Stop trying to Guess: A Plea to Put Truth First (and the problem with 'lived experience')

A real bugbear of mine is what modern cars do when they try to be intelligent.  I bought my first ‘modern’ car a few years ago and on the first week I had it, it started beeping at me, telling me that someone didn’t have their seatbelt on.  I was talking back at it telling it that everyone did have their seatbelt on – I was the only one in the car! I then realised it thought my bag sitting next to me was a person and wasn’t wearing a seatbelt. Moron.

Then there’s the lane change safety feature where my car would swerve back into the lane if I tried to change lanes without indicating (which I sometimes do, especially on a country road or there’s just no one around). The first time it happened it freaked me out so bad I thought the car had gone mad and I nearly crashed. I discovered how to turn this feature off – or at least ‘down’ so now it doesn’t swerve it just vibrates which still bothers me.

The other thing it does sometimes when I’m driving down a narrow road with lots of cars parked on the sides, is it automatically puts on the brakes and flashes up a warning sign telling me to ‘brake’. It thinks I’m about to hit one of the cars, when I’m just weaving between cars (maybe slightly too fast?) and it’s not smart enough to know this.

Between these and several other safety ‘features’ I feel like my care has Generalized Anxiety Disorder and that modern cars have evolved to become just like us with our over-active threat systems (smoke alarms) which prioritize ‘safety’ over feeling calm and relaxed (which then leads to various forms of harm and non-safety but we won’t get into that).

When my car does things like this I find myself getting furious and yelling at it and saying ‘stop trying to think! I’ll do the driving thanks!’ What is my stupid car doing in these situations? It’s working off a formula or an algorithm. We could say, an ideology. In the case of the seatbelt, it must have a formula that weighs what’s on the seats, and if there’s more than Xkg (?) it assumes there’s a person sitting there. It’s not a bad heuristic, and it will work most of the time, but not all of the time. The formula just isn’t advanced enough to know the difference between a small child and a big bag of books.

I find a similar thing happening in psychology at the moment. People aren’t waiting for facts or data about what is true and what is helpful, they are guessing and pre-empting.  Or they are working off simple heuristics that work in some situations but not others. Or, they are jettisoning truth altogether because it is deemed unhelpful. 

I remember a few years ago reading the newly released (2020) 3rd Edition of Judith Beck’s influential book Cognitive Behavioural Therapy: The Basics and Beyond where she explicitly promotes the disease model of depression. She writes:

‘Most clients want to know their general diagnosis and to establish that you don’t think they’re crazy or strange or abnormal…we want them to start attributing some of their problems to their disorder instead of their character…[so I say to patients…] “I’d like to talk to you about your diagnosis. Abe, you have a real illness. It’s called depression…I know that because I have a book that helps me diagnose the problems people have when they come to see me. It’s called the DSM. It lists the symptoms of the real illness called depression.”’ (Beck. p. 96)

It's ridiculous to me now reading this back (‘I know because I have a book…’) but at the time of reading this I was new to the field so I wasn’t sure if depression was a real illness or not. But then I investigated it and quickly discovered depression is not a real ‘illness’ (see here), no biomarkers can reliably diagnose it, and it’s not caused by a lack of serotonin in the brain (see here, here, and here).

Moreover, we now know that presenting depression (and most DSM labels) as an illness does not in fact lessen stigma. In fact, several studies have shown the opposite is true. Far from reducing stigma and improving mental health outcomes, telling people they have a ‘mental illness’ or a disease actually increases stigma and worsens mental health outcomes. So her ‘noble lie’ wasn’t just a lie, it wasn’t even noble!

Notice another level of faulty thinking here: She assumes that the alternatives for Abe are either attributing their problems to their disorder or to their character.  This is a false dichotomy, but very common.  I see the same thing happen everyday with people talking online about ADHD and Autism diagnoses. People will say something like ‘I felt so relieved when I finally got my ADHD/Autism diagnosis, because for so many years I thought I was just lazy…’. The error here is very common and very understandable (because it’s a strong illusion given to us via evolution) but boils down to the belief in some sort of unified or transcendent self, a concept which is scientifically and philosophically unsupported, and the notion that there is an ‘I’ and then this Autism/ADHD/depression outside of the ‘I’ or that there’s a part of ‘me’ (the part without the ADHD) that’s the real ‘me’ and then another part of ‘me’ (the part with the ADHD) that’s not me. I could spend a long time talking about this and it is very complex, so I encourage you to click on the links for yourself to read further (also here).

I don’t think Beck’s mistake here was driven primarily by an ideology. And if I’m giving her the benefit of the doubt, she might talk this way not because she actually thinks this way, but because she thinks most of her patients think this way, and she is trying to help them (which again though, would be guessing, and also condescending).  But ideology is the primary way people make these kinds of mistakes. An ideology is like a heuristic or a formula that a car uses. It’s based off a few (or sometimes just one) key principles (eg. Diversity or Equality) and then everything else is forced to fit into those. You can’t accommodate certain facts because you have a pre-commitment to some other belief or principle. This is why science and critical thinking were invented. Critical thinking: We think deeply and analytically about our beliefs, our theories, our assumptions, and priors. We watch out constantly for cognitive biases like confirmation bias, motivated reasoning, and anecdotal evidence. Science: We make good, falsifiable hypotheses and test them. We do experiments. We wait for the data to come in. We do more experiments (if we need to which we often do).

Critical thinking and science are essential in making progress as a species because…well, think about what the opposites/alternatives are…sloppy thinking and superstition!? That may sound facetious, but those were essentially the principles that we ran on for thousands of years with the attendant results that 95% of humanity lived lives that were ‘nasty, brutish, and short’. Critical thinking is vital because as humans the opposite is much more our natural state. Thanks to modern psychology (again hat tip to science and reason), we are now aware of and study dozens of cognitive biases - all of which are natural and evolved for good reasons - that throw our thinking off and stymie our progress as a species.

I see the same thing happening currently in the so called ‘neurodiveristy affirming’ (sometimes just ‘neuroaffirming’ or NA) space. Activists have entered into the space and are saying all sorts of unsupported things based on scant or no evidence because it fits their ideology and they want to ‘reduce stigma’. They are falling prey to the reification problem which I talk about here. They’re thinking – like Beck with depression - that if they can paint ADHD or Autism or whatever as ‘biological’ then it’s more ‘real’ and the stigma will be less. But second, they are denying the basic definition of ‘disability’ and seeking to redefine words, again, because they think it will reduce stigma. I’m agnostic actually about whether these redefinitions will in fact reduce stigma. They might, history shows that sometimes they do and sometimes they don’t. But the larger problem is just a preference for ‘social justice’ over truth.

These folks actively discourage and condemn looking into causes of Autism or ADHD or looking into why rates have skyrocketed over recent decades, because they are afraid that what is found will strengthen the case for them being disorders which will in turn increase stigma. In other words, they are seeking to shut down science because of a pre-commitment (that is probably false, but even if true, would not justify thwarting science).

On the other side of the fence there are folks like Gabor Mate who say that Autism is caused by social disconnection and ADHD is caused by trauma. You will also hear these folks claiming that their view of Autism/ADHD is less stigmatizing.  These are essentially the two ways people seek to de-stigmatize or remove responsibility from themselves: 1) Place the blame/problem outside of the self (in say, trauma), or 2) Place the blame/problem within the self, but say the problem isn’t a problem (ie. it’s a strength and/or, it’s just a difference). The neuroaffirming stance does a bit of both actually. It says on the one hand that Autism and ADHD are natural/normal/strengths, but also that it is a disability but this is due to society and social structures not accommodating neurodiverse people - called the ‘social model of disability’. If this seems a bit like a have-your-cake-and-eat-it scenario, it is, but the bigger problem is the problem I mentioned already about the self and overidentification to it. Overidentification with self is not just a (understandable) logical and philosophical error, it is the root of defensiveness.

Now I think both these sides are a little bit right and a little bit wrong, but what I am  saying to all these people is: As important as the stigma question is (and I do think it is somewhat important), the more important question is the truth of the matter.  Truth has to be prioritised. The problem is that once you decide that you are an activist, you then want certain things to be true and you become willing to blast through any argument or evidence that goes against your cause because you know you are right. You’re on the side of the angels. Then confirmation bias kicks in and your science is out the window (A consistent finding about human reasoning: If we want to believe X, we ask ourselves “Can-I-Believe-It?” but when we don’t want to believe a proposition, we ask “Must-I-Believe-It?”)

On the ‘social model of disability’, well, this is a bit like looking at a fish struggling because its gills don’t work properly and saying it’s the water’s fault. Fish are to water what humans are to socialising. Ie. we are profoundly and utterly social as a species. Socialising is the ‘air we breathe’ or the water we swim in.  So to have a deficit in socialisation (the first criteria for ASD) is a major problem for a human just like not having gills will be a major problem for a fish (although not having social skills probably won’t kill you, although it might).  But to try to place the burden of responsibility on the water – the ‘water model of disability’ - is a profound mistake and one that will leave you feeling very frustrated. Disability means you are mismatched to the environment you were designed (by evolution) to live in. So a fish without legs is not disabled because a fish does not live on land or fly in the air. But if a land mammal is born without legs then it is disabled because it is designed to have legs so it can walk.  A non-disabled fish will have gills because fish live in water and need gills to breathe. Similarly, a non-disabled human will have social skills because humans are profoundly social. Our ‘superpower’ is communication and cooperation – that is how we came to conquer the world: not through our physical strength or speed, but our cooperation.  So if a human is born with a serious deficit in social skills or comes to have a deficit through a lesion, toxin, trauma, or whatever, then it’s quite reasonable to label this a ‘disability’. There probably isn’t a better word really.

The neuroaffirming (NA) activist might object ‘but why should I have to fit in with society? Why can’t society change to accommodate me?’ The answer to this question depends on how severe the Autism is. And NA activists have made this conversation very difficult by conflating Autism into one giant group (actually the DSM-5 has three levels of Autism but the NA activists don’t like this) encompassing everyone from the non-verbal person with an IQ of 60 right through to the eccentric genius working at NASA with an IQ of 150. Why do this? I think because it enables them to easily deploy the motte-and bailey technique where they conflate two positions that share similarities, one modest and easy to defend and one much more controversial and harder to defend. It enables to them to say at the same time that Autism is bad enough that it should receive disability funding (NDIS here in Australia) but not so bad that they should be treated differently or receive any stigma.  It’s the perfect have your-cake-and-eat-it scenario. But when we do science, we want precision. We don’t want definitions becoming so nebulous they mean everything and therefore nothing. The NA definition/s of Autism are so broad I don’t know what we’re talking about anymore.

And you know who that hurts? Severely Autistic people. The most vulnerable. They’re the ones who suffer because of this conflation. They’re the ones who, often quite literally, can’t speak for themselves and say ‘I am disabled. I want and I need help.’ So once again, people suffer when truth gets jettisoned.

One sign that this is happening is if you use the phrase or see the phrase ‘lived experience.’ This phrase has become very popular in social justice circles today, but even a cursory reflection on what it means and how it is used reveals it to be deeply problematic. Firstly, all experience is ‘lived’ (I’ve never heard a person say ‘in my dead experience’) so what even is the point of adding the adjective? Second, why is one person’s lived experience more important than another’s and who decides? But third, we used to have a name for ‘lived experience’ - anecdotal evidence. What we meant was, we take it on board as evidence, and we treat it for what it is – one data point (or n = 1). If we gather lots of data points, then we have a study and we are starting to do good science. In other words, ‘lived experience’ is bad statistical reasoning and bad science.

Fourth, if you claim that you have special insight into some phenomenon (say racism or sexism or homophobia or colonisation) because you have ‘lived experience’ of it, meaning something like ‘first-hand experience’ of it, the same closeness to the issue you are claiming to boost your voice and authority, could just as easily be said to reduce your authority, because you could be biased or too invested. This is why we don’t allow rape victims to be on juries for rape trials. While these people have ‘lived experience’ of rape, we don’t deem it to make them more qualified to weigh in on rape rials. No, we deem them less qualified.  In this way ‘lived experience’ is a two-edged sword. Being ‘closer’ to a certain issue, can make you more or less qualified to speak about it, depending probably on other factors (critical reasoning skills, education, familiarity with the other side, IQ, etc.).  One can easily think of many cases where having ‘lived experience’ is more likely to reduce your objectiveness and credibility. Think about a drug addict having their way on drug policy, or a paedophile having their way on child sex laws, or simply just a child having their way on how the school, kindergarten, or household should be run.  It’s not that any person’s ‘lived experience’ is worthless. It’s not. It should be listened to and it should be factored into the equation. But it’s just not a trump card.

Social psychologist Jonathan Haidt outlines this problem in his brilliant lecture, Two Incompatible sacred values in American univeristies (or you can read this lecture here). In this talk Haidt introduces the idea of a telos (a purpose or goal) and explains how many Universities in America have drifted away from their original telos of truth and have drifted towards social activism and social justice.

He argues that while an individual or University can pursue both goals ‘no university can have Truth and Social Justice as dual teloses’ and we should embrace truth as the only way that one can pursue activism that will effectively enhance social justice. In other words, we can absolutely have social justice on our list of priorities, but it can’t be first. Truth has to be first.

C.S. Lewis explained this years ago in an essay called “First and Second Things”. In it he explains how if you put second things first and first things second, then you lose both, but if you keep first things first and second things second, then you can hold onto both. Consider running and health. Of these two goods, health must take priority – it must be the “first thing.” If a person becomes obsessive about running and prioritizes it above health, they may continue to run even if injured. Over time, if they continue to prioritize running over health, they will further damage their body, perhaps resulting in a permanent inability to run. Therefore, if one prioritizes running over health, in the end one will end up with neither, but if one puts health first, one can have both.

Truth and social justice are the same. If we prioritize social justice over truth we will get neither; whereas if we prioritize truth over social justice, we can get both. Why is this? In short, because acting on an inadequate understanding of what the world is like and how it works won’t reliably get you what you want. Not just that, it can, and usually does, cause harm.

This is my plea to all the psychologists out there: It’s fine (good!) to care about justice. It’s fine to campaign for what you believe in. But don’t jettison the truth. Don’t guess. Don’t assume. The road to hell is paved with good intentions. If you really want to do good in the world, be a truth seeker and a truth speaker. Put truth first.