Part 4 of my Lost Connections review. Back to part 1
Once, when I was still a teenager, I thought in great depth about technology and the world. I came to a conclusion–illicit substances may or may not have been involved–that it would be impossible to tell if the world was real, and that we could well all be living in a computer simulation. How groundbreaking!
Upon sobering up, I realised that what I’d been thinking about was a fairly well-discussed point in philosophy and other disciplines, and also the plot of The Matrix. And so, I didn’t write a book espousing these amazing insights I’d had.
The thing with Lost Connections is that rather a lot of it isn’t actually all that bad, if you pretend it’s not about depression, and can also spot what’s actually being discussed. In fact, rather a lot of it is fairly classical stuff which is taught in our earliest introductions to psychology.
Take, for example, the chapters in the book dedicated to childhood trauma. This is not a particularly contested fact, because there’s little to contest. There’s this bloke, I don’t know if you’ve heard of him, called Freud, who is considered the father of psychology, and was all about childhood trauma as a driving force of neurosis–which, these days, we’d be calling anxiety and depression. His work still drastically influences research in this field.
And yet, Freud is mentioned precisely once in the book, in passing, and not in reference to the chapters on childhood trauma. Freud’s large body of work on the importance of childhood trauma goes completely and utterly unmentioned.
Another example: in chapter 14, we’re treated to a story of a man who lost a leg, and became depressed because his work caused him pain. His community helped him become a dairy farmer instead, and he lived happily ever after. Now, this is not rare at all, and is quite well-discussed. It ties in with the social model of disability, a phrase which is mentioned exactly zero times in the text.
This pattern repeats over and over again, with fairly well-accepted research being treated as though it’s outsider mavericks speaking truth to power. Brown and Harris’s Social Origins of Depression, discussed at length in chapter 4, is required reading on many social science degrees, with little to contest. Likewise, Marmot’s Whitehall studies, referenced heavily in chapter 6 (although these pertain to stress, not depression). Likewise, Cacioppo’s work on loneliness.
It’s all fairly basic stuff which is taught to most people whose jobs involve poking around in the human psyche. As a result of this, it finds its way into healthcare: for example, interventions like befriending or mindfulness are recommended for treating depression on the NHS.
None of this is The Secret That Big Pharma Doesn’t Want You To Know about, and it galls me that it is presented this way, when that’s simply not true.
It would be very helpful to put the established names to the ideas which are discussed in the book. A part of the reason for this is for clarity’s sake: it would be nice to know when particular approaches are being mentioned rather than having to sit through pages and pages of extended metaphors before finally figuring out that what’s being talked about is status syndrome (a phrase which never appears in the text of the book!). It’s particularly important for someone with a background in plagiarism to refer to academic concepts by their established names.
“But Zoe,” perhaps you cry at this point, “this is a great jargon-free accessible introduction.” Not true, I reply. It’s a wildly irresponsible starting point for the interested newbie to dip their toes into the waters of learning about the topics in hand, precisely because the ideas are seldom credited to their proper names. It is the beginning and the end of your learning process. How do you learn more when you’re not equipped with the right phrase to fucking google?
Good popular science writing takes an established concept, and breaks it down for a layperson to understand, giving them the information they need to learn more, if that’s something that’s whetted their appetite for knowledge. You give people the language, and explain what the language means. It’s an entrance point where everyone emerges knowing a little more than they had, and knows what to look for next. Lost Connections does the opposite of this, and in its obfuscation, it fosters a dependence on the author to explain what in the name of sweet blue fuck is being talked about.
My background is in psychology, and sometimes it took me a while to follow what exactly was being explained, because it wasn’t a very good explanation, and often misrepresented findings which pertained to something that wasn’t depression, to depression. If I were completely new to the subject, I’d find myself unable to learn more about these topics, because I wouldn’t have the language to seek out more knowledge–and I would probably walk away thinking Hari and the handful of experts he talked to were the only people looking about social and environmental contributors to depression, because Big Pharma has silenced everyone else.
I don’t know if Hari set out to deliberately muddy the waters in order to foster this dependence on the author, to draw attention away from the false dichotomy he has set up, and to make it harder to notice that for the most part, he isn’t telling us anything radical or revolutionary, just things already widely-used in the study of and treatment of mental illness. That might have been an intention all along. It could also go the other way: maybe he himself hasn’t realised just how established much of what he’s outlined is.
Either way, social and environmental factors aren’t exactly considered a particularly obscure field of research. They’re so well-known they’re embedded in the public consciousness, which is how Blue Monday, “the most depressing day of the year”, could easily be launched by PR companies to sell more holidays. And social and environmental factors are pretty damn integral to biopsychosocial models of health. As to the question as to why they aren’t more widely-used for therapeutic benefit?
It isn’t because nobody would make any money off it. Once again, as we discussed regarding St John’s Wort, these industries are very lucrative indeed. Same with getting your internet addiction treated at a dedicated rehab clinic, or being tutored in how to meditate.
It’s more that these remedies are often least accessible to those who need it most. Take, for example chapter 18’s case study of how to reconnect with meaningful work, wherein employees of a bike shop took back control and made a workers’ cooperative. That’s great. It’s also about as much use as a chocolate dildo if you’re in one of the professions with high rates of burnout, stress and mental illness, like a teacher or an NHS nurse.
The way depression is treated is because a new job or a holiday cannot be prescribed. It would be very nice if we could change society; I’m a big advocate for communism, but that’s not going to happen any time soon. And so we must make transitional demands, the things which can be achieved: and with mental illness, often that’s about just being able to cope.
To use another ghastly analogy, and this one straight out of Hari’s repertoire, sometimes you need to make the symptoms manageable. The pain can be a message that something deeper is wrong, but that’s no good if there’s no cure for the underlying ailment, or the cure will take a long time to realise. If you have a broken leg, and you know you have a broken leg, and your leg’s in plaster, you’re probably still going to need to take a painkiller to stop your leg from hurting while it mends.
Still, Hari’s proposed reconnections do work for some people. And in our final instalment, we’ll be looking at who they work for the best.
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Another angry woman 
You note that holidays can’t be prescribed. It used to be the case in Germany that you could get two weeks at a spa resort as part of a Kur or ‘cure’, and the expenses would be met by your insurance.
oh my shitting god, Germany sounds amazing
Another example: in chapter 14, we’re treated to a story of a man who lost a leg, and became depressed because his work caused him pain. His community helped him become a dairy farmer instead, and he lived happily ever after.
This is bollocks. Starting a small dairy farm is not a recipe for “happily ever after” even if you love animals and the countryside. Farm gate prices are still piss poor thanks to mega bulk buying by supermarkets. The guy was probably loaded and the farm is a hobby farm, even if the story is true.
I’m inclined to lean towards not calling bullshit–he was in Cambodia, not the UK. It was more a matter of having a couple of cows and some milk to sell than industrial farming. Nonetheless, the intervention described is nothing new and PRECISELY WHAT DISABLED PEOPLE HAVE BEEN CALLING FOR FOR YEARS.