Are we living at the end of an empire?

A thought experiment.

There is a nuclear war in morning. The capitals and major cities are all gone. You happened to have been visiting your aunt in Castle’elsewhere, a cute provincial town, and remained alive and well.

In the wake of the war, you realise that life will never be the same. There is an army barracks that remained unharmed down the road from your aunt’s house. The commanding officer is used to taking orders and is awaiting them. They aren’t coming. Your cousin just returned from the neighbouring Castle’nowhere and said that people have started looting the local shopping centre. Someone has to take charge and you’re not in the habit of relying on others. You win the trust of the commanding officer and now have an army at your disposal – although not much else.

What is the first thing that you do?

thought experiment philosophy

I would find food for the army. My particular Castle’elswhere happens to be in Ireland. We have milk and beef galore, and even some barley and rapeseed oil. Some artisanal cheese. Guinness and Jameson. But the ports are all in tatters and it will be a while until we will manage to import food. Scurvy is a real threat: there is no vitamin C on this island.

I am now Commanderina-in-Chief Martina and I have an army of malnourished men whose teeth will soon start falling out and their clothes are wearing thin. A man who used to grow a few carrots for himself arrives at my doorstep and explains that he can provide a steady supply of carrots, rich in Vitamin C. Let’s call him Captain Orange. Captain Orange is the only man in the country who had the foresight/luck/interest in growing carrots – and the ports are still closed, so he has no competitors. Captain Orange soon becomes a very rich and powerful man as he has something I need to retain my power. I make a deal with him that we should only supply a certain amount of carrots, enough to keep the army healthy and as for the general population we need to supply just over the scurvy-threshold because if we supply more that, it will weaken our power and if we supply less, there will be riots. Power, eh.

how does power work thought experiment

Back to the real world.

This got me thinking of the Googles and Facebooks – the multinationals in Ireland. The lads here aren’t the programmers/engineers that would be able to solve ubercomplex problems (I imagine they are mostly in California). They are human resources, corporate social responsibility, account managers, etc. In the event of such a near apocalyptic event, of what use are the official skills of the majority of these people?

During my short stint in a multinational, I used to always wonder how come there are so many people literally busy doing nothing, or something I simply didn’t understand. Making slides about making slides and trackers about other trackers.

The multinational is Captain Orange. They come to the government and tell them that they have what the government so needs to keep the population just over the (first world) poverty line: jobs. Not just in Ireland, but in lots of places. By moving to Ireland and paying let’s say 10,000 people wages to do nothing  corporate back/middle office jobs, they still save money on tax. By coming to other countries they will gain something else: the points isn’t that Ireland is a tax haven. The point is about solving problems. As Arthur Schopenhauer used to say, talent hits a target no one else can hit and genius hits a target no one else can see. Yes, we all know their product is phenomenal. But the real problem they solve, and the reason they have so much clout, isn’t what it seems. Genius, not just talented. The more enduring the problem and the more efficacious the solution, the more leverage you get.

The next thing I wondered about were our first world problems. Are we living in an age that’s analogous to the end of the Roman empire?

  • Tremendous centralisation and its cousin globalisation.
  • Society is tearing itself apart: different camps of Westerners seem to have more in common with other “tribes” than with each other (just think Clinton supporters vs Trump supporters). Diversity of thought is good, but this is diversity of non-thought. Most of these people aren’t pro x, y, z, they are anti a, b, c.
  • Research is mass produced for the sake of being published and isn’t really coming up with anything hugely new or even worthwhile.
  • The buildings of today look worse than the buildings of 100 years ago, even accounting for survivorship bias. Same with music. Same with art.
  • Lack of innovation. True monopolies: the two main credit card companies, call them V and M, are basically the same entity in their business practices, they interchange staff and outsource to each other in different countries. And they are also indispensable as far as the state is concerned. They aren’t the only example, of course. We neither incentivise innovation, nor do we have as burning a need for it. And then we wonder where the inequality comes from.
  • Changes in sexual behaviour: described pretty well by Gary Wilson

I am by no means saying that things are worse today than they were 100 years ago. But it is a different environment: where do we go from here?


On a recent walk, I took these two pictures from the same place:

decline of the western civilisation

The above pier was built in 1821. Look dreamy.

western civilisation coming to an end

The structure closest to us was built in the 1980s. Looks dystopian.

When they dig up our stuff in 5,000 years, what will they say?

Emotions as the meaning of life

And so we continue our search for the meaning of life. Robert Solomon’s The Passions offered an interesting take on this question. He proposed the idea that emotions are the meaning of life: as in they add the meaning in a life; emotions add meaning to our experience the world.

When I first came across this idea, I thought it was strange, but really it does make sense. Emotions have a strong effect of perception. Perception heavily influences our understanding of reality and thus has an impact on the meaning we attribute to things, life itself being one of those things.

Emotions are probably the strongest mental phenomena, built of thoughts and feelings – and very importantly, ultimately resulting in action, as the name suggests. Emotions are the driver of behaviour. My entrepreneurial soul was quite impressed when I heard that every sale is a promise of a future state. Emotions rule us, so we may try to be a little bit more aware – and perhaps less disrespectful to them.

Solomon argues that emotions are judgements rather than plain feelings arising from bodily reactions. Emotions tells us whether something matters – or is meaningful. Solomon also argues that emotions are in a sense chosen, sort of along the lines of stoic philosophy. As with beliefs, emotional judgements are often unintentional and unconscious, but we are still responsible for evaluating and changing them if that’s warranted.


According to Matthew Ratcliffe, Solomon sees emotions as the ‘meaning of life’, in the sense that they are a precondition for the intelligibility of all our goal-directed activities. If no actual or possible states of affairs were ever judged by us to be preferable to any other, we would have no grounds for action. Without emotions, we could have no projects, nothing to strive for, no sense of anything as worth doing:

“I suggest that emotions are the meaning of life. It is because we are moved, because we feel, that life has a meaning. The passionate life, not the dispassionate life of pure reason, is the meaningful life.”

emotions are the meaning of life robert solomon
Everything looks better in the sun

As someone who has spent some time studying emotions, I occasionally hold out hope that one day science succeeds in transcending the prism of bias and emotion and we are able to see the world without the emotional projections. Being that little bit pragmatic though – and seeing people like N. Taleb do it, I realise that we have to give up on overintellectualising and accept our limitations – or rather break up with our illusion that we are so above our lowly emotions.

The interesting thing about Solomon’s writing is that he emphasises the existential aspect of emotions: this our experience of being present.

The other interesting aspect is how neuroplasticity affects our perception: any time we experience an emotion a certain pathway gets potentiated and the next time we perceive similar inputs, the fact that we experienced an emotion relating to it previously will have changed the way we see the world. There is positive feedback here.

Neuroplasticity affects everything, but a lot of it is mediated through emotion. My personal working theory is that the meaning of life is the impact that you have (appreciating that that’s very vague, but the point here is that it’s different to the en vogue “the meaning of life is happiness”). But how do I decide what is full of impact? I need to feel that it has meaning. The exact values I consider to be full of impact may in theory be independent of emotion, but in reality they are completely affected by emotion. That warm feeling of satisfaction and accomplishment has to flow through me to know that what I am doing is meaningful. I usually only arrive there through what would look to an outside person as a silent CBT session with myself, so it isn’t entirely detached from intellectualising, but it has to feel right in order for me to know that it is right.

What if I do find something meaningful? It is going to invoke strong emotions. The common denominator of meaning does seem to be emotion.

Solomon drew a lot of Martin Heidegger’s concepts of mood. Mood is probably a more more precise word for what Solomon was talking about. The weather (emotion) matters less than the climate (mood) when we decide on the meaning of things around us. Our moods probably invoke the exact brands of biases and focuses of those biases that will allow us then to form our ideas on the meaning of what we see. Heidegger has an interesting definition for mood: it is a background sense of belonging to a meaningful world. That’s kind of like saying that I, as an object, have a relationship with all these other objects and I am trying to evaluate the condition of that relationship. “Sun’s out, so everything is good” or “Nobody is replying to my emails, so I feel like sh*t”. This certainly describes my mood a lot of the time, but then I slap myself and go back to a more Stoic/Nietzschean attitude to evaluating my own actions rather than the world’s response to me.

Reality is real no matter how we perceive it, but meaning is pretty personal.

P. S. I wrote a Haiku while sitting on a beach in Dublin:

An old dog,
once black, now wiser,
at sunset.

Here is the culprit:

robert solomon the passions emotions as meaning of life

P. P. S. I also drew something mighty odd. Feel free to indulge in the madness mindfulness and colour it in.


Download PDF: psychedelic seagull with snail beak

Ok, very last thing. If you liked this, you may also like Footnotes to Plato, specifically a post on the why one would develop a philosophy in life.

Randomness as seen by Nassim Taleb

“Probability is not about the odds, but about the belief in the existence of an alternative outcome, cause, or motive”

Disappointed by Ayn Rand’s overfitting of consequences onto causes, I moved on to the book I’ve been meaning to read for a long time: Fooled by Randomness by N.N. Taleb.

What is Fooled by Randomness about?

Taleb is pretty clear on that:

“This book is about luck disguised and perceived as non-luck (that is, skills) and, more generally, randomness disguised and perceived as non-randomness (that is, determinism)”

This has to be one of my favourite paragraphs in modern non-fiction:

“It [determinism] manifests itself in the shape of the lucky fool, defined as a person who benefited from a disproportionate share of luck but attributes his success to some other, generally very precise, reason.”

Rand would argue that that’s intellect and taking responsibility. Instagram tells you it’s positive thinking. Richard Branson would tell you that it’s looking after your people and taking risk – though I’ve never had the “pleasure” of properly familiarising myself with his wisdom. Ryan Holiday would argue that it is one’s ego that gets in the way.

Life is more random than we care to admit

“... Just as one day some primitive tribesman scratched his nose, saw rain falling, and developed an elaborate method of scratching his nose to bring on the much-needed rain, we link economic prosperity to some rate cut by the Federal Reserve Board, or the success of a company with the appointment of the new president “at the helm”. Bookstores are full of biographies of successful men and women presenting their specific explanation on how they made it big in life (we have an expression, “the right time and the right place” to weaken whatever conclusion can be inferred from them).”

“Symbolism is the child of our inability and unwillingness to accept randomness; we give meaning to all manner of shapes; we detect human figures in inkblots.”

I find this very funny as I am the author of “Cliff notes” on Ireland’s secondary school poetry course. I enjoy looking for patterns where there are possibly none. My job as a doctor is right about the same: fit symptom A with symptom B and develop a list of differentials. While endless creativity is helpful with the Cliff notes, the situation with diagnoses is quite different. Taleb would argue that the conclusions I come to are more of a reflection on me than the material I am reflecting on.

“European intellectual life developed what seems to be an irreversible taste for symbolism – we are still paying its price, with psychoanalysis and other fads.”

Taleb table of confusion fooled by randomness

If there is one cause for this confusion between the left and the right sides of our table, it is our inability to think critically – we may enjoy presenting conjectures as truth.

“We are flawed beyond repair – at least for this environment.”

But it is only bad news for those utopians who believe in an idealised human kind.

He describes utopians (Rousseau, Godwin, Payne) as people who believe that knowing what is good for us will lead to that choice. So for example, telling people that obesity leads to health risks would lead people to lose weight according to this group.

On the other hand, he regards the likes of Popper, Hayek, Friedman, Adam Smith, Tversky and Kahneman, Soros, etc as people who see the world as it is and subscribe to scientific fallibilism.

Taleb advocates going around emotion rather than rationalising them:

“Ridding ourselves of our humanity is not in the works; we need tricks, not some grandiose moralizing help”

Taleb on happiness

Taleb calls upon Plutarch’s Lives:

“The observation of the numerous misfortunes that attend all conditions forbids us to grow insolent upon our present enjoyments, or to admire a man’s happiness that may yet, in course of time, suffer change. For the uncertain future has yet to come, with all variety of future; and him only to whom the divinity yet to come, with all variety of future; and him only to whom the divinity”

The modern equivalent has been no less eloquently voiced by the baseball coach Yogi Berra, who seems to have translated Solon’s outburst from the pure Attic Greek into no less pure Brooklyn English with “it ain’t over until it’s over”, or, in a less dignified manner, with “it ain’t over until the fat lady sings”.

fooled by randomness taleb key points
Now entering Wicklow

Taleb, not unlike Rand, believes in thinking hard, but reminds us to not take our own conclusions too seriously:

“Trading forces someone to think hard; those who merely work hard generally lose their focus and intellectual energy. In addition, they end up drowning in randomness. Work ethics draws people to focus on noise rather than the signal.”

I was very comforted to read the following on clarity vs correctness from Taleb. He spends this entire book fighting against the temptation to oversimplify and overexplain”

“Beware the confusion between correctness and intelligibility. Part of conventional wisdom favours things that can be explained rather instantly and “in a nutshell” – in many circles it is considered law. Having attended a French elementary school, a lycee primaire, I was trained to rehash the popular adage: Ce qui se congoit bien s’enonce clairement Et les mots pour le dire viennent aisement (What is easy to conceive is clear to express/Words to say it would come effortlessly)… Borrowed wisdom can be vicious. I need to make a huge effort not to be swayed by well-sounding remarks. I remind myself of Einstein’s remark that common sense is nothing but a collection of misconceptions acquired by age 18. Furthermore: what sounds intelligent in a conversation or a meeting, or, particularly in the media, is suspicious.”

He gives many examples of things that were genuinely new and good, but rejected when they originally were presented. This supports the whole “makes sense instantly” notion:

“Any reading of the history of science would show that almost all the smart things that have been proven by science appeared like lunacies at the time they were first discovered.”

Having worked with startups, I’ve always been told that one should be able to explain what your company does in one sentence. I just want to remark that this is for the “benefit” of investors alone.

Not everything is worth trying to explain

“I have a trick to know if something real in the world is taking place… The trick is to look only at the large percentage changes. Unless something moves by more than its usual daily percentage change, the event is deemed to be noise. Percentage moves are the size of the headlines. In addition, the interpretation is not linear; a 2% move is not twice as significant an event as 1%, it is rather like four times. The headline of the Dow moving by 1.3 points on my screen today has less than one millionth of the significance of the serious 7% drop of October 1997… We cannot instinctively understand the nonlinear aspect of probability.”

Confidence intervals are more important than the estimate

This point is related to the importance of variance as well as averages:

“Professionals forget the following reality. It is not the estimate or the forecast that matters so much as the degree of confidence with the opinion. Consider that you are going on a trip one fall morning and need to formulate an idea about the weather conditions prior to packing your luggage. If you expect the temperature to be 60 degrees, plus or minus 10 degrees (say in Arizona), then you would take no snow clothes and no portable electric fan. Now what if you were going to Chicago, where you are told that the weather, while being 60 degrees, will nevertheless vary by about 30 degrees? You would have to pack winter and summer clothes. Here the expectation of the temperature carries little importance concerning the choice of clothing; it is the variance that matters. Your decision to pack is markedly different now that you are told that the variability would be around 30 degrees. Now let us push the point further; what if you were going to a planet where the expectation is also going to be around 60 degrees, but plus or minus 500 degrees? What would you pack?”

taleb tricks to deal with being fooled by randomness
Just one track!

Consistency as path dependence

Taleb argues against the compulsion to keep our opinions the same and expect the same of others. From a logical stand points he is completely right. From a psychological one – we suffer greatly when we have to deviate from consistency and we simply don’t trust people who change their opinions. He gives the example of G. Soros, a man her described as “complicated”. He attributes at least some of Soros’ success to this ability to not be married to his views:

“They are totally free from their past actions. Every day is a clean slate.”

Taleb goes on to explain that we have evolved this for obvious reasons:

“Think about the consequences of being a good trader outside of the market activity, and deciding every morning at 8 a.m. whether to keep the spouse or if it is not better to part with him or her for a better emotional investment elsewhere.”

Stoicism as seen by Nassim Taleb

“It is the attempt by man to get even with probability.”

I think that’s a very curious interpretation! A slightly escapist one, but interesting all the same.

“The only article Lady Fortuna has no control over is your behaviour.”

We probably cannot overcome our biases

The epiphany I had in my career in randomness came when I understood that I was not intelligent enough, nor strong enough, to even try to fight my emotions. Besides, I believe that I need my emotions to formulate my ideas and get the energy to execute them.

The good news is that there are tricks.

Avoid eye contact to avoid an emotional response

Psychopathy central, I know. But sometimes, it’s better to prevent motional contagion, for example, in a road rage situation:

One such trick is to avoid eye contact (through the rear-view mirror) with other persons in such encounters as traffic situations.

Don’t listen to people who aren’t definitely worth listening to

Taleb argues that it is best to not engage in reading comments and reviews from people who don’t have a lot of credibility as their comments are more about them then they are about the work supposedly being reviewed. My personal experience certainly agrees with this. This is one of the most important lessons of the book. It’s also a very good thing to remember when asking advice (or, God forbid, getting unsolicited advice). This point subtly arises from the confidence interval point mentioned above.

Manage your exposure to things that have a strong emotional impact on you

Yet I have experienced leaps of joy over results that I knew were mere noise, and bouts of unhappiness over results that did not carry the slightest degree of statistical significance. I cannot help it, but I am emotional and derive most of my energy from my emotions. So the solution does not reside in taming my heart. Since my heart does not seem to agree with my brain, I need to take serious action to avoid making irrational trading decisions, namely, by denying myself access to my performance report unless it hits a predetermined threshold. 

This certainly resonates with me. As I mentioned, I have an online venture. Whenever a sale happens, I get an email about it. In the early days, I used to get so excited when someone made a purchase – it was great! Then I found that if I opened my emails, but the inbox did not contain any such notifications, I would feel a bit disappointed. Furthermore, if a sale was made, I didn’t feel compelled to work quite as hard! If it wasn’t – I was there thinking outside the box of what I could do better. I quickly learnt to only check that email account once a day.

One of the most irritating conversations I’ve had is with people who lecture me on how I should behave. Most of us know pretty much how we should behave. It is the execution that is the problem, not the absence of knowledge.

And the bit that is lacking from most awareness campaigns.

I am tired of the moralising slow-thinkers who pound me with platitudes like I should floss daily, eat my regular apple and visit the gym outside of the new-year resolution… We need tricks to get us there but before that we need to accept the fact that we are mere animals in need of lower forms of tricks, not lectures.

I am not sure I agree. I am quite allergic to these tricks because quite often just like the lecturing, they do not work. However, unlike the lectures, they are held to a lower standard of evidence.

We are not designed for schedules

Our ancestors didn’t work to deadlines. In the second edition of the book, Taleb goes on about how we are designed for randomness: we are more like firemen meditating between calls. Optimising everything may be a very poor decision that will take away the very things that we are trying to achieve – as far as the big picture is concerned.

We favour the visible, tangible and narrated – and scorn the abstract. Maybe I should turn to writing fiction?

nassim nicholas taleb randomness tips to avoid biases
Just a pink house with a gladiolus. How random…

Happiness research: everything useful we’ve managed to gather so far

“Those who live under the self-imposed pressure to be optimal in their enjoyment of things suffer a measure of distress” – Nassim Nicholas Taleb

Is that because those who put try to optimise for happiness are miserable to begin with – or because optimising is a curse?

Happiness seems to be on everyone’s mind.

Yes, we’re on a quest to be happier and we’re trying to game the system.

No, it may not actually be helpful to overall happiness, who knows.

I decided that I will start this post as my one stop shop for all the quality neuroscience on happiness. I am sure it will be elaborated on, but so far, here is what we all have to know.

Lottery winners aren’t happier right now

Back in 1978, Philip Brickman published a study that has since been replicated many times. Its finding are so significant that if I had my way, it would be on the school curriculum. It’s a deeply unsettling study on many levels, yet it is so fundamental for anyone who has an interest in understand how human beings function.

They had three types of people:

  • those who recently won a lottery
  • those who recently lost the ability to move their legs
  • those who haven’t had any major life events recently

The researchers gathered the happiness ratings for the above groups. The main lesson is that there was no statistically significant difference between the the lottery winners and the control groups in terms of their present happiness.

The accident victims were less presently happy than the controls, but their ideas of their future happiness weren’t significantly different.

Daniel Kahneman described further insights into “What proportion of the day do paraplegics spend in a bad mood?” His answer appears to be that over time, people’s attention is drawn away from the negative change. Exceptions include exposure to loud noise, pain and severe depression.

It seems that the strongest emotions of the winners were also quite short-lived:

“Both contrast and habituation will operate to prevent the winning of a fortune from elevating happiness as much as might be expected. Contrast with the peak experience of winning should lessen the impact of ordinary pleasures, while habituation should eventually reduce the value of new pleasures made possible by winning.”

We spoke about happiness being affected by expectations as well as reality. This research shows that the brain is quite adaptable in terms of expectations.

The scary thing about this research is that it attacks the fundamentals of our culture. When the prince rescues us from the tower or the princess breaks the curse by kissing us (underline as required), after a while, we won’t feel much different than we did before. In general, things may be different, but they probably won’t feel different unless you actively pay attention.

So what’s the point of chasing after achievements if they won’t make you happy? Well, I wouldn’t put it quite like that. They will make you happy every time you think of them: which for most of us isn’t that often. They are meaningful (well, I assume they are meaningful) regardless of how much dopamine they fill you with. So don’t give up just yet.

This brings me to my next point, that happiness is less dependent on reality than it is on constant, internal factors.

Long-term happiness is on a thermostat

There is beautiful symmetry in the brain as it relates to happiness – or at least I ill simplify things to look this way for our purposes today.

The right prefrontal cortex is associated with anxiety, anger and unhappiness.

The left prefrontal cortex, it seems, is active among people who report high levels of happiness.

Measuring the ratio of right to left prefrontal cortex activity is predictive of a person’s happiness level. That’t it. That’s your level of happiness.

So are we doomed? Is this it? Our happiness level is set and that’s it? Thankfully, no. The most effective answer is… drumroll… mindfulness training.

Daniel Goleman has written about Richard Davidson’s research for The New York Times if you want more detail.


Money is somewhat related to happiness still

So does this mean money has no bearing on happiness? Not quite. There was a clear positive relation between income and happiness. Importantly, it is subject to diminishing returns – and earlier than you might think.

According to our good friend Daniel Kahneman, by the time you get up to an annual household income of around $50K, the increases become very small. At $81K, the scores peak (2016 USD). By the way, happiness is cheaper in Alabama and more expensive in New York – just like the cost of living.

Think about – and value – time

There is something relieving about Stoic philosophy. Just like Christianity, it was popular among all social classes. Seneca basically sees death as a relief.

I always thought valuing death is nihilistic, but sometimes I just can’t quite resist the pleasure of acknowledging that death is part of life. Perhaps my happiness doesn’t stem from some strangely happy passive death wish. It seems that focusing on time makes people happier. Here is a HBR interview with the researcher.

Experience nature

Going outside, leaving the urban landscape and spending time in a natural environment makes people happy. Peter Aspinall spent time evading urban Scots here. A more comprehensive meta-analysis of these studies suggests there are strong links between nature and happiness.

I am always so happy when there is research to prove the obvious.

Also, hospital patients who get to look out the window do better.

Apparently, if you can’t escape the urban jungle, viewing natural settings can still help. Nat Geo Wild, here I come.

My personal research shows that ice-cream causes happiness, even if you’re just after spending 40 minutes running in the rain

Body language

Body language signals things to the brain, it’s not just the brain signalling things to the body. One of the slickest experiments was designed in way that the subjects didn’t know they were being investigated to assess happiness.

In 1988, Fritz Strack found that people who held a pen between their teeth, which induces a smile, rated cartoons as funnier than did those who held a pen between their lips, which induced a pout, or frown.

It seems, however, that there were questions raised when someone tried to replicate it recently.

Good relationships

Harvard/MassGen psychiatristRobert Waldinger draws an interesting conclusion to one of the longest studies on happiness, carried out at Harvard: “Good relationships keep us happier and healthier. Period.”

Under this heading, I will very briefly go over the highlights of the neuroscience of good relationships: avoiding negative things is more important than having overwhelmingly positive experiences, no dismissive behaviours and seeking new experiences together.


You’ve heard all about this before.


I won’t bore you.


Imagining being happy

I guess we become what we pretend to be. Nakia Gordon studied what happens to participants who pretend to laugh or pretend to cry.

The results were predictable: thinking about laughing made people happy and thinking about crying made people sad.

Happiness begets happiness

Happy people are more productive, have better memories and better immune function.

Side effects of meditation: be warned!

In the professional medical world, Medscape is probably the most trusted up to date online resource. I am delighted to see that yesterday they published an article that highlights some of the more challenging and distressing aspects of meditation based on a recent scientific paper in PLOS One.

The reason I am so glad is that it means we’re moving to a different approach to meditation, one with more well-warranted rigour in how people talk about this intervention and away from the perception that this is something without side-effects.

Crux of the study:

  • the challenging aspects of Buddhist-derived meditation practices are well described in Buddhist tradition but are less so in Western scientific literature
  • the researchers interviewed nearly 100 meditators and meditation teachers from each of three main traditions: Theravāda, Zen, and Tibetan.dangers of meditation, side effects of mindfulness
  • the researchers developed a taxonomy of 59 experiences organised into seven domains: cognitive, perceptual, affective (emotions and moods), somatic (relating to the body), conative (motivation or will), sense of self, and social.
  • all meditators reported multiple unexpected experiences across the seven domains of experience. 
  • the duration of the effects people described in their interviews varied widely, ranging from a few days to months to more than a decade, the investigators report.
  • some meditators reported their feelings, even the desirable ones, went too far or lasted too long, or they felt violated, exposed, or disoriented. 
  • meditation experiences that felt positive during retreats sometimes persisted and interfered with their ability to function or work when they left the retreat and returned to normal life.
  • the meditator’s practice intensity, psychiatric history, trauma history and the quality of supervision are important factors that influence the meditators experience, but not for everyone.factors that influence quality of meditation
  • the study highlights that the one size fits all approach isn’t ideal: “The good news is that there are many different programs out there and different practices available, and with a little bit of homework and informed shopping, someone could find a really good match for what they are after,” she said. “But I think often people just sign up for whatever is the most convenient or the best marketed, and it’s not always a good match for their constitution or their goals.”

Dissecting the side effects 

Here are the reported side effects with the percentage of people who reported them in brackets:

side effects of meditation cognitive, perceptual, affective, somatic, sense of self, social

It’s fascinating to note that nearly 50% noted a change in worldview. Open mind, new philosophy – fair enough. I would be on the fence about saying that I have a different world view because of meditation. It’s clearer, it’s calmer, it’s more adaptable, but it’s not really changed. Thus, it is possible that people who try to meditate are often looking for a new worldview or are quite suggestible.

Nearly the same number of people reported delusional, irrational and paranormal beliefs! I guess this is all based on Buddhism and there is a strong religious element to it. However, people were clearly made uncomfortable by it. I certainly experienced this: this is why I tread carefully when I go exploring meditation resources. A huge number of them are zealous, either for reasons of unquestioning devotion, or commercial ones. Snake oil requires faith.

Again, over 40% reported hallucinations. Just as a reminder – delusions and hallucinations are the key ingredients of psychosis and good reason to admit someone to a psychiatric ward. Obviously, these must not be quite as persistent as those associated with psychiatric disease, but if I had seen this table before starting mindfulness, I would have thought much more carefully. In this sample, 32% of people had a prior psychiatric history. This doesn’t explain how common all these DSM-sounding symptoms are among them.

Fear, anxiety, panic or paranoia came up for over 80% of people. I think is more a reflection on the sample than on meditation. Why to people meditate? Often they come upon it as a cure for anxiety. Indeed, in my experience, besides actually getting rid of the anxiogenic stimulus, meditation is a great method to deal with it. Depression was very common too at over 50%. Anhedonia and avolition – being unable to experience pleasure and not having any desire to do anything – are hallmarks of depression and were experienced by 18%. Personally, anxiety has always accompanied meditation in some way or another, but not in a bad way. It’s a little bit like saying that exercise cause shortness of breath. However, panic and paranoia are step to far.

Where there are mood changes, there are autonomic function changes and indeed they seem to have been affected too: level of energy, quality of sleep, appetite, etc. It’s unfortunate to note that many of those changes were negative with common reports of fatigue and pain.

As expected, 75% of meditators had their mind bent by Buddhist approaches to the self. We also know from MRI studies, that the anatomical self, seated in default mode network is modified by meditation, so this is expected.

Clarity, meta-cognition and increased cognitive processing – that’s our thinking clearly box ticked.

What does all of this mean?

To meditate or not? Meditate, but proceed with caution, a healthy balance of open-mindedness and scepticism – and preferably with supervision. In the words of Dr Walsh, it’s important to be challenged, but not overwhelmed.

As for me, I often take breaks from meditation. If it’s not happening, I don’t force myself too much. Thirty seconds of mindfulness is better than ten minutes of desperate striving effort and then feeling exposed, lonely and inadequate. To give it a Buddhist twist, we can think of the experience as if it is the weather. You may have decided that you are jogging today, but if it is stormy outside, it’s better to be a bit more adaptable, stay at home and practice your planks. Same here.


Lindahl JR, Fisher NE, Cooper DJ, Rosen RK, Britton WB (2017) The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLoS ONE 12(5): e0176239.

P.S. Have a look at this Christian blogger explaining the emotional conflict she experienced when exploring yoga. It’s not important to be religious to understand that imposing one system of beliefs over another, whatever it may be, can be highly distressing.

negative effects of meditation
Just a picture of Dublin in the sun


The neuroscience of creativity

As my readers will have noticed, I don’t publish as much any more. That’t not to say my commitment to this blog has lessened (I have big plans for it!) Having gone through a period of stress, I realised just how damaging it is to creativity. I blame my reduced creative output on my increased adrenal output. It is well known that the “rest and digest” (parasympathetic), not the “fight or flight” (sympathetic) system is associated with complex cognition and creative problem solving.

Where else would my brain then lead me other than to research the neuroscience of creativity?

neuroscience of creativity

1. Listening to happy music

Gene Rowe et al used a sort of a verbal IQ test and had the subjects listen to either happy music, sad music or read a bunch of neutral facts. The participants’ mood was predictably affected by the music. Indeed, the test performance was correlated with the mood level.

I am not sure whether this will get me to delete the Amy Winehouse tracks off my Spotify account, but as far as my n=1 observations go, there is indeed a relationship between one’s ability to function at a given time and a playlist.

There will some people who will want to discredit this study, but I want to note that there is nothing in this study to say that getting out of a bad mood with happy music will lead to creativity.

Indeed, I would say that listening to happy music when you’re sad can be awful. I would say that something energetic rather than cheerful is in order. I guess I will be working on a playlist in the next while.

Interestingly, a test used to assess the ability to focus yielded the opposite results when it came to music: results were improved with sad music and worsened by happy music. The proposed explanation is that happy music broadens our perception and makes us consider alternative solutions which is so important for creativity.

The interesting lesson here is that being creative means being distractible, not focused.

My encounters with people with bipolar affective disorder and schizophrenia come to mind: there is often no keeping them on topic when they aren’t well. The people who suffer with these are also known for their creativity.

I’ve been taught that distraction is a menace. Studying to be a doctor involves a lot of hours in silence, pouring over books, where the only distractions are laziness and loss of the will to carry on. Menace. The job, incidentally, is nothing but distraction. In a hospital, it is impossible to even walk down a corridor without getting five different requests from patients and staff. And it’s no excuse that you’re in the middle of something. In a world obsessed with focus and productivity, it seems anything that seems to be a distraction is disallowed. Maybe, sometimes it pays to chase our distractions.

what makes your brain more creative

2. Walking

I am surprised by the robustness of the finding, though not the finding itself: walking is associated with boosting happiness and creativity. Marily Oppezzo got participants to carry out a creative task while sitting in a chair, standing, walking inside or outside, or being pushed in a wheelchair. Walking won.

I would imagine that sports would also help with being creative. N. N. Taleb also mentioned that he walks a lot and went so far as to say that he gets x amount of pages per y amount of walking (something like 1000 words per mile?) My two cents are that sometimes I feel compelled to go walking. It’s the endorphins, the fresh air, the change of scenery. In fact, whatever it is, it works.

3. Variety

The more varied the participants’ typical activities, the higher they score on tests of creative thinking. People who are in a routine aren’t usually associated with creativity. It has become en vogue to say that everything is a habit, that the best writers have a strong discipline, that Anthony Trollope got up and wrote for 3 hours every morning… There is a difference between emphasising the importance pushing yourself to create and saying that the pushing itself produces creation.

It’s pretty obvious that creativity is the secret sauce, not the bread and butter of actually creating something.

Finding a new connection between two pieces of information (i.e. being creative) will only occur if the two areas of the brain that hold those two pieces of information are active at the same time. The more variety there is in the activation pattern of one’s brain, the higher the chance of a new connection forming.

making your mind more creative

4. REM Sleep

‹REM sleep is that part of the sleep cycles when we see dreams. It seems to be particularly important for memory formation and creation of associations, the direct input of creativity.

Denise Cai got a bunch of sleep-deprived participants to do IQ-like tests focusing on associations and analogies. The participants did some questions, but the real test started after the break. The break was different for the participants who were split into 3 groups: 1) those who got to sleep and enter REM. sleep, 2) those who got to sleep but not enter REM sleep and 3) those whom didn’t get to sleep. When all the participants returned to answer more test questions, the REM sleep group did significantly better than the other two.

This also explains why sleep deprivation results in a functional but lacklustre existence. When we sleep for 8 hours a night as opposed to 6, we get disproportionately more REM sleep. This is because REM periods get longer as you spend more time asleep. So when we cut down on sleep from 8 to 6 hours, we may only lose 2/8= 25% of our entire sleep, but we lose a much bigger percentage of our REM sleep.

A few remarks on the anatomy of the eureka moment

Mark Beeman’s studies focus on moments of insight when trying to solve complex problems. He used fMRI and EEG to reveal that a particular region in the anterior superior temporal gyrus became active shortly before a person reported having an insight. Interestingly, this region is associated with associating distant verbal relations or finding connections between information that is only loosely related.

Pulling it all together

All of the above studies are using crude proxies to creativity. Figuring out what French, cork and list have in common isn’t really creativity (it’s wine, by the way). On a personal level, I feel many of the above tips are useful. Let me know what has worked for you in the comments!

P.S. WordPress tells me I have over 1,000 followers. Thanks so much guys: I really enjoy the company 🙂

Want to be great at something? You simply need to like it

A lot of the literature in psychology, especially the type read by people not trying to get a Ph.D., is focused on success. How to be successful. What do successful people do. You know. It gets quite tiring after a while, especially because for the most part it is a thinly veiled sales pitch or click bait.

Inspiration or perspiration?

I’ve gone through the non-click bait writing/research on the matter and noticed some interesting patterns.

First, I will define success as being in the top 1% of something: swimming, earning money, cutting out adenoids… whatever floats your boat.

It appears that in the majority of cases, someone’s success in a particular field is mostly related to experience and practice, not to innate ability.

I’ve been very fortunate to have gone to school with some incredibly talented people. As we were growing up, I watched their motivations change: some people would get by on raw talent, after all school was never designed to be difficult, while some, who were mediocre to start, became unbeatable.

This observation of mine is echoed in the literature. Even if one’s first attempts at something are poor, it is bears no relationship to the overall outcome. Obviously, there are some factors at play, but they tend to be obvious: like, to be a jockey or a ballerina you simply have to be light.

However, when the mission is a little more intangible, such as becoming a good writer or being good at maths, the impact of practice greatly outweighs that of talent. This dynamic is also congruent with the idea that a mindset of believing in one’s improvement is fundamental to motivation (as distinct from the belief that one’s ability is fixed which ultimately leads to learned helplessness).

how to get good at anything

Aptitude tests show aptitude, not outcomes

Consider aptitude tests. I would argue that they need to be scrapped as they predict nothing at all. Research doesn’t support the assertion behind aptitude tests, namely that the X-factor is present in a person before they put in the work required in a particular field. I also want to prevent anyone from conflating the ideas of practice outweighing talent vs nurture being more important than nature, but I will come to that later.

I like to observe people. I especially keep a mental chart for anyone who I flag as having a high IQ or a high EQ. All of these people consistently make bad decisions in their respective fields of prowess when they aren’t paying enough attention. My musings are once again congruent with available data: SAT scores explain 9% of the variance in first year college grades.

Interest is far more important than aptitude.

Even if you have the aptitude, you still need to focus on what it is exactly you are doing to actually perform well. For example, I did well in my (what you would call equivalent to) SAT’s and in first year of college. But not in fourth year: I was only around 75% centile. Why? I lost interest, didn’t like it, stopped paying as much attention and didn’t put in as much time into the specific subject.

do aptitude tests matter when choosing career

What is the relationship between accomplishment and practice?

Can you max out your practice? Sort of: you can reach 100% in a test, but in reality practice always leads to improvement. There is of course, such a thing as inappropriate practice: overtraining, staying up at night to study instead of sleeping, but you get the point.

Anders Ericsson did some great research in this area. He confirmed a few interesting things:

  • Improvement is subject to diminishing returns. In other words, one makes more progress in the first 1,000 hours practicing something than they do in their most recent 1,000 hours.
  • Interestingly, he found that these diminishing returns often create the illusion of a plateau, however, progress continues as evidenced by a ton of studies.

is it important to like your career

What is deliberate practice?

Ericsson uses the term deliberate practice to differentiate junk hours from practice that will actually make a difference in one’s level of achievement, and this is how he defines it:

1. Focus your attention on the work with the intention to improve.

2. Your practice should be targeted to your current level of skill. 

3. After you attempt something, you should get to immediate, informative feedback until you have complete clarity in relation to what you did right and what you did wrong.

If practice is all I need, how do I motivate myself to practice?

All of this sounds very laborious: having to chip away at something, constantly look for feedback and address endless mistakes. There is only one way to avoid this hell: to like what you are doing. They say that if you pick a job you like doing, you won’t have worked a day in your life. It is sort of true.

My parents’ generation nearly all switched jobs. My parents, being Russian, were in their 30s when the USSR collapsed and so were forced to find a new way to make it. My generation is also constantly changing jobs. I know so many young doctors, nurses, solicitors, accountants who end up changing their field of work: however, they aren’t forced by harsh economic perturbations. They are forced by the discrepancy between what they were taught would be good for them as a career versus what is it actually like.

Aptitude tests and risk-averse parents had aspiring accountants believe they will be good at their job. They are good at it, but they soon realise they are ambivalent about it.

And it is hard to get up early in the morning 5 days a week when you are ambivalent. This is the reason so many people who were so “promising” end up having lacklustre careers: if you don’t like doing what you’re doing, you’re not going to find it easy to practice and if you don’t find it easy to practice, the competition will quickly leave you behind.

I recall taking a deep breath in and out to simply refocus as I was writing a note in a patient’s chart towards the end of a 14 hour shift in the emergency department, the last 9 of those without any breaks. The nurse sitting beside me took this to be a sigh of desperation and said: “It’s just another half hour until you’re finished.” Clearly, this nurse has been in a place where she was literally counting the minutes until she can go home. She was being supportive and relating to an experience she thought I was having. I was just tired. The way she said it was: “I know how much you don’t want to be here; I feel the same”. I bet there was a time when she was really excited about her work. She is good at her job. But she will never get better. And because lack of progress causes tremendous unhappiness in and of itself, she is likely to leave that job.

practice beats talent

What if I like something that I can’t turn into a career?

I think that that’s just a story we tell ourselves. Wearing a suit and going to work 5 days a week isn’t a career. Or maybe it is, but in that case we don’t all need a career. It’s hard for me to guess what people need, but I hypothesise that people need meaningful impact. And in this case, it is possible to make an impact doing virtually anything. Is it possible to make a living out of it? I would argue that it is. It requires some creativity, but with the internet people have been able to find their tribe much more easily. By listening to the audience, it will soon become obvious how to make what you are good at extremely useful to people – and monetise it. You don’t have to be an entrepreneur, you can be a freelancer, or even an employee. As for security, I also believe that that’s more of a story. Corporations collapse, technology makes professions irrelevant, cheaper labour elsewhere leads to job losses… Employment is far riskier that it is made out. 

The point is that it is being good that sells.

If you manage to get amazing at something odd (break-dancing, why not), you are at least as likely to sell it as if you’re mediocre at something for which there is a lot of demand (accounting). I will let you judge the level of happiness attained through these two routes for yourself.

It’s not all that simple of course. If you’re relying on being the best at something, you need to constantly put in the practice or create systems around you that will allow you t grow, e.g. creating things that last like organisations and leveraging other people. If you are relying on being mediocre where there is high demand, you will probably get away with it for the rest of your less-than-happy life.

What if I don’t know what I like?

You do, but it’s hard to be honest with yourself because it may lead to a lot of uncomfortable conclusions.

I’ve always liked writing, but I was always told it is a road to nowhere. Of what use is writing? When you’re 17, you listen to adults and trust them. Having said this, I liked science just as much. However, my interest in science was encouraged, but my interest in writing wasn’t.

It can also feel like it’s a very individualistic thing to say: “I like X”, X being piano, fashion, philosophy, whatever. We’re taught that it’s not about liking things, it’s about finding a good solid field where you can be successful. Whatever that means. So saying “I like X” is immediately contrary. There is an implicit “it doesn’t matter what you like, the choice you make it about your future! This isn’t a game!”

This kind of attitude plants a lot of doubt of course: what if X is just an infatuation? What if in 3 years’ time I am sick of painting and all I want is to start a family which is far easier to do if I become an accountant? It’s a risk, I guess, but I’ve never met anyone who really liked something and actually got sick of it. They may have been repeatedly rejected, something bad may have happened that became associated with X – but I’ve never met anyone who just lost their passion from first principles.

It can even cause guilt: doing something that you like feels like it isn’t work and is therefore not valuable. The insight here is that it feels like work to most people. 

It’s also important to remember that we like things we are good at. It’s therefore good to at least try and differentiate between positive feedback and genuine interest.


How are accomplished people’s brains different?

Isabelle Gauthier and Michael Tarr created a new field of study: Greebles. These are a family of 3-D structures, they are made up, none of the participants of their studies knew anything about them and had to learn from scratch.

As the participants practiced identifying and classifying these ridiculous Greebles, Gauthier and Tarr observed the developments in their brains using fMRI. When participants were first learning about Greebles, a huge portion of their brains was active. As they practiced more and more, fewer regions showed activity, but they ones that remained active became more active. Greebles are a nice example, but there are a number of studies like this that all point that brain activation gets more precise and efficient.

The meaning of meaningful glances

I also like to observe experienced doctors. Every morning, a senior physician would do a round and be presented with the case details of the patients who were admitted through the emergency department overnight. A lot of these presentations are really vague, that’s just the nature of the activity. The experienced senior physicians have a way of narrowing it down effortlessly: and most of the time they are correct. There is one minor detail that I noticed: they tend to fixate on something for a few seconds before they pronounce their verdict on the working diagnosis. It’s like they aren’t really here. The transient but significant fixation is especially juxtaposed with the hustle and bustle of the emergency department.

It turns out that that’s a thing that experts do. Studies of eye-tracking movements of by Joan Vickers call it the quiet eye.‹ Ordinarily, our eyes jump from one object to another, about 3 times per second. The movements are controlled without our conscious involvement. As we focus on a task, these movements become more deliberate. Especially accomplished people tend to stop their eye movements for as much as a whole second as they are about to act (or make a decision). Once again, we are looking at precision and efficiency: limiting the information input to be able to focus on what is relevant. This seems to be the real skill behind being accomplished at something (incidentally, it is also the skill that is directly trained though mindfulness meditation). 

Having reviewed the mechanics of being good at something, it is obvious that it comes at an obvious cost. By going in for the kill each time, the accomplished performer is likely to miss something in plain sight simply because their optimised equation didn’t factor it in. There is valuable flexibility in being a novice.

You may also like:

Paul Graham: What Doesn’t Seem Like Work?

FT: How a ‘no-plan’ plan launched a career at Facebook

Friday’s cognitive curiosities: a trip to the book shop in the age of unenlightenment

My first curiosity is an essay from the Financial Times. I have mixed feelings about the FT. It’s pretty impossible for a paper like that to be neutral, but the FT doesn’t even try. I am constantly disappointed with its sneaky political undercurrent. At the same time, I cannot find a news outlet that would be as well presented and lack the dogma. Anyway, the essay is titled The age of unenlightenment, written by Robert Armstrong.

The author is thinking of why it seems that we are getting dumber.

the age of unenlightment robert armstrong
Spring is in the air, finally. West Pier, Dún Laoghaire Harbour

I used to think that older generations always denounce younger ones because it is a kind of tradition. However, given that the human brain is indeed getting smaller (and chances are we aren’t getting smarter), maybe there is some merit to their nagging?

A book by Sloman and Fernbach entitled The Knowledge Illusion: Why We Never Think Alone offers clever demonstrations of how much we take for granted, and how little we actually understand. An example: try drawing a picture of a bicycle, with the chain, all the bits of the frame, and the pedals all in the correct place. It is not so easy. In an experimental setting, half of people set this task fail it. If that’s too basic, explain how a flush toilet works. Easy? Well, unless you described how a trapway creates a siphoning effect, you got it wrong.

Granted, I am trained as a doctor, however I knew 80% of the basics about how the body functions before I went in to college. It never fails to impress me that most people haven’t a clue about how their body works, but they really think they do. Women endlessly discuss what’s good for their skin, but seem to miss the crucial detail that virtually non of the miracle co-enzymes and ultra-proteins in their creams get absorbed past the epithelium. Guys in the gym would authoritatively discuss the benefits of “fast carbs” immediately after a gym session and how to prevent “knots” forming in muscle tissue, but ask them about insulin or myosin – and they haven’t a clue. And I don’t mean they don’t know the terms, but they just don’t understand the basics. A much more florid and familiar example is of people who love talking about geopolitics. They rarely know where the “enemy” actually is on the map.

Robert Armstrong continues:
Technology has encouraged us to confuse access to information with knowledge. Education treats teachers as customer-service professionals rather than people who know things that students don’t, and offers students inflated grades, meaningless credentials and a false sense of their own wisdom. Journalists are encouraged to give their audiences what they want, rather than telling them what they need to know.

I agree with all of the above. There is a sense in the above lines that it was different in another time. I sincerely doubt that it was. However, I do feel that the rate at which raw information is becoming available is rising. Still, as few people know what to do with it as back in the proverbial day. It seems Mr Armstong’s conclusion is that the books he has read on the matter (listed below) focus more on the problem than on proposing solutions. Frankly, I’ve never read a book that was any good that proposed solutions. Observing what’s going on in plain sight and asking the right questions is usually more than enough. Here are the books:

  • The Knowledge Illusion: Why We Never Think Alone, by Steven Sloman and Philip Fernbach, Macmillan
  • The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters, by Tom Nichols, Oxford University Press
  • #republic: Divided Democracy in the Age of Social Media, by Cass Sunstein, Princeton University Press
The Art of Thinking Clearly by Rolf Dobelli review
A fine Friday afternoon in Dublin

While we are speaking about books, I’ve been into the book shop and looked over the newest books in the psychology section. I sat in Hodges and Figgis’ leather chair and flicked through a few books. I always do that before I decide to read a book: I’ve bought too many “recommended” books that turned out to be either poor quality (as in, I couldn’t even finish them) or insidiously venomous making me wish I hadn’t come across them at all. In any case, I tend to really engage with the books I read, so there is a courtship ritual before I commit to reading the entire work. It went like this:

  • The Art of Thinking Clearly by Rolf Dobelli

“The Art of Thinking Clearly by world-class thinker and entrepreneur Rolf Dobelli is an eye-opening look at human psychology and reasoning — essential reading for anyone who wants to avoid “cognitive errors” and make better choices in all aspects of their lives.”

Mmm, it’s a very practical rewrite of Daniel Kahneman’s and Nassim Taleb’s thoughts. I would have thought that the former were practical enough. The back of the book featured praise by Sam Harris. I found Harris interesting initially but soon was uncannily repelled from his lopsided philosophy. I would be more careful in my choice of allies than Mr Dobelli. Could be a light read for someone unfamiliar with cognitive biases, but if you have any respect for your little grey cells, go straight to Kahneman. My (binary) rating for this book is: Nay.

Mindset : Changing the Way You Think to Fulfil Your Potential by Carol Dweck review
The sun setting over Howth
  • Mindset : Changing the Way You Think to Fulfil Your Potential by Carol Dweck

“After decades of research, world-renowned Stanford University psychologist Carol S. Dweck, Ph.D., discovered a simple but groundbreaking idea: the power of mindset. In this brilliant book, she shows how success in school, work, sports, the arts, and almost every area of human endeavor can be dramatically influenced by how we think about our talents and abilities. People with a fixed mindset—those who believe that abilities are fixed—are less likely to flourish than those with agrowth mindset—those who believe that abilities can be developed”

Psychology classics retold – and not in a very compelling way. Nay.

  • Against Empathy: The Case for Rational Compassion by Paul Bloom

“We often think of our capacity to experience the suffering of others as the ultimate source of goodness. Many of our wisest policy-makers, activists, scientists, and philosophers agree that the only problem with empathy is that we don’t have enough of it.

Nothing could be farther from the truth, argues Yale researcher Paul Bloom. In Against Empathy, Bloom reveals empathy to be one of the leading motivators of inequality and immorality in society. Far from helping us to improve the lives of others, empathy is a capricious and irrational emotion that appeals to our narrow prejudices. It muddles our judgment and, ironically, often leads to cruelty. We are at our best when we are smart enough not to rely on it, but to draw instead upon a more distanced compassion.”

I thought there was some merit in this book, but Daniel Goleman said a lot of the same stuff better. It may seem that he proposes the opposite to what this book is about, but that’s only an illusion. Perhaps, given the denigration of the intellectual and analytical approaches in the media, this books attempts to restore the balance and say that a quest for empathy isn’t going to solve our problems? It’s a nay from me, though the tone of the book is pleasantly contrarian.

Against Empathy: The Case for Rational Compassion by Paul Bloom review
Hopefully, I will find a yay in my next book shop trip

P.S. If you want to see some beautiful nature photos and are interested in travel, my friend Charis blogs about the island I was recently on – Cyprus. I was there with her for some of the trips she describes. I will write more about my escapade to the Eastern Mediterranean at some stage.

A downward facing doc explains the brain wiring behind mindfulness

Do you ever just wish you could get someone who knows virtually everything that’s known about the brain and quiz them about mindfulness? Well, I do – a lot – and I just got my wish!

It is my pleasure to present this interview with John McBurney MD. A practicing physician with of over 35 years’ experience, he is board certified in Neurology, Clinical Neurophysiology and Sleep Medicine. He holds an Integrative Medicine Fellowship… The list of his professional accomplishments is obscenely impressive, so I will jump to the bit we all really want to know about: Dr. McBurney maintains a daily mindfulness meditation practice as well as home yoga practice, hence the downward facing bit. Needless to say, I was beyond curious to find out his understanding of how mindfulness affects the brain.

For those of us who are put off by the mystical connotations that surround mindfulness, could you take us back to a schematic, reflex-arc type view of the process and describe the neurological response to mindfulness practice?

I think that the issue of mindfulness intersect with the leading-edge of neuroscience. It is supported by extraordinarily robust data. This area of study has been termed contemplative neuroscience. The Mind and Life Institute which is an outgrowth of the dialogues between the neuroscience community and the Dalai Llama  is an important sponsor of research and education on contemplative neuroscience. It ultimately comes down to the concept of neuroplasticity.

Donald O. Hebb coined the doctrine: “neurons that fire together, wire together”. It was an extension of the work done by an American philosopher and psychologist William James in the early XX century. You can practice “bad” things or “good” things – and neuronal ensembles form accordingly. In mindfulness, we are essentially practicing good things.

There is a resting ensemble of neural networks called the default mode network that was discovered using fMRI studies where individuals were asked to lay in the scanner and think of nothing in particular. This kind of mindless mental activity is accompanied by a lot of  self-referential ruminative recursive thoughts that are subserved by brain regions that lie along the midline, especially the prominent in medial parietal lobe. Those types of internal mental states that are remarkably robust and persist under deep general anaesthesia and even in a coma and are probably the neural basis for the self.

The more outward facing parts of the brain – like the dorsolateral prefrontal cortex – are more responsible for an outward orientation to the world have top down executive influence on the activation of those networks.

In mindfulness, in cultivating awareness of the breath and voluntary moment by moment awareness of the brain, we are training the brain – just like when you are learning to play the violin or any other complex skill – we are training to break out of those self-referential ruminative recursive mental states and to achieve an orientation toward the outer world and in the present moment rather than anticipating the future or reliving the past.

contemplative neuroscience mechanisms behind mindfulness

There is evidence that mindfulness leads to weaker connections in default mode network. Could we be losing something by focusing more on the external realities rather than the self?

Not everyone has a well formed default mode network. People who have been subjected to severe developmental trauma, neglect and lack secure attachment do not have robust default mode networks. Mindfulness can lower defence mechanisms that are there with good reason. However, most people with a well formed default mode network and secure attachment. We are “taming an elephant”: there is very little chance that we will significantly weaken the elephant.

Occasionally, we do hear of adverse experiences arising from mindfulness. With any robust intervention there are always potential risks.

How long does it take for mindfulness to have a manifest effect?

The results can happen almost immediately, however, they are also cumulative. We are still figuring out what the minimum effective dose it. This reminds me of the discussion of the minimum effective dose of aspirin in stroke and heart attack prevention. When I was a resident, we were advising patients to take two 325 mg tablets twice a day. Over time this dropped to 81 mg of aspirin a day. There is speculation that the required dose may even be lower.

There is a study that defines a new marker. The original fMRI/EEG studies were done by Richard Davidson in Tibetan Buddhist meditators with over 10,000 hours of meditation. This number is somewhat arbitrary and refers to this idea that is the number of hours to become an expert at anything. However, the question arises: what is the relevance of the changes in functional connectivity in the brain in someone who has devoted such a monumental amount of time to meditation to the likes of you and me?

A very neat study was published by David Cresswell in Biological Psychiatry in 2016. They invited individuals with high level of stress, unemployed adults, to a weekend retreat experience. They were randomised to in 2 groups:

  • a 3 day mindfulness retreat (the treatment group) and
  • a 3 day relaxation retreat where they read stories, told jokes and had a good time (the control group).

The study was conducted in one centre over one weekend, so it is well controlled. Initially, both groups rated the interventions as being equally helpful to them, subjectively.

The researchers looked at the functional connectivity between the dorsolateral prefrontal cortex and the cingulate gyrus. They also looked at Interleukin-6, a known marker of inflammation, that has been previously shown to be elevated in stressed out unemployed people.

Even with this brief weekend mindfulness intervention, the treatment group developed increased connectivity between the dorsolateral prefrontal cortex and the cyngulate gyrus. There was a neuroplastic response even after a 3 day mindfulness retreat. This was also associated with a decrease in the marker IL-6. Even after 4 months, IL-6 was decreased in the treatment group, but in the control group, IL-6 levels continued to rise, independent of whether they managed to get a job or not.

This is also relevant to doctors, who are at high risk for burnout. Because of their work commitments, the mindfulness retreat for doctors was condensed from the standard 8 week model developed by John Kabat-Zinn to a weekend intervention. The question was: does the weekend model work? The research at the University of Wisconsin where this was developed was reassuring: the residents are less stressed out, more effective and have a greater level of satisfaction.

We still don’t know the absolute minimum dose, but it seems that a weekend of mindfulness can be life-changing for the brain.

Another paper published in PLOS ONE from the Benson-Henry Institute for Mind Body Medicine in Harvard looked at the practices such as meditation, prayer, mindful yoga, Tai-Chi, Qi Gong, etc, i.e. ones that elicit a relaxation response (as opposed the stress response).

This study showed that in both novice and experienced practitioners of relaxation response modalities, there were changes in the epigenetic transcription of the genome. There was upregulation of pathways associated with mitochondrial integrity, downregulation of inflammatory pathways, improved insulin-related metabolism and improved nitric oxide signalling.

Long term potentiation, the standard mechanism for memory formation, strengthens existing neural connections. This happens immediately, as you read this. Over time, long term potentiation leads to formation of new connections,through synaptogenesis, dendritic arborisation and neurogenesis i.e. brain structure changes. In turn, this affects the most neuroplastic neurons located in the hippocampus.

mindfulness minimum effective dose response neurology

In reference to this fascinating recent study of the fight or flight response, it seems plausible that breathing regulates our stress levels much more than conscious thought. Could you explain the significance of this in terms of mindfulness?

The ancients believed that emotions reside in the body. This comes up a lot in serious yoga classes.

This highly innovative study shows that the control of the adrenal medulla – the main effector of the stress response – is not from the conscious ruminating thinking centres, but by the motor and sensory cortex.

This explains why breathing, as well as yoga and Tai-Chi, are an important part of meditative practice. In my experience, these kind of interventions do affect the stress response in a beneficial way.

Mindful exercise exists in many form. For example, weightlifters need to be very mindful to maintain perfect form. Cycling is another example: it is vital to concentrate on every pedal stroke and maintain an even cadence. Once you start to day dream, you notice straight away that your output is way worse. This overlaps with the concept of flow. It is about getting in the zone. There is a very inspiring TED talk by Judson Brewer MD, Ph.D. that explains the physiology behind flow and how it is augmented by mindfulness. Mindfulness is work, and it does require discipline. There is a paradox here of non-striving and non-doing while also being disciplined.

You are a sleep medicine expert. Could you comment on the relationship between mindfulness and sleep?

Insomnia is a complex problem with many causes. However, for most people with idiopathic insomnia, the cause it these self-referential recursive ruminations. They aren’t able to “turn their brain off”. Through mindfulness practice, they are generally able to tame the default mode network that’s responsible for ruminating and daydreaming. A simple strategy would be to lie in bed and concentrate on the breath. This would ease the transition between wakefulness and sleep.

mindfulness default mode network neurological basis for the self

Mindfulness is a mainstay treatment for many mental health disorders. What about use of mindfulness in the treatment for organic pathology of the brain usually treated by neurologists?

There is some preliminary data that mindfulness training has a beneficial effect of seizure frequency in patients with epilepsy. It is a medical condition associated with tremendous anxiety and stress, so mindfulness could have a significant benefit in more than one way. It may even have a benefit it terms of remembering to take medication on time, etc.

Some robust studies show that the frequency of relapse in multiple sclerosis decreases with mindfulness intervention. The effect from mindfulness is similar in magnitude to the effect from beta-interferon. There is also some research showing that the frequency of inflamed Gadolinuim-enhancing lesions decreases with mindfulness.

John Kabat-Zinn used to take the patients who suffered from chronic pain or had diseases for which we had no answer, and those patients got better. Even beyond neurology, there is some evidence that mindfulness can have benefits in psoriasis. We are probably only at the bottom of this mountain.

Dr McBurney is a board member of Mindful Medicine. It is a non-profit organisation that focuses on teaching mindfulness to health professionals using retreats. He is founder of McBurney Integrative Neurology and is a clinical assistant professor at the University of New Mexico School of Medicine. Dr. McBurney is a native of Alabama and a graduate of Auburn University and the Emory University School of Medicine. He completed his neurology residency and EEG/Epilepsy fellowship at Walter Reed Army Medical Center.  In 2014 he completed the Integrative Medicine Fellowship at the University of Arizona Center for Integrative Medicine.

Dr McBurney has given me so much to think about. I will follow up with part 2 of our discussion that focuses more on the philosophical and life experience aspects of mindfulness once I wrap my head around it.

neurological path mindfulness default mode network adrenal medulla

What psychiatrists think of Donald Trump

It is considered unethical and unprofessional for psychiatrists to hand out opinions about public personalities from afar. This rule was broken recently, with regards to, of course, Donald Trump.

Letter to the editor

A letter to the editor in The New York times, signed by Lance Dodes, an addiction psychiatrist, former Harvard assistant professor (and 34 other professionals) on the 13th Feb 2017 stated:

“Silence from the country’s mental health organizations has been due to a self-imposed dictum about evaluating public figures (the American Psychiatric Association’s 1973 Goldwater Rule). But this silence has resulted in a failure to lend our expertise to worried journalists and members of Congress at this critical time. We fear that too much is at stake to be silent any longer.”

“Mr. Trump’s speech and actions demonstrate an inability to tolerate views different from his own, leading to rage reactions. His words and behavior suggest a profound inability to empathize. Individuals with these traits distort reality to suit their psychological state, attacking facts and those who convey them (journalists, scientists).”

“In a powerful leader, these attacks are likely to increase, as his personal myth of greatness appears to be confirmed. We believe that the grave emotional instability indicated by Mr. Trump’s speech and actions makes him incapable of serving safely as president.”

A strongly-worded response to the letter

A pretty badass response came in the next day, 14th Feb 2017: a follow-up letter to the editor from Allen Francis, who wrote much of the DSM IV, including the diagnostic criteria for Narcissistic Personality Disorder. Much as the DSM IV has its flaws, this guy is really on point, in my more than humble opinion:

Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesn’t meet them. He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.”

“It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither).”

“Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely. Psychiatric name-calling is a misguided way of countering Mr. Trump’s attack on democracy. He can, and should, be appropriately denounced for his ignorance, incompetence, impulsivity and pursuit of dictatorial powers.”

His psychological motivations are too obvious to be interesting, and analyzing them will not halt his headlong power grab. The antidote to a dystopic Trumpean dark age is political, not psychological.”

Should psychiatrists stay silent?

Looking down from her moral high ground on the 2 lads in a newspaper fight is the president of the American Psychiatric Association, Maria A Oquendo, who pointed out that while she could understand the desire to “get inside the mind” of a presidential candidate, having psychiatrists comment publicly about people they have not examined threatens to erode the public’s confidence in the profession.

“Simply put, breaking the Goldwater rule is irresponsible, potentially stigmatizing, and definitely unethical,” she wrote.

As for me, I believe that, psychiatrists shouldn’t be analysing living political figures – as psychiatrists. As people with opinions, however, I feel they should be heard – just like anyone else. They also happen to be very good at analysing people’s behaviour. It is up to the reader to understand that this is not an excerpt from Trump’s personal medical files, instead it is just another opinion made legitimate by our commitment to free speech.

What is this psychiatric condition they are debating about?

Narcissistic personality disorder is a mental disorder in which people have an inflated sense of their own importance, a deep need for admiration and a lack of empathy for others. But behind this mask of ultraconfidence lies a fragile self-esteem that’s vulnerable to the slightest criticism. For those of you not familiar with the DSM, it is a (the?) diagnostic guide for psychiatrists. We are currently of the 5th edition. Here are the criteria for NPD:

The essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose narcissistic personality disorder, the following criteria must be met:

A. Significant impairments in personality functioning manifest by:

1. Impairments in self functioning (a or b):

a. Identity: Excessive reference to others for self-definition and self-esteem regulation; exaggerated self-appraisal may be inflated or deflated, or vacillate between extremes; emotional regulation mirrors fluctuations in self-esteem.

b. Self-direction: Goal-setting is based on gaining approval from others; personal standards are unreasonably high in order to see oneself as exceptional, or too low based on a sense of entitlement; often unaware of own motivations.


2. Impairments in interpersonal functioning (a or b):

a. Empathy: Impaired ability to recognize or identify with the feelings and needs of others; excessively attuned to reactions of others, but only if perceived as relevant to self; over- or underestimate of own effect on others.

b. Intimacy: Relationships largely superficial and exist to serve self-esteem regulation; mutuality constrained by little genuine interest in others‟ experiences and predominance of a need for personal gain

B. Pathological personality traits in the following domain:

1. Antagonism, characterized by:

a. Grandiosity: Feelings of entitlement, either overt or covert; self-centeredness; firmly holding to the belief that one is better than others; condescending toward others.

b. Attention seeking: Excessive attempts to attract and be the focus of the attention of others; admiration seeking.

C. The impairments in personality functioning and the individual‟s personality trait expression are relatively stable across time and consistent across situations.

D. The impairments in personality functioning and the individual‟s personality trait expression are not better understood as normative for the individual‟s developmental stage or socio-cultural environment.

E. The impairments in personality functioning and the individual‟s personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).