On anxiety, society, and tacit magical thinking. A conversation with Marise Timmenga (podcast)

This is the eighth installment of my series Philosophical Chats. In this episode, I have a conversation with Marise Timmenga who is a student at the University of Groningen. After discussing my recent post on my anxiety disorder, we thought that we might contribute to social awareness by talking about some of the ingredients of anxiety. We ended up having a quite intense conversation, which I cut down to a podcast of just under an hour. If you feel like skipping bits or want to focus on a specific topic, here is a rough overview:

Introduction   00:00
What anxiety disorder can be like   01:45
The misleading mind-body dualism   06:00
What helped?   08:43
Awareness and the (un)availability of psychological vocabulary   13:20
Social infrastructures: What can others do to help?   15:00
Do you really have to settle it yourself?   16:25
Educating health professionals   17:50
Mental health in academia   22:05
Some ways of sorting it out – and trigger warnings 25:40
Catching tacit beliefs: magical thinking as a crucial ingredient   34:25
What does anxiety do for me?   35:55
The role of guilt, moral judgments, and pessimism   44:22
Magical thinking as self-ascribing agency   48:30
The role of disowned beliefs   50:40
Having anxiety as a way of keeping yourself safe   52:30  

Oh no, not that!

Is it a good idea to publish rubbish on a blog? Perhaps it’s even a bloody privilege. Who knows? Anyway, I’ve been thinking through a number of issues I wanted to write about. But whenever I sit down to write, I end up wanting to write something different. So everything I attempt to say crumbles into something else.

The frustration of these failed attempts is so strong by now that I simply want to voice it. Here, now I said it. So what now? Might I not say something sensible while I have your attention? – Well, that’s the problem, isn’t it? Thinking about that is like plunging into the Kantian manifold – without the I accompanying anything. – So here is me trying to be clever when some important issues need addressing? Well, not now. I give up, I can’t write a thing now. Perhaps that’s worth saying.

In any case, take care!

Oh, and if you’re interested, here’s a piece of music that features this dithering impatience:

Waiting for Autism. A guest post by Paul Lodge

I have written in a couple of places over the last two years in tentative ways about ‘what it is like’ to live as someone with a bipolar disorder diagnosis (see here and here). I continue to be happy with the idea of representing myself to others as falling under this category in writing, and do so in day to day conversations with people in my more immediate vicinity. But there is always a serious concern in the back of my mind about the crudeness of the criteria that are used to lump people together under this heading. It is manifest in the fact that one of the ways of breaking the ice in those conversations is to allow a slightly uncomfortable joking about some of the more traditional conceptions of manic behaviour: “No, you don’t need to worry about whether I will take my clothes off and dance on the table in the middle of the next faculty meeting – however preferable that might be to the in which such meetings usually unfold.”

I found a way to conceptualise another of the background concerns in the wake of reading a series of papers by Louis Sass and Elizabeth Pienkos, in which they discuss differences between what it is like to be bipolar and schizophrenic. The issue here was that my status as bipolar left me falling into the schizophrenic camp far more often than Sass’ and Pienkos’ analyses should have allowed.

Interesting as the bipolar vs schizophrenia issue is in itself, I want to focus here on something else, though the relationship to this realization should be readily apparent. A couple of weeks ago, I discovered that a person working in another faculty has taken on a central role in the University’s strategy for equality and diversity issues. I’ve worked with this person from time to time over the last fifteen years or so and always found them sympathetic. I put this mainly down to the fact that they speak with a strong northern regional accent (as I did before my years living in the US), and have been involved in the efforts to increase the representation of students from state-funded schools in Oxford (something which has been central to the identity of the college in Oxford of which I am a member). However, it is also because they say what they think without seeming to care too much about the ramifications.

Too cut a potentially long digression short, we agreed to meet up to talk about the ways in which ‘mental disability’ might be more of a focus as the strategy moves forward. Not unsurprisingly to me, it was a really enjoyable, long, and lively conversation, of the kind I find relatively easy with one, but no more than one, other person. It was perhaps easier than usual, given that we both disclosed our diagnoses very early on, and it is here that we get to the focus of this post. They told me that they had received an autistic-spectrum diagnosis very recently. And, as we talked about how that related to the struggles they have navigated, and performed into the shadows, on their journey to becoming a Full Professor, I heard many things that resonated. We discussed various social difficulties that I had thought were best bundled under the bipolar label, or treated as a function of poor socialization, egotism, or simply a result of growing up in Yorkshire.

The meeting was enough to get me thinking. But it was followed the very next day by attending the first event organized by Neurodiversity at Oxford which is aimed at anyone, students or staff, who are looking for community. The event was centred around readings by writer poet and Joanne Limburg, another person who received an autism diagnosis later in life. As she read a selection from her beautiful writings and talked about her experiences growing up as a child and fashioning a life as an academically high achieving individual, I found myself very emotional (as I do even now while reflecting on it) holding back the floods of tears that wanted to emerge. It was like watching Elsa singing ‘Let It Go’ for the first time all over again. I was also very moved to hear of how Joanne’s life has been transformed by finding spaces in which she can meet with others who have the same diagnosis, where she can be herself without feeling social anxiety and the constant fear of performing the ‘wrong’ version of what it is to be a person. And I was also intrigued by her discussion of the way in which she has reconstructed her sense of self in the wake of the diagnosis.

Afterward the event I talked to another of the late autism academics who was there, and asked in more detail about how the diagnosis had changed her life and how she got the diagnosis in the first place. The next day I called my local doctors’ surgery and passed the initial screening required for a referral, doubtless aided by the fact that they already have me down as someone with a mental health problem. All this will happen on the NHS, and it seems the wait will be around 6 months.

So now I am waiting. I’m not quite sure for what. The colleague I mentioned first (I think I really can, and should, say ‘friend’ at this point) warned me that she initially ‘failed’ at the first step of the diagnostic testing – which is a very long questionnaire – because she showed up as too empathetic. It seems it was only her capacity to articulate the reasons for this that got her through to the next stage. I’m not sure whether I will fall at that hurdle too, or others. I’m also not sure how it will feel if I don’t come out with a diagnosis, though I know part of me would like to have the chance to find out what it is spend time with people who find community with those who are autistic. And, as a someone who has spent so much time in academic philosophy, I’m already thinking in that kind of way about what it might be to be in a position to use lots of new concepts to understand my past, present and future self and its actions and relations with other selves. It’s exciting and daunting. But mainly it’s just a messy thing waiting to fall out one way or another.

Joanne Limburg is a very impressive person and a wonderful writer. No doubt aware of the fact that she was talking to a room of people self-identifying as neurodivergent in various ways, she pulled away on occasion from her own identity as autistic. At those times she spoke to something else, her sense of the way in which being autistic allowed her a kind of freedom that went beyond the freedom engendered by her new-found sense of explicit solidarity, a freedom to feel more comfortable with her sense of being ‘weird’. Even if I don’t end up being autistic, I’m grateful to her and to my new friend for already feeling more comfortable with some of the bits of my weirdness that I could never squeeze into my bipolar diagnosis. And, of course, that is really a matter of already feeling just a little bit less weird and less alone in that weirdness after so many years.

Philosophy, language, and my long road to tenure (podcast)

After one of my lectures on the history of philosophy for students from other faculties, Daniel Rebbin and Colm O’Fuarthain, two psychology students participating in the lecture, kindly invited me to a conversation on their Mental Minds Podcast.

So we talked about many things: for instance, about my approach to philosophy, the importance of being confused, language, dialogue, my way into academia, pretence, anxiety, and the meaning of life. Enjoy the conversation and check out their other podcasts. Below I added a rough table of contents (the times might not always be correct):


00:00 Introduction              

01:40 Why should we study and how did I get into philosophy?                      

03:15 On confusion and expectations

10:10 Do we always focus on what people say rather than on phenomena?

12:36 Language as a mode of direct perception

15:31 Interaction through language

18:37 Limits of language, and how we share experiences

29:19 On going into academia and the relevance of philosophy for our lives

43:05 The role of luck, chance, and shame

52:34 Intrinsic motivation? – Adolescent wishes

56:30 What have professors gone through to become professors?

1:21:30 My anxiety disorder

1:30:40 What advice would I give my younger self?

1:42:00 What gives me meaning in life?

Curing my anxiety disorder and the pitfalls of rationalism

As I noted in an earlier post, I have been suffering from illness anxiety disorder, formerly known as “hypochondria” for about twenty years. Five days ago, I had my last therapy session. The reason is that I reached the main goal of the therapy, that is: being able to live with uncertainty. Since I had so many kind reactions to my last post on this issue, I thought it would be nice to post an update and say a little bit about the therapy and how it helped. It was what is called cognitive behavioural therapy, and I received treatment for about eight months. On the whole, I think that the therapeutic devices are so straightforwardly mechanical that they might help with other troubles, too. At the same time, I am still struck by the rationalist thought patterns that might be responsible for part of my anxiety. Let me try and put some order into my thoughts now.

The worst of all possible worlds. – Imagine you notice something, for instance some unusual sensation like a spot on your arm that wasn’t there the evening before. You might think, “oh, a spot” and move on. The fact that I can think that, too, now is perhaps one of the greatest successes of my therapy. Usually, I would think that this is probably the symptom of an incurable disease. If you don’t believe this, it’s easy to shrug it off, but if you do believe it… But how did I get out of this structure of catastrophic beliefs? It’s helpful to break down this question into two parts: (1) What sort of belief made me enter catastrophic thought cycles? (2) How did I block them? Question (1) has a number of answers. Let me focus on the most surprising aspect. One of the most problematic thoughts I tend to have is that there is an explanation for the “symptom”. Now you might think that this is indeed a plausible thought to have. And indeed, as someone trained in the history of philosophy I know I am not alone in recognising this as a variation of the rationalist principle of sufficient reason (PSR).  There is an explanation for everything. Fine. Problems start if you actually expect that you or your doctor or the internet can provide an explanation. For if you’re like I’ve been and there is no obvious or reassuring explanation available, you think, “hey, this might have a sinister or rare cause”. So the PSR keeps the search going until you either find reassurance or an even worse “symptom” to worry about. The thought I didn’t ever entertain is that there might be no explanation available.* So when my therapist suggested this idea I just gave him a blank stare. This leads us to question (2). A common approach in behavioural therapy is to “challenge” such thought cycles. So how do you challenge the PSR? Well, first you try to figure out and write down your precise thoughts. Then you raise challenging questions. The most successful question was this: “Is it actually helpful to worry about this symptom or search for an explanation now?” If you’re honest and not in an actual emergency, you’ll end up having to answer this question with “no”, again and again. What I learned to accept is that it is often more helpful to resign to the fact that no explanation is available rather than keep searching for one. This is, for me, a very concrete way of learning to live with uncertainty.

Magical thinking. – Observing my thought processes, I often wondered why I was so glued to certain patterns. One miserable day I was lucky enough to catch one of the culprits in the act. I thought something like the following: “If I don’t take this symptom seriously, it will turn out even worse.” The thought was so elusive that I had trouble ‘catching it’. But even when I got hold of it, I had trouble seeing what it meant. But suddenly it struck me: This is a variation of the magical thoughts I had as child. Magical thinking is the assumption that your thoughts or some neglect in thinking will cause bad events, like “if I think badly of my parents, they’ll have an accident.” I’m told this is fairly common in children, while adults grow out of it. And of course, I wouldn’t dream of ascribing such assumptions to myself. But here I was! I realised that my thought “if I don’t take this symptom seriously, it will turn out even worse” could most plausibly be rendered as a magical thought like “if I don’t keep fretting over this symptom, I will deserve the illness I ignore right now.” The causal assumptions in the magical thought are closely tied to a moral judgment of deserving or being guilty of my threatening fate, if I neglect it. Of course, it’s hard to be sure, but I’m pretty convinced that it’s this childish superstition that glued me to my anxiety variant of the PSR. While I was shocked and somewhat ashamed to discover this in me, I was equally relieved, because seeing this pattern greatly helped distancing myself from my obsessive search for explanations.

Moving on. – Catching precise formulations and what they mean is actually quite crucial for moving on. I know that I cannot be straightforwardly cured of anxiety, but I can aid the cure by “learning to live with uncertainty”. The reformulation of my therapeutic goals alone already helped me embracing them as something positive rather than as negative. Being interested in social philosophy, you can imagine that I often annoyed my therapist by venting about the missing social aspects in therapy, though. What you (or at least I) need is not just overcoming my mental habits. What I need is a social infrastructure that is understanding and able to deal with conditions like mine. It makes a hell of a difference how a doctor or indeed anyone articulates their diagnosis or suspicions. But you can support your social environment in this. To achieve this, I began to force myself to apply the question “is it actually helpful to worry about this now” not only to my “symptoms” but to all sorts of issues my interlocutors confront me with. Pushing back against concerns of others like this did not make everyone around me happy… But despite some misgivings here and there, this change in my conduct seems to have overall positive effects. What helps is taking the time to explain how and why I attempt to respond and challenge requests with this question now.

The upshot is that, despite my initial scepticism, I would really recommend this therapeutic approach. It is not a magical cure, but that might be for the better.


* I think this “anxiety PSR” is also an epistemic variation of what is known as the just world fallacy, but I might go into this another time.

Relatedly, I just came across a nice piece on the epistemic merits of CBT: “A common idea about CBT is that it does not contribute to the person’s understanding of reality (validity) but encourages ways of thinking that boost the person’s wellbeing (utility). In our brief commentary, we argue that CBT can also contribute to some of the person’s epistemic goals.”

Writing philosophy and avoiding the delete button. A brief conversation about blogging with Anna Tropia (video)

Writing philosophy and avoiding the delete button. A brief conversation about blogging with Anna Tropia

This is the fifth installment of my series Philosophical Chats. In this episode, I have a conversation with Anna Tropia who is an assistant professor of philosophy at the University of Prague. Following up on some earlier musings, we focus on issues of writing (philosophy) as they figure in my blogging. Here is a rough table of contents:

  • Introduction and the focus of “Handling Ideas” 0:00
  • How can and why should we avoid the delete button? 2:17
  • Dare to say something wrong! A general tip on writing 6:53

On shame and love in (academic) reading and writing

“What is the seal of attained liberty? To be no longer ashamed of oneself.” Friedrich Nietzsche

Like many fellow students around me, I learned writing by imitating others. How do I know about the others? Well, because there were no courses on learning how to write. So everyone was left to their own devices. Don’t get me wrong: there were and are many good guides on what desirable academic prose should look like. But these guides do not focus on the process of writing: on the despair, boredom, shame, and love that go into it. Actually, it was the lack of reflections on the process and the more doubtful stages that initially motivated me to start this blog. Speaking about these emotions is not meant as a form of venting or ranting about hardships (although they should have their place, too), but rather on the way these emotions can guide and inform our writing. In what follows, I want to say a bit more about this. I’ll start by looking at the way (emotional) experience figures in academic interaction and writing, and then zoom in on different forms of expressing thoughts.

Let’s begin with shame, though. – If you want to see how shame figures in guiding academic interactions, just start a course by asking what people did not understand in a set text. Most people will remain silent; the more experienced ones will point out passages that fail to be clear enough to be understood, passing the blame onto the text. – If you’re the odd one out who is willing to go for it, you’ll know that it takes courage to begin by admitting that you yourself do not understand. Shame is the fear of being seen or exposed in doing something undesirable (like making a mistake). When we speak or write, shame will drive us to avoid making mistakes. One way of doing that is remaining silent; another way is to pass the blame and criticise others rather than taking the blame. In writing or conversation, we can counter shame by developing technical skills, that is, by learning chops that make it look flawless, elegant, and professional. So we introduce technical jargon, demonstrating our analytical skills and what have you. While technical versatility is often equated with a sober or even neutral style, this asset might owe less to sobriety than to shame.

What’s love got do with it? – Iris Murdoch wrote somewhere that love is, amongst other things, the ability to see someone else as real. (See Fleur Jongepier’s great piece on Murdoch and love.) One way of taking this is that love is an ability, the ability to understand, not yourself and your desires, but the other. How do you do that? My hunch is that understanding others begins with trying to understand their experience. If you are able to express someone’s experience, the other might feel seen. In writing, this can be done in at least two ways. You can try to say what (you think) someone experiences or you can try to create an experience for the reader. Now you might think that this factor is totally absent from academic writing, but that isn’t true. Philosophers typically try to tap into experience by using examples or crafting thought experiments. What is rarely acknowledged is that these items do much more work than meets the eye. Strong examples and thought experiments often live on much longer than the arguments they’re supposed to back up. They are far more than mere illustrations of a point. Ideally, they allow the reader to experience a conceptual constraint on an almost physical level. Knowing a norm, for example, is one thing; being exposed (or imagining yourself) as having transgressed it is quite another.

How does this take on love as understanding the other play out in reading and writing? Returning to the example of asking people what they didn’t understand in a given text, it would be an act of love, in the sense explained, to acknowledge what you do not understand about the text. For if love is seeing the other as real, acknowledging the other’s reality would begin by acknowledging that there is something different, something you do not understand etc. In this sense, acknowledging the other (in the text) begins by admitting a weakness in yourself, the weakness of not understanding wholly. However, ultimately the point is not just to point out limitations but also to explore what constitutes these limits. This means that you also need to see what precisely blocks your understanding of the other (or the text). Seeing how factors in your personality, style, context and history enable or disable your understanding requires you to understand yourself. To use a radical example, if you have never been confronted with an optical illusion, examples of this sort of illustration wouldn’t work for you. Generally, if you never had access to certain kinds of experiences, these will constitute limits of understanding. Likewise, factors such as gender, race and class will inform the way a text speaks (or doesn’t speak) to us and limit the experiential resources available to draw on experience in writing. – It’s important to see that, in this sense, shame and love are in conflict. While love aims at seeing the other and involves the other (and thus ourselves, too) as being seen, shame drives us to disguise ourselves (at least in what we find undesirable) and perhaps even to blame the other for failing to be intelligible to us. In philosophical conversation, then, shame would make us avoid being seen (at least in undesirable aspects), while love would require us to lay bare our weakness of not understanding the other. As a result of this, shame and love play out in how we relate to (personal) experience. Arguably, shame blocks resorting to (personal) experience, while love as an approach to what constitutes borders between ourselves and others requires resorting to experience.

Expressing thoughts and experience. – If the forgoing makes some sense, we might say that shame and love inspire different attitudes in philosophical conversation: shame makes us shun (expressing thoughts by) personal experience, while love requires us to explore experience. Going from shame and love as two guiding emotions, then, we can easily discern two styles of reading and writing. Driven by shame, we find ourselves in a culture that often shuns resorting to experience and relies on techniques that correct for supposedly subjective factors. It is no surprise, then, that philosophers often highlight skills of so-called “critical thinking” as an asset of the discipline. More often than not these skills boil down to learning labels of fallacies that we can tag on texts. Looking at my student days, I often found myself indulging in technicalities to shun the fear of being seen for what I was: someone understanding very little. That said, such skills can be developed into a real art of analysis. Paired with patience, the careful study of arguments can yield great results. Then, it is no longer merely a way of avoiding shame but itself a set of tools for understanding. – Conversely, inspired by what I introduced as love, experience is crucial for understanding what sets us apart from others and the rest of the world. As I said earlier, this approach requires taking into account facors such as personalities, context and history. Crucially, such an approach cannot rely on the skillset of the writer or reader alone. It requires a dialogical readiness that might always undermine one’s own steps of understanding by what remains different. Perhaps it is not surprising that this approach is found mostly in areas that have traditionally enjoyed less acclaim, such as certain approaches in history, standpoint theory or experimental philosophy. – However, while it is important to tell such driving forces and styles apart, they are hardly ever distinct. As I said in an earlier post, if you open any of the so-called classics, you’ll find representations of both forms. Descartes’ Meditations offer you meditative exercises that you can try at home alongside a battery of arguments engaging with rival theories. Wittgenstein’s Tractatus closes with the mystical and the advice to shut up about the things that matter most after opening with a rather technical account of how language relates to the world. Yet, while both kinds are present in many philosophical works, it’s mostly the second kind that gets recognition in professional academic philosophy If this is correct, this means that experience doesn’t figure much in our considerations of reading and writing.

Can we teach failure? – Trying to pin down what characterises this sort of love as an approach in reading and writing, it ultimately seems to be a process of failure. Trying to understand others fails in that success is simply unthinkable. There is no exhaustive understanding of the other, a text, a person, a thing, whatever. Love, in this or perhaps in any sense, has nothing to do with success, but everything with dialogical trying and undermining. Of course, this can be taught. But it has no place in learning outcomes. As teachers of reading and writing, though, it might be helpful to point out that “analysing”, “reconstructing”, “discussing”, “contextualising”, “arguing” and such like are not success verbs. Showing how we fail in these attempts might go a long way in understanding and overcoming shame.

On trying to cure my anxiety disorder

It was around the time of finishing my PhD, so well over twenty years ago, when bouts of my anxiety disorder manifested themselves so clearly that I sought professional help. The reason I want to write about my condition today is that, for the first time, I am hopeful to have found a way of curing it, to a considerable degree at least. I’ll begin by saying a bit about the condition and then move on to what I consider a potential step towards a cure. Since I don’t really understand my condition and the cure very well, I’m not sure that this will be of help to others. But perhaps adding my voice to the people who talk about such things openly can’t do harm. However, before you read on please note that I am not in any way an expert in these matters. All I have to offer is a personal story.

Being a hypochondriac. – Although I have some special anxieties like a fear of hights and fear of flights, my main problem is a more general disorder that goes by the name of “illness anxiety disorder”, formerly known as “hypochondria”. There is a lot I could say about this condition. The main issue is that, often following a perception of what I classify as a “symptom”, I assume to have some rather threatening illness. The kind of illness changes; what’s crucial is that I consider the worst-case scenario. The drama then typically unfolds as follows: I will first heighten the anxiety by paying selective attention to the “symptom” and indulging in refined self-monitoring. “Is it still there? Is it getting worse?” But now it’s not merely the object of my anxiety but knowledge of the anxiety itself that plays into the cycle: Knowing that I have the anxiety disorder suggests to me that my fears are overblown. But if they are overblown, I go on to think, it must be possible to find reassurance. Thus, I seek reassurance either by “investigating via google” or from people close to me, who will often confirm this and allow me to avoid seeking proper medical advice. This is my avoidance strategy. However, knowing that this is an avoidance pattern suggests to me that I am avoiding confronting the initial “symptoms”. Thus, reassurance amplifies the initial fear. This tangle works best in tandem with anxiety-induced symptoms such as an increased heart rate, but believe me it works with just about any kind of “symptom”. While proper panic attacks never last longer than 30 to 45 minutes, such anxiety cycles can go on for as much as five days. Often such cycles run for a couple of days. Then I have some days of gradual relief before they start again, often with a new perception of a different “symptom”. Since I have developed coping strategies that allow me to function well, I can go through these cycles without people around me noticing, unless I ask for reassurance. This means that the anxiety is often present at the back of my head, like an unpleasant noise in the background that sometimes spirals to very high volumes and then feels more like a disability.

For a long time, I didn’t realise that I had what people formerly called hypochondria. Simply because I sought reassurance, not through pestering doctors, but through other means. When I finished my PhD and lived on social security, the disorder worsened considerably. Among the “best of” of my worries was fearing to fall over in the street or during talks, job talks in particular. At the time, I had three meetings with a behavioural therapist. After understanding how anxiety works (especially understanding that its symptoms disappear after a certain amount of time), I felt relieved and got better again. But anxiety works in mysterious ways: Getting a permanent job in 2012 cured me of many existential worries. It’s been a game changer for sure. But something inside of me resisted the good news and clung to the strange belief that bad things will happen to me inevitably. Self-identifying as an optimist, I refused to embrace that belief consciously, but it seems to have worked its way up nevertheless. Having witnessed a number of troubles, illnesses and deaths in the family, I guess that this belief could take hold despite my avowals to the contrary. For quite a number of years, avoidance was my main coping strategy. Let’s look at some things I think were particularly unhelpful.

Things that didn’t really help. – (1) Being “reasonable”: For someone who enjoys – to some degree at least – things like thinking, understanding, and animated discourse, I found living with bouts of hightend anxiety or panic particularly frustrating, because understanding my own condition often did not help or even made it worse. Of course, understanding how anxiety plays out physically and knowing that I have the condition, for example, helped me seeing why things unfold the way they do. But at least my type of anxiety can get heightened through knowing that it might be partly irresponsive to reasons. Knowledge about anxieties can work like a self-fulfilling prophecy: If you know that your heart rate will go up with your next bout of panic, that very knowledge might actually increase the fear of your heart rate going up, and, as a result of this, increase your heart rate. (2) There is a common dualism according to which conditions like anxiety disorders are only or mainly “in your head”. Even if such claims are meant as a reassurance to someone worrying about their physical health, they don’t help in the long run. Apart from the fact that superficial reassurance can backfire quickly by initiating problematic cycles of seeking ever more reassurance, they underestimate the fact that anxiety comes in many physical manifestations. (3) Reassurance or confrontation? Reasonable reassurance that everything is fine (for good reasons) or confronting your fears, for instance, by going to the doctor can certainly help in singular instances. If a friend points out a good reason why a particular worry is unfounded or if I go to the doctor to get a proper check up, these are good things. The problem is that they are useless once they are turned into general coping strategies. Why? Well, it seems to me at least that anxieties will absorb any coping strategy into the anxiety cycle itself. – I’m not saying, then, that these ways of approaching things don’t ever help anyone. Rather, I wish to stress that they might not help in case you have an anxiety disorder. Of course, if you discover something about yourself that makes you worry, any of these approaches might help very well, but they can fail if they are turned into coping strategies. Why? I guess because using them as strategies makes them part of an anxiety cycle. The toxic thing about anxiety is that anything, even something perfectly helpful, can be turned into part of a cycle that ends up feeding the anxiety.

Moving forward. ­– Last year was particularly bad for most of us. Strangely enough, the threat of coronavirus did not overtly add to my anxieties. Rather, I learned to “embrace fatalism” a bit and became a bit more confrontational about my condition. Thanks to the suggestions of a good friend, I also managed to catch up with some medical check ups that I had avoided for about ten years. Worrying that my daughter Hannah might pick up my behavioural patterns, I also considered starting therapy again. Living in two different places during what is called lockdown, the fairly recent death of my father and some work-related pressures made this seem an even more appropriate consideration. I started behavioural therapy again now. But while I don’t want to pass judgement on this, what eventually made me take a good leap is something else.

What helped me, after all these years, is so strikingly simple that I still don’t know what to make of it, except that it definitely does help greatly. So what happened? After a conversation about a recent bout of anxieties, a dear friend sent me a video explaining a simple thing: to slow down my breathing (like in yoga), and providing an image to think about when doing so. Whenever I experience anxiety, I now take a few deep breaths and most of the problematic anxiety symptoms disappear. The heart rate slows down and I feel good. That’s it.

Why does it work? Don’t get me wrong. I have known that this kind of thing might help for a long time. I’ve been doing a lot of physical exercise for many years. In moments of hightend anxiety I instinctively took to slowing down my breathing anyway. There is nothing fancy about the breathing technique as such. Nothing I do is special; most of it isn’t even new to me. So why does it have such a great effect? I think there are two main aspects: First, the image I am thinking of when inhaling absorbs my attention, away from anxiety symptoms, to the positive impact of inhaling. Second, the fact that this video was presented to me as a personal response and gift turns the exercise into a relational act. Both aspects, simple as they may be, strike me as indispensable in explaining the effect it has on me. I am not saying that this has cured me of my anxiety, not least because I ultimately think that at least some of this disorder is the dark side of my personality, inevitably triggered in a certain kind of context. So I’m not saying I’m cured, but what seems to make a difference, for the time being, is that I can accept this, and yet break the cycle effectively. Even if it only works for certain situations, it restores a sense of agency that many of my coping strategies seem to have deprived me of. – I’m not sure this carries over or can help you. But perhaps a bit of hopefulness will inspire trying to look for unexpected resources.


PS. It goes without saying that I am immensely grateful to many friends who helped along the way. You know who you are.

Is ADHD a disorder? Second thoughts about our conversation on ADHD and decision paralysis

After Martin and I talked, I found myself mentally revisiting our conversation more than once. I had been nervous to talk publicly about my experience with ADHD beforehand and that only increased once the conversation was put online for everyone to hear. In hindsight I realised that I had gotten the chronological order of some rather inconsequential biographical facts wrong and, moreover, I was left wondering if I had been good enough of an advocate for that amorphous, and mostly anonymous, group of philosophers who live with ADHD. All of that went through my head, all the while being fully aware that I couldn’t really fail anyone as I was not speaking on anyone’s behalf other than my own.

We spent quite a bit of time talking about a very specific feature that I, in my own idiolect, call a form of decision paralysis.  It was the first time that someone pushed me to give such an elaborate description and get clearer on its meaning by contrasting the inability to make decisions with the, perhaps related, phenomenon of having to solve a difficult problem. As it was in many ways a first for me, much of what can be heard in the podcast on this is me trying to think this through out loud.

There is a lot to be said for paying this kind of fine-grained attention to giving a phenomenological account of our cognitive lives, but sometimes people want to see the forest, before they start focusing on single trees. There may be a possible world in which I elegantly weaved such a broader picture into the conversation, but I don’t think it’s the world we live in. The good news, however, is that I do live in a world in which it is possible to share these afterthoughts with anyone who is willing to take the trouble to read them (much obliged if this applies to you!).

As I found myself thinking about how to do this, Martin pointed out to me that Ingrid Robeyns, who blogs for Crooked Timber, was drawing attention to an op-ed in the Scientific American, in which it is argued that ADHD should not be understood as a disorder.*

Reconstructing and commenting on their argument will allow me to say something more general about ADHD. Again, the caveat applies that I am primarily speaking as someone who has testimony to offer.

The authors point out that – strictly speaking – ADHD is a concept used to describe behavioural patterns and that it is only meant to be a descriptive term. This is valuable, because it allows us to group comparable individuals together and study them, try treatments, etc.

According to the authors the DSM 5, the most recent edition of one of the most widely used manuals to diagnose mental disorders, confirms this: The diagnosis only describes behaviour. And consequently, it is silent on the causal origins of ADHD. As far as the DSM 5 is concerned it is an open question whether the cause of ADHD is environmental or the result of some kind of imbalance in one’s brain chemistry or both or some other possibility.
This is a problem, because in our ordinary language we use ADHD not as a descriptive term, but as an explanatory one. The authors are thinking over conversational dynamics like this one:
‘Why aren’t John and Mary paying attention?’
– Because they have ADHD.
In the authors’ interpretation we would be explaining John’s and Mary’s inattentiveness by saying that they are inattentive and that, we can all agree, would not be sufficiently informative.

Their argument for removing disorder from the term ADHD seems to be motivated by the assumed power that ordinary language has over how we interact with the world. Once persistent causal talk has led us to believe that ADHD is a cause that causes certain traits in individuals, we may be led to believe that there is a distinct way to treat it. By, for example, prescribing them a certain drug.  This, the authors warn us, is a problem, because we may have skewed expectations of individual children. If children mature less quickly or if they just happen to be younger than their class peers, they will be more likely to be diagnosed with ADHD. This kind of misdiagnosis, the authors suggest, may be remedied by delaying the school start of those children who have those traits that are associated with ADHD.

I think that the authors are correct that if we think about ADHD in one-dimensional terms and we would fail to take into consideration the individual’s environment, then we would be doing those who are affected by ADHD a disservice.

In my conversation with Martin I said something that was in the vicinity of what the piece is arguing for: When I have to make a decision and there are no clear criteria to go by, then I often find myself in state that I call decision paralysis. The example that we continuously returned to was of choosing an item from a menu, but there are less trivial ones too: Settling on a dissertation topic, buying a gift for a loved one, …
In my mind those trivial examples were, for a long time, rather detached from the more existential ones, and I just considered them to be a quirk of mine, but it was when I learnt that people around me were seeing this inability as an undue burden on them that I started to conceptualise it as a problem. That seems, to me, a fair example of why we should always be very cautious with locating the cause of any assumed problems that are associated with ADHD.

And yet, I was left feeling rather unsettled by the suggestion to do away with the term disorder altogether.

To see why, I remind the reader that the DSM 5 groups ADHD together with other neurodevelopmental disorders. To be diagnosed with ADHD the behavioural patterns that the piece alludes to must be persistently present both in time and in socially different contexts, in a manner that deviates from what is, generally, appropriate for the developmental stage of their lives.

Consider a variety of the John and Mary-example. They both are behaving in ways that are atypical for their age – they always seem to be loud, inattentive, impatient both in school and at home. But in this case only John is diagnosed with ADHD. They don’t know what is up with Mary.

Let’s focus on John first. Although we don’t know the causal pathway that are responsible for John displaying these traits, the term disorder does do some work here. Assuming otherwise ideal circumstances, it suggests that there are limits to the extent to which we can hold John accountable for being disruptive in class. It tempers expectations that educators may have of John. It suggests that John has educational needs that are different from those of neurotypical children. All of that can be articulated without knowing the precise cause of ADHD.

If we bar the possibility that Mary is an exceptionally gifted actress, we probably should probably grant that she is an hyperactive child with an attention deficit. Yet the question whether or not it is a disorder is still a meaningful one, because we are interested in knowing whether these traits are persistently present over time as well as in socially different contexts.

Doing away with the term disorder would seem to give us fewer resources to discuss any potential differences between John and Mary.

I anticipate that the authors would respond by saying that removing the word disorder would not alter the diagnostic criteria: by re-coining ADHD as ADH we would have all the same resources at our disposal to determine whether Mary’s behaviour fits the criteria.

But here the power of ordinary language, that the authors attribute so much weight to, comes to the fore. We can very well imagine that Mary is hyperactive, loud, and struggling with an attention deficit, but that it was temporary, and that she never sufficiently deviated from the developmental norm. That is not to say that Marry doesn’t deserve our concern. It is also not to say that we know what was ailing her. The only thing that we can say for sure is that if we wanted to describe their respective predicaments, then the term disorder does allow us to differentiate them.

All of that is possible without pretending to know any of the underlying causes, but we do need a vocabulary for it.


* The end of the article makes it clear that ADHD is merely meant as an example and that the argument is meant to generalise to all and any kinds of psychiatric conditions. In the authors’ own words: ‘drop the term disorder from all classifications.’ (Bolded emphasis added.) 

Meditation in philosophy. A conversation with Andrea Sangiacomo (podcast)

Meditation in philosophy. A conversation with Andrea Sangiacomo (podcast)

This is the fourth installment of my still fairly new series Philosophical Chats. In this episode, I have a conversation with Andrea Sangiacomo who is an associate professor of philosophy at Groningen University. In this conversation, we focus on meditation both as part of philosophical traditions as well as an approach that might be a resourceful factor impacting (academic) philosophy, teaching and academic culture. While Cartesian and Buddhist ideas* form a continuous resource in the background of our discussion, here is a list of themes in case you look for something specific:

  • Introduction   0:00
  • Meditation and Descartes’ Meditations   2:20
  • The notion of experience – and objections against experience as a basis in philosophy   9:00
  • Meditation in teaching   21:14
  • Why aren’t we already using these insights in education?   37:00
  • How can we teach and learn effectively?   44:36
  • How can we guide and assess?   52:50
  • Where is this approach leading, also in terms of academic culture?   1:03:00


* The opening quotation is from Andrea’s blogpost What can we learn today from Descartes’ Meditations? Here is the passage: “Since last year, I appreciated the text of the Mediations as real meditation, namely, as a way of practicing a meditative kind of philosophy (for lack of better term), a philosophy more concerned with what it means to experience reality in this way or that way, rather than with what a certain set of propositions means.”

He has published four more posts on this topic on the blog of the Centre for Medieval and Early Modern Thought. They are: