Robyn Reviews: Sway – Unravelling Unconscious Bias

Sway is a thoroughly researched and comprehensive look at unconscious bias and how it impacts day-to-day life, from job interviews to romantic relationships to saving for retirement. It covers a huge number of sensitive topics – sexism, racism, ageism, homophobia – with tact, and combines statistics with stories to paint a fuller picture and enhance understanding. Agarwal also clearly delineates theories with a solid grounding in science from musings which have yet to be proven, presenting references for each argument made and allowing the reader to make up their own minds. Science is ever-evolving, and sadly this is an under-researched field.

Sway is split into several sections. The first, ‘Hardwired’, covers basic neuroscience and psychology – how our brains create an image of ourselves, the world, and how the two fit together. It unravels the pathways involved to give a grounding to the lay reader. I have a neuroscience background, so whilst this was interesting I can’t comment on its accessibility to someone new to the field. However, Agarwal includes several diagrams to illustrate her points, and I imagine these will be very useful to those trying to picture the concepts she describes.

The second section, ‘Smoke and Mirrors’, covers the ways in which our brains reinforce biases and prevent us moving past them. This was fascinating. It covered things like hindsight bias – believing after something has happened that we knew would happen from the start, even though we actually had no or very little idea. These are concepts which we rarely consider day-to-day but are incredibly important for acknowledging our own limitations and mistakes. We cannot confront our own biases and blind spots unless we’re aware that they exist. Agarwal includes plenty of examples and anecdotes to prevent the material becoming dry, again citing all her sources so that those interested can read further.

The third section, ‘Sex Type-Cast’ covers what everyone thinks of when they think of bias – prejudice, from racism to sexism to homophobia. It also covers things that people might think of less – fatphobia, ageism, and discrimination based on ‘beauty’ or conventional attractiveness. Agarwal combines scientific data with her own polls carried out on Twitter, with some rather interesting results. After all, one of the well-known biases in science is research bias – those involved in research studies, including those on bias, are not representative of the whole population, but instead just of the population willing to get involved in research. This is a different group to those happy to spend a few milliseconds clicking on a Twitter poll. Agarwal doesn’t claim huge scientific accuracy to her Twitter poll data, merely including it as a point of intrigue – it supplements the more conventional sources very well.

The final section, ‘Moral Conundrum’ looks to the future and the impact of technology on bias. Technology is claimed by many to be the solution to bias – why would a robot care about race? The answer, of course, is that robots care about race because the humans programming it do, and the data sets they are trained on have their own intrinsic biases. There is a chapter in this section called ‘Good Intentions’ which covers the incredibly contentious topic of how trying to reduce bias can end up increasing or reinforcing it, which should be mandatory reading for everyone. Agarwal covers the issue masterfully and without judgement, merely presenting the facts and highlighting the importance of education and continual learning. Being completely unbiased is impossible – all we can do is continue to learn from our mistakes, learn our own biases, and act on them.

Overall, this is an excellent book – well-researched, informative without being dry, and highlighting some incredibly topical issues. Recommended for everyone.

 

Published by Bloomsbury
Hardcover: 2nd April 2020

Book Review: The Idea of the Brain

This review was written for and first published by Bookmunch.

“This is the story of our quest to understand the most mysterious object in the universe.”

Those who pay attention to the various interests of contributors to this site may have noticed that I review a fair few books that offer insight into how and why people behave as they do from the point of view of properly researched science. I am, however, a casual reader on the subject, not an academic with a background in, for example, psychology or neuroscience. I suspect The Idea of the Brain would be better appreciated by those with a stronger scientific grounding than I possess.

I insert here the caveat that I read the majority of this book during an escalating novel pandemic when the country was required to live under unprecedented lockdown conditions. I found the text dense at a time when my attention was wont to wander. I hoped to enjoy the copious information conveyed more than I could manage.

Following a brief introduction, the book is structured in three parts: Past, Present, and Future. As may be expected, Past covers centuries of study. The author selects those researchers he feels significantly progressed man’s understanding of the brain and describes each of their accomplishments in some detail. It is this detail that challenged my ability to retain focus. There were nuggets to be gleaned. The sections covering areas I already had knowledge of retained my attention the most.

The more researchers learned about the workings of the brain, the more they came to realise how complex it is and how little it is understood.

“To argue that there are things we can never understand is to undermine the whole point of science, which is to explain what is currently unexplainable.”

Many false premises were posited and blind alleys followed. Sometimes these led to the unexpected uncovering of useful knowledge.

The second section, Present, covers progress made in the last century. This includes the invention of various imaging techniques that allow scientists to observe an active brain without removing portions of skull – as had been done previously. The leap forward this offered laid bare how little it helped in understanding how brain activity affects consciousness – the mind, thought.

“There are many scientists who feel we are drowning in a tide of data about the structure of brains, while what we really need are some clearer theories and ideas about how it all fits together.”

“in and of itself knowledge of structure provides no direct understanding of dynamic function. Where is not how.”

Examples are provided of the benefits that became available to patients thanks to the ongoing research – at the cost of a great many creatures sacrificed in labs. Ethical considerations are mentioned along with economic reality. One patient briefly benefited greatly from an item of supportive technology until the company that provided it went bust. Her loss, after glimpsing what could have vastly improved her quality of life, had a distressing impact.

Chemical treatments for depression, schizophrenia and the like were often discovered accidently. These led to the increasing medicalisation of illnesses linked to the brain. As side effects became apparent and few effective new treatments were added after decades of research, pharmaceutical companies lost interest.

“Our understanding of the origins of mental health problems, and how to treat them, remains profoundly unsatisfactory.”

“It is hard to know what to say. We do not understand how a healthy brain and mind work, so it is hardly surprising that we do not know how to fix things when problems arise.”

Brain activity can now be monitored in real time but it remains hard to pin down, from the many parallel processes observed, correlation or causation. On what or where consciousness may reside, even less is known. There remains

“complete ignorance of how neural activity is turned into thought”

The final short section, Future, is perhaps the most bleak in terms of considering progress. Great leaps forward in terms of observation have demonstrated how little is yet understood. The limitations in where to go next with current research are acknowledged.

“’The Brain Has a Body’. And the body has an environment, and both affect how the brain does what it does. This might seem trivially obvious, but neither the body nor the environment feature in modelling approaches that seek to understand the brain.”

“the brain does not represent information: it constructs it”

The author includes an extensive list of notes at the end of the book for those who wish to read further on the research that underpins what he has written.

Any Cop?: My interest in the topic enabled me to plough my way through but this was a challenging read for a lay person. What I take away though is greater comprehension of where the science is now. The increase and development in my knowledge makes me glad to have read the book. It offers a candid and in-depth exploration of a complex topic, skilfully rendered but perhaps recommended only for those who have prior understanding of the basics of brain science.

“The four most important words in science are ‘We do not know’.”

 

Jackie Law

Book Review: Cure

This review was written for and first published by Bookmunch.

Medical research scientists are required to be rigorous in their investigations but also open minded to the lessons that can be learned, both positive and negative, from the results of clinical trials. Drugs that show early promise may not be as effective when tested over the long term on a wide variety of subjects. Side effects of treatments and surgical interventions can be as harmful as the problems they attempt to resolve.

While doctors may be eager to find more effective treatments, particularly for the growing number of chronic conditions, there are deep seated biases against certain alternatives: homeopathic remedies, mindfulness and meditation, distraction techniques, hypnotism, religious belief. What Cure sets out to do is to look at the trials that have been undertaken around such so called woo woo treatments and scientifically question their efficacy.

The book opens with an investigation into the placebo – pills given to patients that are known to contain no active ingredient, or treatment that has been shown not to work after accounting for the placebo effect in test results. Time and again trials show that many patients’ outcomes improve when given a placebo. The author asks why such a cheap and easy alternative is not offered when it could have clinical value. It is now known that the body is capable of producing its own powerful drugs, e.g. endorphins. The brain is a natural pharmacy.

“If someone takes a placebo and feels their pain melt away, it isn’t trickery, wishful thinking, or all in the mind. It is a physical mechanism, as concrete as the effects of any drug.”

There are important limitations in the placebo as treatment; it is limited to the natural tools that the body has available.

“Placebos are good at influencing how we feel but there’s little evidence that they affect measures we’re not consciously aware of”
“Feeling great isn’t everything. We also want to be kept alive.”

Yet for those who do not feel great, placebos could offer a welcome improvement in the way they live. Certain patient groups, especially those with chronic conditions such as CFS / ME, reject that the mind can have such an important impact as they then feel they are being blamed for their illness. This separation of the mind and the body, and the biases such thinking uncovers, may be one reason why the treatments looked at in this book are often dismissed.

Another reason is the difficulty of obtaining funding for large scale clinical trials. Drugs companies are unlikely to support investigations into treatments that will lead to fewer expensive drugs being administered.

Living with long term stress has been shown to create physiological damage and to rewire the brain.

“people in a threat state take longer to recover to baseline once a task is over […] Over time, the extra strain on the heart can lead to hypertension. And as we’ve seen, repeated activation of cortisol can damage the immune system.”

The author investigates a variety of alternative treatments that attempt to train the body to deal with challenges and decrease the harm caused.

“Just as with physical exercise, if we put our bodies under a manageable amount of stress, then go home and rest, this eventually makes us stronger and more resilient.”

The effects of meditation and mindfulness are studied and compared to the effects of antidepressants. Once again, certain patients enjoy benefits yet many medical practitioners dismiss such treatments as nonsense, the proponents delusional. Prejudices are strong.

One problem with alternative and holistic treatments is the way modern medicine is practiced. In the UK an initial consultation typically involves a ten minute GP appointment with the expectation at the end that there will be a prescription or potential for surgical intervention. There may not be a pill for every ill but there could be minimally invasive and effective treatment if the patient is willing.

Drugs for stress, depression and chronic pain are costly with damaging side effects such as risk of addiction. Trials have shown time and again that mind-body techniques can work better on many. Despite the evidence, stigma remains.

Religion is shown to have a placebo effect although only if compassionate and accepting rather than threatening. A sense of belonging – the importance of community and damage caused by loneliness – are also investigated. There is a beneficial effect on health when a patient feels they are a part of something bigger.

“the prolonged impact of having the opportunity to live your life in a way that you find meaningful”

The author is asking: if an alternative treatment works for a patient then why mock and dismiss it? It is clearly stated that a patient may not simply wish themselves better yet there are ways in which the conscious mind can influence outcomes and deal better with painful situations. There is also the argument that keeping alternative medicine within the NHS allows for regulation and the ability to offer conventional treatments as needed. The potential for harm is acknowledged, such as when proven beneficial medications such as vaccines are withheld for spurious reasons.

Each chapter contains details of a variety of patients’ experiences alongside interviews with clinicians and references to papers and journals in which studies are detailed. Throughout, the writing is warm and accessible, the tone clear and inquiring rather than dogmatic. The reader may decide for themselves if improvements in health are worthwhile even if treatment cannot always be fully, scientifically explained in the traditionally accepted way.

Any Cop?: This is a fascinating approach to a controversial subject. The author offers due diligence and a willingness to look for facts without prejudice. The workings of the mind may not yet be fully understood by doctors but this doesn’t mean it cannot be harnessed for innovative and effective treatments. The book offers a compelling and persuasive contribution to a wider conversation. It may change the way rational and informed readers view alternative medicine.

 

Jackie Law

Book Review: Behave

This review was written for and first published by Bookmunch.

Longlisted for the 2018 Wellcome Prize, Behave sets out to explain, from a rational and scientific perspective, why people behave as they do. As the author notes, it’s complicated. The reader must first learn about the neurobiology of how components of behaviour interact – the role of neurons, hormones, genes, evolution, culture, and ecological influences. There are many controlled studies to consider, the results of which offer better understanding but with limitations. The terms used are explained in some detail. Areas of the brain play different roles that must be understood before their impact on behaviour can be rationalised.

As an example of the writing style, from Neuroscience 101:

“some of the most interesting findings that help explain individual differences in the behaviours that concern us in this book relate to amounts of neurotransmitter made and released, and the amounts and functioning of the receptors, reuptake pumps, and degradative enzymes.”

Chapters explain the separate areas of the brain and how they function, reminding the reader that this is simplified as it is a continuum. It is then pointed out that all can change due to experience. Brain structure can adapt over time.

At close to 800 pages, around half of which is fairly technical, this is not a book that can be rushed. The main text regularly refers to notes at the back where the studies cited are detailed. There are also three appendices and an index. Footnotes elaborate on certain deductions reached by the author. It is dense but fascinating.

Examples of behaviours are given throughout, such as how a person reacts when they encounter another who is in pain. The distress this causes may render some incapable, unable to do more than deal with their own resulting suffering. Others will immediately rush to help. Individual reactions depend on brain function. How one judges another’s actions and needs, how they deserve to be treated, also varies depending on how ‘other’ they are judged to be.

Many of the studies detailed involve a variety of primates, some captive and others observed in more natural settings. The former allows changes in areas of the brain to be monitored, such as when processing rewards (the mesolimbic/mesocortical dopamine system). The results are familiar.

“What was an unexpected pleasure yesterday is what we feel entitled to today, and what won’t be enough tomorrow.”

Other studies of the brain’s reactions are more uncomfortable to consider, particularly when a subject observes those of a different race. The exploration of us/them is important and returned to frequently. At its most basic it is an innate desire to reproduce, to pass on copies of genes. The reader is reminded that subjects can learn and modify behaviour.

The topic is complicated as everything is linked to everything else, including the environment in which one exists. The difference between collective and individual cultures is explained along with the impulse markers of those who migrate. Psychology and anthropology have an effect but in drawing neurobiological conclusions there are limitations due to the size and makeup of historic sample data. Many recent human studies have been carried out on university students but did not balance for gender or race. In concluding the first half of the book the author states

“Instead of causes, biology is repeatedly about propensities, proclivities, interactions, modulations, contingencies, if/then clauses, context dependencies, exacerbation or diminution of pre-existing tendencies.”

The second half of the book, while still veering into technical explanations at times, is less demanding to read. The key points from the first half include what has been learned about the function of the amygdale and the frontal cortex – natural vs learned. The author notes of people

“we are just like other animals but totally different”

Moral decision making is explored along with the introduction of spirituality, the effects of proximity on moral intuitionism, entrenched bias, the impact of social groups and perceived beauty. It is clear that primates have us/them minds and that kinship matters. People act the way they do because of how their brain is structured, but brains can learn and change. Empathy is affected by attitudes to others, and if they are perceived to be to blame for their situation.

“our moral intuitions are neither primordial nor reflexively primitive. They are the end product of learning; they are cognitive conclusions to which we have been exposed so often that they have become automatic […] In the West we nearly all have strong moral intuitions about the wrongness of slavery, child labor, or animal cruelty. But that didn’t used to be the case. Their wrongness has become an implicit moral intuition, a gut instinct concerning moral truth, only because of the fierce moral reasoning (and activism) of those who came before us, when the average person’s moral intuitions were unrecognisably different.”

Aroused empathy, or tunnel vision compassion, such as raising money for cancer research after a loved one dies of the disease, is shown to do more harm than good in the broader measure of such things. Help is more likely to be offered based on emotion rather than rational decision making.

The Rwandan Genocide killed more people than the Nazi Holocaust yet garners less attention. Irrational behaviour, including such violence, often relies on dehumanising. The brain confuses reality with metaphor, supporting symbols over people. Contact can decrease willingness to inflict or passively accept other’s suffering. Justice is shown to be difficult to achieve. Even when dealing with individual transgressors in the West

“every judge should learn that judicial decisions are sensitive to how long it’s been since they ate”

Wealth and stability are shown to affect behaviour, although these may not lead to improved acceptance. After basic needs have been met, satisfaction depends not on what one has but on how this compares.

“When humans invented socioeconomic status, they invented a way to subordinate like nothing that hierarchical primates had ever seen before.”

The book concludes on a hopeful note pointing out how much has changed over time. Hateful behaviours still exist but many of these are viewed through a cultural lens. War may bring out the worst in participants but it has been shown that individuals struggle when ordered to kill. Studies prove that cooperation is more beneficial for all than aggression, and that greater equality improves economic growth and stability (if only our current leaders could understand this). Whatever our neurobiological makeup, change in behaviour is possible.

As a personal footnote, I cannot help but feel discomfort at the animals held in captivity and used in the many studies referred to within these pages. I ponder the benefits achieved at the cost of their suffering. The increase in understanding that they provide may be of interest but will people, as a result, change how they behave?

Any Cop?: This is a challenging but ultimately rewarding book to read. The topic is fascinating and explored in detail. The biases of the author are clear but do not detract from what may be learned. It will likely appeal most to those with a pre-existing interest in the science.

 

Jackie Law