Tuesday, January 14, 2014

The Value of Comfort Food

Pacific Standard just published a piece on the Toast craze.

I didn't know there was a magazine called Pacific Standard until today, when Chris Hayes tweeted a link to the story.  It looks like an excellent magazine and as I read through the titles of the online pieces I thought "I should subscribe to this": It looks like exactly the sort of magazine smart, thoughtful, with-it people such as myself read, a west-coast version of The New Yorker.  I have a subscription to The New Yorker and have for years.  Also, I haven't opened a copy in probably three months.  I read half a piece then and left it folded on the coffee table so I could pick it up again, but I believe its been recycled, as we have a rule in my house, more or less by default, that any magazine older than three months gets recycled, even if Dad has left it folded open, but especially if its then covered with subsequent issues of various other magazines.

The last full piece I read in The New Yorker was online, a rather stunning story on "valley fever," an illness caused by a fungus endemic to the soil in the stretch of geography that runs from north of Sacramento to east of Tucson, and possibly further.  And I only read that because I saw a story in the NY Times a few months ago about the prevalence of the disease in central California, which we'd just driven through.  I was going to read it when I got the latest issue and then realized that, while I'm sitting her at work waiting for code to compile, I have time to read, but that at home I won't.

This post is not, however, about how little time I have to read.  This post is about mind, and its already longer than I'd intended.

The PS story about toast I linked to is really about a young woman in San Francisco who opened a coffee shop that serves toast, coconuts and coffee as therapy.  She has schizo-affective disorder, which is a disorder that causes a cluster of behaviors including walking catatonia, mania, depression, and hallucination.  People with schizo-affective disorder can be high-functioning most of the time and then occasionally not at all; something will trigger one or more of the behaviors, and in a repeatable fashion, but even if we were able to make a complete record of all their interactions with the world - audio, visual, nutritional, semantic - we still wouldn't be able to name a single set of causal factors.  The reactions are very much caused by the particular gestalt of the environment.  People who are regularly around and know the schizo-affective person can often predict what kinds or sorts of environments will trigger what kinds or sorts of reactions because the interaction between the environment and the behaviors has its own idiosyncratic sets of implications.  Treatment consists of avoiding the triggering scenarios, medicating the reactions (e.g. the tendency to depression gets smothered by Prozac), and building deep routines.  Its the latter that is behind the invention of Toast as a culinary phenomena: the young woman in the PS story opens the coffee shop to create these deep routines - varied enough not to get boring and to allow novelty, but regular enough to permit the exclusion of triggers and the reinforcement of the foundation on which her high-functioning personality is built.

This is an area filled with fascinating possibilities for analysis, and that I know anything about it and reflect on it as often as I do is due entirely to a very good friend of mind who was also schizo-affective.  He was also very high-functioning - he could sight-read classical Latin and Greek and was a ground-breaking Plato scholar, and attracted beautiful and intelligent women and friends of widely-varying backgrounds - and also given to episodes of extraordinary disorder: mania and depression, hallucinatory behavior, periods of what can only be described as manic catatonia, where he'd scribble furiously into notebooks long reams of material that were frankly unintelligible - what other people would call "flights of fantasy" but that he often came to believe were true, as if he were actively transcribing the contents of all the bits of ephemera his brain was desperate to remove during its maintenance cycles, so that he could return the stuff he should have thrown out back to the shelves.  He didn't survive into his 30s, unfortunately.  The concept of "psychic pain" is not something I put much stock in - is it a headache?  Like a broken arm?  But if you understand it as the confusion, hurt feelings and sadness caused by a general misinterpretation of your behavior and intentions, then you could say that he ended his life because he couldn't find a painkiller strong enough to deal with chronic psychic pain.

One of the books he raved about - and there weren't a lot - was Greg Bateson's Steps to an Ecology of Mind.  Specifically my buddy was intrigued by Bateson's characterization of the notion of the Double Bind.  Now, I haven't read much of Bateson's book, but Bateson comes from a tradition of teaching that the university system has sadly largely killed off, so its not necessary to read the entire thing to get the gist: Bateson's work is about the idea, and not the scholarship.  Bateson takes for granted that the mind and personality develop in a community - that how you learn to deal with things cognitively is based on positive and negative feedback loops from the people around you.  If you get too much negative reinforcement when you engage in an activity then obviously you're going to avoid that activity.  But that reinforcement is itself situated in a context: its colored, itself, by various social mechanisms that explain how you're supposed to interpret it, so you may not see the negative reinforcement as negative.  Words like "negative" and "positive" are too categorical to make the point with enough subtlety, however, because its the meaning, with various shades of grey, that is associated with reinforcement that is net negative or positive, that gets internalized.  Consider the ideal case: a coach has just taken on the training of a figure skater learning how to do a triple axel, but the coach notices the skater has some bad habits that need to be eliminated before the jump can be completed.  The skater must be persuaded both physically and cognitively not to do the unproductive things, and must be made conscious of those unproductive things in the most efficient way possible.  You can see a number of obvious ways in which the coach might go about this retraining, from physical beatings and shocks with a dog collar whenever the skater leans too far, all the way to a reinforcement regime where the skater is conscious of the retraining but doesn't come to evaluate themselves in a negative light at all.  Parents often desperately want to engage their children in the latter way - teach them not just the right things so they learn them, but so they learn how to teach themselves as well - but often end up falling back on the shocks and the sticks. 

Bateson's point is that our understanding of the reinforcement we get from our environment is as much a factor in the success or failure of the reinforcement as the reinforcement itself, including the tenure of the reinforcement.  The packaging of the reinforcement, in other words, is as important as the reinforcement itself.  The coach may package the sticks-and-dog-collars reinforcement as part of a long history of coaching practice designed to toughen up figure skaters, and as ultimately value-neutral, which would make the skater tend to interpret what many of us would consider humiliating, cruel and unnecessarily violent as nothing of the kind.  The coach may package the conscious seemingly-positive retraining in a condescending way, indicating that its only through the coach that the skater could ever learn the important things in life, leading the skater to believe that there's an emotional dependency that must be maintained for their own good.   

What I wanted to focus on specifically though was the implications this has for schizo-affective disorders and mental health in general.  Consider what happens when someone has, for lack of a better term, a temporary or previously-unnoticed physical malfunction.  They may develop a facial tic and not be aware of it, or they may, as my wife observed about a drugstore cashier recently, be going deaf very quickly and not be aware of it.  Their behavior - of which they're not conscious - will trigger reactions in the people around them - and this is perfectly natural on the part of the people around them.  If someone doesn't respond to me when I ask a question, for example, I may reasonably assume that they didn't hear me.  If I repeat the question a little louder and I still get no reaction I might assume they're not interested in my question.  I might reasonably assume they're in a bad mood or unwilling to communicate; many people will take the inference further and question the moral status or emotional health of the person who doesn't want to communicate, and act accordingly.  (Those people might be considered assholes, but who are we, quite literally, to judge?)  Similarly a facial tic, a simple twitch, can create reactions in people that are easy to understand if we know the cause of the reaction.  If we are the unknowing possessor of the facial tic, however, or the woman rapidly going deaf, we don't know why people are inexplicably rude or impatient, or react with a subtext of fear or loathing.  And if the physically irregular behavior - irregular because it is unexpected - continues and we remain unaware of it, our understanding of our social context and the people who are reacting to our behavior will reflect a quite rational understanding, on our part, that people are hostile, rude, out to get us for no reason, and generally strange.  If there's some underlying connection between the behavior that triggers the negative reinforcement from others - perhaps the tic is the result of mild social anxiety which can only increase once people begin to react to it - then we're in an increasingly-negative spiral of reinforcement.

(True and relevant story: A young woman I lived with was once in a horrific accident in which she went into a coma and had, among other issues, a punctured lung.  The doctors turned to her parents, of which there were two distinct sets, for advice on how to treat her early on in the trauma.  First they fed her beef broth through a tube to try to keep up her weight, and she promptly vomited everything back up, leading to an ultimately fruitless search for an injury to her stomach that was ended by me yelling at the attending physicians in frustration when I finally got to her room that she'd been a vegetarian for ten years and couldn't have consumed beef broth without vomiting even if she hadn't been pumped full of morphine.  They also designed a treatment regiment premised on her being a non-smoker, an assumption I just barely caught and contradicted before the treatment began.  That experience highlighted for me the value of information in treatment.)

Its possible to see society as networks of these net-positive-and-negative feedback loops or interactions driven by varying degrees of information.  Networks of interaction are healthy to the extent that they provide information where its missing, and provide it free of charge: young children learn not to shun people in wheelchairs because they have respected neighbors who are in wheelchairs, people going deaf are able to get and afford treatment, people with facial tics have friends and family who can surface the socially-unexpected behavior so it can be dealt with consciously and rationally.  Networks are unhealthy to the extent that they both tightly regulate normalcy and restrict information: Children are thrown in jail for engaging in behavior - like smoking pot - that children in other social groups engage in freely and without consequence; people are unable to treat their deafness medically and thus actively withdraw from society and interaction in general because they believe they're mistreated, until dementia sets in; people are born with a set of sexual impulses that don't match social expectations but don't physically or mentally harm anyone, and are forced to hide or otherwise thwart those impulses and direct the energy elsewhere, often (in recent history) in anger toward other people who share those same impulses.

Our society here in the US is obviously much more like the latter than the former, but its getting better.

There is, however, so much potential locked up by our tight regulation of norms and information.  A woman who would otherwise be studiously and pointedly shunned by everyone for her crazy behavior, lost among the nomadic tribe of homeless people that live in the Civic Center Plaza in San Francisco that tourists daily tramp past, taking pictures (oh look at what they tolerate in San Francisco!), until eventually she overdoses or dies of cirrhosis or worse, can instead, by actively building her own networks and her own routines, become an employer, an entrepreneur, a trendsetter, a mother.

Warms the heart.   

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