Partnership, Chomsky Audio Book

This is more of a personal post, or at least non scientific.

In the morning I met Shlomi, we were discussing the development of a smartphone based mental health app, specifically for OCD management. I felt like he had good product development understanding, and that he quickly learned a field I was mapping out slowly in this blog. I also felt like I had good answers to a lot of his questions, as I've done my mapping well and could provide insight. I feel like this cooperation is driving me forward, and that's cool.

I was riding my bicycles to school today, and I was listening to a Chomsky lecture recording about linguistics and philosophy. He said something that Isaac Newton disproved the idea of a mechanical world, by showing how gravitational forces, can make objects that are not in contact influence each other. Chomsky says that instead of exorcising the ghost from the machine, he exorcised the machine and left the ghost mystery in tact. This made me feel maybe I was not thinking in a high enough philosophical level, that my academic level was no high enough, and that I wish I could study at MIT. Afterwards, I thought maybe this was a weird argument. 

Visual Effects of OCD

I've been looking at the visual effects of OCD in psycnet, and found the following recent studies:

• Visuo-spatial processing and memory are impaired with OCDs (Harkin & Kessler 2011). Specifically, when working memory is overloaded, visuospatial processing is impaired, and therefore memory is impaired. 
• Thinking about one's own thoughts impairs visual memory among OCDs, more than among normal controls (Kikul et al., 2011). This refers to meta cognitive self awareness as the cause, and the visual memory as the resulting problem.
• OCD patients were more likely to perceive disgust and less likely to perceive anger in response to ambiguous facial expressions (Jhung et al., 2010).
• OCDs have memory impairments for complex visual stimuli, low confidence in judgments regarding visual recognition, and a bias towards threats in ambiguous stimuli. (Muller & Roberts, 2005).

Discussion

In a glimpse, it seems OCD has a visual aspect.

What's the risk in these psychotherapy apps?

Today I was asked what are the risks about these psychotherapy apps I've been posting about. I counted the following risks for my OCD Manager app:

1. It could pathologize, by becoming part of a neurotic OCD ritual.
2. Corporate technology that I may ask to ride on, may lead to profit driven abuse of privacy. (PS, a week later, NICE Systems, which I wish to work with as a CRM developer, appears in WikiLeaks as a dangerous surveillance technology developer.)
3. Without a humanistic restraint, it could be an app that sets to delete subjectivity itself.
4. A few hundreds of bucks could be lost from my pocket.

I feel that these risks are out of my control. The only reason I feel free to keep on developing this direction is that I feel like it is ready to be developed by anyone, and it better be me, giving a damn.

This little reverie is after watching Grapes of Wrath, with a Tom Joad kind of tragic motivation.

Existential View of OCD

In his 1917 essay, "Art as Device" about the dialectic dynamic that drives the development of artistic form, Vicror Shklovsky quotes a passage from the great Tolstoy's journal from 1897 in which Tolstoy reports that he cannot remember whether he dusted the sofa or not. Tolstoy is horrified that habit has consumed so much of his conscious life: "...if the whole conscious life of many people passes by unconsciously, then it is as if that life has never been... So life disappears, turning into nothing. Automatization consumes things, clothes, furniture, one's wife and fear of war," and Tolstoy vows never to lose life to a habitualized loss of consciousness. 

Shklovsky holds that art's function is revitalization of consciousness, to cancel the habituation of our consciousness to things, make them new and unfamiliar so we can experience them as they happen, making the stone we pass in the garden stony again. Art does so by showing reality in an unfamiliar way. Art becomes reality as we habituate to it, and then art evolves again, to show reality in an unfamiliar way. That is the driving force and the governing logic for the development of new art forms.

It was in class last year, in Prof Dar's seminar on OCD as a meta cognitive disorder, that I suggested to look at OCD as an attempt to defamiliarize reality. More specifically, we discussed the updating nature of OCD rituals, and the fact that rituals are only helpful as long as they keep the OC person unhabituated to his or her action. Once a ritual becomes automatic, it no longer serves the OC person, and it must be developed further. I told the class of Shklovsky's idea of defamiliarization, and suggested that the same could apply to OCD rituals.

The comparison of OCD rituals evolution to art evolution could lead us to the following ideas:

1) Suggest an existential explanation to OCD, a lack in the sense of being in the world, similar to Tolstoy's concern. This would lead us to treat OCD with existential means, such as the fear from freedom, and the search for meaning.

2) Suggest OC people art as a ritual. Locking the door in multiples of 13 is meaningless and maladaptive (makes you miss the bus). Writing a haiku (a very strict short poetic form) about locking the door is quite cool. Yes, cool. We do many great things that could be considered meaningless and maladaptive, but are rather considered cool, many of these are art. 

I would like to test the following questions:

1) Do OC people have a different relation to art than non OCs?

2) Does art help reduce OC distress?

3) Is OC related to a sense of being in the world?

4) Do therapy methods that focus on sense of being in the world help OCD?

I would appreciate any ideas on how to test this, and of any mediating variables I didn't take into account.

Online Therapy Privacy Concerns

Freud puts patient privacy and the development of the science in conflict. If a patient does not trust that his or her unprocessed thoughts and emotions are kept secret, the patient may censor them by what can harm his or her reputation. If abstract findings are not shared with a scientific community, the ability of a therapist to help a specific patient diminishes. 

Well...

1)  The patient needs the therapist to be the hub of many secrets, and the therapy to based on experience with other people's secrets. In this sense the patient agrees to a scientific study of the anonymous abstractions from the private therapy sessions of many patients. Then anonymity becomes the issue, not privacy.

2) People already share so much online, and right now they do it for facebook's advertisers to be able to deliver them with better ads. The same behavior that is encouraged by consumer culture can be used for good, with the patient's benefit in mind.

So, in my view:

1) Shared psychotherapy information should be anonymous. Not easy as it sounds.

2) Current technological standards should be adopted, as long as the ethical question is "how to help the patient?".

Bertha Pappenheim, was Breuer disguised as Anna O in his case study essay.