Thursday, September 15, 2005

Outside the Box or Around the Bend?

Many of the more sincere pseudoscience and "alternative" medicine supporters continually exhort those of us who are more skeptical to be "more open-minded", saying that we need to "think outside the box". I submit that there is a fine line between "thinking outside the box" and "going around the bend".

A few years ago, in a university far, far away, our department chairman decided that the staff needed a motivational "retreat". So, he hired a motivational speaker and forced the entire department faculty to leave their comfortable homes and trek to a distant scenic resort. The motivational speaker, a perky thirty-something man by the name of Gerry ("Call me Gerry!"), started off by telling the assembled staff that "Nothing is impossible if you believe you can do it!"

Right off, it was clear that Gerry had a lot to learn about reality. I was silently wishing that Gerry would get it in his head to believe that he could fly and would thus end our torment while he learned some important points about gravity. But that was not to be.

Gerry called his particular brand of nonsense "thinking outside the box". He told us that we needed to not be stopped by "the way things are done" and come up with novel, "solution-oriented" ways of doing "our core business". It rapidly became apparent that Gerry hadn't a clue what our "core business" was.

In the end, I learned about thirty minutes of useful information. Unfortunately, it took over sixteen hours for Gerry to impart that information. On the "feedback" form that Gerry asked us to complete, I listed a number of "solution-oriented" ideas for Gerry to apply to his "core business". I expect that he thought they were too "outside the box" for him to use.

Too often, people coming into a field that is new to them will see rules and procedures that appear clumsy or overly restrictive and want to eliminate them. They feel that their newcomer status allows them to "think outside the box" and are usually frustrated when people who have been in the field longer insist that they adhere to the same clunky, burdensome rules and procedures. If they stay in the field long enough, they almost always come to discover why those rules and procedures are the way they are.

One of the more burdensome and clunky rules that science has had to put up with for the past two centuries or more is the rule that hypotheses are not "fact" (or theory) until they have been successfully tested. This rule has stymied thousands (if not millions) of would-be scientists who are so convinced of their ideas that they feel that testing them is a pointless waste of time and effort.

For these expansive thinkers, this is especially irksome because their new ideas are so obviously correct that anyone who understands them should see their truth immediately. The demands for data and testing seem, to them, merely a distraction - a way for the entrenched old fossils in science to mask their inability to understand. If people would only be more "open-minded" - if they would only "think outside the box" - they would immediately comprehend the beauty and truth of it all.

From the perspective of one of the "entrenched old fossils", a lot of the "thinking outside the box" looks like "not understanding the underlying principles of the field". This sort of error is not limited to the scientific novice, either. Linus Pauling, Nobel Laureate in Chemistry (and recipient of the Nobel Peace Prize) made almost laughable mistakes when he strayed into biology and medicine. In his article "Orthomolecular Psychiatry" (will need JSTOR access - see here and here, as well) and the book of the same name, he showed clearly that he hadn't a grasp of the probabilistic nature of biology when he dismissed concerns that his results were not statistically significant.

If a winner of the Nobel Prize in chemistry could be so wrong when he strayed "across the hall" into a somewhat related field, what are we to make of the lesser mortals who disregard the principles of science because they are "thinking outside the box"?

Not all ex box thinking is suspect, however. Much of it is very useful and even insightful - if it stays within the realm of the possible. People who take Gerry's advice (remember "Call me Gerry!"?) too seriously are likely to end up wondering why people won't listen to them.

The best kind of "outside the box" thinking is guided by a thorough knowledge of the field - either from the "out of the box" thinker or from someone they are working with. As an example, interdisciplinary projects (when done right) are marvelous ways to "think outside the box". Members of the team come from different fields and can contribute not only their own particular expertise, but also their field's unique methods and experiences.

This is very different from what Linus Pauling did - he stormed into the fields of biology and medicine with the attitude that he knew more than anyone else. Those that agreed with him were "visionaries" and those that disagreed were simply unable to see his brilliance. In the end, he surrounded himself with like-thinking people and became more and more marginalized. A sad end for a man who thought that he was "thinking outside the box" and was really going "around the bend".

Regrettably, Linus Pauling was not the only Nobel Laureate to trip over his medal. Those things should come with warning labels: "CAUTION! DOES NOT GRANT SUPERHUMAN MENTAL POWERS!".

In 1973, for instance, Nikolaas Tinbergen shared the Nobel Prize in Medicine with Karl von Frisch and Konrad Lorenz for his contributions to animal behavior (ethology). In his Nobel lecture, Tinbergen - freshly hung with his Nobel wreath - ventured to explain autism as a response to environmental stress, ala Kanner and Bettleheim.

In doing so, he not only hopped on the "Refrigerator Mother" hypothesis of autism as it was sinking, but he also managed to set a nearly unbeatable record for shortest time between receiving the Nobel Prize and saying something really stupid about a field in which the recipient had little experience. Tinbergen thought that his experience - and it was vast experience - in animal behavior gave him special insight into autism. It might have, but it didn't.

So, all you mavericks out there who feel that your lack of education and experience in a field gives you a unique ability to see what those who have labored long and hard cannot, remember these two "cautionary tales". And try to keep an open mind about why the people who have been in the field for years and years may not be receptive to your startling insights. When they brush you off or ignore your input, try to think outside the box of "conspiracy and stubborness" and consider a truly novel idea:
You might be wrong.



Anonymous Anonymous said...


15 September, 2005 15:31  
Anonymous Anonymous said...

Brilliant, as usual, Prom! It does, however, make me cringe at some of my own decision-making in the past and how it may have affected others. What's that thing said here earlier about not letting yourself get too emotionally attached to a theory or hypothesis. I will admit to having done that somewhat. I will also admit that I have believed in one particular "professional" more than I should have. Rough lesson, there.

15 September, 2005 16:42  
Anonymous Anonymous said...

Tinbergen (whoses work in ethology has stood the test of time) wasn't just a crackpot when it came to autism, he was a harmful and dangerous crackpot.

He promoted "holding therapy" as a cure for autism. Autistics have identified holding therapy, which was once wildly popular thanks to Tinbergen, as abuse. See

Tinbergen unfortunately typifies how scientists (and non-scientists) can lose their brains, bearings, and ethics when in the vicinity of autistic people. This phenomenon hasn't abated at all since Tinbergen's heyday as heroic rescuer of autistics.

15 September, 2005 19:02  
Blogger Prometheus said...


Thank you for the in-depth information on Tinbergen. I'd known about his brilliant ethology work (he, von Frisch and Lorenz literally started the field) since my undergraduate days and was only relatively recently introduced to the damage he did in the field of autism.

Unless I've missed someone, Tinbergen still holds the world's record for shortest Nobel Prize to utter idiocy time. And he is unlikely to lose that position.

Although I am not well-versed in "holding-therapy", it makes as much sense to "treat" autism that way as it does to treat acrophobia by tossing someone out of an aeroplane. It just reinforces the fact that Tinbergen, like Pauling, utterly disregarded anything but his own ideas.

It was a classic case of "Nobel Prize Encephalopathy".

To Anonymous:

I didn't learn about the difference between "thinking outside the box" and "going around the bend" from books or by observation. I participated in my own "field work", as it were. There's no shame in making mistakes - the shame is in not learning from them.


15 September, 2005 19:16  
Anonymous Anonymous said...

Prometheus said: There's no shame in making mistakes - the shame is in not learning from them.

Amen to that.

Michelle Dawson said: This phenomenon hasn't abated at all since Tinbergen's heyday as heroic rescuer of autistics.
And amen to that!!!

The field of autism research is littered with Heroic Rescuers. Though the mercury theory seems to have more staying power than some of the other more easily disproved theories, it is nonetheless litter on the side of the road. As some discard it, others pick it up and cherish it as something new and wonderful. One man's garbage....

16 September, 2005 06:41  
Anonymous Anonymous said...

The worst thing about Paulings adventures in medicine is that there are still quacks such as the dreadful Dr Rath using Paulings arguments to support their schemes.

16 September, 2005 10:23  
Anonymous Anonymous said...

Very nice article.
Some people need that-
as a dislcaimer after when they get their PhD, too, and another one would be good for purchasers of medical devises, potions and treatments,

"The ability to schmooze and play the role of loving, compassionate doctor with a dream does not mean that the person with that ability is right, or even good."

Gee whiz, if this Timbergen guy had checked the credentials of Bettleheim... would he have followed him into "refrigerator mother land"?

Michelle has a great essay on Bettleheim's legacy:

"...The storm of accusations following his death convinced Pollak that that there was an interesting story beneath the surface, and before long he was embarked on a project of discovery that ultimately led to this definitive exposure of Bettelheim as a charlatan whose life was based on falsehood and self-aggrandizement.
It was not hard for me to tell that the claims of success in treating autism that Bettelheim made for himself in The Empty Fortress were ludicrous. Almost any parent of an autistic child could tell that most of the "autistic" children he claimed to have treated were not autistic. ..."

It's hard for me not to see some parallels between the beloved Dr Bradstreet with his wishful credential claims, and the possibly even more slick and deceptive, Dr. Buttar.

16 September, 2005 15:16  
Anonymous Anonymous said...

Left some words out:

It's hard for me not to see some parallels

between Betteleheim and

the beloved Dr Bradstreet ...

16 September, 2005 15:18  
Blogger Prometheus said...


"Post-PhD Encephalopathy" is undoubtedly more common that "Nobel Prize Encephalopathy", but the latter generally garners more press attention. What Pauling and Tinbergen did outside of their field of expertise has set medicine back by at least a decade. Pauling was not the originator of "orthomolecular medicine", but it would have gone nowhere without his name behind it.

And now, "orthomolecular medicine" and its offspring are siphoning off people's money, energy and even lives at an alarming rate.

Reading Bettleheim's work, I can't help but think that he was projecting his own "unresolved" experiences from being in a concentration camp (as if any therapy could ever "resolve" that). The venom he spewed at the parents (mothers, mostly) of autistic children is appalling - it only begins to make sense as a way for him to "get back" at the SS guards of his past. This does not excuse his actions, but it helps to explain them.

The parallels between Bettleheim and Bradstreet or Buttar that I see are that all three - in some way - blame the parents. Bettleheim in his own perverse "getting-back-at-the-SS" way and Buttar and Bradstreet in a more modern two-pronged attack:

[1] It was the parents lack of prudence that allowed their children to become "damaged" by vaccines.

[2] The parents are to blame for the children remaining autistic unless they consent to give their child innumerable untested, expensive and exhausting "treatments".

Buttar has even gone so far as to berate parents for stopping his treatments when their children worsen - he says that it is a "healing crisis", or some such rot.


16 September, 2005 22:41  
Blogger Bora Zivkovic said...

This is related.

But....this is why we blog! Actually, that is why I write two blogs: one focused on the narrow field in which I DO know something, and the other for ranting about everything else no matter how uninformed I may be. It feels great!

17 September, 2005 14:49  
Blogger Bora Zivkovic said...

BTW, I had no idea about Tinbergen and autism. As a behavioral biologist I idolize him, so this is a cold shower for me.

17 September, 2005 14:50  
Anonymous Anonymous said...

I see two courses of action, depending on what's really going on:

A) You might not be paying attention to what your doctor is really saying.

Or B) He's really living up to the "reductionist" straw man stereotype, in which case, I'd suggest changing doctors. Evidence-based medicine isn't immune to incompetence among its practitioners.

My mother's still alive, thanks to her ability to spot an incompetent, careless doctor, so she switched to one who actually used the scientific method to find her REAL problem, rather than blame the first abnormality that showed up.

07 November, 2005 14:45  

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