Causality vs. Associationism

Depression is associated with worse health outcomes in people with cardiovascular disease.

It is.  Really.

But there is something of a debate as to WHY that is.  Is it because people who are depressed take less good care of themselves?  Of their health?  Is depression related to physiological changes that slow down the healing process in people who are ill?  Is depression actually just the conscious expression of inflammatory dysregulation in some of us?  An epiphenomenon of a cardiovascular problem, if you will?

We are trying to figure all this out.  

But I would like to take a moment to question why we are asking what we are asking.  After all, does it matter WHY depression leads to worsened health outcomes, so long as we know that it does?

Does it matter whether depression causes cardiovascular disease, or is it enough to know that the two are associated?  Correlated.  Tend to happen together.  A lot.

Nobody believes what psychologists say anymore.  We are the scientific version of the boy who cried wolf.  We try to be helpful.  We say things like "people with dogs are happier" and then (logically) we figure that giving unhappy people dogs will make them happier too!  It's not dumb.  It's cute.

Avoiding those kinds of fallacies in our field really is pretty difficult.  Especially when you're torn between being a science that wants to stay pure and being a science that wants to help.  Because if you want to help, then you really need to know HOW to help.  And to know how to help, you need to know WHY good things happen in some cases and bad things happen in others.

If only we weren't so bad at that...

However.  Hope is not lost.  We are very good at knowing which sorts of things tend to happen together.  For example, depression and CVD.  They happen together.  Self-esteem and success.  Social support and well-being.  Exercise and morale.  Yes, let's use exercise and morale as an example.  

In this excellent paper the authors show that: "Regular exercise is associated with reduced anxious and depressive symptoms in the population at large, but the association is not because of causal effects of exercise" (p.897).

Does that mean that you shouldn't bother exercising?  Of course not.  But it DOES mean that if you have been depressed and anxious, once you start exercising, you are likely to be feeling better.

The problem is: so what?  So we can't prescribe exercise to make people feel better (there is plenty of disagreement with this viewpoint, by the way), and we are left completely thwarted in our goal of being helpful.

Harumph.

But.  Let's say we were to bypass the entire problem of causation.  Let's say we were to get really crazy and say that we just weren't going to BUY IN to the whole IDEA of causation.  (Take that, Liebnitz.) And just as an aside, we wouldn't be the first.  Remember Hume: 

"Thus we remember to have seen that species of object we call flame, and to have felt that species of sensation we call heat. We likewise call to mind their constant conjunction in all past instances. Without any farther ceremony, we call the one cause and the other effect, and infer the existence of the one from that of the other."  -- A Treatise of Human Nature (taken from this very excellent slide show) 

But what we do know is that the two tend to happen together.  Associationism.

So you should exercise because people who exercise feel good.  And you should feel good because who feel good exercise.

And if you feel like crap, exercise isn't going to change that.

But if you want to change that, exercise might be something to look into.


I believe that one of the reasons associationism as a philosophy hasn't been embraced by scientific psychology is that it's more mind-boggling than causation.  However, I believe that in certain cases, getting stuck on the question of causality in health is counter-productive.  It is not helpful.

Perhaps if we identify the sorts of healthy behaviors and physiological states we find optimal, and learn how they cluster together, we will be able to DESCRIBE the kinds of healthy states we would like to move towards.  Then we can tackle the question of causality.

Indeed, if we assume that the natural state of the organism is to move towards health -- and there is evidence to suggest that it is -- then perhaps simply presenting people with healthy alternatives will move them towards health, less by cause than by osmosis.

Thought of the day: New Year's Resolutions

Making and breaking New Year's resolutions are a popular pastime.  People resolve to do all kinds of things.  Exercise more, eat better, work harder, bla bla bla.  But what for?

To be happier.

Isn't that right?  Isn't that the real reason that we would put ourselves through the torture of diet and exercise?  (I am of course not talking about all the people who LIKE eating healthy and exercising.  After all, if you're one of those people and you make diet and exercise your New Year's resolution, well that is a cop out, my friend.  A cop out that I, personally, fully approve of, but a cop out nonetheless.)

But the question to me is, will those kinds of resolutions really make us happier?

As I was travelling over the holidays I had the great good luck of having a really interesting conversation with my seat neighbour on the plane.  We were talking about life, the universe, and everything - and how it all relates to medical psychology.  And through our discussion, we concluded the following: living a full, happy life takes a lot of effort.

Now let me be clear.  I have, for many years, tried the whole work harder and be better, fitter, (read: miserable) formula because I bought it when they told me that I would be happier for it later.  Based on my study (n=1, but there are replications), that's bullsh poppycock.  Being miserable will only get you one thing: more being miserable.

The kind of work that I'm talking about here is the kind of work that will get you more being happy.  In other words, how do you work at being happy?  How do you go about living the kind of life you want to live?  Here's a quick list of steps that I have found elucidate the strange process of working towards happiness that avoids the torture-trap of working towards being miserable.

Step 1.  Identify things that you LOVE.  

The basic equation to making sure you love your life is to put more things you love in your life.  So what do you love?  For example, I just bought new curtains, and I LOVE them!  Seriously, I went from walking into my apartment everyday and being dissatisfied, to walking into my apartment everyday and wanting to applaud!  (And I'm not even done redecorating yet!)  It's so small a thing, but it's made such a difference to me.  And that's the important thing.  It made a difference to me.  So what do you love?  Cooking?  Hiking?  Beautiful decorations?  More time with friends?  All of the above and more?  Being happy means you know yourself and you know what makes you happy.  Which leads us to Step 2.

Step 2.  Do the things that you LOVE to do.

Yeah.  I have known that I love sailing for years.  I have yet to take a sailing course.  Why?!  Why do we do this to ourselves?  I mean look at how excited I am over curtains! Just imagine how happy I will be when I start SAILING!  But baby steps.  We all like to get in our own way every once in a while.  That's ok.  (That's  why this is Step 2.  It's harder.)  I say start small.  One of the reasons so many New Year's resolutions fail is that they're too darn big and we are just not ready to make so big a change.  Don't say I will sail around the world, say I will take one sailing class.  Don't say I will become a master pianist, say I will learn to play one piece, and then maybe another.  Don't say I will move into a mansion in another city, say I will buy new curtains.  And then do!

Step 3.  Repeat.
That's it!  :)

Marc Chagall and the Meaning of Life

Science and art are often pitted against one another.  Science is 'Objective' and 'Rational' and art is the opposite.  'Subjective'.  'Emotional'.

But is this distinction real?  There is an art to rationality, just as there is a science to artistry.  But more importantly, art and science are both slaves to the same fundamental question: ''Why?''.  Oh, it's not that we don't care about who and what, when and where.  But science and art need to know why.

And so, predictably, art has come to be the answer to that most dangerous of questions that plagued me for most of the summer:  Why psychology?


Finally, I have an answer:  Marc Chagall.  Bear with me if my explanation seems cryptic, I'm doing my best here.  Psychology's raison d'être - when there are other fields like neuroscience and philosophy, sociology and economics - is that one day a man decided to be an artist.  He asked why love and family, why health and illness, why religion and country...   Chagall is my favorite artist.  And if I had to make up a reason why, I'd say it is because he asked all the right questions without ever being afraid of the answer.

These are themes that we all have to grapple with at some point in this life, and a science of psychology gives us a language, a framework, for talking about and questioning  these themes - and for keeping our answers at least a little bit honest.

There's more to being a science than the answers.  If anything, it's more about asking questions.  And Chagall's work has something to say about that too.  Perhaps in our determination to make sure it is a respectable-looking Science, psychology loses more than it gains because it cannot ask all its questions.  Part of what contributed to my existential crisis over the summer was my devastation at the futility of the questions being posed in social science.  But maybe we are asking uninspired questions because we are afraid of the answers we might get to any better questions.  (After all, few of us actually really want to be saddled with anything like the political nightmare that are Milgram's results).

Maybe this is where art has something to teach us.  Asking 'why' even when it doesn't look like the answers will be all that much fun.  Far from running from it, psychology can be inspired by art to ask all of its questions.

--
Thanks to ArtisticThings.com and GrandeYeoem.com for images.

Psychology's Raison D’Ëtre, Part 2

Scientific modeling of Psychological Truth is hard.  Standard nomenclature is difficult when most of our constructs are expressed in the modern languages (as opposed to having a periodic table of the emotions, let's say, that is universal).  To make matters worse, we rely on somewhat unreliable statistics to tell us whether or not we are Right.  Correct.  In the general area of Truth.

Is this a Science?

I’m going to say Yes. (Obviously.)  But ours is a developing science.  Somewhere on the continuum between Alchemy and Chemistry, Astrology and Astronomy. 

It has been suggested that Psychology is the Science before Neurology. 

I disagree.  Neurological science is going to massively inform Psychology.  But it is never going to replace it.  The reason for this is that nobody goes around saying ‘Oh my neurons are firing wrong today’.  We say ‘I feel sad!’ or ‘I feel happy!’.  And we say those things in predictable ways.  The existence of a micro-level construct does not preclude the existence of (or the importance of) the macro-level construct. 

Depression is not just a problem in the brain; it is a diseased state of mind and ALSO a problem in the brain. 

That being said, I think Psychology will split off into Science-Parts, and Non-Science Parts.  In the future,I think this is what the Science and the Non-Science of Psychology will look like:

-          Research psychology = Science in its own right.  And with major overlap in the biomedical sciences, mainly neuroscience.

-          Clinical psychology = Both science and alchemy.

-          Philosophical psychology = Philosophy.

-          Lay psychology = Some fun, some practical, some common sense.  And some derived from the above.

In short, I am trying to be clear about the Raison-D’Ëtre of psychology in modern science.  In talking to my colleagues, I think there is a shared and only half-spoken unease about the place of our science in the world today.  Who are we, and what are we good at?

I think the answers are there.  I think there will be changes to how we define ourselves.  But the issues that psychology talks about (e.g., relationships, group dynamics, mental health, how we think and why we do things) are so fundamental to our well being and operation as individuals and as a society that we have to study them scientifically, even if there are also other ways to approach them.

After all, when I think of the reasons I went into this crazy field, I remember them clearly.  I thought that a Scientific Psychology would incorporate all my favourite parts of Mathematics, Philosophy, Medicine, and Theology.  And I still do.

--

See Part 1

In Defense of The Scientific Practice of Speculation, Part 2

These days, speculation seems to be almost a dirty word.  There’s good reason for this.  Scientists, especially social scientists (especially psychologists?) are known for drawing conclusions that go way beyond their data.  We tend to be an idealist lot, and we think we have already intuited all there is to know about human nature and are really just conducting these studies and things to confirm our notions (OK – luckily this is not always true… but let’s be honest… “research is me-search” and we are often a liiiiittle more invested in our hypotheses than we should be. I think this is partly a systems issue. But I digress.)

But that's BAD speculation.  And bad science.

However, speculation before the creation of hypotheses I think is essential.  We are altogether too “in the box” these days.  We need to flatten that box into a topological map of psychic life and get some better ideas flowing!  (Kudos if you get the reference.)

And the only way to do that is by being a little bold, a little outlandish, and by being wrong.  Maybe 10,000 times.