Monday, January 21, 2019

What Can Brain Imaging Tell Us About Violent Extremism?


Before answering that question, I'll tell you about an incredibly impressive ethnographic study and field survey. For a one year period, the investigators (Pretus, Hamid et al., 2018) conducted field work within the community of young Moroccan men in Barcelona, Spain. As the authors explain, the Moroccan diaspora is an immigrant community susceptible to jihadist forms of radicalization:
Spain hosts Europe’s second largest Moroccan diaspora community (after France) and its least integrated, whereas Catalonia hosts the largest and least integrated Moroccan community in Spain. Barcelona ... was most recently the site of a mass killing ... by a group of young Moroccan men pledging support for the Islamic State. According to a recent Europol’s latest annual report on terrorism trends, Spain had the second highest number of jihadist terrorism-related arrests in Europe (second only to France) in 2016...

After months of observation in selected neighborhoods, the researchers approached prospective participants about completing a survey, with the assurance of absolute anonymity. No names were exchanged, and informed consent procedures were performed orally, to prevent any written record of participation. The very large sample included 535 respondents (average age 23.47 years, range 18–42), who were all Sunni Muslim Moroccan men.

The goal of the study was to look at sacred values in these participants, and whether these values might affect their willingness to engage in violent extremism. “Sacred values are immune or resistant to material tradeoffs and are associated with deontic (duty-bound) reasoning...” (Pretus, Hamid et al., 2018). The term sacred values doesn't necessarily refer to religious beliefs. One of the most common is the basic human value, “it is wrong to kill another human being.” But theoretically speaking, we could include statements such as, “it is wrong to kill endangered species for sport (or for any other reason).”

In this study, Sacred Values included:
  • Palestinian right of return
  • Western military forces being expelled from all Muslim lands
  • Strict sharia as the rule of law in all Muslim countries
  • Armed jihad being waged against enemies of Muslims
  • Forbidding of caricatures of Prophet Mohammed
  • Veiling of women in public

What were the Nonsacred Values? We don't know. I couldn't find examples anywhere in the paper. It's crucial that we know what these were, to help understand the “sacralization” of nonsacred values, which was observed in an fMRI experiment (described later). So I turned to the Supplemental Material of Berns et al. (2012), inferring that the statements below are good examples of nonsacred values in a population of adults in Atlanta.
  • You are a dog person.
  • You are a cat person.
  • You are a Pepsi drinker.
  • You are a Coke drinker.
  • You believe that Target is superior to Walmart.
  • You believe that Walmart is superior to Target.

But what if the nonsacred values in the present study of violent extremism were a little more contentious and meaningful?
  • You are a fan of FC Barcelona.
  • You are a fan of AC Milan.

Anyway, to choose participants for the fMRI experiment, the investigators first divided the entire group into those who were more (n=267) or less (n=268) vulnerable to recruitment into violent extremism (see Appendix for details). An important comparison would have been to directly contrast brain activity in these two groups, but that wasn't done here. Out of the 267 men more vulnerable to violent extremism, 38 agreed to participate in the fMRI study. These 38 were more likely to Endorse Militant Jihadism (score 4.24 out of 7) than the general fMRI pool (3.35) and the non-fMRI pool (2.43).1 

A battery of six sacred and six nonsacred values was constructed individually for each person and presented in the scanner, along with a number of grammatical variants, for a list of 50 different items per condition. The 38 participants were randomly assigned to one of two manipulations in a between-subjects design: exclusion (n=19) and inclusion (n=19) in the ever-popular ball-tossing video game of Cyberball. [PDF]2



Unfortunately, this reduced the study's statistical power. Nonetheless, a major goal of the experiment was to examine how social exclusion affects the processing of sacred values. I don't know if Cyberball studies are ever conducted in a within-subjects design (perhaps with an intervening task), or if exposure to one of the two conditions is too “contaminating”. At any rate, in real life, discrimination against Muslim immigrants is isolating and causes exclusion from social and economic benefits. Feelings of marginalization can result in greater radicalization and support for (and participation in) extremist groups. At this point in time, I don't think neuroimaging can add to the extensive knowledge gained from years of field work.

Nevertheless, the investigators wanted to extend the findings of Berns et al. (2012) to a very different population. The earlier study wanted to determine whether sacred values are processed in a deontological way (based on strict rules of right and wrong) or in a utilitarian fashion (based on cost/benefit analysis of outcome). As interpreted by those authors, processing sacred values was associated with increased activation of left temporoparietal junction (semantic storage) and left ventrolateral prefrontal cortex (semantic retrieval). Berns et al. suggested that “sacred values affect behaviour through the retrieval and processing of deontic rules and not through a utilitarian evaluation of costs and benefits.” Based on those results, the obvious prediction in the present study is that sacred values should activate left temporoparietal junction (L TPJ) and left ventrolateral prefrontal cortex (L VLPFC).


Fig. 3A (Pretus, Hamid et al., 2018).


Fig. 3A shows that only the latter half of that prediction was observed, and there was no explanation for the lack of activation in L TPJ. Instead, there was a finding in R TPJ in the excluded group which I won't discuss further.

Of note, the excluded participants rated themselves as being more likely to fight and die for nonsacred values, compared to the included participants. This was termed “sacralization” and now you can see why it's so important to know the nonsacred values. Are we talking about fighting and dying for Pepsi vs. Coke? For FC Barcelona vs. AC Milan? Not to be glib, but this would help us understand why social exclusion (in an artificial experimental setting) would radicalize these participants (in an artificial experimental setting).



Fig. 3B (Pretus, Hamid et al., 2018). Nonsacred values activate Left Inferior Frontal Gyrus (IFG, aka VLPFC) in the excluded group, but not in the included group. This was interpreted as a neural correlate of “sacralization”.


Another interpretation of Fig. 3B is that the exclusion manipulation was distracting, making it more difficult for these participants to process stimuli expressing nonsacred values (due to increased encoding demands, syntactic processing, etc.). Exclusion increased emotional intensity ratings, and decreased feelings of belongingness and being in control. This distraction could have carried over to the task of rating one's willingness to fight and die in defense of values.

Even if we say the brain imaging results weren't especially informative, the extensive ethnographic study and field surveys were a highly valuable source of data on a marginalized group of young Muslim men at risk of recruitment by violent extremist groups. It's a vicious cycle: terrorist attacks result in greater discrimination and persecution of innocent Muslim men, which has the unintended effect of further radicalization in some of the most vulnerable individuals. To conclude, I acknowledge that my comments may be out of turn because I have no authority or expertise, and because I'm from a country with an appalling record of discriminating against Muslims.


Footnotes

1 I was a bit confused by some of these scores, because they changed from one paragraph to the next, and differed from what was in Table 1. Perhaps one was a composite score, and the other from an individual questionnaire.

2 I've written extensively about whether Cyberball is a valid proxy for social exclusion, but I won't get into that here.


References

Berns GS, Bell E, Capra CM, Prietula MJ, Moore S, Anderson B, Ginges J, Atran S. (2012). The price of your soul: neural evidence for the non-utilitarian representation of sacred values. Philos Trans R Soc Lond B Biol Sci. 367(1589):754-62.

Pretus C, Hamid N, Sheikh H, Ginges J, Tobeña A, Davis R, Vilarroya O, Atran S. (2018). Neural and Behavioral Correlates of Sacred Values and Vulnerability to Violent Extremism. Front Psychol. 9:2462.


Appendix


Modified from Table 1 (Pretus, Hamid et al., 2018).

[The] measures included (1) a modified inventory on general radicalization (support for violence as a political tactic) based on a prior longitudinal study on violent extremist attitudes among Swiss adolescents (Nivette et al., 2017); (2) a scale on personal grievances and previously used on imprisoned Islamist militants in the Philippines, and Tamil Tigers in Sri Lanka (Webber et al., 2018); (3) a scale on collective narcissism which has been shown to shape in-group authoritarian identity and support for military aggression against outgroups (de Zavala et al., 2009); (4) a self-report delinquency inventory adapted from Elliott et al. (1985), based on the disproportionate number of Muslim European delinquents who join jihadist terrorist groups (Basra and Neumann, 2016); and (5) a series of items assessing endorsement of militant jihadism (“The fighting of the Taliban, Al Qaida, ISIS is justified,” “The means of jihadist groups are justified,” “Attacks against Western nations by jihadist groups are justified,” “Attacks against Muslim nations by jihadist groups are justified,” “Attacks against civilians by jihadist groups are justified,” “Spreading Islam using force is every part of the world is an act of justifiable jihad,” and “A Caliphate must be resurrected even by force”) that we combined into a reliable composite score, “Endorsement of Militant Jihadism”...

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Monday, December 31, 2018

2018 Was a Year to Forget. Really.

Our memory for the details of real-life events is poor, according to a recent study.

Seven MIT students took a one hour walk through Cambridge, MA. A day later, they were presented with one second video clips they may or may not have seen during their walk (the “foils” were taken from another person's recording). Mean recognition accuracy was 55.7%, barely better than guessing.1


Minimal recognition memory for detailed events. Dashed line is chance performance. Adapted from Fig. 2 of
Misra et al. (2018).


How did the researchers capture the details of what was seen during each person's stroll about town (2.1 miles / 3.5 km)? They were fitted with eye tracking glasses to follow their eye movements (because you can't remember what you don't see), and a GoPro camera was mounted on a helmet.


from Fig. 1 (Misra et al., 2018).


One problem with this setup, however, was that the eye tracking data had to be excluded. The overwhelmingly bright summer sun prevented the eye tracker from obtaining accurate images of the pupil. Thus, Experiment 2 was performed inside the Boston Museum of Fine Arts with a separate group of 10 students.


from Fig. 1 (Misra et al., 2018).


Recognition performance was better in Experiment 2. Mean accuracy was 63.2% well above chance (p=.0005) but still not great. Participants correctly identified clips they had seen 59% of the time, and correctly rejected clips they hadn't seen 67% of the time. One participant (#4) was really good, and you'll notice the individual differences below.

Dashed line is chance performance. Adapted from Fig. 2 of Misra et al. (2018).


In Exp. 2, the investigators were able to look at the influence of eye fixations on memory performance. Not surprisingly, people were better at remembering what they looked at (fixated on), but this only held for certain categories of items: talking people, objects rated as “distinctive” (but not distinctive faces), and paintings (but not sculptures).




How do the authors interpret this finding? We don't necessarily pay attention to everything we look at.
“What subjects fixated on also correlated with performance (Fig. 4), but it is clear that subjects did not remember everything that they laid eyes on. There is extensive literature showing that subjects may not pay attention or be conscious of what they are fixating on. Therefore, it is quite likely that, in several instances, subjects may have fixated on an object without necessarily paying attention to that object. Additionally, attention is correlated with the encoding of events into memory. Thus, the current results are consistent with the notion that eye fixations correlate with episodic memory but they are neither necessary nor sufficient for successful episodic memory formation.”

For me personally, 2018 was a year to forget.2 Yet, certain tragic images are etched into my mind, cropping up at inopportune times to traumatize me all over again. That's a very different topic for another time and place.


May your 2019 brighten the sky.


The number 2019 is written in the air with a sparkler near a tourist camp outside Krasnoyarsk, Russia, on January 1, 2019. (The Atlantic)


Footnotes

1 However:
“Two subjects from Experiment I were excluded from the analyses. One of these subjects had a score of 96%, which was well above the performance of any of the other subjects (Figure 2). The weather conditions on the day of the walk for this subject were substantially different, and this subject could thus easily recognize his own video clips purely from assessing the weather conditions. Another subject was excluded 260 because he responded 'yes' >90% of the trials.”

2 See:

I should have done this by now...

The Lie of Precision Medicine

Derealization / Dying

There Is a Giant Hole Where My Heart Used To Be

How to Reconstruct Your Life After a Major Loss


Reference

Misra P, Marconi A, Peterson M, Kreiman G. (2018). Minimal memory for details in real life events. Sci Rep. 8(1):16701.




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Sunday, December 23, 2018

Folie à deux and Homicide for the Holidays



Nothing says home for the holidays like a series of murders committed by family members with a shared delusion. So sit back, sip your hot apple cider or spiked egg nog, and revel in family dysfunction worse than your own.

{Well! There is an actual TV show called Homicide for the Holidays, which I did not know. Kind of makes my title seem derivative... but it was coincidental.}


“Folie à deux”, or Shared Psychotic Disorder, was a diagnosis in DSM-IV-TR:

(A) A delusion develops in an individual in the context of a close relationship with another person(s), who has an already-established delusion. 

(B) The delusion is similar in content to that of the person who already has the established delusion. 

(C) The disturbance is not better accounted for by another Psychotic Disorder (e.g., Schizophrenia) or a Mood Disorder With Psychotic Features and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Folie à deux occurs in the secondary partner, who shares a delusion with the primary partner (diagnosed with schizophrenia, delusional disorder, or psychotic depression). In in DSM-5, folie à deux no longer exists as a specific disorder. Instead, the secondary partner is given a diagnosis of “other specified schizophrenia spectrum and other psychotic disorder” with a specifier: “delusional symptoms in the partner of individual with delusional disorder” (APA, 2013).

The first cases were reported in the 19th century by the French psychiatrists Baillarger (1860) and Lasègue & Falret (1877). The latter authors note that insanity isn't contagious, but under special circumstances...
a) In the “folie à deux” one individual is the active element; being more intelligent than the other he creates the delusion and gradually imposes it upon the second one who is the passive element. At the beginning the latter resists but later, little by little, he suffers the pressure of his associate, although at the some degree he also reacts and influences the former to correct, modify, and coordinate the delusion that then becomes their common delusion, to be repeated to all in an almost identical fashion and with the same words.
The two individuals are in a close relationship and typically live in an isolated environment.

A recent paper by Guivarch et al. (2018) covered the history of the disorder, and performed a literature review on folie à deux and homicide. They found 17 articles:
In the cases examined, homicides were committed with great violence, usually against a victim in the family circle, and were sometimes followed by suicide. The main risk factor for homicide was the combination of mystical and persecutory delusions. The homicides occurred in response to destabilization of the delusional dyads.

Body mutilation is not uncommon: “These features appear in the reported case of a mother who was delusional and killed her young son by hitting him on the head 3 times with a hatchet.”

The authors presented a detailed history of induced psychosis involving Mr. A (the secondary) and Mrs. A (the primary, who had a family history of delusion). Shortly after getting married, they had a child who was removed by social services due to inadequate parenting.
Subsequently, the couple engaged in several years of delusional wandering in France and Italy, traveling from village to village to accomplish “a divine mission”, during which time they were hosted in monasteries or abbeys. They expressed delusional feelings but never visited a psychiatrist and were never confronted by the police. The couple's relationship transformed; the partners stopped having sexual relations and quickly established a delusional hierarchical relation, with Mrs. A being called “Your Majesty” and Mr. A considering himself “King of Australia, Secretary of Her Majesty”.

After about 20 years of this, in a fit of overkill, Mr. A murdered a random 11 year old child by inflicting 44 stab wounds. Earlier, he had felt humiliated and persecuted at a police check point, which provoked an “incident.” The murder of the child was part of their delusional divine mission, to make a necessary sacrifice that would restore balance.


Paranoia of the exalted type in a setting of folie à deux

The famous case of Pauline P (“a dark, rather sulky looking but not unattractive girl of stocky build”) and Juliet H (“a tall, willowy, frail, attractive blonde with large blue eyes”) was also mentioned (Medlicott, 1955). The two girls established a very close bond, constructed an elaborate make-believe world of fictional characters, withdrew from all others, became sexually involved, and developed a superiority complex. They killed Pauline's mother “because one of the girls was going to move with her parents, which would have led to the separation of the delusional dyad (Medlicott, 1955).” This formed the basis of the fantastic 1994 film, Heavenly Creatures, featuring Melanie Lynskey and Kate Winslet.




Granted, their indissoluble bond was pathological, but laughable 1955 views of same-sex relationships were on display in this analysis:
There is of course no doubt that the relationship between these two girls was basically homosexual in nature. Pauline made attempts in 1953 of establishing heterosexual relationships, but in spite of intercourse on one occasion there was no evidence of real erotic involvement. All her escapades were fully discussed with Juliet which is a common feature amongst people basically homosexual in orientation.

Yes, we can generalize and say that all teenage girls in the 1950s commonly bragged about their heterosexual exploits with their lesbian lovers.

From Pauline's 1953 diary:
“To-day Juliet and I found the key to the 4th World.  ... We have an extra part of our brain which can appreciate the 4th World. Only about 10 people have it. When we die we will go to the 4th World, but meanwhile on two days every year we may use the key and look in to that beautiful world which we have been lucky enough to be allowed to know of, on this Day of Finding the Key to the Way through the Clouds.”

Your family gatherings may not always be harmonious, but presumably your delusional children are not plotting to kill you. Happy Holidays.





References

Baillarger J. (1860). Quelques exemples de folie communiquée. Gazette Des Hôpitaux Civils et Militaires 38: 149-151.

Guivarch J, Piercecchi-Marti MD, Poinso F. (2018). Folie à deux and homicide: Literature review and study of a complex clinical case. International Journal of Law and Psychiatry 61:30-39.

Lasègue C, Falret J. (1877). La folie à deux (ou folie communiquée). Annales Médico Psychologiques 18: 321-355. English translation (Dialogues in Philosophy, Mental and Neuro Sciences, December 2016).

Medlicott R. (1955). Paranoia of the exalted type in a setting of folie à deux; a study of two adolescent homicides. The British journal of medical psychology 28:205-223.

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Wednesday, November 21, 2018

Manifestations of Fear in Cross-Cultural Interpretations of Sleep Paralysis


Frontispiece from: Blicke in die Traum- und Geisterwelt (A look into the dream and spirit world), by Friedrich Voigt (1854).


What are you most afraid of? Not finding a permanent job? Getting a divorce and losing your family? Losing your funding? Not making this month's rent? Not having a roof over your head? Natural disasters? Nuclear war? Cancer? Having a loved one die of cancer?

FAILURE?

There are many types of specific phobias (snakes, spiders, heights, enclosed spaces, clowns, mirrors, etc.), but that's not what I'm talking about here.

What are you really afraid of? Death? Pain? A painful death?

Devils, demons, ghosts, witches, and other supernatural apparitions? This latter category (haunting, demon possession) is common among many cultures with religious or spiritual practices, and can evoke primal fear. As a former Catholic, I am still frightened by movies or TV shows that involve demonic possession, like American Horror Story: Asylum.




I used this show as an exemplar in a post about Possession Trance Disorder in DSM-5.

A fantastic long-form article by Nike Mariani has just appeared in The Atlantic. The author intermixes the individual case study of Louisa Muskovits with the history of exorcism and facts about its modern-day resurgence.

American Exorcism
Priests are fielding more requests than ever for help with demonic possession, and a centuries-old practice is finding new footing in the modern world.
 . . .
  • The official exorcist for Indianapolis has received 1,700 requests so far in 2018.
  • Father Thomas said that as many as 80 percent of the people who come to him seeking an exorcism are sexual-abuse survivors.
  • Some abused children are subjected to such agonizing experiences that they adopt a coping mechanism in which they force themselves into a kind of out-of-body experience. As they mature, this extreme psychological measure develops into a disorder that may manifest unpredictably. “There is a high prevalence of childhood abuse of different kinds with dissociative disorders,” Roberto Lewis-Fernández, a Columbia University psychiatry professor who studies dissociation, told me.

This brings me to another topic I've been meaning to write about for weeks. Sleep paralysis is the terrifying condition of being half awake but unable to move (or speak or scream). It can feel like you're frozen in bed, aware of your surroundings yet completely paralyzed. This is because the complete muscle atonia typically experienced during REM sleep has oozed into lighter stages of non-REM sleep. Scary dream imagery can intrude while in this state, making it even worse.

A fascinating new paper covers interpretations of this frightening phenomenon across different cultures (Olunu et al., 2018). A common theme is being attacked, visited, or sat upon by supernatural beings, such as demons, witches, ghosts, and spirits.


-- click on image for a larger view --


The eerie presences are called Jinn in Egypt, Kabus in Iran, Phi Um in Thailand, Old Hag in lots of places, and the especially horrifying Kokma in Saint Lucia, which are “attacks by dead spirits or unbaptized babies that jump into a body and squeeze the throat”. In Nigeria, believers in supernatural explanations exist alongside others who hold rational explanations:
Nigerians describe it as “visitation of an evil spirit, witches, or some form of spiritual attack.” Others have beliefs that it may be due to anxiety or emotions associated with family problems.
The Wikipedia page on the folklore of the night hag also has a pretty good listing.


Interestingly, sleep paralysis was considered as a partial explanation for “demonic possession” in the case of Louisa Muskovits (Atlantic):
Louisa seemed to vacillate between this unhinged state and her normal self. One minute she would snarl and bare her teeth, and the next she would beg for help. “It definitely had this appearance where she was fighting within herself,” Harp [her former therapist] told me.

. . .
[Another time] Louisa ... woke up abruptly, only to find her body locked in place—but with the added shock of what seemed to be visual hallucinations, including one of a giant spider crawling into her bedroom. Louisa was so jolted that she barely ate or slept for three days. “I didn’t feel safe,” she said. “I felt violated.”

. . .
Sleep paralysis seemed like a promising explanation. A phenomenon in which sufferers move too quickly in and out of rem sleep for the body to keep up, sleep paralysis causes a person’s mind to wake up before the body can shake off the effects of sleep. Hovering near full consciousness, the person can experience paralysis and hallucinations.

But Louisa didn’t think this could account for the hand on her collarbone, which she swore she’d felt while she was completely awake [oh of course it can account for this phenomenology!].


What are your experiences of sleep paralysis?


Further Reading

When Waking Up Becomes the Nightmare: Hypnopompic Hallucinatory Pain

The Phenomenology of Pain During REM Sleep

The Neurophysiology of Pain During REM Sleep

Possession Trance Disorder in DSM-5

Spirit Possession as a Trauma-Related Disorder in Uganda

"The spirit came for me when I went to fetch firewood" - Personal Narrative of Spirit Possession in Uganda

Possession Trance Disorder Caused by Door-to-Door Sales

Fatal Hypernatraemia from Excessive Salt Ingestion During Exorcism

Diagnostic Criteria for Demonic Possession

The Devilish Side of Psychiatry


Reference

Olunu E, Kimo R, Onigbinde EO, Akpanobong MU, Enang IE, Osanakpo M, Monday IT, Otohinoyi DA, John Fakoya AO. (2018). Sleep Paralysis, a Medical Condition with a Diverse Cultural Interpretation. Int J Appl Basic Med Res. 8(3):137-142.



Scene from The Wailing. Although it's certainly not for everybody, it is an amazing film.


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Wednesday, October 31, 2018

Survey Skeleton



Karger Medical and Scientific Publishers has a lovely Survey Skeleton peeking out enticingly on some of their journal websites now.




It's to lure you to take their survey, where you can win attractive prizes....




...such as the unique Vesalius: The Fabric of the Human Body (value CHF 1,500).





Just thought you should know.


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Tuesday, October 02, 2018

There Is a Giant Hole Where My Heart Used To Be

With profound grief, I announce that Sandra’s journey has come to an end.



Gardens at Government House, Victoria BC (June 2017)


Sandra Dawson was taken from this earth by the indiscriminate brutality of metastatic cancer. She died on October 2, 2018 at the age of 51. This horrific experience was not a “fight.” She did NOT lose a battle against the unchecked proliferation of malignant cells. Instead, Sandra saw the final phase of her life a journey. She was incredibly brave while facing the ravages of this terrible disease, and she was ultimately accepting of her fate. She was gracious and generous in sharing the final stages of her journey with friends and family, and also with nearly 25,000 followers of her @unsuicide Twitter account.1 There was an outpouring of love and support and visitors and flowers, which buoyed her spirits and made her feel loved.

She really loved flowers.




Sandra was many things – a writer, a blogger, a jewelry designer, a crochet artist, a mental health advocate, a board member of the Mental Health Commission of Canada, and the 2016 winner of a Sovereign's Medal for Volunteers from The Governor General of Canada, for over a decade of work in suicide prevention.



Government House, Victoria BC (June 2017)



September 10 was World Suicide Prevention Day, and Dr. Erin Michalak of CREST.BD wrote a touching tribute to Sandra’s work.

Sandra Dawson’s Legacy

. . .

“Most significantly, Sandra created the Unsuicide directory of online and mobile crisis supports, as well as a popular corresponding Twitter feed (@Unsuicide) with close to 25,000 followers. Her Unsuicide online supports are authentically grounded in her lived experience of bipolar disorder, but also unfailingly focused on helping people, regardless of their geography, to access credible and safe online and mobile support tools. In 2016, she was awarded the Sovereign’s Medal for Volunteers from the Governor General of Canada in acknowledgement of the impact of her work as an advocate for people facing mental health challenges and in suicide prevention.”

But mostly I think of her as a writer.



Radar Queer Reading Series, SF Public Library (October 2016)


She was also my partner and wife of nearly 12 years.


December 2017


We met in 2006 through our respective blogs, The Neurocritic and Neurofuture. The neuroblogging community was quite small then. Neurofuture started in January 2006 a blog about Brain Science and Neurofuturism that was ahead of its time (so to speak):
The future is now, in many ways. Neuroscience and psychiatry are fields that have experienced tremendous growth, especially in the last few decades, and these advances already have practical applications. … At the same time, much is still unknown…
. . .

Neuroscience, psychiatry, neuroethics and transhumanism are the four areas of focus for this blog. They have applications in a broad range of fields, and I'll be aggregating diverse information. Expect a lot of interesting links. I invite your comments.

In June 2006, she started a video blog, Channel N, that shared interesting content related to neuroscience, psychology, and mental health. Channel N eventually moved to Psych Central, a trusted mega-site for mental health, depression, bipolar, ADHD & psychology information. Sandra also wrote posts for World of Psychology, the main PsychCentral blog, including many Top 10 lists, which were always popular.

Along with Steve Higgins, she blogged for Omni Brain (from December 2006 – January 2008), which was “an exploration of the serious, fun, ridiculous / past, present, future of the brain and the science that loves it” – as part of the long-defunct Science Blogs network.


But Sandra’s real love was writing fiction (mostly under the pseudonym S. Kay). She wrote an unpublished novel (or two), flash fiction, and a novella that was published by Maudlin House (ironically titled Joy).





The advent of Twitter really changed her writing. She started writing microfiction, ultra-short stories in the form of Tweets (140 characters or less). Sometime they were standalone zaps that told an entire tiny tale.





Other times, she crafted a number of tweets together to tell a longer story. These were published in various venues and included pieces such as Neurotech Light and DarkCloud Glitches, Facebook Algorithm of Death,2 and her final piece, Goth Robots (robots were always a favorite theme; see the interview Weird words with S. Kay). Her blueberrio tumblr has a comprehensive list of her published work.




Her masterwork was Reliant, “an apocalypse in tweets” published in 2015 by the late tNY Press (but still available for purchase at Amazon):
“Selfies, sexbots, and drones collide in these interwoven nanofictions about a society before, during, and after its collapse. With dazzling humor and insight, debut author S. Kay reveals a future that looks disconcertingly like the present. Beautifully illustrated by Thoka Maer, Reliant is a bold examination of society's unrequited love for technology.”
There was a nice review in Entropy by Christopher Iacono.




But my proudest literary-moment-by-proxy was when Sandra read at Writers With Drinks, a long-standing, monthly series of readings by spectacular writers, held in a bar and hosted by the talented and amusing Charlie Jane Anders. It was a fun evening and the ideal crowd for reading Reliant.



Writers With Drinks (Nov. 14, 2015)


Sandra's next book, Lost in the Land of Bears (designed and published by Reality Hands), had a truly unique limited edition faux fur cover, but it's still available as an e-book.


James Knight wrote a great review at Sabotage Reviews.


Sandra was an early adopter of all forms of online communication. She was an avid blogger, social media user, and before that an online diarist. She was prescient about the future of social media:
I have no optimism that social media will bring the world together with mutual empathy improving society. Sheep are still sheep and their bleatings still need shepherds to make them a coherent flock. An important lesson for the next decade. The media is still the media and if anything, is more segregated than ever.

Sandra Dawson, January 4, 2007


I could go on and on about her other wildly creative projects, like her Spambot Psychosis origami text cube, her beachpunk jewelry, her minibook necklaces (sample here), her upcycled cashmere brooches, her Postcards from the Post-Apocalypse, and her exhibit of crocheted art hats (and bonus EEG cap) at Femina Potens (the Cultivating Cozy exhibition).



January 18th, 2008



But what I can't express in words right now is how much I'll miss her.






Footnotes

1 Like me, she had many Twitter accounts and blogs and pseudonyms; the latter included Sandra K, Sandra Kiume, and S. Kay.

2 Sadly, this was based on a true story that had an even more tragic ending.




I love you.
RIP.

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Thursday, September 20, 2018

Dr. Bernard Carroll: blogger, funny tweeter, and critic of scientific and ethical lapses in psychiatry


Dr. Bernard Carroll (Nov 21, 1940 – Sep 10, 2018)




I was friends with Dr. Carroll (“Barney”) on Twitter, and always enjoyed his wit.



Before that he was an early commenter and supporter of my blog, The Neurocritic. Which pleased me to no end, given this brief biography from his blogger site.


My blogs Health Care Renewal
Occupation Psychopharmacology
Introduction Past chairman FDA Psychopharmacologic Drugs Advisory Committee.
Past chairman, department of psychiatry Duke University Medical Center.
Interests Professional ethics, medicine


He didn't know who I was and didn't care. He assessed me by the quality of my writing, and allowed me entrée into a world I would have no access to otherwise.1

As I'm facing the most catastrophic loss of my life, I will miss him too. He was a brilliant, principled, and compassionate man.


Remembrance from Health Care RenewalRemembering Dr Bernard Carroll


Obituary in BMJ by Dr. Allen Frances (and Dr. Barney Carroll):

Barney Carroll: the conscience of psychiatry
A pioneer in biological psychiatry, more recently Bernard Carroll (‘‘Barney’’) became a withering critic of its compromised ethics and corruption by industry. Shortly before his death, he helped prepare this obituary—his last chance to help correct the perverse incentives that too often influence the conduct and reporting of scientific research.
. . .

Barney rejected grand biological theories that offered neat, simple-but-wrong explanations of psychopathology. Ever aware of the complexity of the human brain, he was an early rejecter of blind optimism that any simple imbalance of monoamine transmitters could account for the wide variety of mental disorders. More recently, he deplored the ubiquitous hype that suggested that genetics or neuroimaging or big data mining could provide simple answers to deeply complex questions. He predicted—presciently—that these powerful new tools would have great difficulty in producing solid, replicable findings that could be translated to clinical practice.





Footnote

1 i.e., Very senior male psychiatrists. When I wrote my blog post about being female, and my wife's diagnosis of stage 4 cancer...

So yeah, think of this as my “coming out”. Sorry if I've offended anyone with my ability to blend into male-dominated settings.

Thank you for reading, and for your continued support during this difficult time.

...Barney was the first to comment, with his usual wit and grace: “I am pretty sure we can handle that. Bless you both.”

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