Monday, August 11, 2008

meditation, prozac, and cognitive therapy

The final chapter of the Happiness Hypothesis series (1) book to own: happiness hypothesis, 2) the evolution of the elephant and the rider, 3) the mind and morality, 4) man's misuse of morality) looks at what works and what doesn't when it comes to improving our flawed cognitive processes. The elephant and rider aren't perfect, but by understanding their nature, we can improve their functioning.

To begin, let's remember that the elephant (often equated with our intuition or instinct) "was shaped by natural selection to win at the game of life and part of its strategy is to impress others, gain their admiration, and rise in relative rank. The elephant cares about prestige, not happiness." I want to stay on topic, but I'll note that Haidt distinguishes between the interest in relative social status and happiness, which have been conflated in modern discussion about inequality.

Back to the main show, what do with our intelligent, but slow-acting rider and stubborn, hyper-emotional elephant?

The answer isn't whipping the stubborn elephant into submission, but rather to "drop the brute force method and take a more psychologically sophisticated approach to self-improvement. ... Human rationality depends critically on sophisticated emotionality. It is only because our emotional brains works so well that our reasoning can work at all. ... Reason and emotion must both work together to create intelligent behavior."

Leave it to Ben Franklin to put the point most succinctly, "If Passion drives, let Reason hold the Reins."

Reason, in this case, "knows how to distract and coax the elephant without having to engage in a direct contest of wills."

Enough of the vagueries, Haidt points to three methods for improving our cognition: meditation, cognitive therapy, and Prozac. I'm only going to spend a moment on meditation (its utility is well-documented), a few more on Prozac (for the eyebrows raised by its inclusion), and concentrate on cognitive threapy.

The "goal of meditation is to change automatic thought processes ... proof of taming is the breaking of attachments." These types of attachments "are like a game of roulette ... the more you play, the more you lose. The only way to win is to step away from the table ... Although you give up the pleasures of winning, you also give up the larger pains of losing."

Prozac is controversial because it appears to be a shortcut -- "cosmetic psychopharmacology" -- that shapes minds like a cosmetic surgeon augments breasts. Haidt notes that our culture endorses two partly opposing perspectives -- "relentless self-improvement as well as authenticity - but we often escape the contradiction by framing self-improvement as authenticity. ... As long as change is gradual and a result of the child's hard work, the child is given the moral credit for the change, and that change is in the service of authenticity. But what if there were a pill that enhanced tennis skills? ... Such a separation of self-improvement from authenticity would make many people recoil in horror."

Haidt explores the stigma on cosmetic surgery as well, but I'll focus on his criticism of those who criticize Proaz as a chemical shortcut -- "It's easy for those who did well in the cortical lottery to preach about the importance of hard work and the unnaturalness of chemical shortcuts."

Haidt supplies research that argues that each person is born with an inherited chemical balance, which goes largely unchanged throughout life, which will dictate the range of emotion of happiness and sadness the person is susceptible to -- " many people really do need a mechanical adjustment. It's as though they had been driving for years with the emergency break halfway engaged."

Prozac shouldn't be seen as cosmetic for the "worried well", but "like giving contact lenses to a person with poor but functional eyesight who has learned ways of coping with her limitations." Contact lenses and Prozac both are a "reasonable shortcut to proper functioning."

Fascinating.

Finally, cognitive therapy was born as a means for therapists to engage depressed people, who weren't being reached by the Freudian exploration of painful memories and forced sexual innuendo. Cognitive therapy allowed patients to get beyond the bad memories and critical thoughts by questioning "the legitimacy of his patients' irrational and self-critical thoughts." The key was to "[map] out the distorted thought processes characteristic of depressed people and [train] his patients to catch and challenge these thoughts."

Just as depressed patients are convinced of their self-critical beliefs, we also deploy distorted thought processes "not to find the truth but to invent arguments to support our deep and intuitive beliefs (residing in the elephant)." For depressed people, the three types of irrational distortions are "personalization" (seeing events as reflection of self), "overgeneralization" (take an event and believing it ALWAYS happens), and "magnification" (arbitrary inference, or jumping to a conclusion without evidence).

These should sound familiar, as they are cousins of the cognitive biases and distortions that are well documented in non-depressed people. I think this is meaningful. Accurate and realistic judgment is good for your mental health.

Cognitive therapy is about "challenging automatic thoughts and engaging in simple tasks" to create positive habits that will further shape your automatic thought processes -- "it teaches the rider how to train the elephant rather than how to defeat it directly in an argument." You get better at thinking the same way you do at anything -- practice -- "write down your thoughts, learn to recognize the distortions in your thoughts, and then think of a more appropriate thought."

Specifically, Haidt refers to psychological studies that found that writing about the impact of biases doesn't change behavior, though it does allow one to predict the behavior of others better, and neither does writing an essay arguing the opposing view. The only thing that worked was asking subjects to read an essay on biases and then write an essay about the weaknesses of their own case; this made study participants far more fair-minded. That said, the study didn't ask them to question the deeply-held beliefs one associates with personal character, only recently assumed positions. Still, it's a start.

In sum, man comes "equipped with cognitive processes that predispose us to hypocrisy, self-righteousness, and moralistic conflict. ... By knowing the mind's structure and strategies, we can step out of the ancient game of social manipulation and enter into a game of our choosing. ... By seeing the log in your own eye you can become less biased, less moralistic, and therefore less inclined toward argument and conflict."

Redux

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