Month: December 2011

The Placebo Effect and the Self Management System

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Nicholas Humphrey, a theoretical psychologist and author of A History of the Mind, has a fascinating post on the placebo effect and the relation between the health management system and what he dubs the self-management system. The basic premise is this: we know the placebo effect has a way of making people feel better in the medicinal sense. But what if we could prime people to change their behavior, attitudes, and personality?

It’s been a tremendous surprise for experimental psychology and social psychology, because until now it’s been widely assumed that people’s characters are in fact pretty much fixed. People don’t blow with the wind, they don’t become a different kind of person depending on local and apparently irrelevant cues . . . But after all, it seems they do.

So if we don’t discount the placebo effect in medicine, how does it fit in with the rest of the argument?

Placebos work because they suggest to people that the picture is rosier than it really is. Just like the artificial summer light cycle for the hamster, placebos give people fake information that it’s safe to cure them. Whereupon they do just that.

This suggests we should see the placebo effect as part of a much larger picture of homeostasis and bodily self-control. But now I’m ready to expand on this much further still. If this is the way humans and animals manage their physical health, there must surely be a similar story to be told about mental health. And if mental health, then—at least with humans—it should apply to personality and character as well. So I’ve come round to the idea that humans have in fact evolved a full-blown self management system, with the job of managing all their psychological resources put together, so as to optimise the persona they present to the world.

You may ask: why should the self need any such “economic managing”? Are there really aspects of the self that should be kept in reserve? Do psychological traits have costs as well as benefits? But I’d say it’s easy to see how it is so. Emotions such as anxiety, anger, joy will be counterproductive if they are not appropriately graded. Personality traits—assertiveness, neuroticism, and friendliness—have both down- and up-sides. Sexual attractiveness carries obvious risks. Pride comes before a fall. Even high intelligence can be a disadvantage (we can be “too clever by half”, as they say). What’s more—and this may be the area where economic management is most relevant of all— as people go through life they build up social psychological capital of various kinds that they need to husband carefully. Reputation is precious, love should not be wasted indiscriminately, secrets have to be guarded, favors must be returned.

So, I think humans must have come under strong selection pressure in the course of evolution to get these calculations right. Our ancestors needed to develop a system for managing the face they present to the world: how they came across to other people, when to flirt, when to hold back, when to be generous, when to be mean, when to fall in love, when to reject, when to reciprocate, when to punish, when to take the lead, when to retire, and so on. . . All these aspects had to be very carefully balanced if they were going to maximize their chances of success in the social world. 

Fortunately our ancestors already had a template for doing these calculations, namely the pre-existing health system. In fact I believe the self management system evolved on the back of the health system. But this new system goes much further than the older one: it’s job is to read the local signs and signs and forecast the psychological weather we are heading into, enabling us to prejudge what we can get away with, what’s politic, what’s expected of us. Not surprisingly, it’s turned out to be a very complex system. That’s why psychologists working on priming are discovering so many cues, which are relevant to it. For there are of course so many things that are relevant to managing our personal lives and coming across in the most effective and self-promoting ways we can.

You should read the entire piece here.

The Largest Wealth Gap in America

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From this Bloomberg piece, the surprising (?) answer to the place where the wealth gap is the highest in the United States:

Nowhere is the contrast between rich and poor clearer than in the metropolitan region abutting New York, stretching from Greenwich on the west to Bridgeport on the east. This 625- square-mile swath, where subsidized housing complexes sit blocks from multimillion-dollar mansions, is home to the widest income gap of any metro area in the U.S., according to Census Bureau data compiled by Bloomberg. If this region were a country, it would be the 14th-most unequal spot on the planet, ranking just below Brazil, based on figures in the CIA World Factbook.

The region is described as the microcosm of the United States:

Connecticut’s per capita income is the highest of any state in the nation at $36,775, according to the census. In the Bridgeport-Stamford-Norwalk metro area, 53,076 households took home at least $200,000 — and 16,505 earned less than $10,000.

And the startling statistic about Greenwich, perhaps the world capital of hedge funds:

One doesn’t need to leave the town to see disparity. About 2,150 of its 60,000 residents live in poverty, defined as less than $22,113 for a family of four, according to the 2010 American Community Survey. More than 10 percent of public school students are eligible for free or reduced-price lunch, the United Way’s Greenwich chapter says, and there are 1,195 units of subsidized housing.

On a related note: how is income inequality measured? It is via the Gini coefficient, defined per Wikipedia:

The Gini coefficient is a measure of the inequality of a distribution, a value of 0 expressing perfect equality where everyone has equal shares of income and a value of 1 expresses maximal inequality where only one person has all the income. It is commonly used as a measure of inequality of income or wealth. Worldwide, Gini coefficients for income range from approximately 0.23 (Sweden) to 0.70 (Namibia) although not every country has been assessed.

The United States’ Gini coefficient increased from 0.46 in 2000 to 0.469 in 2010. By comparison, the Gini coefficient for Bridgeport, CT was 0.537 in 2010, up from 0.459 in 2000.

On Shuffling and Randomness

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From this fascinating piece in The Wall Street Journal, we learn about the randomness (or lack thereof) when shuffling cards:

The standard way to mix a deck of playing cards—the one used everywhere from casinos to rec rooms—is what is known as a riffle (or “dovetail”) shuffle. You begin by splitting the deck into two roughly equal stacks. Then you flick the cards with your thumbs off the bottoms of the piles in alternating fashion, interleaving the two stacks.

For games like blackjack or poker to be truly fair, the order of the cards must be completely random when the game begins. Otherwise a skilled cheat can exploit the lack of randomness to gain an advantage over other players.

How many riffle shuffles does it take to adequately mix a deck of 52 playing cards?

As it turns out, you have to shuffle seven times before a deck becomes truly scrambled. Not only that, the cards become mixed in a highly unusual way: The amount of randomness in the deck does not increase smoothly. The first few shuffles do little to disturb the original order, and even after six shuffles, you can still pick out distinctly non-random patches.

But right around the seventh shuffle something remarkable happens. Shuffling hits its tipping point, and the cards rapidly decay into chaos.

The seven-shuffles finding applies to messy, imperfect riffle shuffles. The deck might not be divided exactly in half, for instance, or the cards might be riffled together in a haphazard way. Far from undesirable, a little sloppiness is actually the key to a random shuffle.

A perfect (or “faro”) shuffle, meanwhile, wherein the deck is split precisely in half and the two halves are zippered together in perfect alternation, isn’t random at all. In fact, it’s completely predictable. Eight perfect shuffles will return a 52-card deck to its original order, with every card cycling back to its starting position.

And this doesn’t just work for 52 cards. A deck of any size will eventually return to its starting order after a finite sequence of faro shuffles, although the number of faros required isn’t always eight—and doesn’t increase linearly. If you have 104 cards, for instance, it takes 51 faros to restore the deck. For a thousand cards, it takes 36.

These findings are among the many fascinating results explored in Magical Mathematics, a dazzling tour of math-based magic tricks. The authors, Persi Diaconis and Ron Graham, are distinguished mathematicians with high-powered academic pedigrees. Both are also accomplished magicians who have taught courses on mathematical magic at Harvard and Stanford.

I’ve put the book on my to-read list.

Tim Tebow’s Miracle

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Tim Tebow won another game last night. That’s six out of seven games in which the Denver Broncos, under his helm, have proved victorious. Is it a miracle of some sort? Frank Bruni’s op-ed column in The New York Times provides good commentary about the rise of Tebow’s “Gospel of Optimism”:

In sports as in politics, business and so much else, we like to think that we’ve broken down the components of achievement and that, looking at those components, we can predict who (and what) will prevail. But if any football analyst at the start of this season had said that a quarterback averaging under 140 yards of passing a game — that’s Tebow’s sorry statistic — would have a 6-1 record as a starter and be considered the linchpin of his team, few people would have bought it.

BUT Tebow tends to have his worst 45 minutes of play when it matters least and his best 15 when it matters most. And while he makes many mistakes, their cost is seldom exorbitant. These aren’t so much skills as tendencies — inclinations — that prove to be every bit as consequential as the stuff of rankings and record books. He reminds us that strength comes in many forms and some people have what can be described only as a gift for winning, which isn’t synonymous with any spreadsheet inventory of what it supposedly takes to win.

Maybe the best part is that The Times links to a Tumblr blog about Tebowing:

Which brings us back to religion. With Tebow there’s no getting away from it. He uses the microphones thrust in front of him to mention his personal savior, Jesus Christ, and has said that heaven is reserved for devout Christians. He genuflects so publicly and frequently that to drop to one knee in the precise way he does has been given its own word, along with its own Web site, where you can see photographs of people Tebowing inside St. Peter’s, in front of the Taj Mahal, on sand, on ice and even underwater.

And here is what Chuck Klosterman wrote last week, after the Broncos defeated the Vikings 35-32:

The crux here, the issue driving this whole “Tebow Thing,” is the matter of faith. It’s the ongoing choice between embracing a warm feeling that makes no sense or a cold pragmatism that’s probably true. And with Tebow, that illogical warm feeling keeps working out. It pays off. The upside to secular thinking is that — in theory — your skepticism will prove correct. Your rightness might be emotionally unsatisfying, but it confirms a stable understanding of the universe. Sports fans who love statistics fall into this camp. People who reject cognitive dissonance build this camp and find the firewood. But Tebow wrecks all that, because he makes blind faith a viable option. His faith in God, his followers’ faith in him — it all defies modernity. This is why people care so much. He is making people wonder if they should try to believe things they don’t actually believe.

What do you think? Are the Broncos headed for the playoffs this season?

How Doctors Choose to Die

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Ken Murray, a Clinical Assistant Professor of Family Medicine at USC, writes a powerful essay about how he wishes to die, as a doctor. I am not sure if his essay can speak for all doctors, but his is a strong and resonant message:

How has it come to this—that doctors administer so much care that they wouldn’t want for themselves? The simple, or not-so-simple, answer is this: patients, doctors, and the system.

To see how patients play a role, imagine a scenario in which someone has lost consciousness and been admitted to an emergency room. As is so often the case, no one has made a plan for this situation, and shocked and scared family members find themselves caught up in a maze of choices. They’re overwhelmed. When doctors ask if they want “everything” done, they answer yes. Then the nightmare begins. Sometimes, a family really means “do everything,” but often they just mean “do everything that’s reasonable.” The problem is that they may not know what’s reasonable, nor, in their confusion and sorrow, will they ask about it or hear what a physician may be telling them. For their part, doctors told to do “everything” will do it, whether it is reasonable or not.

The above scenario is a common one. Feeding into the problem are unrealistic expectations of what doctors can accomplish. Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles (for those who want specifics, he had a “tension pneumothorax”), walked out of the hospital. If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming. Poor knowledge and misguided expectations lead to a lot of bad decisions.

But of course it’s not just patients making these things happen. Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Imagine, once again, the emergency room with those grieving, possibly hysterical, family members. They do not know the doctor. Establishing trust and confidence under such circumstances is a very delicate thing. People are prepared to think the doctor is acting out of base motives, trying to save time, or money, or effort, especially if the doctor is advising against further treatment.

Some doctors are stronger communicators than others, and some doctors are more adamant, but the pressures they all face are similar. When I faced circumstances involving end-of-life choices, I adopted the approach of laying out only the options that I thought were reasonable (as I would in any situation) as early in the process as possible. When patients or families brought up unreasonable choices, I would discuss the issue in layman’s terms that portrayed the downsides clearly. If patients or families still insisted on treatments I considered pointless or harmful, I would offer to transfer their care to another doctor or hospital.

…

But doctors still don’t over-treat themselves. They see the consequences of this constantly. Almost anyone can find a way to die in peace at home, and pain can be managed better than ever. Hospice care, which focuses on providing terminally ill patients with comfort and dignity rather than on futile cures, provides most people with much better final days. Amazingly, studies have found that people placed in hospice care often live longer than people with the same disease who are seeking active cures. I was struck to hear on the radio recently that the famous reporter Tom Wicker had “died peacefully at home, surrounded by his family.” Such stories are, thankfully, increasingly common.

Several years ago, my older cousin Torch (born at home by the light of a flashlight—or torch) had a seizure that turned out to be the result of lung cancer that had gone to his brain. I arranged for him to see various specialists, and we learned that with aggressive treatment of his condition, including three to five hospital visits a week for chemotherapy, he would live perhaps four months. Ultimately, Torch decided against any treatment and simply took pills for brain swelling. He moved in with me.

We spent the next eight months doing a bunch of things that he enjoyed, having fun together like we hadn’t had in decades. We went to Disneyland, his first time. We’d hang out at home. Torch was a sports nut, and he was very happy to watch sports and eat my cooking. He even gained a bit of weight, eating his favorite foods rather than hospital foods. He had no serious pain, and he remained high-spirited. One day, he didn’t wake up. He spent the next three days in a coma-like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20.

Torch was no doctor, but he knew he wanted a life of quality, not just quantity. Don’t most of us? If there is a state of the art of end-of-life care, it is this: death with dignity. As for me, my physician has my choices. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like my mentor Charlie. Like my cousin Torch. Like my fellow doctors.

The full essay is here.

Analysis of the New, New Twitter

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I think the best analysis of the New Twitter (on Twitter: #NewNewTwitter) that was unveiled yesterday comes courtesy of Dan Frommer:

  1. Most important: Twitter is shipping. There’s been a bit of negative press about the company over the past several months. And yes, some of its early and/or important employees aren’t there anymore. But Twitter is a large company now. And to release something this big, this good, this smoothly, it actually seems to be working. (And in my observation, Twitter CEO Dick Costolo and Executive Chairman Jack Dorsey actually seem to play off each other pretty well. At least in public!)
  2. This is the beginning of Jack Dorsey’s real vision for Twitter combined with Dick Costolo’s vision for a real-time social advertising product. The main components: writing and Tweets, obviously; having conversations with other people; discovering what’s happening in the world through Twitter; and seeing a promoted message from brands here and there.
  3. Twitter is trying to de-emphasize private messaging by moving it a layer deeper in the user interface. I’m guessing there are a bunch of reasons for this, not limited to: Simplicity, perhaps relatively low usage by most users, potentially confusing rules around DMing, and that more public content is probably better for Twitter’s product and advertising goals. Some long-time and hardcore Twitter users are probably going to be upset about this, but one of Twitter’s strengths has always been its willingness to design for its mainstream users at the expense of its geek users. (Tip: To get fast access to your DMs on Twitter for iPhone, you can swipe up the “Me” icon at the bottom.)
  4. Twitter is emphasizing real-name identity more than it did before. It’s now saying “retweeted by Dan Frommer” instead of “retweeted by @fromedome”. While I’ve always appreciated the playfulness of Twitter handles, this is probably more useful for Twitter going forward. It adds a sense of civility. It starts to make Twitter an alternative to Facebook for real-name identity management. (Something the market wants.) And as Twitter grows, and as having a unique handle without numbers becomes trickier, it looks cleaner.

I actually frown upon the emphasis of real names on Twitter, as I know people I follow by their Twitter handles  (and perhaps so do you). By proceeding with this emphasis of real names, Twitter is becoming more like Facebook and Google Plus, which is unfortunate.

Read the rest of Dan’s post here.

Batman and Iron Man in Academic Literature

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E. Paul Zehr, a professor of kinesiology and neuroscience at the University of Victoria (Canada), writes how he was able to make scientific concepts accessible through the incorporation of popular characters from the films Batman and Iron Man:

Hugely popular movies like Iron Man, Captain America, The Dark Knight, and its forthcoming sequel, The Dark Knight Rises, illustrate the public interest in participating in the transient experience of being a superhero—at least for the duration of the movie. For scientists, those movies offer a way to communicate with the public about our work. The result for me has been two books: Becoming Batman: The Possibility of a Superhero and Inventing Iron Man: The Possibility of a Human Machine.

I settled on Batman and Iron Man because both icons are pitched as real humans who used training (Batman) or technology (Iron Man) to achieve extreme outcomes that seem believable. That part of their mythologies is what makes them attractive and grounded in a reality of hard work, invention, and achievement. In my books I have turned that mythology around and essentially asked: Is it really scientifically possible? And if so, how would it work, and what would it mean?

I settled on Batman and Iron Man because both icons are pitched as real humans who used training (Batman) or technology (Iron Man) to achieve extreme outcomes that seem believable. That part of their mythologies is what makes them attractive and grounded in a reality of hard work, invention, and achievement. In my books I have turned that mythology around and essentially asked: Is it really scientifically possible? And if so, how would it work, and what would it mean?

In both books, I explain neuroscience concepts to the general public, using the physical and technological marvels of the fictional characters to expose the real-life workings of the human body. Those concepts include: the hierarchical organization of the nervous system; supraspinal and spinal reflex control of movement; neural adaptations to skill training and motor learning; the neuropsychology of martial-arts training and combat; pathophysiology of concussion; neural plasticity associated with injury and training; cortical somatosensory and motor maps and phantom limbs; and the concept of neuroprosthetics including brain-machine interface.

My goal in writing this essay is merely to encourage other like-minded academics to understand the value of engaging the public in an accessible way, and to think about integrating pop-culture touchstones into their own outreach and teaching practices.

A natural extension: how (else) could teachers and professors around the country use popular culture to make what they teach more accessible?

Predicting the Future of Computing

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The New York Times has a fascinating interactive post on where you, the reader, can submit snippets on what you expect to happen in the field of computer in the near (and distant) future.

Here are some predictions I see, as of current viewing (readers can vote the prediction up or down in terms of when they think the event will happen):

2015: The price and availability of computers will be such that more than half of the world’s people will have one.

2017: Mobile web browsing on phones surpasses desktop browsing.

2019: Irrefutable evidence will show that computers consistently make more accurate diagnoses than specialists in all branches of medicine, including psychiatry.

2023:  The most common forms of cancer will be treated with a personalized therapy based on genetic sequencing. A patient’s therapy will be retargeted every six months as a result of resequencing the cancer to track its inevitable evolution.

2029: Your entire medical history from birth till death will be collectively combined in one universal system and available to all your different doctors.

2035: Most people will own and use a Personal Life Recorder which will store full video and audio of their daily lives. This will be a fully searchable archive that will radically augment a person’s effective memory.

2041: Cash will become illegal, replaced with electric currency. [Bizarre prediction!]

2071: Humans will be able to implant their dogs’ brains with a neurological device such that the images of what the dog is thinking appear on a special contact lens the dog owner is wearing.

2106: Medical advances will permit the first human to live for a period of 200 years or more.

2154: Humans will become so integrated with electronics that more people will die from computer viruses in a year than from biological viruses.

2180: Old knowledge will not have to be learned; only new knowledge will need to be created. Learning will become obsolete. All known knowledge will be contained on a super computer. Individuals can download all known knowledge pertaining to any subject directly to the brain as desired.

2225: Artificial Intelligence is awarded full citizenship.

2283: Abundance happens. Digital and physical sciences produce abundance so great that wealth becomes meaningless as a difference between people.

2416: Thought-based communication surpasses spoken and typed communication.

What do you think is the coolest prediction from above? Which one is unlikely to happen in the next 400 years?

If you have a New York Times account, you can submit your own predictions. You can vote up/down predictions without an account. It’s a fascinating experiment!

Airline Safety Pamphlets as Art

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Avi Steinberg’s post “The Unlikely Event” at The Paris Review is fantastic. He analyzes the relationship between airline safety cards and art:

The best airline-safety-card artists know how to amplify these details without creating too much noise. They are, after all, artists. They work within and bend the conventions of their form by playing with allusions to earlier work. Take, for example, a current US Airways safety card that portrays the conventional water flotation scene. We see a beautiful woman, with lush red hair, floating effortlessly, gazing ahead in an attitude of easeful melancholy. The airline artist has recruited Dante Rossetti’s 1877 Mary Magdalene, with perhaps an ironic nod to Botticelli’s Venus, as the heroine of our worst-case scenario. Thus the “fallen woman” motif is reimagined in the most urgent terms: this airline Magdalene is a woman who has quite literally fallen. And this is where we find her, floating in limbo, clutching a lily-white life preserver to her breast (instead of a vase, as in the 1877 portrait). Like Rossetti’s romantic Pre-Raphaelite Magdalene, this woman’s lowly state serves only to magnify her elemental beauty. Here she is, Our Lady of the Plane Crash. “I will make you fishers of men,” says the Christ. “We will rescue you in any corner of the globe,” says a Pan Am safety card. The fallen woman will not remain cast away forever—and, if we follow her lead, the artist assures us, neither will we. It is a pretty vision of earthly salvation.

My favorite part is this bit about the AeroMexico safety card that resembles René Magritte’s The Son of Man:

The artist behind a current AeroMexico safety card is not convinced. In an echo of The Son of Man, the 1964 painting by Belgian Surrealist René Magritte, the AeroMexico man is rendered in realistic detail—from rolled up sleeves to tousled hair—all of which is, however, a set up for the darkly comic punch line: the man has no face. This bit of surrealistic surgery, more than the yellow life preserver, is what we remember. It is plain to us that this creepily inanimate son of man is, in struggling to preserve his life, in some sense already dead.

Click through to see the whole post and the accompanying images.

The Unintended Consequences of Driverless Cars

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This is some interesting food for thoughts about driverless cars, currently being developed and tested by Google:

Google has been working on driverless cars for a few years now. The obvious selling point is that the cars will be much safer without a human behind the wheel.

Currently, a car spends 96% of its time idle. Compare that with planes which spend almost their entire lifetime in operation/airborne. Idle planes aren’t making money, and they need to recoup their hefty $120M price tag. There is an unforgiving economic incentive to make sure it is always in use.

The proliferation of driverless cars will have a similar effect. Cars will spend less time idle: why would a household buy 2 (or even 3) cars, when they only need 1? Ride to work, then send the car home to your spouse. Need to go grocery shopping, but your kid also needs a ride to a soccer game? No problem, a driverless car can handle that.

What will begin as households cutting back to a single car, will expand. Why would a family need an entire car to themselves? That’s crazy! It may start as extended family in the same area sharing cars, then neighbors sharing cars, and then entire apartment/condo complexes in cities offering driverless cars bundled into their HOA/rent.[2]

The operating percent of a car will go from 4% to that 96%. But back to my leading statement: there are unintended consequences. Parked cars will be a relic from the past. What happens to car insurance prices if a driver is no longer part of the equation? And if cars are receiving 20 times more actual use, that would imply that there would be 20 times less cars sold.[1] This is the kind of disruptive change that can reshape the automotive industry. The recent GM/Chrysler bailout may have been for naught.[3]

[1] Of course, this isn’t exactly the case, as the cars would need to be replaced more often due to nonstop usage, but the point stands.
[2] Hell, I’d share a car with my condo complex. I currently don’t own a car, I walk or take taxis basically everywhere.
[3] Of course, car companies realize this. And I can guarantee you, they will lobby against driverless cars.

The brief post is written by . For some reason, I hadn’t even considered that driverless cars would operate without someone in them, but as Dutta explains, it would make sense for families to own fewer cars.