Schizophrenia and Loose Associations

I often get hits on my blog from people searching for examples of Loose Associations

First, it may be helpful to know that I am a psychiatrist who works much of the time on an adult inpatient psychiatric ward at an academic medical center. My blog is just a hobby, and for entertainment (my own mostly) purposes only. I thought that the term loose association fit well with the format and content of this blog. I use the term in a general way, but it is apropos because of my line of work. I thought I’d take a moment to describe what a loose association is and talk a bit about schizophrenia.

The term loose association is used clinically when assessing the mental status of a patient. It refers to illogical connections between thoughts and statements. A loose association is a logical misstep. It is when the successive individual thoughts in a train of thought are loosely associated with each other. The train of thought is derailed. Loose associations can be appreciated in a variety of psychiatric disorders, but are very prominent in patients with Schizophrenia. To understand what a loose association is, it may be helpful to understand Schizophrenia.

Schizophrenia is a devastating neurological disorder that usually causes life long suffering and alienation. It is a  characterized by 3 categories of symptoms: positive, negative and cognitive. Positive symptoms are usually in the form of hallucinations (most commonly auditory i.e. hearing voices) and delusional thinking (fixed, false beliefs i.e. paranoia.) Negative symptoms are harder to treat and often cause some of the most devastating effects of schizophrenia. Examples of negative symptoms would be extreme apathy and social isolation. Finally, there are the cognitive symptoms. Patients with schizophrenia have difficulties with thinking. They have difficulty with sorting out and prioritizing their thoughts. This leads to below average functioning in an otherwise intelligent person.

Patients with schizophrenia often get caught in a downward socioeconomic spiral. Their symptoms and behavior often alienate loved ones, and their decreased functioning often leaves them with little ability to care for themselves. Too often these folks succumb to homelessness and drug addiction. There are some effective treatments that improve functioning and quality of life. These include anti-psychotic medications, supportive therapy and aggressive case management. Though a general lack of resources for the mentally ill often makes it difficult, treating folks with these issues can be rewarding.

So there you go. My blog is called Loose Associations because I intended to write on vast array of loosely associated topics. I also meant for it to be a nod to my day job.

Thoughts on “The Greatest Show on Earth” by Richard Dawkins – Chapter 3 “The Primrose Path to Macro-Evolution”

Chapter 3 discusses examples of naturally occurring evolutionary change. The previous chapter illustrated that humans consciously breed many different species of both plants and animals for all manner of economic and aesthetic purposes. This chapter moves us from artificial selection to natural selection.

Dawkins makes the argument that insects “domesticated” flowers long before humans did (along with hummingbirds, bats, frogs etc.). Flowers need a way to transport pollen in order to fertilize other flowers. This is done via luring an agent, such as an insect looking for nectar. When the insect lands, their legs are dusted with a bit of pollen destined to get dropped off at the next flower. Insect can see well into the ultraviolet spectrum, beyond what humans can see. If you look at certain flowers with an ultraviolet camera, patterns that the insects see that we can’t become apparent. If a flower is more attractive to an insect, it is more likely to reproduce. Therefore, based on the behavior of the insects, certain attributes of the flower are naturally selected.

This same phenomenon can be seen in the mating preferences within a species. Male pheasants are known to have very brightly colored and elaborate plumage, which is somewhat of a disadvantage since they are not well camouflaged. However the bright colors are preferred by female pheasants and therefore they are selectively bred for. The trick is that the peacocks tail has to be elaborate enough to attract a female, but not too much that it attracts a predator. With these countering  pressures, a balance is achieved. In areas with decreased numbers of predators, peacock tails are observed to be consistently longer and more brightly colored.

In this chapter, Dawkins uses very familiar and easy to understand examples of natural selection. I’ve just summarized two of them in this post, but he elaborates on several others.

Thoughts on “The Greatest Show on Earth” by Richard Dawkins – Chapter 2 “Dogs, Cows and Cabbages”

Cross-Posted on The Ramblings of a Jewish Skeptic

Chapter 2 further displays Richard Dawkins’s ability to put forth a very understandable and logical argument in a way that most readers can follow very easily.

In this chapter Dawkins begins the argument for evolution by providing a possible explanation as to why it might be so counterintuitive. We are introduced to Plato’s concept of the essentialism, a philosophical concept that everything is just an imperfect shadow of its true essence. We learn that this is very misleading and inaccurate when applied to biology.

When applied to biology, this mode of thinking makes it appear that all species of animals are clearly separate and neatly contained in groups. For example a rabbit would be the shadow of the true essence of “rabbit.” This type of thinking makes it hard for us to conceptualize that lineages of animals change gradually over long periods of time and that all species have various common ancestors.

We then move on to very tangible and inarguable examples of how humans have bred different animals and plants. This is under the heading “Sculpting the Gene Pool.” He uses examples of the various breeds of dogs, the various types of vegetables that were formed from cabbage, and domesticated dairy cows.

It was interesting to learn about the different species of dogs, how they evolved from wolves and the  process in which they became domesticated. He discusses an experiment in which the foxes were domesticated by selectively breeding the tamest individuals from each generation. After only five or six generations the foxes became quite tame. Interesting as well they also started to assume some of the characteristics of dogs, such as non-bushy tails and floppy ears.

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Thoughts on “The Greatest Show on Earth” by Richard Dawkins – Chapter 1 “Only a Theory?”

Reposted from my The Ramblings of a Jewish Skeptic Blog

I’ve just finished reading the first chapter of The Greatest Show on Earth by Richard Dawkins. I aspire to write some thoughts and reflections on each chapter as I read through it.

Chapter 1 is titled “Only a Theory?” He begins by going into some depth defining the word “theory,” distinguishing it from an hypothesis. He also points out that the human life span is too short to directly observe evolution, but that this does not preclude accumulation of convincing evidence. He likens this to a crime investigator arriving at the scene of a crime, noting that evidence for evolution well excedes the legal criteria of “beyond a reasonable doubt.”

Evolution has been vilified by well organized and well funded opponents, such as Answers-in-Genesis. He equates this level of incredulity to that of other groups of “deniers” such as Holocaust deniers. Despite over-whelming evidence, they still hold on to their ideologically biased beliefs.

Dawkins sets the context for this book, and begins the defense of Evolution by noting its acceptance by both scientific as well as theological scholars. He observes that most religious scholars who give serious consideration to the theory of evolution, more often than not, come to accept it, perhaps reluctantly at first.

It is amazing to me that in the United States, 40% of the population believe that the universe is less than 10,000 years old and that humans co-habitated with dinosaurs. How can this be when there are mountains of scientific evidence from multiple different fields of inquiry disproving it? There is a great need for understandable and approachable education, which is what Dawkins is hoping to provide.

I love Dawkins writing style. It is very clean and logical, with a bit of a swagger.

I look forward to reading and commenting on the rest of the book!

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The New Dawkins Book is Here!!!

I just received my copy of The Greatest Show on Earth: The Evidence for Evolution by Richard Dawkins. I’m very excited to read this book. I’m not an expert on Evolution, but I’ve read several books on the topic and took a Vertebrate Anatomy course in college, so I have some familiarity with the concepts. I’ve enjoyed reading two other Dawkins books, The Blind Watchmaker and The God Delusion. I’ve found that Dawkins is gifted at explaining complex scientific concepts in an understandable and exciting way. These are the same attributes that I admired in Carl Sagan.

Since attending Rosh Hashanah services last week, I’ve been thinking more lately about science and religion. I have another blog called The Ramblings of a Jewish Skeptic that I started about a year ago. This was in my blog experimentation phase (which I am still in.) I started it not long after reading The God Delusion and meant for it to be a format for me to work through my science vs. religion issues. After a lot of self assessment, reading, writing and thinking, I can now proudly say that I am both an Atheist and a Jew.

As a vehicle to continue reading and learning about science and skepticism, I am planning to post more regularly on Ramblings of a Jewish Skeptic. One thing that I’m giving consideration to is writing a review for each chapter of The Greatest Show on Earth: The Evidence for Evolution. I want to finish reading my current book The Blank Slate by Steven Pinker first, so it may be a while before I post.

So please check out some of the old posts on my other blog and let me know what you think. Since I am busy with my job and family, I’m sometimes a sporadic poster on my blogs. I strive to be more consistent.

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Happy New Year

Today is Rosh Hashanah, the Jewish new year. Traditionally this is celebrated as the birthday of the world, a celebration of creation. While over the past year I have fully consolidated my identity as an atheist, I have not yet been able to fully reconcile this with being Jewish.

One way to counter this that I’ve come up with is to choose scientific readings that resonate with me but also have some continuity with the themes of various holidays. For example, this year for Rosh Hashanah I’ve decided to read Chapter 8 of A Brief History of Time by Stephen Hawking. This chapter is titled “The Origins and the Fate of the Universe. I’m taking the opportunity that Rosh Hashanah provides to acknowledge the origin of the universe.

I’m always awestruck by the immensity of the universe and by the smallness of humans. Science has not yet provided a clear explanation as to the origins of the universe or life. The best theory that we have, based on the observation that the universe is expanding, is that the universe began as a Big Bang. We are uncertain as to the ultimate fate of the universe. Will it keep expanding? Will it ultimately stop expanding and contract in a cataclysmic Big Crunch? Either way we are occupying the minutest of slivers of this process.

I belong to Reform Synagogue. The reform movement does not take the Torah literally; however, I still feel a need to defend against the literal translation of Torah. There is no way, based on obvious and irrefutable scientific evidence, that the world was created in six days. That’s just ridiculous. Honestly I don’t think many Reform Jews believe this. However the fact that it’s written in a document that is highly revered by the Jewish tradition, it still bothers me at some level.

I have no idea how the universe started, and I don’t really even understand the science behind the Big Bang theory fully. However I choose to conceptualize the beginning of the universe this way because I trust the process of science more than the process of religion.

Book Review: The Blind Watchmaker by Richard Dawkins

I enjoyed reading this book. It was written in the late 80’s by British evolutionary biologist Richard Dawkins. It is a detailed description of how evolution works with many examples. It also goes into various 1980’s computer models of evolution, which is kind of entertaining to read in 2009. There are some direct refutations of creationist counter arguments that are very much old news to anyone who has read anything about this debate.

Evolution is the cornerstone of modern biology. Its fundamental premises are not really even questioned anymore by biologists that are doing scientifically sound and rigorous research. Sure there are still points of disagreement and areas that still need to be researched, but that is the way science works. It works by pushing back the darkness and sorting out what we see. As the evidence comes in, we change our theories and premises. This is what is cool about science. It thrives on the complex and the unknown.

The religious arguments against evolution are such a distraction. As new evidence comes to light that refutes the written word of a bronze-age civilization, the religiously dogmatic scramble to either retrofit it into their belief system or to outright refute it. This is so far outside of the way I see the world that it is hard for me to understand how someone can feel comfortable doing this. It truly blows my mind.

Anyway, this was a good book, but there are other, more contemporary books on the topic.

The Metastasis of Bureaucracy

Did you ever get frustrated by having to fill out tons of paperwork? Do you ever sit through long meetings that seem important, but are mostly boring and irrelevant? Did you ever make a phone call, then get transferred three times only to end up being transferred back to the person you called initially? As Pink Floyd said, “Welcome my son….Welcome to the Machine!”

Every facet of our existence is impeded by bureaucracy. Business and organizations are formed to do something. As they grow, more people are added and the scope of the task broadens. As this happens, the tasks of the organization become fragmented and have to be centrally controlled. But the central control is difficult to maintain as the fragments become more fragmented. The rules become more and more generalized, to the point where getting anything done is no longer a merit of hard work or expertise, but of the ability to navigate the system.

This happens to us as individuals as well. Most of us in our competitive American culture, regardless of occupation or status, are compelled in some way to produce. We are often judged by our productivity. When we are productive, we are rewarded. We often use our rewards to buy things. These things accumulate quickly and soon become clutter. Our livelihoods are dependent on consumption.

There is not necessarily anything wrong with being productive, that’s how we progress. We are blessed with a high standard of living and adequate sanitation and public health. One problem is that the option of doing nothing is not often employed or considered. Also, when things are not working well we often keep doing them.

This is how bureaucracies grow. If they keep growing, they can choke off the blood supply and metastasize like a malignant tumor.

One task where you can’t do this is writing. A good writer has the ability to be concise. By editing down the words and choosing them carefully, the final product is clear and to the point. There is no room for the tangential or self indulgent. As Stephen King put it in his book On Writing, “you have to be willing to kill your babies.” If a writer just kept adding things in the editing process, but not taking things away, the end result is an un-digestable mess.

We would be better off if we used our resources more prudently and if we were better at editing how we do things. The inability to say no or take something away is the reason we are innundated with so much useless mental and physical clutter.

Book Review – Why Darwin Matters: The Case Against Intellegent Design by Michael Shermer

Why Darwin Matters: The Case Against Intelligent Design by Michael Shermer

rating: 4 of 5 stars

This was a very interesting primer on the evolution vs. intelligent design debate. It provides good talking points to arm yourself with if you plan to enter a debate with a creationist.

It is interesting that the intelligent design movement is just a warmed over version of creationism that is trying to pose as scientific. Their main strategy so far has been to refute evolution. They do not have any research or evidence to back up any of their claims.

The whole creationist mind set is based on ancient texts that can not be edited or updated when new evidence comes to light. Since they see the bible as the unerring word of God, they cannot incorporate the evidence of evolution because it renders their texts inaccurate.

The creation myths of Genesis are understandable as a means for a Bronze Age civilization to explain their world. But given the tools and methods of science that we have now, there is no excuse to believe that the accounts of the worlds creation in the Bible are true.

Get this book and read it. Then discuss with your creationist friends!

View all my reviews.

Making Changes

For the past few months, I have not been exercising, and not eating all that well.

For the past few weeks, I have made an effort to correct this. A few weeks ago, my wife threatened to cancel my gym membership if I didn’t use it. Now I go at least once a week to lift weights and swim,  and I started a weekly fitness yoga class (which was really hard the first time!).

In addition to this, I’ve also started running. I’m using the Couch to 5K running plan from www.coolrunning.com that was set to music in a pod-cast I downloaded several years ago. I’m on week 2 of 9 with this.

As far as my diet goes, I am trying to break some bad habits. My routine for a while has been to run through the Tim Horton’s drive-thru on the way to work and pick up coffee and donuts. My Mom never spoke truer words to me than she did when I was a teenager “if you eat donuts for breakfast every day, you are going to get fat.” So now I am bringing some food from home to eat in the car. I am also packing a lunch instead of eating out. This is way cheaper and way healthier.

So far so good with all of this. My wife accuses me at times as doing things in a non-sustainable, all or nothing way. We’ll see…