November 23, 2017

Sam Harris, Meditation, Mental Illness and a Question from British Columbia

Picture from ABC News 

I'm going to preface this post by saying that I like and respect Sam Harris. I think he is one of the preeminent popular intellectuals that is currently active and I am in agreement with him on the majority of issues which he speaks about. I think his takes on identity politics, free speech, religion, and many other topics are largely correct.

In addition to that, one thing I really appreciate about Sam is how thoughtful he is. That thoughtfulness can be heard in his podcast in the respect he has for his guests, in how he wants his guests treated by his audience after they are on the podcast and in what he wants the experience of being on his podcast to be like ( about 28 minutes in.

In addition to that, he shows his thoughtfulness in his approach for donations to his podcasts where he asks for donations, but limits his request to those who can easily afford it. This may seem trivial, as someone who doesn't have the money to donate, probably wouldn't donate anyway, but it shows how he is expressing a feeling for his listeners that often isn't expressed. I respect him making that statement and the thought that went into making it.

Yet, I do have an issue with something Sam said in response to a question asked at The Orpheum Theater in Vancouver that was recorded in his most recent podcast. I think in answering the question he missed the thoughtfulness that he usually gets right.

Question: "Hi my name is Randy. My question is for Sam. I wanted to know what role meditation has played in your mental health, I guess. Have you been more resilient to depression or anxiety? Because it seems like your always kinda being attacked by somebody either Batman or having Charles Murray on your Podcast. Because I'm at a point where I'm kinda done with antidepressants, psychotics and mood stabilizers. I want to try something new, so what's your take on meditation as a mental health treatment?"

Answer: "Well, I think it can be incredibly useful. I think there are certain people who probably shouldn't go on intense silent meditation retreats so I wouldn't recommend the most intense meditation experiences for everybody. There are people who find going into silence for a week or a month destabilizing and that's a tiny percentage of people but you should be aware that it is possible to have a bad experiences doing a lot of meditation. 

The kind of meditation I recommend is just learning to pay much more careful attention to what it is like to be you. When you pay attention, you begin to notice all the ways in which you are suffering unnecessarily. The universe didn't have to be this way, but is just so happens there is a direct connection between seeing more of what is actually happening in your own mind and ceasing to suffer in many of ways that are unnecessary. Honestly, it is the most important thing I've ever learned, but it's not necessary to learn most other things, it's orthogonal to almost everything else we care about intellectually. It's not that I don't suffer in all the ordinary ways that I suffered with before I learned to meditate. The half-life of suffering, the half-life of something like anger or anxiety or embarrassment or fear or whatever the negative mindstate is, it's cut way way down and also behavioral consequences of those negative emotions, the door is closed to those. 

When you think of the difference between being angry 10 seconds and then actually letting it go and being angry for an hour, right, it's an enormous difference, because in that hour you can get up to doing all kinds of life deranging things on the basis of anger and feel good about doing those things, right, because you damn well should be doing those things because you're pissed. Just shorting the time of all these negative states is [an] enormous benefit. Meditation is a great tool for that."

I didn't want to judge Sam's response and write this without looking into the efficacy of meditation as a treatment for depression and there is some pretty solid evidence [1, 2] that meditation may be as effective a treatment as antidepressants for depression, but this is to be taken with some precaution. The general results from different studies tend to point to mindfulness being more successful at dealing with stress than anxiety or depression, which each have smaller effect sizes. There does seem to be an effect for meditation in the treatment of mental illness, what I presume Randy was suffering from, with meditation.

However, there are two larger problems pointed out by Steven Novella.

1.The problem with this research is that it is largely preliminary, as the specifics that makeup mindfulness is not always consistent, and there remain questions about what type of people benefit the most and with what severity of condition mindfulness is most effective at treating. This is fine as the results seem to be trending in the right direction of it being an effective treatment, but there are issues that remain to be settled.

2. The control measures used as opposite of mindfulness are not adequate. Mindfulness is tested against medication and placebo medication, but not against relaxation or sham mindfulness. This is problematic, as it makes it unclear if there is something specific about mindfulness that is helpful or if it is a product of relaxation which isn't specific to mindfulness.

That being the case and my expectation that Sam, who is likely more educated on the subject than I, should have had a more thoughtful response to that question. I am fine with him talking about his experience and how it has affected his life, but I think that his response lost track of the context of the question being that, the person asking the question is someone with serious problems talking about ceasing to take all their medication. Somewhere in that response there needed to be a caveat about talking to a doctor about his decision or getting some kind of medical advice before just stopping his medication.

Sam's response, unfortunately, reminded me of the type of response that is characteristic of proponents of alternative medicine, 'Here is my personal experience of it working and it was good for me.' In that, I expect a higher quality response for Sam Harris and maybe he simply lost track of that part of the question, but I was disappointed that it wasn't there from someone who usually gets those parts correct. Further, he didn't mention the evidence in support of meditation being used to help treat mental illness which is also disappointing, but that bothered me less than not addressing the context of a person threating to stop taking all their medication.

Given that there is some medical evidence for meditation being helpful am I over-reaching in my criticism of Sam's response? Does he, as a proponent of meditation, have an ethical responsibility when someone is asking a question like that?

November 21, 2017

Book Summary: The Structural Transformation of the Public Sphere

The last summary, Society Against the State, was received fairly well, so I decided to also publish a similar summary assignment I wrote for Jurgen Habermas's, The Structural Transformation of the Public Sphere. This text was a chore to read and understand, as it is written with a sentence structure that made it harder to follow than a text should be, as there were many sentences which were subdivided by multiple explanations, imagine there being three elaborations like this within a common sentence but only longer and more complex, within the book.

Outside of that literary criticism, I also think that the degree of rationality and the adherence to rational thought doesn't reflect how people actually act; Habermas thinks people are rational to a greater degree than would be empirically supported.

That said Habermas is saying something interesting about how a society should function and describes a phenomenon which is commonly referred to without ever really being flushed out. The feedback I received on this summary was that I didn't get deep enough into the economic conditions and the meaning those conditions have on the public sphere, but that was a conscious choice. I didn't think that, that amount of depth was needed to explain how the functioning of the public sphere was actualized in any given period of time. That may be a mistake, so if someone is assigned a similar project it may be beneficial to expand that area. Anyway here is my summary of The Structural Transformation of the Public Sphere.

The Structural Transformation of the Public Sphere – Summary

In The Structural Transformation of the Public Sphere Habermas is attempting to track the existence and transformation of the public sphere. The public sphere is an elusive and perpetually evolving concept which transforms in response to different social pressures and requires Habermas to embrace historical, philosophical, economic, and sociological sources of information to encompass the totality of the range of effects that cause changes in the functioning of the public sphere. Those fields, when used together, are able to account for the complete history of the public sphere from its non-existence in feudalism, to its emergence in the separation of private and public in the early capitalist commercial economy, to its near ideal functioning in the bourgeois public sphere and finally in the breaking down of the public sphere in modern society through the collapse of the private/public distinction from which the public sphere once emerged. Despite historical accounts of the public sphere the task in this work is not that of a historian. Habermas isn’t simply explaining the emergence, proliferation and deterioration of the public sphere, he is active in imputing his thoughts about the ideal public sphere and how it should function. His recommendations sit numerously among historical details of representative publicity, the use of letters and changes in suffrage. In this way Habermas’s task in The Structural Transformation of the Public Sphere is similar to that of a medical doctor; Habermas diagnoses the health of the public sphere as it transitions through history, tracking its functionality against the ideal of an informed private populous participating in rational-critical debate to ‘subject domination to reason’ (Habermas, 1991, p. 117).

Habermas begins his book with the description of a few key terms that are widely used, but he makes critical distinctions to his definitions that if not understood would cause misreading of his conclusions. Two definitions stand out as being of paramount importance, public opinion and the public sphere. In the opening section, Habermas lays out qualifications for something to be considered public opinion. There is an essential requirement of public opinion to be created by a ‘critical judge’ (Habermas, 1991, p. 2). The understanding of what defines a critical judge is best explained in Habermas’s criticism of modern society when it is stated that, “…it [opinions] could only be realized in the measure that these personal opinions could evolve through rational-critical debate of a public into public opinion—opinion publique.” (Habermas, 1991, p. 219) This expresses that a private idea becomes a public opinion through the act of that idea being subjected to rational-critical debate. However it is not enough that an idea is debated publically, it has to be debated by an informed literate public as those are the ‘kind of opinion[s] capable of becoming public’ (Habermas, 1991, p. 247). This is of great importance as Habermas’s criticism against modern society is based on the loss of not only the lack of critical judgment, but the impossibility of people to be ‘critical judges’.

The public sphere is then understood as the totality of the societal conditions that support the formation of public opinions (public places) and the public opinions/actions themselves. To explain the public sphere Habermas references the Greek model of society where the agora is the public place, lexis is the public sphere in discussion and praxis is the common actions of a group all of which constitute the public sphere (Habermas, 1991, p. 3). This creates the foundation, but it is vital to detail the importance of private/public distinction, as it will be significant for discussing the functioning of the public sphere in different societies. People with no political power, office, position or who are not able to participate in debate would have no publicness and would be excluded from the public sphere (Habermas, 1991, p. 11), while the private sphere is classically attached to the interior of the household where the individuals have no effect on state interests. The reproduction of life, the labor of the slaves, and birth and death are all described as part of the private sphere (Habermas, 1991, p. 3).

With those definitions, it is then possible to understand the first diagnosis in Habermas’s medical examination of the public sphere. His first examination is of feudal society in the High Middle Ages. The diagnosis is that the public sphere is non-existent due to the lack of separation between public and private (Habermas, 1991, p. 5). That lack of separation between public and private leaves the public sphere unable to exist as its own entity, and due to that there exists only a representative publicity entwined with private power.

This can be seen in the as the defining characteristic of feudal society where ‘lordly’ and ‘publicus’ could be used interchangeably with no loss of meaning (Habermas, 1991, p. 6), where the King enjoyed being synonymous with ‘publicness’ (Habermas, 1991, p. 7) and where the nobleman could be an authority to the degree that he displayed having such qualities (Habermas, 1991, p. 13). This means that the entirety of what would constitute a public sphere is encapsulated within the lord and the lords household, leaving nowhere for the public sphere to take place (Habermas, 1991, p. 5). In feudal society publicity and publicness is a ‘status attribute’ to those with power (Habermas, 1991, p. 7).

After the High Middle Ages there is a transition period between feudal lordships and the budding capitalism where Habermas makes no diagnoses of functioning, but instead limits himself to describing the changes that allowed for the creation of the bourgeois public sphere. This period took place after the Renaissance, specifically when representative publicity broke down. At that time there becomes a need and use of specific words to designate private people from those who had public positions thus generating the first private and public sphere in the modern sense (Habermas, 1991, p. 10-11). This was a time of transitions for the public sphere, the first public budget was separated from the rulers private holdings creating public interests separate from private wealth (Habermas, 1991, p. 12), the economic conditions changed from feudalism to being early capitalist creating ‘horizontal economic dependencies’ (Habermas, 1991, p. 15), the press created public discourse when news letters were printed in ‘political journals’ (Habermas, 1991, p. 20), and feudal authority was transformed into the use of ‘police’ over private people (the addressees of public authority) (Habermas, 1991, p. 18).

That transition had effects on both authority and economics which led to the emergence of the public, public opinion and the functioning public sphere that would develop into the bourgeois public sphere. This was done through the steps detailed in the previous paragraph, which were able to create both a private/public distinction and the possibility of rational-critical debate (Habermas, 1991, p. 28-29) and culminated, in England, in the founding of the Bank of England, elimination of censorship and the first cabinet government (the precursor to the full parliamentiarzation of state authority (Habermas, 1991, p. 58).

With the effects of the transition period in place, economic and social pressures were able to create the bourgeoisie public sphere. It is this public sphere which Habermas finds comes closest to identifying and actualizing the existence of the ideal public sphere, as there is a literate and informed public that critically-rationally debates ideas which is able to create a state responsive to and forged by public interest (Habermas, 1991, p. 158 and 246). Habermas still finds fault with one aspect of the bourgeois public sphere, as it is largely limited to property-owning men and, “A public sphere from which specific groups would be eo ipso excluded was less than merely incomplete; it was not a public sphere at all.”(Habermas, 1991, p. 85). Habermas makes the attempt to posit that so long as there is the allowance for the possibility of universal access to the public sphere then that criticism wouldn’t hold, but the limitation of the public sphere to property owners put those property owners in a position to protect and limit the public sphere (Habermas, 1991, p. 86-87).

Even with the problem of exclusivity the bourgeoisie public sphere came close to being a completely healthy functioning public sphere for Habermas. That proper functioning is epitomized by the salon, as Habermas writes glowingly, “Only the name of salon recalled the origin of convivial discussion and rational-critical public debate in the sphere of noble society.” (Habermas, 1991, p. 45). It was where men and women could both step out of the private sphere and into the public sphere (Habermas, 1991, p. 45-46) to debate publicly the issues able to constitute a public opinion (Habermas, 1991, p. 98). The barrier of being a property owner or man didn’t exist in the salon, which is important as it constituted the major problem with the functioning of the public sphere in bourgeoisie society; making the salon the ideal public sphere.

The social pressure created by public opinion and a well-functioning public sphere created, “…The constitutional state as a bourgeois state [which] established the public sphere in the political realm as an organ of the state so as to ensure institutionally the connection between law and public opinion.”(Habermas, 1991, p. 81). The public had become ingrained into the state and was no longer an element of society, but society’s defining feature (Habermas, 1991, p. 88).

The public sphere would then undergo another major transformation into the modern public sphere. This transformation erodes most of the positive features of the bourgeois public sphere and leaves Habermas to diagnose the modern public sphere as non-functional. The modern public sphere is suffering from the ‘refeudalization’ of society. Refeudalization is the exact malady, as it is the return to an inability to separate public and private that Habermas views as the cause of the dismantling of the public sphere and public opinion.

The public sphere adopted the interests of civil society which resulted in a feedback loop, instead of private people debating to create public opinions, the public civil society was influencing the opinions of itself; the public was defining itself and blurring what was private (Habermas, 1991, p. 142). Amplifying the blurring the public/private distinction was the transfer of public functions to private bodies (Habermas, 1991, p. 142). Those two effects created a social sphere where, “…the distinction between ‘public’ and ‘private’ could not be usefully applied.” (Habermas, 1991, p. 142).

This refeudalization then inhibited the formulation of public debate. Private reading, the precondition for being rational/critical, was the necessary condition for a person to contribute to public debate. The intersection of refeudalization and reading is that reading is the act of a private individual and as such the pressures of refeudalization pushes private people away from it and into acts where there is a privacy among other people (watching television as a group) (Habermas, 1991, p. 158).

Those problems created by the pressures of refeudalization would be enough to threaten the existence of the public sphere, but it is refeudalism’s ability to create the private citizen as a public consumer that is the death blow for the public sphere. Private enterprises are able to manipulate people to the point that, “…in their customers the idea that in their consumption decisions [private decisions] they act in their capacity as citizens…” which causes the public to ‘address its citizens like consumers’ (Habermas, 1991, p. 195). The citizen and the consumer cannot be the same person if there is to be a private/public distinction. It is clear that Habermas views the option of voting with your wallet as no public vote at all, and a choice separated from the public realm.

Habermas expresses two ways forward from refeudalism that can be distinguished in the final section On The Concept of Public Opinion. The first way forward is through the implementation of qualifications of private people to form public opinions based on ‘autonomous hierarchical qualities of representation’ which, when simplified, means that the ‘best informed’, ‘most intelligent’ and ‘most moral’ are who can debate to form public opinion (Habermas, 1991, p. 238).This suggestion implies that there are informed people capable of creating a public sphere in the modern environment. The problem is that current societal conditions make that spheres existence, in the near-universal way that existed in the world of letters, impossible, so public opinion is needed to be formed to the scale in which it is conditionally possible.

The cost of this solution is high, as, “The element of publicity that guarantees rationality is to be salvaged at the expense of its other element, that is, the universal guaranteeing general accessibility.” (Habermas, 1991, p. 238). This seems like an extreme option, but in reality it would amount to the creation of a representative public sphere based on merit, not unlike the ideal for representative democracy in government. It is elitist, but not exceedingly so and if Habermas is correct in his diagnoses of the modern public sphere than it may be akin to valuing beneficence over non-malfeasance when examined in ethical medical terminology.

The second option is expressed near the end of the book and is also centered on the proper relationship between information and debate to create informed decision making. Just as some individuals are capable of creating a functioning public sphere, there is another group Habermas observes with the same potential. By function with informed private opinions which are critically debated to form conclusions that can be trusted, the intraoganization is the other entity capable of forming a public sphere. At the intraorganizationial level there are the conditions for the public sphere in the ‘mutual correspondence between the political opinions of private people’ that create a ‘quasi-public opinion’ (Habermas, 1991, p. 248). That functioning can be transferred to attempt to inform society where, “…a public can be brought about only in this way: through a critical publicity brought to life with intraorganizational public spheres, the completely short-circuited circulation of quasi-public opinion must be linked to the informal domain of the hitherto nonpublic opinions.” (Habermas, 1991, p. 249-250).

With those recommendations, Habermas no longer sees a universal public sphere as a viable option, and instead, the public sphere needs to be limited to individuals still capable of forming public opinions or the intraorganizations that have the framework of a ‘quasi-public opinion’ within their structure. Society needs to amputate itself from the head down.

Works Cited

Habermas, J. (1991). The Structural Transformation of the Public Sphere: An Inquiry into a Category of Bourgeois Society. (T. Burger, Trans.) Cambridge: MIT press. (Original work published 1962)