Voicing Opinions

The Eastern concept of mindfulness is pretty straight forward, so needn’t be seen in an esoteric light. It simply requires you to be wary of yourself and how you relate to the world. In a nutshell, it asks that you pause before ‘doing’ so as to give yourself time to reflect and observe, and sometimes change tack.

I find it fun trying to be mindful, but it is not all pluses. You do learn to frequently nip temper in the bud by re-framing it in that moment of pause, diluting its potency. And a life with less unnecessary anger is generally a happier, more sociable one.

But there is also a slightly negative side. You start to see a disconnect between your conscious mind – the reflective state in the pause – and the subconscious mind plus body communicating its needs and desires. And because you start to notice, without judgement, your sub-conscious intents before you might act on them, you get to see some nasty ways you have. Ways that have served your ancestors well, such as the urge to take umbrage when someone corrects you, but which often do not serve you well. Gradually, you start seeing the ego manifest – often childishly defending your position in the light of contrary information.

Without the pause to reflect, you are often propelled into action, and become embroiled with something that only hindsight might then see you regret.

The point about mindfulness is not to entertain some fancy Eastern high-falutin concept, but to make your life smoother and happier. It is useful for the simple matter that subconscious and bodily communications fail to come with value labels. We may have an urge to do something for reasons that our conscious mind would deem invalid. We may get irritable because the body is not well rested and keeps complaining to us, urging, for some strange reason, to get grumpy, as if that would correct the bodily problems. Ignoring the urge to irritability works – the urge does pass and you relax, accepting the bodily complain as something to be contended with rather than complained about.

But on this matter of mindfulness, it occurred to me only this afternoon in conversation with a student that such conversations are not two way. I, or at least the conscious part of me, was enjoying the chat, but it was caught between the words from the companion, and the messages from my subconscious and my body. The thrust of such multiple dialogues is a very tangible one, as I often get caught listening to someone speak at length while, at the same time, my mind is desperate to interrupt with my viewpoint on the matter. Without mindfulness, we might suppress or concede to this desperation, but develop no real consistent improvement. Being wary of it, we can strike a balance between the two. Maybe – I am still learning this art as my subconscious is very insistent.

And there is another facet of mindfulness – that such urgent subconscious requests are not direct caused by our conscious mind. They come from me, but not from the part of me engaged in the conversation. So I cannot blame my conscious mind – what I see as ‘me’ – for such genetically determined habits. So I fuss less about this as a ‘weakness’. That is relaxing. But it does not stop me taking responsibility for modifying this habit – to try to work around its anti-social nature.

I am an over-reactive type of human. I did not choose to be – this is simply my genetic inheritance. So I cannot blame myself – nor can others blame me for that.

However, genetics is not a mandate, but a kind of framework. And both environment and your own choice of behaviour can override many aspects of genetic predisposition. So the over-reactive type cannot fully abdicate responsibility for their overreactions.

The excellent book ‘Quiet” by Susan Cain discusses introversion, a personality type that is often the result of an over-reactive nature. It might appear to be a paradox that the noisy baby lying by the side of the quiet baby is likely to become the introvert, and the quiet baby the extrovert. But if the noise is the result of an emotional reaction to sensory overload, then it makes sense that a baby might grow up to seek refuge in the quiet of a book. Conversely, that the quiet baby, calm in the face of the same stimulation as the noisy baby might grow up to sensation seeking to get his kicks.

Resulting habits – such as the desire to read and live in your mind – may be consequences of sensory overload avoidance rather than consequences of a genetic inclination to an academic lifestyle.

The over-reactive nature is essentially a result of an over-reactive amygdala – the emotional centre of the brain, in effect. It is found in the more primitive part of the brain, receiving sensory signals before the conscious mind does. This permits the potentially life-saving fast fight or flight response before we are even aware of what has happened.

But an overly-sensitive amygdala can make for a harder time as the emotional response to life is essentially amplified. Unless they have a good upbringing, over-reactive types are more likely to get stressed and/or suffer depression. They are also more likely to be empathic – to feel what others feel – as long, that is, they are not exhausted from overload!

However, Cain revealed something very interesting about over-reactive types in her book – that a nurturing, loving upbringing will make a reactive-type more healthy than a low-reactive type. Less likely to get depressed for example. A sensitive nature, accepted and nurtured by parents will allow a reactive-type to flourish. Conversely, a harsh upbringing will mean a much harder life for an over-reactive type than their tougher skinned brethren.

It all makes sense of course, in hindsight – a sensitive microphone can excel in capturing delicate sounds (nuances) but will distort (overreact) with loud sounds. A robust microphone is a good, all purpose device, but will miss out on subtle (and often exquisite) sounds.

I mentioned that I was an over-reactive type because I wanted to relate some personal discoveries on the matter.

At one period in my life, I had bouts of acute anxiety that are termed panic-attacks. You literally feel like you are about to die, or at least have a heart attack. It is, in essence, an extreme emotional reaction to a potential threat, real or perceived (it can even simply be a situation that looks like one that was a danger in the past). The brilliant “Self help for nerves” by Claire Weekes allowed me to manage my way out of this caustic anxiety spiral.

The essence of her method is counter-intuitive to a large degree. You must not try to push away or ignore the intensely horrible feelings of a panic attack (such as pounding heart and light headedness). You must use the Eastern Philosophical concept of acceptance to just see it as it really is without judgement. Trying to push it away or worrying about what is happening will inflame and hence aggravate the attack. Accepting it will allow it to slowly fade away.

It would seem that the mindfulness is a key part to retraining your amygdala. By observing without judgement, you are quietly telling the amygdala that this is not a big problem – you provide a calming effect as well as a cue that the situation in the future is not one that is to be so concerned about. But you must be patient.

Most Christmas days, I have to endure the mother of all bad headaches, caused by a catch-22 situation where my subconscious thinks back to previous years where it got overloaded and tenses up in preparation for a possible repeat. This year, I was able to ignore the tension headache that awoke me at 4am and eventually go back to sleep in a relaxed state. It has taken years to develop this capacity to relax on demand, and it does not always work, but this time I ventured from my normally solitary life-style to a day with my sister and her family.

But relaxed or not, I felt deeply, deeply uncomfortable sat there watching all the presents being unwrapped. It was a reaction, in part, to losing the quiet of my own company. But it was way over the top. I knew this, but that knowledge cannot directly get through to the inflamed amygdala to calm it down. It screamed at me to run away or to tell people to be quieter or behave differently. I felt so uncomfortable that my mind desperately wanted the discomfort to end. What is deeply frustrating to over-reactive types about this situation is that their mind that is creating the discomforting feelings in the first place.

This was not a panic attack, but I decided to apply the same techniques. I observed what was happening in the room – people actually having fun and getting excited – and observed my deep agitation – and did what Weekes advises – just let time pass.

It was a very interesting experience. I suspect I helped accelerate the process because I knew that the discomfort would indeed fade, and that I reflected on the disparity between feeling and the innocence of the scene causing the feeling. It was like being patient with an impatient child nagging at you – sooner or later then would give up, as long as you did not react.

I reckon it was about an hour before the discomfort faded away. Remember that this discomfort is not one of my choosing – I was literally sitting there receiving the feelings, at odds to how my conscious mind wanted to proceed.

But I believe that similar situations where I suffer acute discomfort can benefit from this mindfulness approach. Except, maybe the headache I get when in conversation with certain people – people who do not seem to sense how I feel. ‘Unempathic’ is probably the best way to describe such people. I cannot observe in a detached manner as I am part of what is being observed – the dialogue. I will have to work a way around that type of problem.

On the plus side, my highly reactive nature lets me enjoy many simple things in life with an exquisite intensity that I suspect that extroverts can only experience in highly charged situations, much less common parts of daily life. So if I can defuse and reframe my negative reactions to life and revel in the positive things, then life will be sweet!

One of the features of many middle aged and old people that bores young people senseless is their ill health complaints. It does get terribly predictable and dull to hear about recurring aches and pains, pushing to one side more interesting things that could be discussed. So I am in great danger of boring you with talk of my headaches. So I hope to make it interesting enough to keep your attention.

Imagine if you had been badly bitten by a dog, and are trying to overcome the fear each time you see a dog. What you will notice is that the fear reaction has kicked in before you are fully aware of it. It is then engaged and entrenched – your thoughts more likely to inflame it than passify it.

My 18 years of tension headaches often start in much the same way – when I encounter someone who is awkward to chat with. They may talk too intensely or not listen, matters that I strain to cope with. But I realise now that I generally tense up in such situations before I am aware I am doing so – my subconscious is overly aware of such difficulties in times past so it puts me into a defensive, apprehensive, tense state. I tend to notice this only after it has started because most of my conscious attention is on making conversation.

This tense state is the start of a headache – a headache triggered in too many social situations even though I am generally very gregarious, frequently really enjoying chatting with friends and complete strangers alike. I simply do not know when my hair-trigger tendency to go onto a tense, headache inducing state, will occur. By the time I sense that I am tensing up, it is generally too late.

Now none of this would be particularly worth mentioning but for the fact that the headaches tend to last for the rest of the day, often into the night, damaging sleep, and into the next day quite often also.

So a moment’s overreaction to a situation gets rewarded with a headache of average duration of maybe 15 hours. A debilitating, ‘let this day finish and the next start afresh’ type of headache.

Given this accumulated plight, what would you do? Would you avoid people altogether? No, of course not. Would you be on your guard for the slightest hint of tension, withdrawing from a situation as soon as you detected it? No – it is socially very damaging and avoiding situations simply labels them as dangerous, thereby perpetuating the problem. So I carry on much as normal and survive and endure, hoping that by grinning and bearing the problem and ignoring it as much as possible will eventually desensitise my subconscious. Except that after 18 years, there is no sign of this happening.

Do you have any suggestions?

Such admonishments are frequently directed at people suffering with ‘taboo’ mental health problems, especially chronic depression.

But those who are fortunate not to suffer necessarily tend to see the suffering of others as they would suffer themselves. If they were in a downbeat, slightly depressed mood, they could readily ease their way out of the trap, and therefore think that chronic sufferers can do likewise, albeit with a proportionally greater effort to shift a deeper state.

But this proportional assumption is a key misunderstanding, for lack of proportion is one of the signatures of entrenched mental health. The other is displacement in time – a bout of suffering can appear that is disconnected from any current cause.

So, to repeat, a chronic depression sufferer will have symptoms that are an amplification of any causal event on the day. And they can have a general depressed state that bears no relation to their current thinking – it is background feeling of deep discontent that has a long term momentum, and is virtually immune to requests by others to ‘just snap out of it’.

But if you have not experienced either of these enslaving factors of mental ill-health, you will likely fail to understand or empathise with a chronic sufferer. This is part of the taboo perpetuation of mental health issues I feel.

My personality is largely characterised by my excitable, emotional, sensitive, reactive nature. This is my inheritance – whether I am happy or not with this cocktail, it is there in the background, flavouring my experience of life for good and bad.

In a sense, my experience of life is amplified compared to the average man. The coupling of this with the vulnerable, sensitive, empathic aspect of my personality was always a recipe for mental health problems I feel. Not a mandate, but a formula ready to ignite given the right life events.

When young and free from mental health issues, my life was mostly normal and enjoyable. I would periodically be overwhelmed by things, but was able to cry and survive and move on rather than accumulate hurt.

As example of the kind of problem I experience now after decades of submerging into a sea of mental health problems, most of the ideas for this entry came between 6am and 7am this morning. A steady stream of ideas and connections. My reaction to these was strong – I sensed that there was some insight here – but the point is that I really should have been sleeping. My reactivity – the amplification of feeling about these ideas – relegated sleep into a distant second place. So I now write this in a distinctly tired state.

Impulsivity of ADHD

As another example, the impulsivity that comes with the ADHD that I have seems to be a natural and almost unavoidable consequence of my reactive nature – in conversation I will experience things intensely and will feel a sense of urgency to give my reply. This blocks out my ability to listen further – the urge to respond being so strong. So I fail to listen enough to details since I am reacting too much to the emotional element in the conversation. So, over the years, my short term memory atrophies through underuse – I simply do not pay attention to the details as they are too low in emotional impact to register enough. This short term memory problem then exacerbates the impulsivity – I feel the urge to interrupt as I will simply forget the thing I want to say if I do not say it quickly enough. If I do not get to say it, my over-reactivity to that failure makes me feel bad – and hence creates a greater urge to interrupt and speak next time. This is an example of negative feedback. (This is a theory that came to me in the stream of thoughts this morning – this thought took about 10 seconds to flesh out).

We all experience times of difficulty in life, and the healthy person does so in a proportional way – their reaction is appropriate and not amplified. If your nature, like mine, amplifies experiences, then they become that much harder to manage – you are hot-stepping from one important event to another. This was fine when I was younger, as I was able to live through the experiences and let their effect manifest and dissipate nicely. But if you experience a cascade of overloads, your ability to cope can be overwhelmed, and your mind tags the experiences as ones to avoid. The mere anticipation of a repeat of such an experience creates a physical reaction in the mind and/or body as a defence mechanism. So the likely overreaction if the experience does indeed repeat is mixed in with the anticipatory feelings, and thereby becomes amplified further.

And here we have a feedback mechanism – a previous experience is fed back into the new experience, creating a vicious cycle.

Feedback loops

This concept of feedback loops seems to me a common thread to many mental illnesses.

The mental illness state can be nourished by further feedback paths, for example :

• You experience incapacity that is new to you, so you dwell on the matter in the hope of understanding and resolving it. This tends to feed back negatively.
• The incapacity withdraws you from certain situations in life, so your life experience dwindles and the illness becomes a bigger matter proportionally.
• Your friends and family feel uncomfortable with you, and this feeds back negatively.
• If the condition becomes severe enough, you become increasingly isolated, which gives you much greater time to dwell on your condition, and hence amplify it.
• The mind and body are tightly interlinked, so the body’s manifestation of the illness feeds back to the mind – the symptoms are generated by the mind and separately experienced – if you sense doom in this experience, the mind will create more symptoms.

The symptoms of an overload – this mental illness – can disassociate from the cause and continue unabated via one or more feedback loops. Chronic anxiety and chronic depression are examples of this. The ongoing prevalence of symptoms creates feelings of hopelessness that in turn generates further negative feedback.

Wave-like nature

When you have a toothache, in most cases, the pain will not be constant. It will fade in and out. So it is with mental illness – the mind generate the symptoms in an ebb and flow manner. This flux in a panic attack, for example, is relatively fast. You can be going about your daily life before a scene will trigger an attack that rapidly overwhelms you. The experience is so enormous that it cries out its own importance so we think the worse and it enflames even further.

But if we do not participate in its affairs, it will fade after a few minute. But it will then return – at reduced intensity – in a series of subsequent waves.

Tackling the feedback loops

They key to releasing the effect of panic attacks is to stay calm and thereby avoid the worry feedback that sustains the attacks.

It occurred to me that other mental health conditions could also have a wave like nature. So I looked at my own current mental health issue – headaches, excessive tiredness and foggy head. To awake with a foggy head, headache and extreme tiredness of mind (not body, strangely), that generally lasts all day is tough to take. So an anticipatory mechanism builds up, which almost certainly makes repeat occurrences more rather than less likely.

I have noticed, however, that the blanket day-long nature is not actually the case. It can fade – so slowly that I barely notice.

Why not, I decided, to treat this condition as I have successfully done with panic attacks (which were criminally bad, but are now extremely rare for me). Rather than feel encumbered by my ‘day-long’ plight, try to recognise when my symptoms faded in and out, and let them flow without judgement rather than feed back and amplify.

But the key, I feel, is also to tackle the real root of this and many mental health conditions – the anticipatory fear feedback mechanism. So for the past few days, I have been engaged in these twin activities. Last night I went to a board games meetup. Such occasions at the tired part of the day, with many strangers, and intense game rules to learn, for me generally trigger a tension headache. This is indeed what happened last night. And here I will digress a little.

If someone last night asked my why I was tensing up, he would in effect be asking the wrong question. I was in a relaxed state of mind – or rather, I was consciously cultivating a relaxed, unreactive mind state – as was my plan. I was mindful of any sign of fear, (mostly anticipatory, I noticed, since the people were friendly), and defusing it. But I was nevertheless tensing up (albeit much less than normal, thanks to my fear defusion). But I was not in fact tensing up – I was not making myself tense – it was happening to me.

And this is key to many who misunderstand mental illness. They tell a depressed person to snap out of their depression even though on that day the sufferer most certainly did not create the depressed state – it was imposed upon them by their subconscious in a feedback loop. Saying this to a depressed person is like telling a person to stop beating themselves up when someone else is punching them – they are addressing the wrong cause.

The net effect of my exercise last night was, alas, a headache that lasted into the small hours of the night. But maybe not as bad as I might have expected. But by disengaging with the sense of fear that my headache was trying to instil, I relaxed into the company around me in a way that I rarely do when I have tensed up before. I let the headache continue without buying into its false, historic message.

And I started experiencing the relaxed wandering mind that I now remember was how I behaved normally when younger. The key to the fear, it felt, was that I had learnt to dread people saying or doing things I would react adversely to. (So we go back to the original reactivity issue). This time, I stopped dreading that, and just experienced my reaction – the natural way to behave. And as a result, I started feeling the urge to do what I used to do as a way of dissipating the resulting ill-feeling when younger – I started challenging things. I had stopped doing this for years in order to please people – to tolerate discomfort to maintain harmony. We were playing a complex game and I was tensing up trying to understand the rules. So I broke the ice to say I thought the game was too involved (after all, I had asked the organiser for an easy game to pick up). Straight away, the young lady to the next of me then aired the same concern and I relaxed further. By challenging the underlying habits, I am hoping that I am now setting up a positive feedback loop!

The key, I believe, to much of my mental health is decades of amplification and feedback of the strain from the desire to please other people, which in turn was a response to an often rebellious, childish or inappropriate natural response by myself to uncomfortable social situations.

So my next step is to allow my natural reaction to manifest in difficult situations rather than to suppress is. To express the reaction may be a step too far for now. I will take the Buddhist approach first – to be mindful without judgement.

In conclusion

The conclusion here is a sad one in my eyes. It is like the proverbial flapping of a butterfly wing eventually effecting the global weather patterns – the suppression of my initial relatively innocuous tendency to say and do socially inappropriate or silly things snowballed into decades of extremely disproportionate symptoms, amplified and fed-back into a self-sustaining miasma.

The turning point was my marriage. I had grown used to tolerating the annoying ways of my wife-to-be as they were small compared to her virtues – I rightly reasoned that no marriage was perfect. But the anticipation of the continued suppression of them made confinement with the same person for the rest of my life a forecast that freaked my mind out. This happened just too late, a few days before the wedding, so I did not pull out – I did not have enough time to reflect on events to cancel the marriage. And the habit to suppress became entrenched – I had set a precedent in a marriage I really wanted to make work. The suppression snowballed to eventually generate the headaches and other problems I have now. I believe.

It has parallels to the often life-long effect of the callous words of a parent who repeatedly tells his daughter that she will never amount to anything. Something plausible and innocuous enough not to cause undue alarm as a child at the start becomes embedded internally and negatively dictates a restraining outlook on her whole life, the source unknown to the conscious mind. The belief manifested – she acted out her beliefs that she was useless – and this failure enacted fed back to reinforce the belief.

The mind, it seems, in conjunction with the body’s part in the expression of the mind’s thoughts, can spiral out of balance very quickly via the feedback mechanism.

(2,000 words written and checked in 2 hours – not bad going!).

© Neil Moffatt 2012

I have a little saga to recount. In hindsight, it seems somewhat farcical, but at the time, it was painful and very frustrating. It is a UK/NHS story, but not one that aims to criticise the NHS. I would hate to have been in the US without insurance with this problem.

I received a phone call from my dentist a couple of weeks ago asking if I wanted a check-up as I had not been for a while. Sure, I said, and one was duly booked for 2:30 (read “tooth-hurty”) for 8 days ahead.

By a strange turn of fate, just 2 days later I got struck by a vicious toothache. At midnight. It alternated between tolerable and severe, and was accompanied by a band of headaches that were almost as intense.

The next day it all calmed down, but I rang my dentist to see if I could have an emergency appointment. They said that I would have to ring a central emergency line. I chose to leave this until the Monday, and was booked into a local dentist by good chance. At which point, the tooth pain, in my upper left molar area, vanished. I had not been sure exactly which tooth was to blame as the pain was broad in feeling. And the dentist could not solicit any pain. So there was no guarantee that a good tooth would not be worked on. SO I went away and tried hard for 24 hours to identify the guilty molar.

Was granted another emergency appointment the next day and again, zero pain. And this dentist refused to take action. Not even an X-Ray. He said I should see my own dentist.

So that happened two days later. The day inbetween, I took Ibuprofen to try to ease the day an night pain. It worked, but I then suffered stomach pains.

I arrived at my dentist only to discover that there was no appointment for me. And that my registration with them had lapsed. I was not sent an email, text or letter to say this would happen. You just get cut off. Who on earth rang me to make an appointment? I still do not know.

Meanwhile, the pain shifted from the upper molar region to the lower region. No idea why, but it seems that I had two molar problems, and the two combined to feel as if in the upper area. I guess. But enduring pain and not knowing when it would be fixed or by whom was very frustrating.

I was fortunate to find another NHS dentist here in Cardiff – the only one taking new patients, and was booked an appointment for 3 weeks hence. Not ideal since the pain was ongoing.

So I went another emergency appointment the next day. They said I ‘might have to wait a little’. Neither the emergency line issuing these appointments, nor the dentist themselves explained what that meant. It seems that as an emergency, the surgery can choose to book you in at 3pm, as it did for me, and slot me only if there was a cancellation or the end of the day arrived. SO I sat waiting for nearly 2 hours before being treated.

Fortunately, the sharp eyed dentist found the lower molar problem and made a temporary filling. the upper molar problem was in a vast filling that would need to be treated by my own dentist.

But I had good news – the new dentist rang to say that there had been a cancellation, so now I had a much sooner appointment, only 5 days hence.

The pain has persisted, top and bottom, but not so intensely, as I wait for the next stage in the saga.

By the time of the checkup with my new dentist, the pain had pretty much gone. They took no less than 5 X-Rays, which seemed a bit heavy. None revealed any decay or infection that might be causing me the pain. There was a damaged tooth that needed repair.

Now I must wait 5 weeks for the appointments to fix the teeth. So I must hope that the pain does not return.

To be continued.

When I was awoken at midnight one night with severe tooth pain from an abscess, I did not just have the joy of 5 hours of agonising wakefulness. My subconscious generated excruciating pain to alert me into action, yet was patently unaware that I was not going to find an open dentist’s at that time of night. But it then generated anxiety to accompany the pain – it had presumably seen this prolonged pain and panicked about it, anxious as to its cause, again presumably ignorant that it had created the pain in the first place.

This illustrates one of the problems with the mind – it frequently acts in disjointed ways. The conscious mind can tell the subconscious that the pain can be safely switched off and resumed mildly in the morning because, please, I want to get a good night of sleep. But it is also unaware of the consequence of sustained night time pain – that it will severely hamper thinking ability the next day to deal with the problem.

We really can suffer from a lack of homogeneity in our ways. But what can we do to circumvent such matters?

It is 3am, and I cannot sleep because of anxiety. It was brought on by a combination of the stress and ensuing headache of recent events and awareness of their impending recurrence. For those who suffer thus, you will understand how uncomfortable it can be.

Sufficiently uncomfortable to force me to take action to suspend or cancel the cause, even if it lets others down. An extreme reaction for an extreme situation.

However, the degree of discomfort and hence degree of urgency that necessitates this action will most likely not be sensed or understood by the affected parties. It will most likely be seen as inappropriate and will likely cause another layer of stress in my life. Precisely at a time when I need some comfort and relief from stress and the cascading nature of its effects.

Those who do not suffer mental health issues not only frequently act in this anti-empathic way, but never even see any need to behave differently. They are not caught up in spiraling situations that brutally detach you from normal engagement with life – what is not personally felt is not personally understood. But, it seems, there is no urge to try to understand when it comes to mental health issues. A situation that, as as I have tried to explain, exacerbates the problems of sufferers.

There appear to be subtle benefits from the community living humans adopted as a ‘norm’ until recent centuries. The extended family that was a key part of such life provided more than just grandparents to help their offspring cope with new arrivals. There was much greater integration, with a strong focus on educating and empowering children.

But one consequence of such a lifestyle concerned parents who realised that they did not have a good rapport with one or two of their own children. Rather than survive years of claustrophobic tension confined to a single house, the children could and would intermingle with others more often. If they struck up a better rapport with an uncle or even someone beyond their family, this was no cause for alarm. Better for the child to have a healthy upbringing as it relieved the tension between parents and child.

The salient point behind this is that there was presumably less possessiveness as a result – a child was brought into the world by a couple, and was the child of that couple, but was not ‘owned’ in quite the same way as today. Defusing such strict lineages would make for a more relaxed, flexible society.

In the same book, many modern day maladies are deemed to be a direct consequence of the alien nature of life now compared to then. Schizophrenia, for example, is quite strongly correlated city size.

Statistics has generally been a weakness in my mathematical armoury. This is in most part because it is quirky, and frequently counter-intuitive.

It is for these very reasons that when a health message is predicated on a statistical feature, you really want to be sure that the messenger is being honest with you.

The recent Lancet report of cholesterol used a meta-analysis of prior research results to conclude that all over-50s should be given statins even if they were healthy as a preventative treatment. The matter of side-effects, which can be pretty nasty for statins, was downplayed.

The conclusion was that you could reduce the long term chance of a coronary heart disease (chd) by a certain percentage by taking them. The exact details are not so crucial here as the principle in such statistical matters is that they sound appealing more because of the manner of expression than the reality that this expression hides.

If the chance of something happening is currently 5% for most people, then it will happen to 5 in 100 people. If action is taken to reduce that chance by 20%, then the 5% is reduced to 4% or 4 people in 100.

If all 100 of those people had to take a tablet every day for the rest of their life to try to appreciate the advantage of the 20% improvement, then only 1 of their number will gain, statistically speaking. So 99 people will be taking the tablet for no real gain – 99% of people doing something for no reason. This is a much more telling statistic.

But the large percentage now recommended to take statins will not just be wasting their time, but now introducing ‘side-effects’ into their bodies, adding to risks of other ailments.

This is why stats can be very dangerous – even a reasonable reduction in a small probability does not make much difference. By way of example, if you buy a second lottery ticket, you increase your chances of winning by 100% but the chance is still in the millions to one against.