Speaking up about perceptions of mental illness

I recently heard someone from a helping profession refer to depression as being a "selfish illness".  It was meant as an explanation as to why a depressed person in the conversation had taken actions to harm themselves that also affected a great number of other people.  The others in the conversation (all from the same kind of profession) either nodded their head in agreement or, like me, tacitly agreed by way of silence.

I was shocked by this at the time, as I expect that sort of comment from the general public but not from people who have training, knowledge, and firsthand experience with helping people who are struggling with issues that make them "different" from the status quo.  However, after a brief google search I realized that this is apparently a common perception, even from magazines that profess to educate the public about things like mental illness.

As someone who's had first, second, and thirdhand experiences with people who suffer from mental illnesses like depression, I can say that I have never known any of these individuals to be what we mean by the word "selfish".

Selfishness implies that someone behaves in a certain way for their own personal gain, regardless of the effect on others.  Is a mother who cancels her child's trip to the swimming pool "selfish" because she is in too much pain from her arthritis to leave the house?  Is a person with cancer "selfish" if they spend all day in bed and don't help their spouse with the laundry and groceries?  What about a colicky child who screams all night and "doesn't let" his parents sleep because he has severe pain in his tummy and can't communicate it?  Or someone with mononucleosis, who doesn't have the energy to respond to phone calls or emails from friends?

Extraordinary pain causes people to behave in often extra-ordinary ways in order to relieve the pain or discomfort. 

Imagine you had severe chest pain that was constant, non-stop, and completely undiagnosable.  Every medication the doctors gave you didn't work.  Every movement you made was excruciatingly painful, and you could no longer participate in your daily activities. Would you not try everything you could to relieve the pain? What if you couldn't communicate the source of the pain to others, or they didn't believe you, or the pain prevented you from leaving the house to seek treatment?  What if this severe pain went on for years and years, and seemed to have no end in sight?  Suddenly the option of suicide doesn't seem so completely illogical. 

Would someone that attempted to harm themselves in the above condition really be considered "selfish" by most people?  Confused, in distress, in obvious need of medical and societal attention, yes - but selfish?  If the intent is to get rid of immeasurable pain after you have (seemingly) exhausted every option, then the function of your behaviour isn't to "be selfish".  The function is simply to find a solution to your pain.

The extreme emotional distress experienced by individuals suffering from depression is an illness like any other.  It often requires medication to alleviate the symptoms.  We would NEVER think to interpret the relief-seeking behaviour of someone with cancer or arthritis as being "selfish"; why do we do so for depression?

While there has been some public education education about mental illnesses, I don't really believe it has been enough.  The Canadian Mental Health Association says that "20% of Canadians will personally experience a mental illness in their lifetime" and that ALMOST HALF of people who have suffered from depression have never gone to see a doctor about the problem.  In Canada, suicide is the leading cause of death among 15-24 year olds, and only one in 5 children who need mental health services actually receive them.

These are scary statistics.

I should have spoken out to that individual, for if even those in helping professions have this damaging assumption, we are a long way from a world where everyone with mental illness seeks helps without fear of shame.

Society for Music Perception and Cognition 2013

As those who know me are quite well aware of by now, I wear a lot of hats.  This weekend, I've donned my music-psychology hat and am attending a four-day conference hosted by the Society for Music Perception and Cognition (SMPC).

In 2010 I attended the international version of this conference.  I was in the beginning stages of my graduate degree and wanted to immerse myself in the current research at the time, so I could pin down a direction for my own M.A. thesis, so I made the trip all the way out to Seattle for the occasion.

This year, the SMPC is conveniently being held in Toronto, so I had no excuse not to submit my now completed research to be considered for presentation.

Much to my excitement (and alarm), I was selected to give a talk.  Despite my terror at the idea of public speaking, apparently I was coherent, got to tell a room of people about my research for fifteen minutes and answer their questions.  I even got a lovely write up by Dr. Victoria Williamson's music psychology blog, who is live-blogging the conference proceedings.  (Make sure you check out the rest of her blog, which is a great place to read about other topics in music psychology in friendly, accessible language).

So what do music psychology researchers talk about at big fancy conferences like these?  Does applying "science" to the study of music take away from it's visceral experience?  Do "experiments" give us insights into real-life music performance and teaching experiences?  Is any of this research applicable to real-world problems?

The short answer is yes!

Here are some of the many varied topics I've heard about in the past few days:

•  Preliminary findings show that giving music lessons to deaf children with cochlear implants may improve their abilities to perceive and produce emotions in speech.  ("Music and linguistic benefits of music training in deaf children with cochlear implants", Arla Good, Ryerson University).
  
  
•  While studies have shown individuals with autism do not integrate auditory and visual cues when perceiving language (i.e. spoken words with lip movements) the way others do (to help enhance meaning), they do not appear to have this deficit when perceiving musical tones + gestures.  "These findings have potential implications for understanding core features of sensory processing in [autism] and for designing related treatment interventions."  ("Using music to explore sensory processing in autism" - Laura B. Silverman, University of Rochester School of Medicine and Dentistry).
   
•  Setting multiplication facts to unique musical melodies, fun lyrics (e.g. "three times three, nine cans of pee"), and simple movements helps children memorize otherwise tedious math facts.  While it is unknown if this method works better than others, it is an intriguing use of music and the children shown in the video presented were obviously having a lot of fun! ("Music as a kinesthetic pedagogical tool to teach mathematics in early elementary years", Afarin Mansouri Tehrani, York University)
  
  
•  Music doesn't make you smarter!  Despite an explosion of popular media outlets and research studies claiming otherwise, a careful analysis of the real factors involved in who takes music lessons reveals that high IQ and doing well in school are not caused by musical training.  Instead, "young children whose parents are high in openness-to-experience... are those who tend to become musically educated."  Personality factors of the child are also the biggest predictors of which children continue with music lessons and for how long.  This is a very important finding because it frees up music educators from trying to make a case for music lessons as having unrelated benefits and allows us to begin to have an honest discussion of what music DOES do for us.  Music is a unique and important part of the human experience; it doesn't need to be "justified" by appealing to unrelated benefits. ("Predicting who takes music lessons: The role of demographic,cognitive, and personality variables."  E. Glenn Schellenberg, standing in for Kathleen A. Corrigall, University of Toronto Mississauga.)



• Ever had a song repeat over and over in your head that you couldn't get rid of? Fascinating research still in it's infancy shows that over 90% of people experience this phenomenon at least once a week, and that people try a huge variety of methods to try and get rid of them (if they're deemed unpleasant, which they often are not).  Many songs have been identified as "cures" for earworms if they are played in the head to "replace" the repeating song, which brings up an interesting question - what are the features of these songs (many people even reported the same song to work, like God Save the Queen or Happy Birthday) that makes them effective at getting rid of the ear worm?  Dr. Williamson also brought up another fascinating use for this research - imagine if all the things we wanted to remember (e.g. information for an exam) sprang to mind as easily as an earworm? ("How do you control your earworms? Coping strategies for managing involuntary musical imagery", Victoria J. Williamson, Goldsmiths University of London).  (Want to be part of this exciting research?  Visit the The Earwormery!)

To view the abstracts of all the talks, visit this link. 

The conference is only half over; I have this hat on for the next two days.  Looking forward to the rest of the upcoming talks!

Philosophy from the mouths of babes: Identity

A couple of months ago, I was walking home the four year old I babysit from school.  We were chatting about nothing in particular, and after a lull in the conversation she said "Do you sometimes wish that you were me and I was you?"

After over 8 years of working closely with children, I have a pretty good sense of when they're asking a genuine question and when they're rambling nonsense.  This was the former, so I answered her seriously - "No - I would miss being me."

"But why?" she asked.  "There would still be an Ana in this country."  (Translation:  The "I" that is "Ana" would still exist "in the world" - I would still "be" even if I wasn't actually the one being me.  Why should I miss "being Ana" if "Ana" still existed?)

*                    *                    *

At the time I had just finished reading "Why does the world exist?  An existential detective story" by Jim Holt.  After a fascinating whirlwind of a journey through different theories about the nature of existence from  all manner of disciplines, he spends a brief chapter towards the very end exploring the nature of the existence of the self.

Consider the following thoughts from that chapter:

"The coming-into-being of my genetic identity was indeed a long shot.  But was even that enough to ensure the coming-into-being of me?  Could this genetic identity not just as easily produced not me, but, as it were, my identical twin?  (If you happen to be one of a pair of identical twins, try this thought experiment.  Imagine that the zygote that split apart shortly after fertilization to produce you and your twin had instead remained a single clump of cells.  Would the unique baby born to your parents nine months later have been you?  Your twin?  Neither?)"  (pp.255-256)

"But what happens if I undergo amnesia and lose all my memories?  Or what if a fiendish neurosurgeon manages to erase all my memories and replace them with your memories?  And what if he performed the reverse operation on you?  Would we find ourselves waking up in each other's body?" (p.258)

"But if psychological factors don't determine my self-identity, what could?  The obvious alternative - endorsed by [Bernard] Williams and later, more tentatively, by Thomas Nagel - is the physical criterion.  My identity as a self is determined by my body; or, more specifically, by my brain, the physical object that is causally responsible for the existence and continuity of my consciousness.  On the "I am my brain" view, the actual contents of your stream of consciousness don't matter to your identity.  What is all-important is the particular blob of gray meat that is lodged in you skull.  You cannot survive the destruction of this blob.... Nagel has gone so far as to suggest that even if an exact physical replica of your brain were created, and then stocked with your memories and lodged in a clone of your body, the result would still not be you." (p.259)

If me and my little charge switched bodies (i.e. if my brain was implanted into her body and vice versa), it is conceivable to me that "I" would still exist - I would, however, suddenly have the body of a four year old.  There's no shortage of movies based on this idea.

But still... would that really be me?  Is my brain the only source of my identity?  Could identity be transplanted so easily from one physical container to the other?  Are our identities a collection of all our thoughts and memories?  Our repertoires of behaviours?  Is a new born child, armed with only a few fuzzy memories of sound heard from the womb, essentially devoid of identity, of self, until they have amassed enough memories and thoughts in their brains to be called a "self"?

What about the girl I babysit - she is 4.  She definitely has what most of us would call an "identity".  Yet, 20 years from now, she will probably remember very little of what she thought, felt, and experienced as a four year old.  Will her current identity have been annihilated and replaced with a new one?  Most of us, myself included, would instinctively say "no" with a great deal of certainty - what is it that remains, then?  An unconscious recollection of experiences?  A repertoire of intricately "conditioned" behaviours collected through our life time but which we no longer know the source of?  A "soul", some sort of essence outside the physical body that persists and "gives identity" to a particular body in a particular place and time?  How could such an intangible non-substance even exist - what would it be "made" of - how can an idea of an identity, which is essentially what a soul would be, exist without a thinker or perceiver of the soul?  (Why, that would be "God", you say - he/she/it thinks us and knows us and that solves the problem of our existence. 'But then, mummy, who created God?')

*                    *                    *

Flummoxed by the depth of her response and how much it reminded me of Holt's (and my own) ponderings, all I could muster in response was something like "I would still miss being me... it wouldn't be the same", and we both continued the rest of the walk in pensive silence.

Evolution - toddler version

When I was five years old, I asked my mother, “Where did the first carrot come from?” My mother, not really understanding the question, replied “Carrots come from seeds that we plant.”

“But where did the first seed come from?” I asked again. My mother, starting to sense the profoundness of the question, tried to explain that a long time ago, the world had no people and God made all the plants and animals. Unsatisfied, I pressed on – “But where did those carrots come from? Where did the first seed or carrot come from?” My mother, unable to come up with any other explanation, simply said, “God made the first seed,”  and promptly changed the subject.

This was very unsatisfactory to me even as a five year old, but I got the sense my mother just didn’t know the answer, so I put the question in the back of my mind.

A few nights ago, I was babysitting and toweling off a four year old and her two year old sister after their baths. She was asking me about the bath water and where it came from. I have explained to her about pipes and plumbing in the past, so I was surprised she was asking again. As I started to remind her, she interrupted me and said “No, where did the first water come from?”

I was caught off guard.  I asked her to clarify. 

“How did the water get made? How did it come to the dinosaurs’ bathtubs?” I laughed and told her that dinosaurs didn’t have bathtubs, and that a long, long time ago there were no bathtubs or streets or cities in the world and dinosaurs got their water from oceans, rivers and lakes. But she pressed on. “But who made the world?”

I realized that if she was anything like my five year old self, the answer “God made it” would not be satisfactory (and I try to let parents do the religious explanations if they're at all religiously inclined; it's not really my place).  

I said, “That’s complicated to explain. Let me think about it for a minute.” (Meanwhile, I’m in the middle of putting a diaper on a wriggly two year old, looking around for her pajamas and trying to respond to her deepest query of the night – “where is my dolly?” all while trying to figure out how I’m going to explain evolution to a four year old!) This is the explanation I came up with:

“A long, long time ago, there was no world. There was only tiny pieces of rocks, dust and diamonds floating in outer space. One day, they all stuck together and made the world. Then, slowly, oceans and trees started to appear. (“Like magic?” she interrupted.) Kind of like magic, but different. It’s a magic called science. They started to grow very slowly, First the world only had fish and bugs. Then one day, a fish came out of the ocean to see if he could live on the sand. And he started to change a little bit – he started to grow legs. And more fish came out and little by little they changed into different things like turtles and lizards. (“And hippos?” she asked.) Yes, hippos too. Then one day, some of the lizards decided to walk into the forest and see if they could live there. And they started to change a little bit. Some of them started to grow wings and become birds, others started to grow fur and become rabbits, squirrels, lions and monkeys. 

Then one day, some of the monkeys decided to come out of the trees and see if they could live on the ground. They started to stand up straighter and walk, and their fur went away. And they turned into people. And the people started to walk all over the world, and make houses and cities and bathtubs.”

She listened intently to every word, and there were no more questions.  I hope my explanation made some sense to her; it's hard to explain eons of time to a toddler who can't even grasp the meaning of an hour yet.

I’ve essentially given the same explanation to six year olds, but I’m able to add in the concept of heredity since they have a better grasp of time (i.e. One day a monkey had a baby that looked a tiny bit different, and then when that baby monkey grew up it had a another baby that looked a little bit more different, and in thousands and thousands of years, they had changed to people.) A four year old can barely grasp the meaning of a year or numbers above twenty, so my approach had to be different.

Sometimes I wonder if religion was invented for the purpose of answering our children’s questions. In the absence of scientific knowledge, our ancestors had to come up with something to quiet young minds.

(I don’t think evolution necessarily interferes with anyone’s religion either, as the same child later exemplified in a conversation about dead people: “So when we’re dead we can play with Terry Fox and baby Jesus?”)

I’m interested to know how other people have explained the universe to their young children. I wonder if anyone’s written a book on evolution for toddlers?

[edit: I just googled it and wow, yes they have!  I'll have to check some of them out.]