Nothing to Do with It

Now we’re ready to look at some disturbing (and familiar) therapies that have nothing to do with the conditions that they are designed to therapize, no matter how much they are argued to be grounded in common sense.

Common sense isn’t automatically right; in fact, common sense is often just plain wrong, and imagination can extrapolate that error into a procedure that harms one whole hell of a lot of people. It can take centuries (if not millennia) for the quackery to be exposed.

We don’t want communication disorder quackeries to plague us for that long.

When Figurative Illustration Goes Wrong

The following are examples of therapy names that seemed right to someone based upon how little they actually understood about what was going on, or where they chose to ignore the crucial ways in which their analogy promoted a lie.

“Hysteria”

Let’s start with the term “hysteria” (< Gk. “uterus”). Can a uterus actually travel around inside of the body, causing pathological emotional behavior? Of course not. But there was a time (not nearly long enough ago) when “hysteria” was taken to represent an accurate functional explanation for a certain set of behaviors; in other words, the functions were as grossly misunderstood as the dysfunctions. On those ignorant grounds, culturally systemic quack therapies were developed that harmed distressingly vast swaths of people... sometimes to death.

Did any of those therapies ever help anyone? I don’t know. I have strong reason to doubt it. Any benefit could only have been due to accident, rather than because the therapy addressed anyone’s truly wandering womb.

As time passed, there would be no research of any value to support such therapies, in contrast to all manner of research that would come to earnestly cry bullshit.

The point: When it comes to emotional function, “uterine wandering” has nothing to do with it.

And any contemporary therapist who tells a woman that she is suffering from hysteria is a therapist who is tired of life.

“Object Permanence and ADHD”

ADD/ADHD is coming to be identified as Variable Attention Stimulus Trait [VAST]. The term “object permanence” has become an in-group bonding term among some people who identify with VAST, and a discussion of this new use has infiltrated various media venues. In those contexts, the term refers to forgetfulness or absentmindedness that is more along the lines of “out of sight, out of mind.”

These people don’t mean that when they set their phone down and look away, they will fail to understand that it exists anymore, or that they will believe that it is a different phone the next time that they see it.

What they mean is that they don’t always notice what they do with things in general.

Such changes in meaning are to be expected and valued in a living language.

But does this new use of the term run a risk?

Only if someone is misled in a way that results in harm.

So far, I haven’t come across any therapists promoting quackery that treats the original meaning of “object permanence” as a functional basis for describing the inattentiveness that is sometimes associated with VAST.

The point: When it comes to the function of attention in specific, “object permanence” (the original) has nothing to do with it.

To be clear: I would be very wary of any practitioner or product that advertised itself as addressing attention issues by treating conditions related to object permanence.

“Zebras Don’t Get Ulcers”

In his book entitled Why Zebras Don’t Get Ulcers,^⇲ Robert Sapolsky offers up an (erroneous) explanation that made common sense to him, namely: zebras don’t get ulcers because (a) they only experience episodic stress (as they have no significant cognitive capacity for simulation of the future), where (b) they flush out that stress episode by fleeing its source (such as running away from a predator).

Unfortunately, this interesting discussion about types of stress is couched in an inaccurate understanding of ulcers; that is to say, the real reason that zebras don’t get ulcers is as follows;

They can’t.

They wouldn’t even if they did experience chronic stress.

And yes, there’s scientific proof…

There are two identified causes of ulcers, neither of which pertain to zebras (zebrae):

A particular kind of bacteria called Helicobacter pylori (H. pylori) causes ulcers; in specific:

a) when stress (or other causes, see below) disrupt the homeostasis in the stomach (where that balance normally holds the bacteria harmless… and possibly beneficial), then

b) the bacteria attacks the vulnerable lining (and makes a meal of it).

The zoonotic risk is very low indeed; for example, H. pylori has only rarely been found in domestic cats, and not at all in dogs. So zebras don’t get ulcers because (a) even were they to experience a homeostasis disruption (which they do not), (b) there would be no H. pylori bacteria present to take advantage of that vulnerability.

Non-steroidal anti-inflammatory medicines (NSAIDS) such as aspirin and ibuprofen can lead to ulcers.

a) Your body tries to maintain a balance of prostaglandins, a hormone that helps to heal tissue damage: too much of that hormone and you can experience symptoms associated with inflammation, but if there’s too little then your stomach is not protected well enough while functioning as a bag full of acid, so…

b) While NSAIDS can relieve the inflammation symptoms by reducing the level of prostaglandins, that very same lowered hormone level also leaves the stomach vulnerable to damage from its own acids. This damage will occur whether or not H. pylori is present, but if it is there then the bacteria will eat the stomach lining and make the ulcers worse.

And zebras? There is some research to show that NSAIDS can lead to GI tract ulcers in horses (even without the bacteria present), and a horse of course is a very distant cousin to a zebra; however, the wild zebras in Sapolsky’s book don’t take NSAIDS. So once again, the real reason that zebras don’t get ulcers is because they are not dosed with NSAIDS, rather than due to a lack of exposure to chronic stress.

So why did this bullshit illustration become so popular, and why do people still blithely accept it (and quote it)? Couple of reasons:

There’s value in the comparison between episodic and chronic stress, where the latter is exacerbated in creatures that do simulate the future (for planning and so on). The people who read the book seem to appreciate the distinction in stress types without caring that the proof is rotten.^⇲
Who knows why? The book was originally published in 1994, and the discovery about H. pylori’s role in GI ulcers had already been established in 1983, which means that Sapolsky failed to become adequately educated before deciding that he was an expert. That information is also available to his readers now, including what is known about the narrow distribution of H. pylori beyond humans… but (with few exceptions) those adherents aren’t subjecting his proclamations to critical review. His book is still sitting on the shelf at a local university counseling office… which is an orange flag if you’re going to be treated there.

“Lungs are Bellows”

Some people use bellows as an illustrative example of lung function (even in a medical setting^⇲); however, lungs simply don’t work that way during regular respiration.

Of course, such examples are not intended to be exact across all of the details of an equation (e.g., saying that someone’s voice is like silk usually means that it’s smooth, not that it sounds like it’s being expressed from larval salivary glands); however, the elicited comparison should at least avoid being wrong about the specific parts that are being illustrated (i.e., you run a risk of harm if you teach people that the roughness that is observed in laryngitis is caused by “Silky Voice Syndrome”).

That is the problem with the bellows simile. Unlike the lungs, bellows contain no elastic materials. The structures around the lungs pull that elastic tissue open, so (unlike bellows) regular “tidal” exhalation is not a matter of compression; instead, lungs expel air as a matter of elastic contraction.

Bellows push, lungs pull.

The exception to this tidal respiration occurs when the structures around the lungs do compress (beyond the end state of elastic contraction) to expel the “expiratory reserve volume” of air beyond that normal tidal collapse. But that isn’t typical of how people breathe; I mean, how often do you try to empty your lungs of all air?^⇲

Be Figurative Only When Accurate

So I don’t take issue with figurative language being used to teach a lesson: we learn new stuff based on the old stuff that we already know. That’s a good thing.

Rather, I am saying that bellows should not be used to illustrate things that bellows don’t do, to misrepresent what something else does do. And if someone tells you that cats don’t get appendicitis because they’re so chill, find out if they even have an appendix.^⇲

Yes, lungs do use compression in a rare form of exhalation, and bellows do act similarly in that unusual case. But bellows do not do what lungs do for nearly all of the time that lungs are doing anything.

The point: When it comes to usual lung function, “bellows” has nothing to do with it.^⇲

This equation runs a risk of harm in a context where the error might result in a quack creating a therapy based on bellows functions to treat someone’s wholly unrelated lung dysfunctions.

And yes, those (utterly inapplicable) bellows-based products do exist. For realsies.

Standards for Therapy Names

The common theme across such examples should be clear. When it comes to:

1) a description of a

a. (speculated) function, and

b. a claim of a relationship with a (similarly speculated) dysfunction,

2) an illustrative example should validate its equation (i.e., be accurate); otherwise,

3) that illustration is misleading; in which case,

4) it should be rejected (for this use).

Labels can be bad for a variety of reasons,^⇲ and harmful ones should be rejected. Any therapy that is developed on the basis of such invalid speculations is quackery, and can be identified in part by the inaccurate product labels that highlight that misguided foundation.

After having rejected the bad label, if a need yet remains to illustrate the related (dys)functions, then the misguided examples should be replaced with better ones (as well as the new labels that encapsulate those examples).

It should be said that there are some few therapies that are valuable despite being misrepresented by their existing names;^⇲ for example, there are some among the so-called “mind-body” therapies whose applications do not rely on the functional existence of a mind-body duality. Such misleading names should still be changed, however, because people should be allowed to make informed decisions about their participation in such therapies, and not because they have been misled to believe that the mechanism of the therapy works by addressing an actual duality.^⇲

Let’s consider one such change that has already been occurring.

Don’t Get Hysterical

Instead of “hysteria,” other terms now tend to be applied, but not all such changes are improvements; for example, “histrionic personality disorder” is no better.

“Conversion disorder”^⇲ claims that emotional (di)stress can be “converted” (by an unknown mechanism) into physical and sensory signs of dysfunction (e.g., paralysis, blindness, and similar), where none of those signs can be shown to have a basis in any known neurological pathology. The implication is that some people are so stressed out that they “convert” their emotions into physical symptoms… with no explanation of how that actually works in a human body; in fact, the lack of any rationale is the reason that therapists apply this diagnosis (i.e., so that they can hide their ignorance by pretending to know what’s going on).^⇲

A therapeutic approach to this distress would have much greater value if it accurately (a) addressed the actual system that produced the physical and sensory signs that are displayed during such times of emotional stress, and then (b) treated a dysfunction in that system; however, this alternative is not currently available because the research has never identified any such “conversion” mechanism, most likely because it doesn’t exist.

There is reason to stop referring to this relationship as a “conversion” in the meantime. Emotions are integrated with our physiology; therefore, we might expect that when extreme events occur in (a) the physiology supporting our experience of emotions, there would be consequences for (b) everything else that is tied into those same systems. That dynamic is not a “conversion.” So unless an actual “conversion” process is ever revealed, the term is just smoke and mirrors disguising insufficient knowledge.

In comparison, “dissociative disorder” addresses a specific subset of the observed behavior, where the term suggests that there is an associative function that integrates the various components of your continuous experience of yourself in your world (e.g., memories, identity, surroundings, and so on). The presumption is that there is some system that helps people to keep all of that orchestrated as a sense of self; otherwise, we could not experience ourselves in that way (which we do). The related disorder occurs when that typical sense of self/world is not continuous in time (i.e., the person experiences an excursion away from their usual sense of self), with some parts having become dissociated from their more continuous, primary experience.

So far, this label hasn’t been bad, but it’s not as good as it could be. The research hasn’t made the underlying neural mechanisms clear, so the illustration might turn out to be bullshit in that regard, at which point it should be changed. But the general notion of there being an associative function, and a related dissociative disorder, does not promote a system that is incompatible with known physiological systems. People are not knowingly being misled when this example is used.

Opacity

Another observed subset of the former “hysterical” behavior is now identified with the term “epilepsy,” where the related (dys)functions continue to be heavily researched. The term originally meant “to be set upon” (Gk. “epi-”) “by an attack” (Gk. “lambanein”). Few people who use the term would still be familiar with these roots, and the word is treated as a single, whole unit that means “seizures of some sort.”^⇲ That generic nature can be unhelpful, but the expectation is that details will be established for a given person, and its application (albeit generic) is not currently wrong.

This sort of diachronic change in meaning leads us to consider opacity, namely where the original (transparent) meaning of a word fades into obscurity over time.

For example, speakers of (different sorts of) English vary in their awareness that the word “hippopotamus” derives (through Imperial Latin) from an ancient Greek compound meaning “water/river horse.” That usage was coined by people who knew much more about horses than they did about hippopotameese.^⇲ Clearly, these intriguing creatures are more like bovapotami, but whatever.^⇲

Opacity, however, would not excuse any continued use of “hysteria” as a therapeutic term for epilepsy, as it still references no valid cognitive function, so it can target no real dysfunction.

But the same standards don’t apply to the contemporary, colloquial use of “hysteria” to identify an uncontrolled outburst of emotion. So that use can be left to function (albeit harmfully) as a social term of contempt, but not to be used as a therapeutic diagnosis.

Interlude: Determining Some Terms

Before we continue, we should clarify a cascade of terms (in simplified definitions):

• Independence: doing something on your own

• Autonomy: making choices independently

• Self-Determination: making choices autonomously about yourself

Autonomy only came to be incorporated into the ethics of medical practice in the US after the Nuremberg Trials (late 1940s), but those “ethics” still excluded people with disabilities. Civil rights (let alone human rights) weren’t extended to people with disabilities until the early 1970s, and there was still a struggle for self-determination in federal agencies 20 years later. Pilot projects to promote self-determination for students in schools started to be established only 20 years ago.

(Yeah… dayum.)^⇲

It’s not surprising, then, that the therapies developed in the 1970s were predicated on significantly insufficient knowledge regarding the domains related to autonomy.

Which brings us to Facilitated Communication [FC], on our way to the products that I ultimately intend to target.

Facilitated Communication

There are people who are not able to access their natural voice and/or an ability to sign or write in a way that allows them to communicate successfully with their partners. Of specific interest here, they are not able to express their autonomous choices of meanings by relying on their independent control over motion; for example, they do not readily access meanings represented through assistive devices by trying to touch them (such as with a keyboard or other alphabetic objects).

To put things simply (with sincere determination):

• Sometimes this issue is associated with a disability that primarily affects physical motion (i.e., without there necessarily being any concomitant cognitive disorder).

• Sometimes it is more a matter of neurodiversity, as in an intellectual disability or an autism spectrum disorder.

• Sometimes it is both.^⇲

When it came to autonomy in neurodiversity (and any complex interaction with physical disabilities), Rosemary Crossley (PhD in Education) was insufficiently knowledgeable about the function of the underlying systems, and overestimated her competence (to the detriment of others).

You no doubt recognize those two characteristics from their identification earlier in the tutorial.

Starting in the mid-1970s,^⇲ she decided that any such person only needed a sort of “borrowed activation” to be able to implement their own motor plans. That sort of scaffolding made sense in her imagination, where a partner physically supported a person’s hand/arm while that person typed (or made selections from an array of other items).

Her techniques led to some reported successes,^⇲ notably all with people who shared at least one specific trait in common: they all had cognitive and motor skills sufficient to at least calibrate the meanings that they had been helped to express.^⇲

Crucially, those people could independently identify (such as with the likes of a ‘yes/no’ eye-gaze gesture) those messages that were inaccurate enough to require another attempt.

Similarly, they could express messages that drew upon their knowledge, even when that information was not also known to their partner.

Crossley did not understand (any better than her adherents did/do) that this success could not safely generalize to those people who were not able to validate the meanings that were attributed to them.

Her failure of imagination was grounded deeply in the DKE.

It has been repeatedly and rigorously demonstrated that such messages are only able to convey information that is already known to the facilitator.

In addition, only the facilitator’s meaning was ever expressed. Some facilitators adamantly deny that they were consciously manipulating the message, blaming some sort of ideomotor reflex response for making them influence the message… which is how a Ouija board is generally understood to operate. That’s why FC “works” even when the communicator is asleep.^⇲

The same goes for other methods of facilitation, such as: Rapid Prompting Method, Spelling to Communicate, the Informative Pointing Method, and the spurious claims of telepathy made by Diane Hennacy Powell and her adherents.^⇲ Clearly, a better name for this particular kind of snake oil would be “hydra oil”; that is to say, when we lop the head off of FC, out springs RPM, S2C, and IPM.^⇲

As methods of assisted communication technology improved, the FC fraud was revealed by its victims in no uncertain terms; for example, when finally given access to the likes of an eye-gaze system, a communicator could autonomously describe the abuses of FC that had been wrought upon them.

The point: When it comes to communicative function, “facilitation” (by any name) has nothing to do with it.^⇲

We are more closely approaching the primary target of my sophisto-snit. But that material will be a whole lot easier to understand after I cover a couple of entrenched misconceptions. One has to do with the colloquial use of the word “meaning,” and another with the term “delayed echolalia.”

So let’s get those out of the way.

Semeiognomy: The Meaning of “Meaning”

A language learner is exposed to an environment replete with external forms (including word shapes) and internal conceptions (thought-feelings that are encyclopedic in nature, and which are ultimately grounded in sensorimotor experience). At base, those all have ill-defined boundaries.

Your understanding of that encyclopedic nature is crucial. There is a pervasive myth that portrays “meanings” as if they were more like a simple set of dictionary definitions, all small and contained. The underlying conceptions are complex in a variety of ways, among them being the inclusion of every memory that you have of an experience that overlaps that information.^⇲ That includes all of the bodily sensations that occurred at the time (which includes any that are evoked as you relive or project such experiences). What follows is a pared down explanation of how we help to navigate that wilderness.

Based on conceptions, a conceptual structure is a real product of a process of conceptualization; specifically, it is: (a) a formal representation of (b) an electrochemical event that is (c) processed in a body (d) as that body thinks and feels.

When a conceptual structure is evoked specifically by a communicative expression (i.e., by something that someone has signed or spoken, rather than an environmental event such as experiencing the wind blowing), then it is also a semantic structure; that is to say, semantics arise specifically as a conception’s communication-evoked contents.

A semantic structure is, consequently, the conceptual pole of a symbolic link with a phonological structure (which is the other pole, whether signed or spoken).

When a semantic structure is given a profile (i.e., some part of it is highlighted for prominent attention), it is that construal function that finally establishes a meaning; in fact, go ahead and memorize this:

Meaning is the construal of content.

To quote myself, “a phrase makes a person think/feel something in a particular way.”^⇲

A generic conceptual structure might represent: a head, a set of shoulders, and a vertical relationship holding between them. The associated phonological structure will profile part of that information to evoke a construal, determining whether that base structure is going to mean “head over shoulders” or “shoulders under head.”

These are some of the critical functions that provide for the development of language. Note how much they rely on the ability to resolve a seriously extensive, heterogeneously textured mass into a network of boundaries and multifarious interconnections (based on learning to recognize patterns in that texture).

The information that I have just related is so abbreviated as to be barely adequate for our purposes; therefore, in addition to this passage,^⇲ you should find the time (at some point) to read the full tutorial on semeiognomy.

That takes care of one entrenched misconception, namely the colloquial meaning of “meaning,” defining it with the rigor needed for the rest of this discussion.

To move on to “delayed echolalia” (i.e., the next misconception), we first need to outline the broader family of behavior within which it ostensibly resides, namely the family of imitation.

Head to the next stage of the tutorial.