Selling conspiracies

Nearly twenty years ago, a chap called Nathan Poe posted an item on a Christian forum which said:

Without a winking smiley or other blatant display of humour, it is utterly impossible to parody a Creationist in such a way that someone won't mistake for the genuine article.

In fact, as testament to the gullibility of the human race, what is called Poe’s Law applies across the board to all extremist groups. Mr Poe, wherever he is now, must have been smiling on January 6^th 2021, when he watched the debacle taking place in Washington and saw numerous signs bearing just the letter Q. This is the symbol of the amorphous movement known as Q-Anon, which says that the US Government has been taken over by an international cabal of paedophiles and lizard people who kidnap children and torture them to obtain a chemical called adrenochrome which has all sorts of amazing properties such as keeping people young. In fact, there doesn’t seem to be any madness that won’t attract a following in Q-Anon, as Mia Bloom and Sophia Moskalenko detailed in their 2022 book Pastels and Pedophiles: inside the mind of Q-Anon.

I mention this because my daughter recently asked: “When you were my age, were people as mad as they are today?” The short answer is No, and, as always, we can blame the internet but the longer answer is that humans never tire of conspiracies. They come and go in waves. Fifty years ago, there was one really big conspiracy, the “reds under the bed” trope that powered McCarthyism in the US and similar extremism around the world. In the Middle Ages, the big worry was witchcraft: by order of the Church, everybody had to believe in witches. Anybody who didn’t was obviously an agent of the devil, a witch in disguise, and needed to be burned.

There is obvious survival value in believing that what seem to be random events are actually the result of groups of people working secretly against the common good: it’s better to be safe than sorry. Also, believing in a conspiracy makes me feel better: it proves you're lying, it says I'm smarter than you, and believing is always better than uncertainty. But are people more susceptible to conspiracies these days? Probably not but, with social media, they can find each other much more easily and set up their own echo chamber. Also, there’s no shortage of enterprising individuals who realise they can make money out of peddling conspiracies, either because they believe it or because they’re conmen who will move on to another racket when this one runs dry.

Conspiracy entrepreneurs, as they’re called, include lovely characters like Mr Alex Jones in the US who spread the idea that the Sandy Hook school massacre of 2012 was a hoax, that nobody was killed and the parents involved were either lying or were actors. He has now been sued by the parents and bankrupted. In delicious irony, his poisonous TV show Infowars is likely to be sold to the satirical magazine, The Onion, so they can mock people who believe crackpot and/or dangerous conspiracy theories. But this raises an important question: what is a conspiracy theory, as distinct from an actual conspiracy, and how do we tell the crackpot from the genuine? There are various definitions of conspiracy but the essential elements are: it involves two or more people, who are acting in secrecy, to benefit themselves in some way, by working against the public good. Mostly, that involves stretching or breaking the law.

Are there conspiracies? There most certainly are, especially in business. Volkswagen conspired to conceal the awful results of its vehicle emissions. Enron conspired to cheat the Californian electricity market. There was the tobacco conspiracy, where manufacturers deliberately raised doubts about the studies showing tobacco caused lung cancer (they employed London University professor of psychology, HJ Eysenck, to argue that addiction was a personality factor, unrelated to nicotine; he was paid £500,000, an enormous sum of money at the time). Fossil fuel producers still use the “tobacco playbook” to confound scientific research. Politically, the classic conspiracy was the Russian invention from 1903 called The Protocols of the Elders of Zion, which was exposed as a fraud in the 1920s but there are still plenty of people who believe it was true. Closer to home, we have the conspiracy in the US to overturn the 2020 election. Britain has had any number of conspiracies and, not to be outdone, Australia had a full-blown conspiracy called Robodebt, in which people receiving social security benefits were falsely charged with overpayments and ordered to repay impossible sums of money. The essential point is that, in order to keep it quiet, people deliberately spread false information around to conceal what was going on. They knew the truth but they don’t want anybody else to know it. People have to know that what they’re doing is wrong before it becomes a conspiracy.

The next step down from frank conspiracies involves what are called conspiracy theories, where somebody looks at a couple of events and decides he knows the hidden agents that caused them. However, it’s just his opinion as he has no evidence, which is why it’s called a theory. Sometimes conspiracy theories turn out to be true, sometimes they’re proven to be false but mostly they just fester quietly on the further reaches of the internet. These days, conspiracy theories are getting belated attention because they seem to be able to swing elections: is it true that disease-ridden and criminal illegal immigrants are flooding into the country, because a lot of people believe they are and vote accordingly. This is potentially very dangerous as the Nazi party came to power by screaming about international conspiracies against Germany. On the other side, anybody who does raise the possibility that all is not what it seems to be is likely to be accused of being a “conspiracy theorist,” a form of abuse intended to stop the conversation. From the psychiatric point of view, there is no reliable method of distinguishing between an elaborate conspiracy theory and frank delusions: they both involve beliefs with no obvious support.

A recent article in Psychiatric Times raised some of the difficulties in trying to separate law-breakers who are “sane with whacky beliefs” who should go to prison from “insane with delusional beliefs” who should not go to prison. The problem was that they didn’t have any larger theory as a base for making the decision. They could only offer a few operational points, such as whether the person developed these ideas in isolation or got them from an existing group; whether there are any other symptoms of mental disorder; how firmly they are held, and so on. While they didn’t emphasise the point, they indicated that it isn’t possible to differentiate between nonsensical conspiracy theories and delusions on the content alone. That’s lucky for all the eager people in Q-Anon, because just believing in “lizard people” alone would once have bought you a ticket to the nearest mental hospital.

To make sense of all this, we need some definitions. As mentioned, an actual conspiracy is two or more people working in secret to benefit themselves against the public good. A conspiracy theory is an opinion that two or more people are working together, etc, but for which there is insufficient evidence. There may be grounds to be suspicious, but that’s not enough for a conviction. Some people, however, will be convinced and will act on the idea (e.g. invading the US Capitol building) and it’s important to know why. Are they mentally deranged, or upright patriots, or tourists having a bit of fun? It depends on what you believe but this is where it gets difficult as there is no formal difference between different types of beliefs, and not even agreement on what a belief actually is.

We can start with the basics: a belief is an item of information which can be communicated from one person to another. It’s not a sensory experience or an emotion, both of which are private and can’t be communicated, but, as mental events, they’re all closely related. That is, experiences normally give rise to beliefs, and beliefs commonly generate emotions. As information, a belief is always about something, known as its propositional content, which can be true or false or indeterminate. For the believer, a belief is true by definition: it isn’t possible to say “I believe XYZ but I know it isn’t true.” The actual informational content of a belief has no emotional content but it can serve as the trigger to generate emotions. People get worked up when they feel their beliefs are challenged, and vice versa: if they’re getting agitated, they’re feeling threatened. Finally, our beliefs are the basis of our actions in life. I can’t get out of bed unless I believe there is a solid floor to step on, or eat anything unless I believe it’s safe.

We have no idea how many individual beliefs we have, probably millions. Every incident, every person we know, every memory or experience generates its own belief statement. Importantly, these have to be consistent. Each belief has to mesh in with all the others otherwise we end up with what is called “cognitive dissonance.” This is the state of emotional upset that comes from suddenly realising that two important beliefs are actually contradictory; we know we can’t hold both but we don’t want to give up either of them. Obviously there has to be a hierarchy of beliefs, with a few fundamental beliefs of such importance that they can’t be questioned, and other beliefs of lesser importance that can be dumped if the facts change. That’s the ideal; plenty of people would rather kill than admit they’re wrong.

The economist JM Keynes put this best: “When the facts change, I change my mind. What do you do, sir?” This is a critically important point: facts should determine beliefs, not the other way around. Science is based in this notion: it doesn’t matter what you want to believe, if the facts say you’re wrong, you have to adapt to them. John Burroughs, an American naturalist, said: “To treat your facts with imagination is one thing, but to imagine your facts is another.” By definition, the early stages of a conspiracy are unknown, because the plotters make sure of it, so if people say they know what’s going on behind the scenes, how do we know they’re right? Have they joined the dots correctly and what they say is correct; or are they genuine but seeing only the dots that will match their fundamental beliefs (i.e. protecting their belief systems – and their incomes); or are they certifiably insane; or are they lying; or are they just idiots with over-active imaginations who believe any nonsense that, for example, comes from their heroes? These days, the world is awash with false information and it’s about to get a whole lot worse so sorting it out is starting to become very serious, even a matter of life and death.

It may seem fairly easy to separate these people but the problem is that “truth” as we understand it has a strong cultural element. We are raised to believe there are only two categories of truth: True and False. In fact, that’s wrong, there is the third called Indeterminate. By definition, anything relating to the future is indeterminate so if somebody says “It’s true that X will happen,” that’s not true, that’s just his opinion. Same applies to the long-distant past; if you weren’t there, how can you be sure? Overwhelmingly, we are presented with material that is supposedly true but is actually indeterminate. For politicians, this is their stock in trade, so we reserve judgement on whatever they say. Mostly they don’t know, they can’t distinguish between what’s good for the country and what’s good for them.

A single person who claims to know “the truth” that nobody else knows is probably not right. All you need do is ask for proof, and there won’t be any. Is he deluded? The definition is “a fixed, false belief out of context with the subject’s intellectual, cultural and educational background.” Believing that politicians are actually lizard people should qualify, except for the cultural element. If a person belongs to a group that insists it’s true, then he isn’t deluded, but he may well be an idiot. Politicians, lone wolves, weirdo groups, they’re the easy ones. The difficulty arises when people believe what they’ve been taught and incorporate it in their self-perception. For example, for thousands of years, people were told the sun rotates around the earth. This was incorporated in religion so when a couple of nuisances said it was wrong, the people with the power to decide these things became very angry and reacted badly.

Similarly, the people today who control the curriculum or the airwaves decide what they want people to know, but how do we know they’re telling the truth? Are they schemers or uncritical nitwits or deluded? When Tony Blair told the UK Parliament that Saddam Hussein had weapons of mass destruction that could reach London in 45 minutes, which of those was he? According to his intelligence people, he was a schemer (which he still denies) but it caused a lot of trouble for millions of people who had no say in it.

When it comes to health, we would like to think that the information the general public is given is reliable but all too often, it’s not. Does immunization cause autism or does it not? Indeed, is there such a thing as autism? Does a genetic brain disease called ADHD exist or is the whole thing just a cultural artefact? These are really important questions, they can determine a person’s entire life. The trouble is, a great deal of information in psychiatry in particular is presented as “True, factual,” when as a matter of logic, it is actually indeterminate. However, as politicians know only too well, indeterminate doesn’t sell. If Blair had told the UK, “Well, Saddam Hussein may have weapons of mass destruction, or maybe he doesn’t, but we’re going to invade him anyway,” he wouldn’t have got very far. When it comes to matters of health, people want certainty. They don’t want to be told gloomily: “Maybe it is or maybe it isn’t, who can tell?” They want calm certainty: “This is the diagnosis. Here’s a pamphlet, take these and come back in a month.” If it’s wrong, they don’t know, but they feel better.

Fortunately, medicine has all sorts of systems in place to make sure that what people are told is factually correct, but always with the proviso: “To the best of our knowledge…” Unfortunately, psychiatry doesn’t have the same systems. There is a “standard view,” and every practitioner is expected to stick to it. For the mainstream, criticism of their standard view is seen in the same light as Copernicus and Galileo arguing that the earth revolves around sun. Currently, the standard view in Australia and New Zealand is that the intellectual basis of psychiatry is a particular model. Position Statement No. 80 of the Royal Australian and New Zealand College of Psychiatrists (RANZCP, 2013), currently in force, states:

Medical expertise: Psychiatrists apply their medical knowledge, specialist clinical skills and acumen in the provision of person-centred care. They understand the impact of ‘biological’, ‘psychological’ and ‘social’ factors on mental health and the causation of mental illness. This ‘bio-psycho-social’ model is a holistic approach that recognises the impact of social adversity and physical health on mental well-being.

Similarly, in a letter, the current president stated: "... the biopsychosocial model (is) ...the predominant theoretical framework underpinning contemporary psychiatry ... a relevant and useful component of training and practice ... " (Moore, E. correspondence, Nov. 20th 2023).

For years, I’ve been saying there is no such thing as a “biopsychosocial model,” it doesn’t exist. Psychiatry does not have at its disposal an integrated model of mind and body to guide its practice, its teaching and its research. Therefore, it is not a scientific endeavour. Clearly, however, a significant group of people believe it does and they actively support each other in rejecting the criticism. At the same time, however, they resolutely refuse to provide a copy of their vaunted model, or to show where it has been developed and tested, as scientific models must be. Similarly, extensive searching of the literature over many years has failed to unearth a copy of this thing, so what’s going on? Does modern psychiatry have a formal basis in an articulated, publicly available model of mind or mental disorder, or does it not? On the face of it, in making the claims quoted above, psychiatrists are conspiring against the mentally-troubled, the general public, the regulatory and funding bodies, and medical students but is this true? Are they conspiring, or are they simply failing in their duty to question what they’re told, or do they believe this because the alternative is too scary, or is it the money and status and power, or even a group madness? Good questions. Yes, they are very good questions.

Now, as the numbers of psychiatric diagnoses proliferate and ever more fanciful treatments are hawked around, it’s clear that Poe’s Law applies with a vengeance. Watch this space.