4 Comments
Mar 19, 2023Liked by Awais Aftab

Found the 4 patterns of group behaviour described by W. Bion in Experiences in Groups which lead in part to the development of the Leicester model, the most helpful way to think about unconscious group dynamics.

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Mar 20, 2023Liked by Awais Aftab

What a thought provoking and clear piece of writing. Thank you! The rationalist account of belief change in the face of evidence, and conspiracy theories-- when that fails, is impressive. I suspect though it is an incomplete one. It privileges a cognitive, mechanistic explanation over the emotional/social functions of conspiracy theories. The idea of "trapped priors" sounds quite similar to the "backfire effect" where protected values/beliefs get stronger in the face of contradicting evidence. Strongly held beliefs develop in a social matrix. There is a community of believers similar to one out there. One's mind is embedded in a network of minds so to speak. For this network or community, issues of deeply held values, social identity, perceived power imbalances are important in fostering and maintaining "conspiracy theories." Years ago, I read somewhere that cognition/thinking developed as an almost ornamental function of the human mind. While the implications of this may seem less optimistic, it is important to take into account the social milieu in which conspiracy theories develop, if there is going to be a meaningful chance of addressing them.

I agree that how, we as professionals, respond determines the outcome of these conversations. There should not be any safe-guarding "acceptable discourse" outside which the response would be confusion and ridicule.

On an only tangentially related note, I will take a trip down memory lane to share my own experience from my training days on how NOT to deal with conspiracy theories. Sometime in 2007/08, when I was a first year resident, there was grand rounds on HIV/AIDS at my training academic institution, and a certain doctor asked about the origins of the HIV virus, and if there is any truth to the allegation that the early epidemic in Africa coincided with the mass vaccination campaigns by the World Health Organization. Now, I did not know anything about this issue. I am still not sure what to make of these stories. I remember, however, how the some of the professors and the presenter responded. They behaved as if the most ridiculous question was asked: as if it was not worth their time. To this day, I could vividly see their reaction. Their confusion, irritation, and embarrassment. The message was, "do not ask such stupid questions."

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Thanks for a very useful discussion of conspiracy theories (CTs), Awais. Dr. Joe Pierre and I discuss these in detail in several articles, including my recent posting on Psychiatric Times:

https://www.psychiatrictimes.com/view/false-flag-conspiracy-theories-psyche-society-and-the-internet

It's important to emphasize that CTs are not, in most cases, "delusions" in the sense most psychiatrists would use that term; rather, they usually represent over-valued and poorly evidenced beliefs that have been strongly reinforced by certain cultural subgroups, typically via social media and the internet.

It is also important to note that CTs can arise on either side of the political spectrum, and that some CTs (though probably a minority) eventually prove to be true.

Finally, it hardly needs emphasizing that psychiatrists who treat patients espousing CTs should avoid patronizing or disparaging the patients; rather, the psychiatrist should keep an open mind; understand and empathize with whatever fears may underlie the patient's CT; and gently provide corrective information or appropriate "counter-narratives" for the patient to consider.

For more on this, please see:

https://www.medscape.com/viewarticle/945290

Best regards,

Ron

Ronald W. Pies, MD

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