Monday, October 27, 2014

Unwilling Unbelievers

There’s a very interesting class of person that gets far too little press. A huge amount of contemporary Christian thought and attention goes to loud-mouthed Atheists. But there are atheists who do not want to be atheists. Actually, a surprising number state that they’d rather believe if they could.

Others are on the opposite end of the spectrum: they want to disbelieve, and the intellectual arguments are face-saving excuses. I once had a very long conversation with an atheist that ended with my discussant acknowledging that Christianity was the more rational position. Rather surprised by the concession that I had actually won a heated argument, I asked if he was ready to convert. He stated that, despite its irrationality, he preferred the illusion of being in control of his life.

Distinguishing those who want to believe but can’t from those who don’t want to believe is quite important. To identify the former group, I've started asking: “If I had a perfect rational argument that would utterly convince you intellectually that God exists and the Jesus rose from the dead, would you become a Christian?” Had I asked this question, I would have saved myself many hours of pearl-casting on a person who disbelieved for emotional reasons. But even in those who answer “Yes” to my question, there still may be a lot of psychological resistance to conversion. This can be explored in a variety of ways. There is the cool, abstract question, “What psychological or emotional difficulties might there be in becoming a Christian?” But my favorite is an emotion-laden visualization, “Imagine I convinced you rationally right now. Then imagine we walked down the street to my church’s baptismal, and then had my pastor baptize you. How would you feel?” In one person, this produced an overwhelming feeling of disgust and horror. Once generated, the emotions can be explored, “Why did that frighten you?” There’s a wide variety of emotional reasons to resist conversion with more or less rational backing. I’ll write about this separately. But once this is done and it becomes clear that the person’s disbelief is honest, yet they are motivated to change, then what? They can’t just flip a switch.

As far as I can tell, there are three major paths to overcoming the resistance.


The first way is a kind of workaround. Most of our beliefs of whatever variety are formed by our social connections.

The social effect is unbelievably powerful. Of course, close friends can convince us better than strangers. But even a handful of strangers can override basic visual processing. If you set an experimental subject in a room with five other “subjects” (who are actually experiment confederates), and ask basic questions like “which line is longer?” you can get normal people to trust strangers’ eyes more than their own. It would seem that seeing is not believing: hanging out is believing. In general, the closer the ties, the stronger the effect.

The old argument, “You only believe X because you were born in Y” is a true statement about efficient cause; it is the manner by which it came about. That is, the mechanism by which a vast majority of our beliefs come about is social geography. This works in early childhood; a person might say: “I was born in Texas; when I was younger, I believed in the Republicans.” In adulthood, it still works: “…then I went to UCLA and reconsidered a lot of my old beliefs. Now [like a vast majority of my friends and professors] I am a Democrat.” Of course (though apparently this is not obvious to everyone), how someone came to a belief says nothing whatever of the truth of that belief. The social mechanism is truth-independent: it would work for any belief, true or false. But that’s exactly what this tool is for in human history. A pipe wrench can’t measure the true distance between two points; social beliefs can’t tell you whether those social beliefs are true or false. So it’s a very good idea to only intentionally use this mechanism to help change oneself from a false belief to a true one. Or, for those of you who disbelieve in the idea of truth, the social mechanism should be used only to change an unhelpful belief to a helpful one. The fact remains: one big and effective way to change your mind is to join a particular social network that holds a target belief.

Stanford Anthropologist Tanya Luhrmann has written about this effect in Evangelicals (and previously, in psychiatrists). “When God Talks Back” is, in part, about how beliefs are reinforced by social participation and ritual. In other studies of conversion, it is often found that social networks play a huge role. The most natural and common way to change your mind is to spend time with people whose mind you want to share. If you want to be a Christian, go to church. Sing the songs. Attend Bible studies. Make friends with Christians, particularly Christians qua Christians. While it’s helpful to see them at work or on the golf course, it’s even more helpful to go to the place where they are feeling Christian emotions and thinking Christian thoughts that, as with all emotions and thoughts, are contagious.


The next way is somewhat contested. While it boggles my mind, there are apparently-thinking people who are convinced that thinking is not a way to change one’s mind (these poor souls are among the most tragic casualties of Post-Modernism). I suppose there are those in this world who have never had the wonderful experience of hearing an argument and changing their minds; more likely, this has happened, but they forgot to pay attention.

We live in so-called “Western Civilization,” and one of the defining and differentiating aspects is our conviction, at least since Socrates, that systematic thinking is a noble pursuit, that arguments are worthwhile, and that by engaging in it, we might actually make progress toward what’s true. I have had the experience several times of having a vigorous discussion with another person, and then my making some comment like, “So what you’re arguing is [summary of their position]” to which they respond in all sincerity, “I’m not arguing anything. I don’t think what I say is true.” I am skeptical of those skeptics who fire up the great engine of rigorous thought and forthwith drove with terrifying speed to the conclusion that they never went anywhere.

Some less skeptical folks will maintain that reason is great for science, but is useless elsewhere. I had an intense discussion with someone recently, who aggressively demanded of me, “What empirical proof do you have that God exists?” It’s a fine question; it implies that if empirical proofs are lacking, then a thing cannot be known. The argument goes like this: “1) Assume only physical things can be known 2) God is not a physical thing 3) God cannot be known.” The trouble with the argument is that just about everybody believes that 2+2=4, that killing Jews in a holocaust is wrong, and that sunsets are beautiful. ‘4,’ ‘wrong,’ and ‘beautiful’ are not physical things, but most of us are pretty sure they’re real. Those who make the arguments that start with “what proof do you have that [spiritual thing]?” are almost never willing to ask the same thing of addition, morality, or beauty.

But enough! If you think reasoning a worthwhile endeavor and have the courage to apply it to the non-physical, read on! For the rest (for whom I've never quite understood why you’d read anything in the first place), feel free to skip. For those of you who are willing to gird up your intellectual loins, get ready for a new experience! There is an entire field of study for the rational defense (and offense) of the faith. It even has a name: “Apologetics.” The first thing to note about the field is that it, like Chuck Norris, doesn't say “sorry.” The English name comes from the Greek word, apologia, meaning either “verbal defense” or “a reasoned statement or argument”; the root, logos, is the same one used in the English word “Logic.”

For the unwilling unbeliever, one could explore apologetics for a lifetime without exhausting it. If one really wants to be persuaded, there are a multitude of possible arguments. The two kinds of argument can roughly be divided into “offense” and “defense”: part of apologetics involves providing evidence and arguments for why Christianity is true (e.g. historical evidence for the resurrection of Jesus; philosophical arguments for the existence of God); the other part of apologetics involves responding to arguments against Christianity or answering “hard questions” (e.g. “How can a good God allow suffering?” “What happens to those who never heard of Jesus?”). Apologetics is a wonderful field because it is a multi-disciplinary pursuit. It’s quite open-minded and acknowledges that we can be persuaded by historical truths as well as philosophical truths. While most of the credit and history of the field goes to the philosophers and theologians, I know that some of the more significant shifts in my opinion have come from arguments based on history.

This article is meta; this is an article about apologetics, not directly an apologetics article. Nonetheless, I’ll give you three apologists that have influenced me, describe their work, and allow you to investigate the arguments yourself: William Lane Craig (philosopher), NT Wright (historian), and Rodney Stark (sociologist).  Craig is a professor of philosophy who has become perhaps the foremost apologist in contemporary Christendom, debating the top atheists in the world and winning (even by Atheist accounts). He presents well-validated mostly philosophical arguments for God’s existence with precision and conciseness. Craig’s writings and materials are a prime specimen of what most Christians mean when they say ‘apologetics.’ However, this line is less influential to those who are disinclined to think philosophically. Much of the ire against Christianity, and conviction in secularism is the belief that, more or less, religion leads to war and superstition, and secularism leads to peace and prosperity. This subconscious “reason” was powerfully at work in me until I read Rodney Stark. He takes a broad sweep of history and argues that Christianity was the reason for the peace and progress: Science, Representative Government, Capitalism and the end of slavery, were all fruits of Christianity. The book summarizing his other books is The Triumph of Christianity. Wright is probably the foremost historian of first century Palestine; he provides an eminently scholastic account (video summary) of how the resurrection of Jesus was so un-Jewish and un-Roman that it requires an extraordinary explanation, “That is why, as an historian, I cannot explain the rise of early Christianity unless Jesus rose again, leaving an empty tomb behind him.” He also does a superb job of explaining how Christianity is exactly not about “dying and going to heaven,” but involves making earth like heaven.


I once had a change of mind like a dam-bursting. It was an experience on the rational path, but has lessons for the spiritual path. In the course of a two-hour lecture, I went from one side of an argument to the other; I was taking notes on my own feelings and opinions in the margin, and was able to identify a period of 20 minutes where I went from a solid opponent of the idea to avid defender. It was like a chemical reaction: I found a lower and more stable energy state, never to return to the starting position once catalyzed. I've seen this sort of thing happen with belief in God after a spiritual experience: a person goes from reluctantly granting some arguments for God’s existence, and then leaping to an expression of faith in the resurrection of Jesus.

I've seen people who wanted to believe follow either the social-emotional or the rational path for a time, and sometimes a long time. Then something happens. Maybe it’s a dream that shakes them to the core. Maybe it’s a ‘coincidence’ of profound personal significance. They were making glacial progress, as one who went from convinced atheist to tentative theist over the course of years. But then, in a flash, they find that they arrive at the destination of Christianity. Others don’t even start down the path when they are called. A famous case is the Apostle Paul, who started as a persecutor of the faith when he was called, but he was obedient to the vision. I've heard many accounts of this sort of thing happening today, often in the Muslim world. Whatever progress one has made, it can be accelerated by miracle.

The final way to go from unbeliever to believer is to meet God. It’s actually not as hard as it sounds. If the hypothesis that “there is a personal God” is true, then it is, in principle, entirely possible to meet Him. This is completely compatible with an honest scientific perspective. Science involves taking the sense-information and incorporating it into a theory of how the universe works; one cannot arbitrarily exclude sense-information that happens to align with Theism.

Try to pray regularly for a time. Play a lower-stakes version of Pascal’s Wager: if God is real, He hears and may respond. If God is not, you've gained new information about the existence or nature of God. Ask God to show Himself to you. Ask for a sign. But be careful, especially before attempting this path. The danger is this: sometimes when you ask for a sign, He shows you one.

After His resurrection, Jesus appears to the disciples when Thomas was away. They told Thomas about it but he would not believe, “Unless I see in his hands the mark of the nails, and place my finger into the mark of the nails, and place my hand into his side, I will never believe.” Thomas would not believe on the testimony of others; he needed to meet Jesus himself. Jesus was happy to oblige, appearing to him and saying, “Put your finger here, and see my hands; and put out your hand, and place it in my side. Do not disbelieve, but believe.” This is all in accord with Jesus’ words on the Mount of Olives: “Ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you.”

So, if you dare, knock. But do not be surprised if the door opens.

Friday, February 28, 2014

Dark Horse

“And I beheld, and lo a black horse” - Revelation 6:5 

“What’s the right thing to do?”

I asked the question was asked to a group of middle and high schoolers at SPLASH. Hands shot up. Answers were given. But not to the question I asked. They all conspired to, completely without my approval, answer a different question: “Why is it impossible to do the right thing?”

While no doubt an interesting question, it seemed to the students indistinguishable from my first. It seemed no matter how many times I repeated my question or clarified, they obstinately persisted in offering answers to the second question. I heard about studies in moral psychology, sociology, and evolutionary biology. I heard personal anecdotes of students doing what they seemed to think was the wrong thing, defeatedly declaring it inevitable. I was very familiar with relativism, the fashionable (and crazy) idea that all moral truth is relative [1]. I even knew about moral agnosticism, the slightly less fashionable and slightly less crazy idea that there is an objective moral world, but it was unknowable. The majority of the class wasn’t set on relativism, or at least not set on it deeply. But the class did seem to be utterly convinced of the depravity of the human condition: we know the right thing to do, but have no ability to actually do it.

The only philosophical system that I know of that has so low a view of human capacity is the extreme end of Reformed Theology, people like the Puritans. But even that system is optimistic because the solution (Jesus) is provided. The Ancients had ideas that things like tradition, education, religion, wisdom or reason were paths to a virtuous life. But my students had been told of no such paths. But their previous teachers had not been idle; they made sure to pile rocks of explicit doubt on the best paths, and obscure the rest under a light snow of relativism. The tragedy of my poor students was matchless.

“Part of me wants to do what’s right. But part of me just wants to be rich.”

So said my friend in the midst of a career decision. So far so good. We all have unholy desires and impure motives. It’s good that he recognizes it.

“So I don’t know what to choose.”

There are those boldly wicked men like Thrasymachus [2] (about whom much of Plato’s Republic is set out to refute), who actively argue that injustice is better than justice. But my unfortunate friend was in a different place. He wanted to be a good person, and he knew what a good person would do. But there is another part of himself which he could not deny which wanted something else, and he did not know which part of him had the valid claim: the rational, just part; or the greedy, unjust part. It is like his mind is the Manichean cosmos: there are two gods, a good one and a bad one, and neither has the ultimate claim to being Right.

This is a new thing. Humanity throughout the ages was pretty well convinced of how totally awesome Reason was. The question “should I follow reason?” was pretty well taken for granted. In fact, there’s not much of human craft that is possible if the answer turned out to be “no.” In fact, much of my future profession is dedicated to dealing with people who seem to have that question in the negative. To the Greeks and many Christians, Reason (not the Hokey Pokey), was what it was all about. This is Reason in the highest sense (all apprehension of capital T “Truth”), not just what you learned in Geometry. Aristotle says this about the purpose of life: “The function of man is activity of soul in accordance with reason, or at least not without reason.” The consequences of not living out this purpose are described in vivid (believe me, vivid) descriptions of H-E-double-hockey-sticks by Dante; the Inferno is a place for beings who, to varying degrees, abandon or corrupt their Reason. To Dante, Hell is nothing less and nothing more. Previous generations required that vice be concealed as virtue, that the irrational put on the clothes of reason. Today, it seems, vice can walk the streets naked and unashamed.

“I don’t know if I’m in love with him. Should we break up?”

She’d been in a relationship for over a year, but the passion faded and/or wasn’t as strong as it “should be.” This is a classic case. And, as numerous conversations with friends have demonstrated, we have no flipping idea how to make decisions about relationships. Sometimes, we don’t even think we should use “cold” reason in such a fiery thing as love.

“Love” apparently meant, “warm feelings” and these were, apparently, supposed to be really, really strong. And if they weren’t then it meant the many months of dedication and sacrifice were for naught. That person must not be “the one.” This conviction is cemented by the common experience of having a previous lover with whom one did have really, really warm feelings towards. Why that relationship (the one with the feelings) didn’t work out will not be reflected on.

Passion is far too weak a glue to bind two people together for any significant time. It certainly does a very adaptive thing for humanity and gets us to commit to each other while intoxicated by love. But that was back when the good king Reason ruled and acknowledged that promises and commitments had force even when feelings faded. Now that the Passions are ruling, this is now a conscience-driven process. “Feelings are the Good, and if they are absent, then I’m out, promises be damned.” All the other things that people considered in their partner are now all but ignored. It is not temptation but Reason-endorsed conviction that causes me to consider breaking my commitment.

To Be or Not to Be?

In The Willpower Instinct, Kelly McGonigal tells the story of a girl who had recurrent suicidal thoughts, tried to suppress them, and had even more recurrent suicidal thoughts (a transient obsession that McGonigal attributes to the white bear effect). As a result, she concluded that the recurrence of these thoughts reflected the fact that, deep down, she really wanted to kill herself. Her conscious, rational self has no reasons to offer, but that must mean that the conscious, rational self is ignorant of the true reality.

Why would anyone think all subconscious ideas contained deep and irrefutable truths about us? I suppose it’s partly because of a watered down and corrupted legacy of Freud. But it may also be because that the thoughts and feelings that occur to us outside our conscious control arrive from a mysterious source. They, like visions or prophecies, have the appeal of mystery. And in an environment where we know everything is false, at least with the private idea-generator called the subconscious, we don’t know that it’s false; it stands alone in our minds as not having its epistemological foundations undermined.

The Reign of the Dark Horse

The common theme of all these stories is that many modern people seem to think feelings are inviolable. It’s a bizarre inversion of what has always been the ideal. Classically, when the Passions overpowered the Reason, it was a tragedy. Now the Passions rule, but the Reason is actually complicit. At best, Reason has one vote amongst the Passions. At best, Reason is as impotent as a junior congressman from Idaho. Sometimes, Reason is just an observer, along for the ride like a tick on a dog. Our minds are adequately muddled to permit for a new thing in the history of the world: not forced servitude, but voluntary commitment of Reason to the Passions.

One of Plato’s allegories compared the human soul to a chariot pulled by two horses. The driver is reason, one of the horses (white) represents the good emotions or “spiritedness” and the other horse (black) represents the carnal or base passions. The driver’s job was to bridle and direct the horses; not suppress them, or let them guide the chariot (for a fuller account, check out this Art of Manliness article). Plato called the failure of the rider and the triumph of the Passions, “…the ruthless enslavement of the divinest part of himself to the most despicable and godless part” and submitted that such a man should be “deemed wreched.” All Plato could imagine seemed to be an incompetent driver (which was just “wreched”). Our modern insanity seems to have been unforeseen: he couldn’t imagine a rider so insane he would yoke himself beside the other horses and allow the Dark Horse to lead. I don’t think he could have imagined conscious and intentional mutiny of Reason against Wisdom, not just being enslaved by the Passions, but swearing allegiance to them.

My students seemed as if they were trained from childhood to yoke their Reason beside their passions and to pull with it in whatever direction the Dark Horse was inclined to go. My money-loving friend knew what was right, on some level wanted to do right, but gave his Reason an equal vote. My friend in the relationship thought the Dark Horse’s inclinations were the only reliable guide. The suicidal girl allowed her Passions to persuade her Reason.

After thousands of years of trying by a multitude of means, humanity seems to have finally given up trying to break the Dark Horse. But rather than just enjoying a directionless chariot ride, we have kept our Reason active, pulling the now-empty chariot beside the Dark Horse here and there and everywhere. Plato described the integrated soul, when the rider and two horses worked together: he told of how such a soul could rise up into the heavens with the gods. But such cannot be our fate. Our souls will be scattered across the plains and deserts of the earth, driving madly in a direction we know not.




Unless Reason can rules again.

[1] Paul Blume famously opens his book on American universities with this line: “There is one thing a professor can be absolutely certain of: almost every student entering the university believes, or says he believes, that truth is relative.” As for its craziness, the strong defenders of the hypothesis are hard to find.
[2] “injustice, when it comes into being on a sufficient scale, is mightier, freer, and more masterful than justice.”

Sunday, February 9, 2014

Mediterranean Diet in a Bowl: SuperStew 4.0

Mediterranean Diet in a Bowl: SuperStew 4.0

This is a super filling, super low glycemic index, evidence-based food. It has several ingredients which are proven to be good for diabetics or preventing diabetes. As with all my SuperStews, it’s designed to be a “desert island food,” that is, you wouldn't die if it’s all you ever ate.

3 onions
½ bunch of celery
2 bell peppers
½ lb Jalapenos
2 large cans of diced tomatoes
1 large can of crushed tomatoes
½ lb navy beans
½ lb soybeans
1/8 lb wild rice
1.5 lbs chicken thighs
Montreal steak seasoning
2 cups olive oil
½ lb peanut butter (crunchy, natural)
½ lb almonds (sliced)
½ lb sunflower seeds (shelled)
¼ lb ground flaxseed
2 cups Greek Yogurt
1 cup shredded coconut
½ cup apple cider vinegar
¼ cup molasses

Spices (part 1)
4 tbsp (1/4 cup) black pepper
2 tbsp cayenne
2 tbsp coriander

Spices (part 2)
2 tbsp mustard seed
2 tbsp cumin
½ cup Italian spice

Makes 25 servings.

1. Rinse the beans (navy and soy). Put them in a large pot, cover with water and bring to a boil. Simmer for 1 hour.
2. Roughly chop all the veggies except the greens (don’t worry about deseeding the jalapenos… unless you’re a wimp). Put ½ cup of olive oil in the stock pot. Fry on medium heat for 5 minutes. Add coriander, cayenne and black pepper. Fry for another 5-10 minutes (the onions should start to look a little see-through).
3. Add the tomatoes, broth (and/or cubes), remaining oil, and remaining spices. Bring to a boil and simmer for 15 minutes.
4. Drain the beans. Add to the main pot and mix in.
5. Heat the grill to the high “grill” range. Cover the chicken with copious steak seasoning (yeah, I know, it says “steak” on it; trust me on this one). 5 minutes per side should work if the meat’s not too thick (i.e. you didn’t buy genetically engineered “I can’t walk because I’m so fat, but it doesn't even matter because my cage is too small to stand up in anyways” chickens). Cut into ~1 inch pieces and add to pot. [note: if you don’t have a grill, prepare the chicken however you like, or just add it to the pot at step 3]
5. Add in wild rice and stir. Add water as is necessary to keep it liquid. Simmer for 15 minutes.
6. Add in everything else. Stir.
7. Done! (you can use step 7 as an occasion to put it into Tupperware and/or do the dishes)


The stew has several unique features which I will reference when I have more time (I actually pulled the papers this time). First of all, I want to talk briefly about the fats. It has 40g of fat (eek!) by design (???). In one of the few well-designed randomized trials done on diet, Atkins actually came out on top (beating the Ornish “eat mostly plants” diet and other “intuitive” diets). Surprising I know. Even in terms of cholesterol readings. Even more surprising. This is probably because we all have metabolic syndrome and have way too much sugar/carbs floating around to be good for us. Previous iterations of this stew went partway, incorporating more low glycemic index grains. But this time, I went further. More fats. They fill you up, and improve your cholesterol and health. In a randomized (nonscience people read that “totally believable”) study, adding nuts or olive oil to a diet reduced cardiovascular events by around 30%. You don’t really need the oil for frying purposes, but I’ve told you to add it so that you have more healthy fats: monounsaturated fats in olive oil increase your good cholesterol and decrease you bad. There is also a decent literature on dairy (especially cultured dairy) preventing development of diabetes, so I added yogurt (and Greek yogurt had more protein and less sugar than normal). Flaxseed is good for your heart (Omega 3 fats). Coconut oil is also supposed to be good for you (that’s where a lot of the “saturated fat” is coming from… don’t worry, it’s not bad!). In looking how to cheaply get coconut oil into my stew, I discovered that the oil was hella expensive. But shredded coconut is cheap, and as it turns out, has coconut oil inside (I snuck out of Whole Foods without them knowing I had gotten coconut oil out of the building without losing my shirt). There is a ton of work about how inflammation is bad, and how anti-inflammatory stuff is good, and hence the large amounts of spice (for cheap, high quality spice, try or visit the planet Dune). One bowl of this has 7x what is good for a full day. Stuff that is “anti-inflammatory” tends also to have anti-cancer anti-oxidants. But, alas, inflammation and anti-oxidation is hard to actually measure by science as it’s so variable, so there’s not spectacular evidence to support so heavy a use of spice (at least not in the nutrition section… but the taste is another story). I had done vegetarian versions before, but the grilled chicken wasn’t that expensive, tasted great, and was actually pretty good health-wise. Vinegar has been shown to increase satiety and improve insulin response. The fiber is good (41% of daily value), but has been reduced from prior versions because it generally comes with carbohydrates. Fiber independently is good for your heart, reduces cholesterol and (some research suggests) helps transport the antioxidants down to the colon where they can work to help prevent colon cancer. And, of course, there’s a ton of veggies which are, as your mother said, good for you. I haven’t recalculated for this version, but the original (which had a similar amount of veggies) contained >5 vegetable servings in 2 bowls.

It’s got a good amount of calories, macronutrients, minerals, and all the vitamins except for D and B12. So go outside, see the sun, and eat a steak every once in a while and you’ll be fine.


For a 574 Calorie bowl of stew, the cost is $1.56. Not too shabby. The Dollars Per 1000 Calories (a unit I explain in more detail here) is 2.71. Food Stamps cutoff, that is, the cost where one could actually live on nothing but the food provided by food stamps, is 2.44. Black beans alone come in at 0.9 and a Big Mac is 7.6. My 2.71 number was arrived at by buying most of this at Whole Foods (except the veggies, which I went to my local Mexican supermarket). In other words, I bought things like Run-Around Chickens (i.e. pasture-centric; Whole Foods Grade 4). If you bought the stuff at Costco or a normal grocery store, you’d considerably increase the value (as well as the guilt on your soul :P).


It took about 1 hour to shop and 2 hours to cook (and I doubled the recipe, so ~50 meals) and about 30 minutes cleaning and storing. Not counting the 3 hour literature review (yeah… that’s how I roll. And cook. I both cook and roll via reviews of the primary scientific literature), it took me ~4.2 minutes per meal of cook time. From fridge to microwaved takes another 3 minutes per meal. So for about 7.2 minutes of my time, I can have this super healthy stew that tastes great (for reference, it takes  7.5 minutes to prepare a Hungry Man TV dinner; and yes, I did have to Google that).


Best yet. It’s amazing! I think I am white enough to prefer the Jambalaya-style spices over the Indian-style spices I had been using before. Probably because it’s so fatty, it is, dare I say it, scrumtrulescent. It is spicy (caliente) enough to keep me interested, and the yogurt and maybe vinegar move the taste into the sour axis just slightly, just enough to get interesting. And the grilled chicken was a very, very good decision. As this is what I will literally eat just about every day for a month or more, I am always happy when it turns out J. Enjoy!

Sunday, February 2, 2014

The Willpower Instinct (McGonigal) - Review and Critique

The Willpower Instinct is the best book out there for building the virtue of Temperance. Kelly McGonigal does an incredible job helping us make sense of our “willpower failures” and to learn to better respond to them. This is one of America’s greatest failures, and so I can understand why her class is so wildly popular.

There is little on the subject that she does not cover; there are few modern perspectives that are not considered. She then goes the extra mile and proposes ways to think about these failures in the reader’s own life, and exercises for trying to overcome the failures. It is eminently practical, one of the most practical self-help books I’ve come across.

Chapter by Chapter Summary and Discussion
In chapter 1, McGonigal makes the case that there are three kinds of “willpower”: I will, I won’t and I want. She advises that it is often useful to reframe challenges; for example, instead of “I will go to bed on time” she suggests trying things like “I will not use the internet after 10pm.” She also points out that focusing on our desire for “long term goals” is an important way to keep on track.

In chapter 2, she describes stress biology. She describes “fight or flight” versus “pause and plan” and talks about heart rate variability as a “store” of willpower. She describes how slowing down can improve your ability to make good choices and recommends relaxation exercises to aid with this process. A feature that comes up in a big way in this chapter is the translation of everything into cave-man fairy tales. Don’t get me wrong: I love fairy tales. I don't mean that she proposes developed evolutionary hypotheses that I happen to disagree with. Though well read on neuroscience and psychology, she didn't seem to bother studying evolutionary biology, but instead uses it as a narrative inspiration. The problem with this is that there are plenty of poor schmucks who probably can't tell the difference between McGonigals otherwise superb ability to summarize complex science and her speculations on human evolution. While showing remarkable restraint in staying within the bounds of the science in most places, she seems to be unable to exert “I won’t” power, and so we are transported back to the savanna every few pages to forage for hyena carcass or wear hippopotamus loin cloths.

She briefly summarizes the totally awesome work of Roy Baumeister in chapter 3: that willpower is like a muscle, can be depleted, built with practice and how it even runs on sugar (this work gets a little bit of a short shrift; for fuller treatment see Willpower by Baumeister). Otherwise, I think she did quite a good job on this front.

She deals with “licensing” effects in chapter 4, and describes the dangers of our moral illogic: a woman losing weight may reason, “I just burned 200 Calories on the stepper; I deserve extra dessert.” She points out how our moral logic of good works vs. bad works is counterproductive. Her advice is: forget virtue and focus on goals and values.  The major shortcoming of the book is McGonigal’s treatment of morality. She seems to implicitly treat it like nothing more than social shame, a set of emotions that is either useful or not toward achieving “long-term goals.” Nowhere does the light of any other perspective break through the clouds of her post-modernism. Never does she consider that most people through most of history were pretty sure that the only worthwhile long-term goal was morality. Plato’s pursuit of Justice in the Polis, or Aristotle’s description of the virtuous life of Eudemonia, or Jesus’ appeals to holiness, or Paul’s calls to godly life in community, or Augustine’s Confessions and call purity; no eightfold paths; no five pillars. Long-term goals are personal, and generally seem to include things like “losing weight” or “checking Facebook less”; at best, “improving my relationship.” But coming from Harvard and now at Stanford, she can hardly be blamed; moral relativism is pretty well taken for granted and individual freedom and choice is unquestionably thought to be The Good. She may also be excused because she’s using the word ‘virtue’ in the vernacular, as used by members of her class with nothing at all to do with what the word has traditionally meant. The irony is that while she repudiates virtue, I consider “The Willpower Instinct” the most practical modern workbook for those wanting to build the virtue of Temperance.

In chapter 5 “The Brain’s Big Lie,” she provides a delightful discussion of the work on dopamine and motivation, starting with the Olds and Milner brain stimulation-seeking rat (here’s the unrelated-to-the-book actual video, go to 2:30) and moving into the more recent literature. She seems to want to frame it as “the stupid basically-still-chimpanzee brain is lying” rather than “the incredibly well-tuned motivation circuits are hijacked.” Otherwise, for a lay-audience, I saw little room for improvement.

The “what the hell” effect was discussed in chapter 6: what happens after the sobered alcoholic falls off the wagon, or the dieter “blows” the day. I never realized how moralizing people get about their willpower failures, and how badly wrong they are about how morality works. Here, she makes up somewhat for her bad advice in chapter 4 with the good advice: accept yourself in your present condition, and try again.
Chapter 7 was a discussion of behavioral economics. She talked about delayed discounting, and some of the human vs chimpanzee delay-of-gratification experiments, as well as the Walter Mischel marshmallow experiment (here’s an awesome kid-trying-not-to-eat-a-marshmallow video). What was new to me was some of the new work on improving “future self continuity.” Some of this included VR interactions with “old you,” but other exercises like writing letters to “future me.” It reminded me of GK Chesterton’s essay about rash vows: “The man who makes a vow makes an appointment with himself at some distant time or place.”

Chapter 8 focused on the contagion of willpower, bringing up the intriguing studies on the Naval Academy and Framingham. She described evidence of both good and bad behaviors spreading and she brought up the concept of the “social self.” These ideas are thought-provoking as we are rediscovering what the Greeks took for granted; i.e. that the “self” is only really a “self” in community.

Chapter 9 was a great treatment of the “White Bear” paradigm: telling people not to think about a white bear and then watching them squirm. She discusses a strategy that is often used in dialectical behavioral therapy and/or mindfulness therapies of “Surfing the Urge”; she recommends not fighting negative feelings or urges, but just experiencing them and observing how they affect the body. She covers a lot of work done on this effect, but has significant omission of Jeff Schwartz’s work on OCD.

4 out of 5. While spectacular and eminently usable, the omission of a mature discussion on virtue when writing a book about a virtue leads me to leave off granting a perfect rating.

In the end, she and reminds the reader to be a scientist: that is, to test her claims. I think this was a really effective approach. The Buddhist idea to experience the truth for yourself, or the Psalmists admonition to “taste and see” are (perhaps subconsciously) applied. Though I may quibble with some points, I think the Willpower Instinct is an important book with a very important message. It is a message that Americans desperately need to hear in the cacophony of voices that seems to say nothing other than, “Your failures are inevitable.” I am in total agreement with McGonigal’s mission to enhance willpower, and I agree with the conclusion of her book: “The is a secret for greater self-control, the science points to one thing: the power of paying attention.”

Sunday, September 8, 2013

What it is like to be a Man

A Discussion on the Subjective Experience of Masculinity

This week someone* had the experience of treating a patient with gender identity dysphoria, that is, someone who is transgendered. The standard treatment for female to male is treatment with biweekly testosterone injections. I reviewed the consent form for such treatment. The major focus of the consent was explaining the physical changes that would occur when taking hormones. No mention was made, with the exception of increased libido, of psychological or mental effects of testosterone. I considered this, and was rather surprised. If I were a patient considering taking hormones, I would be most concerned with what it would do to my mind. Bodily changes are important, but not nearly as important as how it would affect my thinking and behavior.

But what does testosterone do to the mind? There is very little research on this question. The only research I’m aware of is the work by Paul Zak. He showed that men will behave differently when given testosterone in certain economic/psychological games (the study was restricted to men, because of concerns for affecting women’s hormonal systems). The game most affected by testosterone is called the Ultimatum Game. This game involves two players: player A is given $10 and can choose to give any amount is that to player B. Player B decides whether to accept the offer or, if the offer is too unfair, to nuke the whole pot so nobody gets any money. When given testosterone, player B is more likely to reject unfair offers. Such punishing behavior is critical, Zak argues. He discusses another experiment where two groups compete with each other. One group is allowed to, at individual expense, punish free riders, while the other group is not. The group that is allowed to punish is wildly successful and out-competes the group that is not allowed to punish. Zak sees testosterone as a driver toward enforcing laws and fighting free riders, two essential functions for a functioning society.

As far as I know, this is the major work done on the psychology of testosterone. Why aren’t more people interested in this question? I think because we are just beginning to emerge from behaviorism. Since the cognitive revolution, we’ve started to think that ideas might impact behavior, that psychological experiences might actually matter. I remember a comment in paper comparing motivation to pleasure. The authors noted that the early work in the field was done by behaviorists who did not collect data on subjective mental states; as a result, the conclusions of the early work could not speak help separate motivation from pleasure. I think a similar thing has happened with testosterone. No one asked, after Thomas Nagel, what is it like to be a man? So we must start from scratch.

What is it like to be a man? The difficulty with this question is that comparisons are hard to find. It is difficult to identify individual subjective experiences and attribute them to one’s sex. How can one know if a particular state is common to men and women, or is a direct result of being a man? Further, are there subjective states that only men have that women do not? Or is it a more fluid thing? I think the experience of transgendered people can speak to these questions. For those who experience gender identity dysphoria (the DSM diagnosis), they often report feeling like a man, even though they were born genetically, anatomically a woman. I’ve spoken about this question with Ben Barres, a female to male transgendered individual and a professor in neurobiology at Stanford. The emphasis of his experience was on the social conventions surrounding the genders (e.g. preferring to dress up like a soldier rather than a princess). Transgendered people often go through operations and take hormones to change their physical appearance. They often report this reduces an enormous amount of anxiety and depression, as they now look on the outside how they feel on the inside. The feeling of being a man is an understandably difficult thing to define or describe, but from transgendered people, we learned that part of what it means to be a man is to look like a man; there is a mental state that is somehow incompatible or conflicting with breasts.

But what is that state? I recently had insight into this question when I had a testosteroney day. I’ve heard some argue that men have hormonal cycles as women do, but have not seen good evidence to this effect. Nonetheless, I experience certain days that I can describe none other than testosteroney. I’ve had others describe states of mind with the very same word. On one such day, I was pondering this question. I began to note the things that I did differently, or how I thought differently. When driving to work, I noticed that I drove a little faster, took a little more risk, and was ruthlessly just in traffic etiquette (if someone wanted to cut in the traffic line, I normally let them; on this particular day, I did not). At work, I was confident with my supervisors and patients. On my breaks my mind wandered to projects, solving world problems, launching businesses, and responding to arguments; this is somewhat typical for me, but on this particular day, my own individual concerns were afforded almost no attention. I also noticed on that day that the oh-so-difficult Christian command to not look at a woman to lust after her was especially difficult. When I got home from work, I did not procrastinate and was very productive.

I began to ask myself: when else do I feel like this? In parallel with this, I recalled the tiny bits of research on testosterone and things that increase it. Do I feel like this when my team wins? Yes! Do I feel like this when I handle a gun? Yes! Do I feel like this when I drive fast? Yes! Beside the research I’m aware of, are there other times I feel testosteroney? Competitive activities, lifting weights and summiting a mountain all seem to give this feeling. They also tend to be enjoyed more by men than women (at least more frequently). For some reason, climbing on top of large piles of rocks seems to be a stupidity associated with my sex.

What about women? Can they feel testosteroney? Of course! They also produce testosterone, and whether it is literally increased or not under the circumstances is an empirical question that has not been asked. Perhaps it is the case that women cannot increase their testosterone to the same degree as men; men certainly have anatomy to suggest that they might experience testosterone rushes of greater magnitude. But this is just speculation, and experiments need to be done.

In this rambling essay, I think my conclusion is that we just simply need to hunker down and do this research. What frustrates me is that the experiments have not been done. This essay has focused on male hormones, mostly because I have direct access to their release. I would guess that women’s behavior and psychology is also affected by hormones (female friends assure me that my guess is secure and that female behavior is not constant through the month; I have not had the opportunity to make these observations myself). What do hormones do to our psychology? This is a critical question for medicine if we intend to continue using hormone therapy. Our patients ought to be told all the risks and benefits of a particular treatment, including the psychological. It is inexcusable that we do not have this information. Let’s get to work.

*Because of HIPAA, I cannot tell you whether that person was me or not. Also, if I were to divulge that I treated a patient from “Northern California,” I would be in violation of HIPAA; the punishment for such an offense is imprisonment. I’m not joking. If you think this is unjust, please work to reform HIPAA.

Saturday, August 24, 2013

Rodin: A Genius Without Hope

Rodin: A Genius Without Hope

After completing a difficult rotation, I decided to spend the afternoon in the Rodin sculpture garden, and exploring the Rodin collection at Stanford’s Art Museum. First off, I must say that I love Rodin. He is able to masterfully express emotion in his sculpture. As an aspiring psychiatrist, I find such expression powerful.
One of the things that Rodin is famous for, is his ability to show motion in sculpture. My favorite piece that does this is called the Walking Man. The sculpture is after one of Rodin’s favorite models, the man whose face became John the Baptist. It also demonstrates Rodin’s habit of leaving a sculpture unfinished. His earned him much critique in his day, but I think had great effect here. Before Rodin, sculptors had to complete either a bust or a complete sculpture. With Walking Man, there is no head and there are no arms. The entirety of the viewer’s attention is directed at the torso and legs. And Rodin is able to give the powerful illusion that the bronze is in motion. It is a metaphor made of bronze.

This is common in Rodin’s work also: he is less concerned with accurately portraying a person or a character, and more concerned with the idea or ideas they represent. This earned him much malice from those who commissioned him to create a sculpture of themselves. While their friends often agreed that it really did look like them on the inside, warts and all, those who paid for them were often disappointed to have them revealed to the world. Unlike previous sculptors, Rodin would not be perfectly accurate in his portrayal of classic scenes. He would be more concerned with communicating the emotions, the ideas, or the morals of the story.

Regarding emotions, Rodin is a master of masters. He realized perhaps more than any other sculptor I have ever seen, that the whole body expresses emotion. He pays particular attention to hands. Whether it be a defiant fist, or an upturned hand of despair, or hand embracing a lover, there is often more emotion in the hands sculpted by Rodin than the faces sculpted by others. Perhaps my favorite piece, or collection of pieces, are the burghers of Calais. The inspiration of this piece is a situation during the Hundred Years War where the King of England put the town of Calais under siege. Six of its distinguished citizens, called burghers, went out to sacrifice themselves to the King while pleading mercy for their city. The piece demonstrates six approaches to defeat. The Stoic is present, who marches steadfastly into oblivion, gravity on his face, but nothing more. Another of them is despairing, another is confused, another is mourning with his head in his hands. My favorite among them is Jean d’Aire. Jean is defiant. His muscles are tensed, his jaw is tight, and his eyes are looking out with confidence despite his defeat. Of the six, I most wanted to be like Jean; I thought he represented the Christian response to defeat in this world.

I was discussing the piece with a friend, and she noted that Jean did not express joy, so was not really a Christian response. That got me thinking about the rest of Rodin’s work. Despite having an impressive collection, Cantor did not have a single sculpture by Rodin with a smile. Actually, there was one that I found after three hours of looking at Rodin. In his masterpiece, The Gates of Hell, a piece with hundreds of figures, there is a tiny two inch baby with a smile. I began to survey the emotions he did express. His most frequent emotion was sorrow or despair. Sensual emotions were also quite common; some of Rodin’s work is actually quite erotic. Amongst his subjects were Stoics, philosophers, dreamers, and artists. But none of them expressed simple joy. I realized that Rodin, in considering his work as a whole, expresses pre-Christian emotion. Rodin occasionally sculpts Christian subjects, but does not seem convinced them. The emotions expressed by Rodin are like pre-Christian philosophies: they fully express the truth that they see, but do not know the inexpressible joy brought by Christ. The Gates of Hell is perhaps Rodin’s most powerful piece; it captures the horror of the place, it is devoid of hope. Like the Greeks and Romans, I think Rodin was absolutely convinced of Hell, but doubted Heaven. Rodin’s genius in portraying the Gates of Hell may never be surpassed. We must wait for a Christian sculptor of equal genius to attempt The Gates of Heaven.


Because he is a much better writer than me, and because he discusses Rodin also, I will here share Robert Heinlein’s perspective. In his book Stranger in a Strange Land, one of the protagonists describes the rich meaning in two of Rodin’s pieces.

She Who Was the Helmet Maker's Once-Beautiful Wife
Anybody can look at a pretty girl and see a pretty girl. An artist can look at a pretty girl and see the old woman she will become. A better artist can look at an old woman and see the pretty girl that she used to be. But a great artist — a master — and that is what Auguste Rodin was — can look at an old woman, portray her exactly as she is… and force the viewer to see the pretty girl she used to be…. and more than that, he can make anyone with the sensitivity of an armadillo, or even you, see that this lovely young girl is still alive, not old and ugly at all, but simply prisoned inside her ruined body. He can make you feel the quiet, endless tragedy that there was never a girl born who ever grew older than eighteen in her heart…. no matter what the merciless hours have done to her. Look at her, Ben. Growing old doesn't matter to you and me; we were never meant to be admired — but it does to them. Look at her!

Fallen Caryatid with Stone
Now here we have another emotional symbol — wrought with exquisite craftsmanship, but we won't go into that, yet. Ben, for almost three thousand years or longer, architects have designed buildings with columns shaped as female figures — it got to be such a habit that they did it as casually as a small boy steps on an ant. After all those centuries it took Rodin to see that this was work too heavy for a girl. But he didn't simply say, 'Look, you jerks, if you must design this way, make it a brawny male figure.' No, he showed it… and generalized the symbol. Here is this poor little caryatid who has tried — and failed, fallen under the load. She's a good girl — look at her face. Serious, unhappy at her failure, but not blaming anyone else, not even the gods… and still trying to shoulder her load, after she's crumpled under it.

But she's more than good art denouncing some very bad art; she's a symbol for every woman who has ever tried to shoulder a load that was too heavy for her — over half the female population of this planet, living and dead, I would guess. But not alone women — this symbol is sexless. It means every man and every woman who ever lived who sweated out life in uncomplaining fortitude, whose courage wasn't even noticed until they crumpled under their loads. It's courage, Ben, and victory.

Monday, July 29, 2013

Side Effects: A Cure for Stigma and Call to Arms in Psychiatry

It is the rare film that takes something I’m already excited about and makes it even more exciting. But Side Effects achieves this: it is a Da Vinci Code for psychiatry, a whirling adventure that takes the viewer through the psych ER, the clinic and the hospital. I must tip my hat to its director, Steven Soderbergh, for he even made a literature review a thrilling, plot-changing scene. He demonstrates that modern psychiatry has all the ingredients of a high-adrenaline thriller: high stakes (pharmaceutical profits), complex character motivations, and a lot of ambiguity. With beautiful cinematography and masterful use of light and focus, the whole movie looked like an antidepressant commercial.

The thriller genre draws the audience along and succeeds in educating them “by the way.” Viewers see the many faces of modern psychiatry, including everything from pharmacotherapy counseling sessions to electroconvulsive therapy, and the attentive layperson can leave the theater with basic knowledge of depression and SSRIs, along with their side effects and what it’s like to be on them.

Psychiatry is an easy field to oversimplify. But Side Effects avoids both witch hunting psychiatrists and propagandizing SSRIs. Its critique of psychiatry is oblique. In 1975, Milos Forman aimed for psychiatry’s chest and unloaded both barrels with Nurse Ratched in One Flew Over a Cuckoo’s Nest. Side Effects used the facts of modern psychiatry as a mostly accurate (if somewhat exaggerated) background; it is a great film set against the intriguing tapestry that is modern psychiatry.

Side Effects seems to cover all the sticky issues in Psychiatry. Lesser movies would simplify the issues. Side Effects keeps them sticky, and uses the stickiness to make the plot gripping. It is uniquely able to do this because of its genre. In a non-thriller, the good guys and bad guys are usually pretty clear; the viewer’s sympathies rarely shift. In Side Effects, Soderbergh is able to give the viewer sympathy for good and bad psychiatrists, good and bad patients, and everyone in between; it is truly a full-spectrum emotional experience. The viewer gets to feel the deep sadness and isolation of depression, despair of suicidality, shame at having to see a psychiatrist, discomfort at a doctor’s “frivolous” prescription, hope that an antidepressant is actually working, and frustration at intolerable side effects. The viewer sympathizes with the psychiatrist’s guilt from a terrible patient outcome, anger at the malingerer, tiredness from overwork, and stress about finances. The viewer sees even the patient’s partner’s perspective, feeling their frustration and powerlessness.

The film powerfully combats stigma against those with psychiatric illness, and it does so by not combating it. In the late 1980’s, Jay Winsten and the Harvard Alcohol Project convinced popular TV shows (e.g. Cosby, Cheers) to donate several seconds of their scripts to including a “designated driver.” Without much finger-wagging or public education, the concept caught on and dramatically reduced the stigma of arranging to have someone drive you home. Side Effects does a similar thing with psychiatry. It doesn’t do much finger-wagging; it simply shows the pain caused by stigma and judgment and the dark road a depressed patient must walk down. The audience actually feels empathy for someone struggling with depression and the pain of judgment. Such empathy is very difficult to generate, especially for people who are “crazy.”

Despite its being a thriller, the film also touches on the deep philosophical question: who are we? A psychiatric patient is defended from a crime by claiming she was a, “victim of circumstance and biology.” The film asks us all, “Are we all victims of circumstance and biology?” Various high-performing not-mentally-ill characters seek medication to help improve their performance which, as one character explains, makes it, “Easier to be who you are.” Are we truly ourselves only when on our medications? And are medications the only defense we have against sadness and stress? In a poignant scene, a depressed character begins crying at a party. Her friend comes as if to console her, but ends up only offering a drug recommendation. The party guests look on the crying woman with embarrassment, unable to comfort or accept her, and she runs out of the party, ashamed.

The most important theme of the movie, and the crux of the plot, deals with diagnosis. The central tensions of the thriller are the daily questions of the psychiatrist: Who is really sick? Did this pill cause that? What should I, the doctor, do? These everyday uncertainties become matters of life and death, fame and disgrace. In the film, the stakes are very high for knowing if the symptoms are real. This fictional story reminds us that for patients, these are always matters of life and death. A correct diagnosis may well change a patient’s life.

In the film, one of the psychiatrists points out that the cardiologist can see the heart attack coming because he has tests, and then asks, “What test there is for sadness?” I hope that this is the last decade that such a film can be set. “The Sting,” a film set in the 1930’s, shows a central dupe which required the protagonists to delay telegraph information. When I saw it, I smiled at the quaint idea of slow information. I hope that our children can look at Side Effects and remember the quaint time when mental illness could not be diagnosed except by interview.