Hysteria; a case of bad science

Hi folks,

I actually had my letter of complaint about the bias nature of the recent article on therapeutic touch in Canadian Nurse (see post last month) published in their letters column, and boy did I get some venomous mail in response! I guess this isn’t that surprising, but sadly most were ad hominem attacks of the “how dare you, you positivist dinosaur” variety, rather than giving a good argument to support TT. Mind you I had a few e-mails supporting my position too, which is somewhat encouraging.

Anyhow, on to other matters. Last week I enjoyed watching the movie Hysteria, which was surprisingly good for a period rom-com, and has much to commend it. For those who have not heard of it, it explores the period in history when the medical fraternity used the diagnosis of “hysteria” to explain the female sexual response, and the following development of the vibrator. It handles the difficult sexual politics pretty well, and could easily have turned out another sensationalist sexploitation movie, but avoids that trap. There was also an excellent short documentary on the DVD about female sexuality and current legal position in many states in the USA, where the sale of such devices remains illegal. For example a US citizen in Texas can go into a gun store and purchase any manner of lethal armaments, but should they  wish to purchase a vibrator, apparently the vendor would be breaking the law. Come on you Texan’s get a grip on your legislature!

Anyhow, as an appalling example of bad science and medical practice, it is worth us considering further. Here we have an example of an incorrect theoretical basis (hysteria) used to explain a phenomena (the female sexual response) that was a product of the current socio-cultural paradigm of the time. I.e. it represented the views of male dominated, patriarchal victorian society. The female orgasm was more or less unrecognized by the medical profession, and was described as a paroxysmal response to mental instability, irrationality, resulting in relief, resolution and a return to clear thinking! My feminist colleagues are quite right to cite this as a key example of the male patriarchal dominance of the medical profession. Now we find this laughable, and hard to believe anyone could actually ignore the obvious, but that is because as we have (thankfully) moved forward somewhat in terms of sexual equality. Scientifically we have moved through what Thomas Kuhn would describe as a paradigm shift, and to my mind this is as good an example of that as any. My postmodern thinking colleagues would also probably also use this as an example of the unreliability of science.

The question, then arises as too how science would prevent this today. How do we know that our current explanations and theories are not equally incorrect in the explanation of phenomena. The answer is, of course, we can’t, and we have to recognize that any explanation of a phenomenon is rooted in our current understanding of the world, and social contexts. However, few modern scientists would dispute that, and post-Kuhnian science makes clear that we have to temper our explanations and be prepared to have them challenged, and overthrown as better explanations arise. Nevertheless, that does not mean we have a free-for-all and should consider any explanation is as good as any other. Modern science seeks to A) provide evidence a phenomenon actually exists (either directly or indirectly and at least providing a high probability), and B) provide a theoretical explanation that adequately explains that phenomenon. Now, the order in which those two components occurs can vary (which seems something a lot of academics get hung up on) but fundamentally the process is the same.

The beauty of science is that once we have undertaken this creative activity, we then open it up our ideas to debate, discussion and for others to test. Those hypotheses and explanations that seem to hold up become accepted and those that do not fall by the wayside.

With hysteria we had an observed phenomenon (the female orgasm) that was explained by a ludicrous theory of its time, but was eventually consigned to the scrap heap of duff ideas (although staggeringly, the diagnosis persisted into the 1950’s). Today, we likely have some some equally bad explanations, but as new discoveries arise, and by testing we can move forward. On the other hand, this does not mean we should not simply accept whatever explanation seems fashionable, or explanations that are irrational and unprovable when there are better ones available. Academic discrimination requires us to weigh up competing hypotheses and use the ones that seem to offer the best explanation given the current state of knowledge; not accept ones that conjecture fantastic and unprovable theories that are currently unsupported by any empirical work. It’s fine (and expected) for us to conjecture new explanations to overthow the old ones, but then we need to get to work and demonstrate they actually do offer a better explanation, and devise ways to demonstrate this. This sadly means science will progress slowly, in fits and starts, but at least if offers us a way to progress, and avoid getting bogged down for too long.

The alternative, is the “anything is possible “approach, which to my mind offers little hope for human progress, and worse opens up the potential for “anything is permissible” and history has shown us all too well where that leads. At least hysteria was eventually consigned to its rightful place in history as a defunct, useless and harmful theory. I just wish it had happened sooner, but with today’s information and communications technologies and possibility for anyone to challenge theories with a better idea, and things move a little quicker. That, to my mind, offers great hope for the future of science.




Freud, S. (1888). Hysteria. The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume I ( 1886-1899): Pre-Psycho-Analytic Publications and Unpublished Drafts, 37-59

Bernheimer C. & Kahane, C. (1990). In Dora’s Case; Freud – hysteria – feminism. New York, Columbia University Press.

Borch-Jacobsen,M. (2009);  Making Minds and Madness: from hysteria to Depression. Cambridge, United Kingdom; Cambridge University Press





The Truth is Out There; maybe…

This week we go all X-files with a consideration of the nature of “truth!”

This article from The Conversation by Dr. Patrick Stokes fired up some thoughts on the subject. In general I agree with his argument, although feel it might possibly be a little overstated.

The argument he presents is, that saying “everyone is entitled to an opinion” is OK but opinions expressed (particularly in public forums) should always be supported by clear arguments. I would agree, and like most teachers, I try and get my students to think and present sound arguments for their positions, and consider alternatives, rather than just declaring what they think or have read (or repeating what they have been told by their last professor). Getting students to consider what is the best argument in considering competing positions is an important part of critical thinking in higher education. Nevertheless, getting people to revaluate their positions or change their minds is very challenging, as many behavioural studies have demonstrated over the years. After all, no one wants to admit they were wrong.

Anyhow, Dr. Stokes argues that modern interpretations of freedom of speech have become shorthand for “I can say or think whatever I like”  and has led to experts and non-experts being presented for equivalent viewpoints in the media, and belief based statements with no empirical support being presented up against scientific argument. To some extent I think this is certainly true, but the problem arises in defining “expertise” which then inevitably falls back on defining which epistemological framework you are grounding your arguments to claim “expert knowledge.” This also then raises the quesions of what knowledge do we consider experts to posess, and what do we value as “certain knowledge” or truth.

Let’s delve a bit deeper into what consitutes a truth. The ancient Greeks identified theoria as knowledge leading to truth, whilst Plato distinguished between opinion or common belief (doxa) and certain knowledge. However, what we determine as certain knowledge is precisely the issue here. We can argue that 1+1=2 is certain knowledge, but even that relies on us defining the terms of those values and the mathematical formula represented.

Opponents of science are often arguing that there is no such thing as a single definable truth, as we cannot divorce ourselves from the perceptual process. They characterize science as positivist dogma; but of course, modern science does not claim this is the case anyhow, so this is rather an old, boring straw-man argument, and we should move on. As we saw with our previous discussion of the problem of induction (and in post-positivist science; after Thomas Khun) we can only really suggest that certain knowledge is what we can state as the best explanation given our current understanding of the phenomena in question.

These are not exactly new arguments, the rationalist René Descartes (1596-1650) argued that the criterion of the truth should not be sensory, but intellectual and deductive. Another of his most influential ideas in science was his principle of doubt. Cartesian Doubt is the systematic process of doubting the truth of one’s beliefs (skepticism), and Descartes advocated the doubting of all things that could not be justified through logic.

From a practical and empirical perspective our old friend Charles Sanders Pierce (1839-1914) tackled the issue in an article entitled How to Make Our Ideas Clear (Pierce, 1878). He suggested pragmatism, which purports that something is true only insofar as it works. Pragmatism considers practical consequences or real effects to be vital components of both meaning and truth, and this represents one of the central tennets of modern science, and is particularly important aspect of modern healthcare where we are interested in practical outcomes.

So determining which arguments get put forward as the “truth” is not as simple as it first appears, but as Dr. Stokes points out, there are problems in putting up empirical scientific arguments against those based on alternative belief structures, and suggesting both are equivalent in terms of practical outcomes. They are not, and where individuals are put foward presenting empirical arguments in a debate based on a specific set of scientific theories and evidence, it is reasonable to expect them to have some expertise in the field. Calling for people with little knowledge of science to be given equal airtime in a public scientific discussion makes little sense. Likewise calling  moves to stop this “censorship of a scientific debate” is also nonsense.

The real question is do we want public health policy debates to be argued from scientific or alternative perspectives? I would hope the former, given that practical outcomes are at stake. Sadly it doesn’t always seem the media is on board with that, as their objectives are often not concerned with the notions of “truth” and “knowledge” but more focused on audience and circulation.


Useful Sources

René Descartes http://www.renedescartes.com/

Pierce, C. S. (1878). How to make our ideas clear Retrieved 8/23/2011, 2011, from http://www.marxists.org/reference/subject/philosophy/works/us/peirce.htm





Scientific reasoning and the problem of induction; the big one!

Hi folks,

Roger is currently tied up with a writing project, and being hounded with menaces by some large henchmen sent round by his publisher. Apparently, something about chapters being overdue. As he has gone into hiding I have volunteered to cover the blog for the next few weeks, and so to kick us off with a good weighty topic to frazzle the grey cells. So here we go with the problem of induction.

Although in essence inductive reasoning appears fairly simple (generate a list of probable explanations to explain an observed phenomenon) there are some underlying assumptions that are more problematic, and together these are known as the Problem of Induction. This is quite complex to grasp, so be warned, if you are new to these arguments, the following may give rise to headaches and palpitations. Here is a synopsis of the problem based on my feeble grasp of it:

Firstly there is the assumption of generalization. Induction requires we generalize about the properties of a set of objects based on repeated observations of particular instance. For example, we may infer that all the sheep are white, based on multiple instances of observing only white sheep, but this would later be found to be false, when we discover a black sheep. This would make any proposition derived from this generalization equally invalid (see the famous black sheep joke for a good example).

Secondly we have the assumption of uniformity. In inductive reasoning we presuppose that a sequence of events will occur in the future just as they have in the past (for example, the sun will rise in the east). This assumption itself relies on inductive reasoning, as the only way we can predict the future is by speculation based on past experience. This is circular reasoning by deriving a conclusion from premises that presuppose the conclusion. I.e. we are basically saying that the future will be the same as the past because in the past the future has been the same as the past!

Causality is the third area raised in criticism of inductive reasoning. Causality is a basic assumption of science and although we generally accept the concept of cause and effect, philosophically it is a challenging principle. Aristotle discussed ideas of deliberate (prior) and accidental causation, but the great thinker David Hume (1711-1776) outlined more detailed principles suggesting three basic elements.

If there is a causal link between A and B:

1) One must always precede the other (temporality),

2) The cause and effect must be in contact (spatial contiguity), and

3) There is some power in A to cause B (necessary connection).

This third point is philosophically a little more problematic in that it requires a theoretical element, “something that exists in the mind, not in the objects” (Hume, 2000). That is to say, a mental notion must be established linking the two types of object or event. Hume suggests it is our mind that makes this connection between objects or events when in reality they should be regarded as separate isolated instances. Relativity and quantum mechanics have also forced physicists to abandon their assumptions of causality, as they don’t seem to apply at the sub-atomic particle level. However they seem to remain valid for what happens at the level of human experience.

The major problem identified with inductive reasoning lies in the fact that to justify generalization or causality we use experience and inductive reasoning, creating a kind of circular logic, as we are justifying an inductive argument with more inductive reasoning.

The Raven Paradox

Carl Gustav Hempel (1905-1995) technically described this problem in logical terms with his Raven Paradox. Inductively to describe ravens we can hypothesize “all ravens are black” based on our observation of a subset of all ravens (as we cannot view them all). Over time with no non-black ravens encountered we accept this hypothesis. Therefore, by logical implication we can also state “everything that is not black is not a raven.”  Our hypothesis “all ravens are black” therefore has the equivalent form “all non-black things are non-ravens,” or more precisely, “if an object isn’t black then it is not a raven.” Logically, if every sighting of a black raven confirms our hypothesis, then every sighting of a non-black non-raven should equally confirm our hypothesis. This is where he argues inductive logic falls down, as if I look at my car, and see it is green, and it is not a raven, this confirms my hypothesis that all ravens are black! This of course makes no sense at all, but by the rules of logic, if I accept inductive hypotheses and confirmation by observation, then every observation (except one that refutes my hypothesis) confirms it, even when totally irrelevant.

The problem of induction is an argument frequently used by philosophers to “beat up” science, by suggesting that science is no better than alternative narratives for explaining the world. However, Karl Popper proposed a partial solution to the problem of induction with falsifiability, and  Charles Saunders Pierce gives us a pragmatic framework that appears quite effective at generating effective outcomes in the hypothetio-deductive model. So practically the problem of induction remains more philosophical than practical in its nature.

At worst the problem of induction represents a set of arguments that show inductive reasoning can only suggest a truthful explanation but cannot ensure it. We should certainly accept that there could well be alternative explanations for a phenomenon that we have not considered and be open to them.

Pragmatically, we should also note that we frequently use inductive reasoning everyday in general learning for the real world. For example, in learning to drive we learn how to start a car engine by turning a key, and generalize this technique to use in other models of cars. For science, we still rely on induction, and it is very much part of the creative (and arguably most interesting) part of scientific inquiry. The inductive conjecture about best treatment options is also a central part of the evidence based practice process in healthcare. Of course, scientists also discovered that inductive reasoning becomes much more powerful for systematic inquiry when combined with deductive reasoning.

Anyhow, in order to stimulate some creative thinking Roger and I are offering a fabulous prize (as yet to be determined, but surely some object of unimaginable wealth and beauty) for the most inventive solution to the problem of induction posted below. Go on you know you want to give it a go…



P.S. I got reunited with my luggage eventually, so take back all those bad thoughts I had about Virgin Atlantic.


Hempel, C. G. (1965). Aspects of scientific explanation and other essays in the philosophy of science. New York: New York Free Press.

Hume, D. (2000). A treatise of human nature (originally published in 1739). Oxford: Oxford Philosophical Texts.