When a medical student goes to Alcoholics Anonymous

"My name is Erica and I'm an alcoholic"

is not something I could imagine myself easily sharing, much less in front of rows--at least ten rows filled--within the confines of the St. Aloysius Catholic Church, much less to follow that statement with a personal speech interjected with casual fluency interspersed with shouts from the crowd. Yet it is what I witnessed alcoholics do this Saturday evening. As a medical student non-alcoholic observing the proceedings of an Alcoholics Anonymous meeting, I was an outsider even before I stepped in. Crossing across the Harlem streets between Frederick Douglass St and 132nd St, I paused before the church with some uncertainty, before a man asked, 'Where you going, sweetie?" and as we both approached the entrance, I replied with awkward cheer, "here!"

At the entrance

Certainly he was not the first person to raise an eyebrow at my entrance--I, an Asian American twentysomething carrying my backpack, felt quite conspicuous in the midst of the middle-aged mostly black crowd. Thinking back to my visit to the Frick Collection earlier in the day, I started to reflect that my feeling of awkwardness was something these people experienced daily in entering the kind of 'white spaces' which have unconsciously become so natural for me. 

Despite feeling rather out-of-place, I also felt a great sense of camaraderie in the crowd--so that rather than feeling like an uninvited stranger at an official meeting, I felt like a new acquaintance joining a close-knit group of friends, whose inside jokes went over my head. And rather than a therapy session in which I imagined myself as a wallflower, I found myself smiling and nodding along with the shared stories like a (somewhat-clueless) audience member at a comedy show.

For their stories were reminiscent of those from The Moth radio hour where members of the public share gripping personal tales with a receptive audience--they were fun, casual, personal; they elicited laughter and cheers from the crowd; they were told with flair and comedic effect. A man with a blazer and T-shirt went up in front of the crowd, half-grunting half-laughing, "I am certified NUTS!" (laughter from the crowd) "I know I'm crazy," and, referring to his alcoholism, "I know I gotta get out." He goes on, "Alcohol removes," and with dramatic pointing, "Table.... Leg... (laughter). Brain... Kidney... Liver." And a woman with camouflage cap and shirt announces in clear, stately tones, "If it weren't for AA, I wouldn't be here today." 

The last speaker was celebrating her 14th Anniversary--that is to say, it was her 14th year as part of AA, and celebrated with candles and cake. She spoke with flair, spunk: "I was loud. I'm still loud. " And then, sincerely, "My baby teaches me to be better. You all teach me to be better." And, "Others help us see what we don't see in ourselves." As I approached her after the session, along with many others who expressed their congratulations, she turned to me with a bright smile and extended arms--"Are you new?"

I left with the feeling I get when I attend mass at a church and religion I don't "belong to," and why I attend in the first place: that the world is a better place, and can become a better place. That despite our differences, we all seek to be better. And that matters, for alcoholics and for me. 

Psychologists use smartphones to measure ethics

What would you do if you could divert a train to save five men but kill one man as a result? Would you do so? What if you had to push that man in front of the train to save the others?

Psychologists often use these kinds of “trolley problems” on test subjects using desk computers in their laboratories to study our moral reasoning. But recently a study published in the journal Science went beyond hypothetical questions into real life. Psychologists now have a sophisticated lab tool for examining morality not just in the lab, but in everyday life: the smartphone.

In the study, 1252 participants of varying ages, ethnicities, and educational levels from the US and Canada texted—in their homes, in the streets, wherever they happened to be. At five random points each day, they would receive a survey by text message, and they would briefly describe the moral or immoral acts they had committed, been the target of, witnessed, or learned about (e.g., through gossip, news, and the internet) within the last hour. From the texts, the researchers were able to measure the frequency and content of moral and immoral acts.

They found that people who were non-religious committed about as many moral acts as those who were religious. And liberals reported more moral acts of fairness, liberty and honesty, while conservatives reported more moral acts of loyalty, authority, and purity. Committing a moral act was associated with a greater sense of purpose, and being the target of a moral act was associated with higher levels of happiness.

Overall, moral acts were reported just as often as immoral acts, but there were some interesting imbalances. Acts committed by the self or received from others were more than twice as likely to be moral than immoral. The opposite case emerged for learned-about acts: they were more than twice as likely to be immoral. The use of smartphones allowed researchers to examine interactions in real-life time, which previously had not been possible in the laboratory. This allowed them to examine how one moral act determined the occurrence of another throughout the day.

Their findings provided evidence for a kind of moral slacking that psychologists call “self-licensing”: people who commit a moral act early in the day are less likely to do so later on, and more likely to commit an immoral act. But there was also evidence for what psychologists call “moral contagion”: people who receive a moral act are more likely to commit a moral act themselves later that day. Self-licensing and moral contagion are amenable to social intervention. So we may be able to alter moral behavior by intervening in the moral course of people’s days.

Researchers foresee the ability to use the smartphone not only for data collection, but to provide interventions to increase self-discipline. According to the original paper, “Given these different mechanisms, it seems important to find out more about how the principles of moral contagion can be used in public policy interventions, and how moral slacking may be prevented.” The study is one of the first of its kind to study ethics outside of the laboratory. More studies will need to be done, but this one has made striking entrance into the real world.

It collected an impressive number of 13,240 responses, substantially more than most psychology studies. The larger the number of responses, the better that sample represents the general population of interest. This allows for robust results and generalization across large populations. But since participants were sampled exclusively from the West (US and Canada), researchers weren’t able to examine how cultures differ in their prioritization of moral values across cultures – a subject of great interest to moral scientists.

Still, the study provides evidence that controlled but artificial laboratory findings also apply to people’s everyday moral experiences. Although the findings are tentative, they provide important areas for further research, and new methods to do so in real-time, everyday situations. “I think of this as a first look of how morality plays out in real life,” says Dr. Brian Nosek, a psychologist at the University of Virginia. “The first telescopes didn’t tell us everything about the galaxy, but they gave us a tantalizing sense of what’s out there.”

Rightly Wrong: Understanding the Autism-Vaccine Misbelief

The evidence is clear: vaccines are not linked to autism (American Academy of Pediatrics, Center for Disease Control, World Health Organization, Institute of Medicine). Yet, many people (Jenny McCarthy on Oprah, John McCain) and parents refuse to believe the science. Even after various pro-vaccinations campaigns - facts, science, emotions, stories - no kind of intervention is effective in making people change their minds. If you are thinking, "Why??," so am I.

A recent NY Times article, "I Don't Want to Be Right," provides some insight.  The article is about why people refuse to change false beliefs, even in the face of clear factual evidence and acknowledgement of the truth of such evidence. Take, for example, if someone says, "I know that the world is round, but I'm going to believe it is flat." Why would this happen? 

Consider this scenario:

...not all errors are created equal. Not all false information goes on to become a false belief—that is, a more lasting state of incorrect knowledge—and not all false beliefs are difficult to correct. Take astronomy. If someone asked you to explain the relationship between the Earth and the sun, you might say something wrong: perhaps that the sun rotates around the Earth, rising in the east and setting in the west. A friend who understands astronomy may correct you. It’s no big deal; you simply change your belief. 

But imagine living in the time of Galileo, when understandings of the Earth-sun relationship were completely different, and when that view was tied closely to ideas of the nature of the world, the self, and religion. What would happen if Galileo tried to correct your belief? The process isn’t nearly as simple. The crucial difference between then and now, of course, is the importance of the misperception. When there’s no immediate threat to our understanding of the world, we change our beliefs. It’s when that change contradicts something we’ve long held as important that problems occur (Maria Konnikova, NY Times, I Don't Want to Be Right).

Why would false belief happen? It'd happen if the belief tied in strongly with your sense of self, if that belief changes beliefs about a whole range of other things, if that belief threatens something you stood for with conviction. "A man with a conviction is a hard man to change. Tell him you disagree and he turns away. Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your point." So wrote the celebrated Stanford University psychologist Leon Festinger" (See related article: Chris Mooney, Mother Jones, The Science of Why We Don't Believe Science).

What can scientists and physicians do about the vaccine and autism mis-belief, then? The answer is not clear, since the topic has become one of such conviction; one highly invested in emotion for parents and caregivers. But, at least it is not an inherently ideological one. The best we can do is try to prevent it from becoming more so - and that applies to all our politics and debates. 

And that, ultimately, is the final, big piece of the puzzle: the cross-party, cross-platform unification of the country’s élites, those we perceive as opinion leaders, can make it possible for messages to spread broadly. The campaign against smoking is one of the most successful public-interest fact-checking operations in history. But, if smoking were just for Republicans or Democrats, change would have been far more unlikely. It’s only after ideology is put to the side that a message itself can change, so that it becomes decoupled from notions of self-perception. 

Vaccines, fortunately, aren’t political. “They’re not inherently linked to ideology,” Nyhan said. “And that’s good. That means we can get to a consensus.” Ignoring vaccination, after all, can make people of every political party, and every religion, just as sick (Maria Konnikova, NY Times, I Don't Want to Be Right).

Calmness as Insight

Jeff Nunokawa is a Professor of English at Princeton University. He writes daily notes on facebook available to the public at https://www.facebook.com/jeff.nunokawa/notes, and is currently working on a book which puts together these notes. I can't recommend his notes enough for the insights he provides on everyday life, the struggles we all go through, the importance of connecting with others, and the way he speaks at once so personal and so general. His note (#5172!) this morning is beautiful. Just think, if we both read these each day, we're making daily connections, being a part of something greater, something shared. What a beautiful thought! Please join me? 

5172, Calmness as Insight

March 7, 2014 at 11:59amby Jeff Nunokawa

I do not think the craving for placidity is religious; I think a religious person regards placidity or peace as a gift from heaven, not as something you ought to hunt after. Look at you patients more closely as human beings in trouble and enjoy more the opportunity you have to say 'good night' to so many people (From M O'C Drury, "Conversations With Wittgenstein").


You wake up angry and you remember why you're lonely. (You can't get too close to other people. No one can see that much of you: you're too easily annoyed.) And you go and read something calming that some wise man said in another century. (See above.) You're all set to open the far sighted gift that's come your way from far away. (The calming gift that lets you know that calmness is a gift. See above.) 

But then you notice that's something's off with your vision in one eye. Maybe you always have this problem and you're just noticing it now. Then you start to look around at what else you're just noticing now. Like the rest of what the wise man had to say (see above): Look at you patients more closely as human beings in trouble. Maybe say it twice for both eyes. (If you type it out, and don't just copy and paste it in, you might be able to see it better.) Look at your patients more closely as human beings in trouble. Look at the people around you as people in trouble. (You don't need 20/20 vision to enlist for that.) Look at yourself as a kind of First Responder. (You don't need a license to practice that.)

Look at good night and good morning as two aspects of the same greeting. Look at every greeting as a gift from something glowing. Look at every glowing as a gift from somethinggoing. 
Look at every going from the corner of one eye.
Look!
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Note: As my two eyes make one in sight (Frost, "Two Tramps in Mud Time")