adapt to a situation/adopt new strategies that might be more appropriate to the situation
  • Impairs communication and language skills
  • Makes you less able to control mood/impairs mood stability
  • Impairs insight

It has serious consequences for physical health too and poor sleep is associated with increased risk of obesity and heart disease(6).

For a long time disturbed sleep was seen just as a symptom of depression but more recently researchers have been looking at poor sleep as a causal factor in depressive illness(7-8). This perspective presents us with the opportunity to target sleep disorders as a treatment for depression. So, what can you do?

  • Keep cool – Cooling body temperature is a physiological indicator that it will soon be time to sleep. If your room or bed are very hot this can make it harder to drop off and impair sleep quality (think of those hot summer nights). Use the right tog duvet for the season, and use a quiet fan if you need to. You can also promote this sleep-inducing effect by taking a warm bath about an hour before bed, the cooling of the body once you step out of the bath can help to promote sleep.
  • Step in to the light - We all have a natural sleep-wake cycle that coordinates – based on light-exposure – to the 24hr day/night cycle. This is part of the circadian rhythm. Left to its own devices this cycle can drift slightly; it needs light at the right times of day to stay 'anchored'. Try to get at least 30 minutes of bright daylight in the morning or at lunchtime. A half hour walk after lunch is perfect if you can manage it.
  • Hack your ultradian rhythm - As well as the 24hr rhythm you also have a shorter, 90 min cycle clicking over throughout the day, your ultradian rhythm, and tracking this can help you to identify when is the best time for you to go to bed. The ultradian rhythm is remarkably consistent making it a very useful measure and you can track it by timing your yawns. See the image on this page. At the peak of the wave you are at your most alert and this is a great time to work through your to-do list or focus on a challenging problem. 45 minutes later you are at the trough of the wave, at your most sleepy and most likely to yawn. So, if I yawn at 7pm but it’s too early for me to go to bed, I know that I am likely to be most sleepy again at 8.30pm, 10pm and 11.30pm. I might plan, then to be in bed by 10pm or 11.30pm in order to get to sleep quickly.
  • Put down your phone – Smartphones, tablets and computer screens emit blue light. This is the same wavelength as dawn light, and this is received by the suprachiasmatic nucleus (the brain region responsible for controlling the circadian rhythm) as a message that it is time to wake up, be alert and get active. Try to avoid using these devices for at least 60 minutes before heading to bed, or, if you absolutely must, download an app that can help to filter out the blue light.
  • Make sure the room is as dark and quiet as possible (unless that freaks you out). Think about using eye masks, blackout curtains and ear plugs if you live in or near a noisy environment.
  • Avoid alcohol before bedtime – Although it can promote the initial falling asleep, alcohol disturbs the quality of sleep, preventing your brain from entering the deeper sleep stages.
  • Try not to drink too much before going to bed – I mean just normal drinks here. It seems obvious but a lot of people underestimate how detrimental midnight trips to the loo are to a good night’s sleep. Have a bottle of water by your bedside so you can rehydrate in morning.

Also, remember that here is no magic number. The right amount of sleep is the amount that is enough for you, for you not to feel excessively sleepy during the day. That might be seven hours, that might be nine, we all have different sleep needs. So, work out what is right for you and try to achieve that more often than not.

Next week, the effect of nutrition on brain function. Until then, wishing you a very restful night.

Kx

 

References

  1. Yuenyongchaiyat, K. (2016). Effects of 10,000 steps a day on physical and mental health in overweight participants in a community setting: A preliminary study. Brazilian Journal of Physical Therapy.
  2. Castres, I., Tourny, C., Lemaitre, F. & Coquart., J. (2016). Impact of a walking program of 10,000 steps per day and dietary counseling on health-related quality of life, energy expenditure and anthropometric parameters in obese subjects. Journl of Endocrinological Investgation, DOI: 10.1007/s40618-016-0530-9.
  3. Horne, BD., Muhlestein, J. B. & Anderson, J. L. (2015). Health effects on intermittent fasting: hormesis or harm? A systematic review. American Journal of Clinical Nutrition, 102, 464-470.
  4. https://www.cdc.gov/features/dssleep/
  5. http://cdn.yougov.com/cumulus_uploads/document/bt915di765/YG-Archive-140520-Sleep.pdf
  6. Kecklund, G. & Axelsson, J. (2016). Health consequences of shift work and poor sleep. British Journal of Medicine, 355, i5210.
  7. Chen, Y., Keller, J. K., Kang, J., Hsieh, H. & Lin, H. (2013). Obstructive sleep apnea and subsequent risk of depressive disorder: A population-based follow up study. Journal of Clinical Sleep Medicine, 15, 417-423.
  8. Roberts, R. E. & Duong, H. T. (2014). The prospective association between sleep deprivation and depression in adolescents. Sleep, 37, 239-244. 

Millennials, Smartphones and Mentalisation

Human beings are in a perpetual state of conversation and conflict between our ancient biology and the modern world. Physiologically we evolved to enjoy and seek out sweet tastes as these foods (typically fruit and tubers) tended to contain useful amounts of energy and were unlikely to be poisonous. This tendency to sweetness was beneficial in pre-agricultural environments where these foods grew seasonally, had to be foraged and were eaten whole, but our modern, industrial food landscape - in which sugar is extracted from one food and added to another - is associated with the over-consumption of refined sugar, of energy intake outstripping expenditure and, in turn, many of the ‘diseases of a modern life’: metabolic syndrome, Type II diabetes and heart disease.

Similarly, the conflict of our ancient brains – predisposed to identifying risks in the environment and anticipating and simulating future problems – and the stresses of modern life are associated with increased incidence of chronic stress, anxiety and depression.

On Christmas Day 2016 a group of educationalists, authors, psychologists and psychotherapists published an open letter(1) in The Guardian calling for government intervention on the amount of screen time children are exposed to citing risks to children’s self-regulation and emotional resilience. Their concern is that increased screen time comes at the expense of meaningful interactions with caring adults and self-directed outdoor play. I think these concerns are sympathetic and well-founded. It will be important that anecdotal and hypothetical links are also borne out in good-quality research that looks at the relationship between use of screen-based devices and mental wellbeing so that the issues may be addressed effectively.

It occurs to me that one potential casualty of our screen-based lives is mentalisation. Mentalisation is the capacity to consider the contents of one’s own mind. It may also be referred to as ‘reverie’, ‘thinking about thinking’ or metacognition. Think of it as the ability to think about our own thoughts; to be able to answer questions like Why did I do that? What am I feeling? It is the cornerstone of self-awareness and higher cognitive functions such as planning, attention, decision-making, reasoning and problem-solving.

A number of offender management programmes focus on increasing the capacity to mentalise. Often offenders struggle with understanding the motivation for their crimes or seeing a connection between the circumstances and their actions. ‘I don’t know what happened. I don’t know why I did it. It just happened. I wasn’t thinking’. In a more general sense all of therapy can be said to be concerned with increasing self-awareness, whether the question we are asking is ‘What do I want to do with my life? Or ‘Why do I feel so sad?’

Here’s the thing, a huge part of the process of developing the capacity to mentalise is space. It is within the quiet of safe isolation (as opposed to a fearful abandonment or loneliness) that we become aware of the contents of our own minds. One of the reasons that babies and young children become so distressed when separated from their parents is because they have yet to develop object permanence; when mum or dad are out of sight they ‘cease to exist’ and this is incredibly frightening for an infant. With time s/he is able to understand that a) the parent continues to exist in the world even when they are not immediately available and b) the loving relationship also continues. In the physical absence of the parent the developing child can conjure up images and associations of the parent, and can soothe themselves with the knowledge of that parent and the belief that they will return.

The positive trajectory of this process is that the child will become aware of their own feeling states. If the experience could be put in to words it would look something like, ‘I am anxious because mum/dad has gone away. I feel lonely. I am frightened that they will not come back. But they have been away before and they did come back and it was okay. It will probably be fine.’ But this process requires absence. It needs for the child to realise and acknowledge that they are alone before they can consider how they feel about it. It is a psychological function that developed, along with the rest of our minds, in a pre-industrial, pre-technological world. It is my suggestion that ready access to smart phones and tablets impedes this process by ensuring that we never really experience solitude. As soon as we are by ourselves, at the touch of a screen, we can be connected to an infinite number of others, whether that’s friends on Facebook, a group on Whatsapp, or the innumerable anonymous masses on Twitter. We can immerse ourselves in somebody else’s life, either as observer or participant and the pesky reality of our own emotional world can be avoided for a while longer.

I have had younger patients (Millennials, if you will) look at me in genuine confusion when I have asked ‘What goes through your mind when you are not doing anything?’ They are never ‘doing nothing’. And then horror when I suggest that it might be interesting and useful to spend just five minutes doing nothing to see what emerges.

‘What do you mean?’

‘I mean, at some point during the week, I would like you to spend five minutes doing nothing.’

‘No, I can’t do that. No. That sounds awful.’

Part of this ‘Terror of Nothing’ is the result of the well-intentioned but ultimately disastrous insistence on efficiency. We spend so much time manically seizing the day and ‘only living once’ that we risk losing the skill of actually living; of appreciating the moment and being aware of our emotional response to it. We’re so busy working out the best angle for the selfie that we miss the glorious #sunset. But, I think, a large part is that as long as you have a smartphone and 4G you never have cause to be doing nothing. There is no solitude. Whether it’s listening to music, scrolling through a news feed, reading a blog post (ahem!) a distraction is at our fingertips. The modern world is one of constant stimulation, instant gratification and certainty. Suffering from momentary boredom? Play a game! Seen a thing that you like? Order now for next day delivery! Unsure about anything?  Ask Professor Google and be uncertain no more.

The problem with this? The problem is that, in order to live meaningful lives, we need to know ourselves. We need to become familiar with the contents of our minds in quiet moments of solitude. We need to be able to tolerate what emerges there whether it is something we consider pleasant or unwelcome. If it is pleasant, why? If it is unwelcome, what does it mean? And we must be able to tolerate uncertainty. Why? Because that is life. Life is uncertain and vacillating. Whether the ambiguity is about a relationship, a job, our own sexuality, our faith, the truth is that most of the time we are unsure. But the task isn’t to be sure. Certainty is a comforting illusion. The task is to be uncertain and still be able to live; to make choices in the direction of our values. To not be paralysed by fear and ambiguity but to know that, though we are not 100% on this, we are still able to take action in line with a deep knowledge of our own minds, needs and morals.

Our personal devices provide an extraordinary opportunity to improve our lives; connecting people across continents; increasing access to education and employment, to inspiration. But they also have the capacity to distract us from other important internal and external events, like an engaged, meaningful conversation, the innate awe of a beautiful sunset, or thoughtful, purposeful nothing.

 

1. https://www.theguardian.com/education/2016/dec/25/screen-based-lifestyle-harms-health-of-children

Freud on Pornhub

Originally published 21 January 2016

Telling people that you are a psychologist (or even a psychology student) tends to evoke two responses in others: curiosity or hostility.

The curiosity almost always takes the form of the rather hopeful exclamation, “Oh my God! Can you tell what I am thinking? I bet you’re analysing me right now!” This response is so common that there are memes, articles and merchandise based around it. For the most part the curiosity is funny and light-hearted and leads to a normal conversation that sits appropriately in the realms of polite social interaction. It’s the hostility that catches you off guard. During my training I had started a new job, unrelated to psychology, in a corporate environment. My new colleague asked me what I was studying. I told her. She said with a snarl, “I would never go to see a therapist. It’s a sign of weakness. I think you should be able to deal with things by yourself. My dad bought me up to be a strong person and not have to rely on other people for help.’ I said, “Okaaaaaay…”

I get it. Our mental and emotional worlds are bizarre but deeply personal places and people either want to invite you in so that you can help make sense of them, or to keep you out at all costs. Sometimes, mindful of not wanting to betray their hostility, people dress it up in intellectual clothes. I was out at a club once and on hearing what I do for a living the man I was talking to said something about it being complete nonsense. I thought to myself ‘Seriously. We’ve just met and you’re telling me my vocation is  worthless? And when I was polite enough to not even mention your dance moves? Is this really happening? Am I…am I being negged?’ But I didn’t say that. I asked him what he meant. You know, because I'm a professional. He made a comment about Freud’s theories of infantile sexuality being false and irrelevant. He didn’t put it like that though, of course, because he hadn’t read the theories. He apparently had only read or heard someone else’s detracting statements on them. What he said was, “Well I certainly don’t want to have sex with mother. That’s disgusting.” I let out a laboured sigh. Honestly? Honestly?! This is your well thought out counter-argument to over 100 years of psychoanalytic thought?  It doesn't feel nice?  Really? Not even an attempt at a supporting reference? Just your subjective report of a thought you haven’t had about something that was never actually said? Good grief. I could have let it go; it was late, I was having a nice time but I had just come from work and, well, he started it. I had to take a moment to educate the man.

Here’s the deal. This guy was of course referring to the much misquoted Oedipus Complex. First, a little bit of background. Sigmund Freud was a doctor and a neurologist. I make this point in an attempt to demonstrate that the man was primarily trained in the rational, natural sciences. The observable and the objective were the basis of his work and his research. During his clinical practice he became intrigued by a curious phenomenon which he referred to as ‘Hysteria’ but what modern medicine calls Psychosomatic Illness, Somatisation or the more politically correct ‘Medically Unexplained Symptoms’. It is the observation that people frequently present with physical symptoms for which no biological basis can be found. The NHS reports that up to 20% of GP consultations in the UK are for these kinds of symptoms (1). That, according to the British Medical Association(2), accounts for some 68 million consultations. That’s a huge proportion and it made Freud wonder, what, if not physical, was creating these symptoms and, crucially, why?

Through many observations and in treatment with his patients Siggy deduced that there was something psychological at play and something of which his patients were not themselves aware.

The ‘unconscious’ is the term given to the processes that go on in our minds automatically and outside of our conscious awareness. If you see a ball coming rapidly towards your face you do not think to yourself ‘Incoming threat to facial integrity. Aversion procedure: close eyes. Turn away. Cover face with hands.’ If you did you would be out cold on the floor with a broken nose before you could say 'Have you had an accident that wasn't your fault?' But you do the actions anyway, evidence of an automatic (unconscious) response to the external stimuli. Far from necessitating blind faith, neuroscience now provides a compelling case for the brain basis of the unconscious (3). Neuroscientist and author Sam Harris is one of the more recent and recognisable to say ‘Free will is an illusion’ (4) so compelling is the case, he says, for power of the unconscious.

The unconscious, Freud believed, played a huge part in determining our behaviours, beliefs and personalities and the Oedipus Complex was the metaphor that he used to describe some of the behaviour that he observed in children and the child-like aspects of his adult patients. That’s right, it was a metaphor. An allegory. Freud used the very entertaining (you should read it) Greek tragedy ‘Oedipus Rex’ as a symbol of the intense feelings that a child experiences for the opposite sex parent. He did not say that children want to have sex with their parents. Children at the age he was describing do not (or should not) have any notion of what adult sex is. What does happen, to which many parents will attest, is that children will talk of deep love for their parent. Little boys who want to ‘marry mummy’ are so common that there are adorable (and of course wholly innocent) YouTube videos posted about it. This is what Freud was talking about, that intense love that children feel that means they want to have that parent all to themselves, exclusive of the other parent. Matrimony is what little children understand love and ‘exclusive possession’ to mean. No sex but deeply intense feelings that are as close as sex gets for little children. That said, the child comes to understand, or so the theory goes, that these feelings are unacceptable or dangerous and that they should be abandoned. They are pushed away into the far recesses of the mind not to be thought of again. Having forgotten about the intensity of their childhood feelings and overlaying their adult knowledge people hear the word ‘sex’ in the context of their parents and freak out: ‘I don’t want it be true. It can’t be true. It’s nonsense!’ The powerful social and biological incest taboo (Freud talks about that too) means that we won’t even allow ourselves to think about those infantile feelings, employing all sorts of defences to deny, suppress or repress them. Inevitably though, what cannot be thought about will find its expression in some other way.

That’s why I chuckled to myself when I read an article from the popular science blog ‘IFLScience’ which listed statistics from PornHub, the world’s most popular porn website, on the UK’s most popular porn searches (5). Three of the top five searches by men were for mother figures: ‘step-mom’ (sic) was top, followed by ‘milf’ (mother I'd like [to] f**k) and ‘mom’ at positions three and four, respectively.  ‘Step mom and son’ also made an appearance at number nine. Freud was not right about everything and there were a few important things that he abandoned due to social pressure. But it looks like he was on to something with this one.

 

1. NHS Choices – Medically Unexplained Symptoms. http://www.nhs.uk/conditions/medically-unexplained-symptoms/Pages/Somatisation.aspx

2. British Medical Association. Media Brief. http://www.bma.org.uk/-/media/files/pdfs/news%20views%20analysis/press%20briefings/pressbriefinggeneralpracticeintheuk_july2014_v2.pdf

3. The Neural Basis of the Dynamic Unconscious. http://www.nyu.edu/gsas/dept/philo/faculty/block/papers/BerlinTreatment.pdf

4. How Free Will Collides With Unconscious Processes. http://www.scientificamerican.com/article/how-free-will-collides-with-unconscious-impulses/

5. IFLScience – Here Are The Most Common Porn Searches In The UK http://www.iflscience.com/health-and-medicine/here-are-pornhub-search-habits-british-public

6. Metro (online) - Lesbian, British and step mum among top PornHub search terms this year. http://metro.co.uk/2015/11/18/lesbian-british-and-step-mum-among-top-pornhub-search-terms-this-year-5509619/

Think. Hard

Originally posted 31st March 2015

I retweeted a quote this morning by Carl Jung. A contemporary of Freud, he was full of interesting and inspirational nuggets like:

“Who looks outside, dreams; who looks inside, awakes.”

But this morning it was:

“Thinking is difficult, that’s why most people judge.”

People who believe themselves to have a ‘thinking problem’ will often say that their problem is that they ‘think too much’ or that they ‘over-analyse’. Usually that is not the case at all, and it’s much more likely that they are conflating ‘thinking’ with ruminating, procrastinating, worry or obsessive thoughts. They confuse having a mind that is preoccupied with one thought with thinking.

Real thinking is difficult: it often means being able to hold in mind conflicting thoughts and beliefs; taking in to consideration other’s points of view; challenging one’s own assumptions; accepting our own envy; taking responsibility for past errors, and facing the possibility that you might have been wrong. Real thinking is a vulnerable process, which is why most people avoid it most of the time. We’ve all said ‘I don’t want to think about it’ when what we mean is something like ‘I don’t want to face the possibility and consequences of my mistakes’. When we’re unwilling to face this discomfort it is easier to condemn the other. If you make the other person wrong you win by default. But, of course, in reality it’s not that simple. If you ever find yourself making very quick and harsh judgements it might be worth asking yourself what it is you don’t want to think about.