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Kevin's Reviews > Lost Connections: Uncovering the Real Causes of Depression - and the Unexpected Solutions

Lost Connections by Johann Hari
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bookshelves: health-public-social, theory-psych, 2-brilliant-intros-101, 1-how-the-world-works

Can there be any Redemption for Pop Psychology?

--Judging by this book's popularity/stellar ratings in a genre I have avoided, I was preparing a niche review contrasting this book with bad “pop psych�.
…Tn, I noticed the top review accuses this book of being another bad “pop psych� book! “Instead he presents another wildly oversimplistic explanation and then claims credit for Figuring It All Out Unlike Those Actual Scientists And Doctors.�
…So, I’ll first unpack the negative review (a useful exercise in salvaging a disagreeable review), then bad “pop psych�, and finally the book.

1) Lost in Communication:
--The top (negative, 1-star) review claims that this book took an obvious claim (depression can have social causes; “no shit�) to build a strawman claim (the understanding and treatment of depression have only focused on chemicals in the brain; “literally nobody thinks that�, “because doctors are not fucking idiots!�).
--It’s always disappointing how messy communication is:
a) I found the author’s reminders of it’s-complicated/there-are-exceptions-including-biochemical-and-genetic/antidepressants-can-be-part-of-helpful-treatments adequate for a popular presentation (and thus even repetitive).
…T core of the book is to explore other treatments beyond relying on antidepressants (while listing sources supporting antidepressants, i.e. Kramer’s Listening to Prozac), and the author frequently adds that antidepressants can be a useful addition in treatment, mirroring the reviewer’s coup de grâce: “there's often an antidepressant which will give the person a bit of a boost in conjunction with sorting out other stuff. But Hari doesn't engage with this.�
…T changing debates and medical practices (i.e. modern Western; the brief contrasts with non-Western is worth exploring elsewhere) on depression are summarized at the start (ex. Irving Kirsch vs. Peter D. Kramer, DSM diagnostic guidelines, etc.). Healthcare changes (look at how DSM classified homosexuality). This book is not an attack on healthcare professionals, who are limited to their institutions and cannot resolve many wider social issues. The author supports the NHS (UK’s National Health Service) as a cornerstone of social services (“well, of course�).
…Social causes are often systemic so this is not (and cannot be) a cheap self-help book. Interactions between social and biological factors (ex. neuroplasticity, snowballing effect) are indeed complex and covered, once again mirroring the reviewer’s counter “There are levels of cause and effect, and interactions between these levels. Life experience affects brain activity. Brain activity then both creates and affects life experience. The problem with depression is often a feedback loop between life and the brain.�

b) Meanwhile, the reviewer’s reaction: “Well Hari starts by saying that everything I know about depression is wrong, which is a bold claim given that I've lived with it, waxing and waning, for most of my life.�. This is an (ironically) ※پ� caricature of a presentation which the reviewer also finds to be mostly obvious (“no shit�). The presentation is clearly for a popular audience and not an academic tome, with all its advantages and limitations.
...Update: for the Guardian article , see my breakdown in Comment #10 below my review. Yet another attempt to critique exaggeration that ends up relying on exaggeration.

2) Bad “Pop Psych�:
a) I ended up dropping a star (from 5, which I try to be very finicky giving as to not dilute gems!) given the advertising hype/spin employed in some of Hari's passages (the major limitation of popular writing, as it seems to be treated as a requirement); this definitely detracts from what is otherwise 5-star content and is a misuse of creative writing.
...My go-to for engaging writing on the topic without shortcuts in nuance is medical doctor/epidemiologist/science writer Ben Goldacre (Bad Science: Quacks, Hacks, and Big Pharma Flacks). Goldacre's collection I Think You'll Find It's a Bit More Complicated Than That has numerous articles directly related: "Heroin on Prescription", "Neuro-Realism", "The Least Surrogate Outcome", "The Stigma Gene", "Brain-Imaging Studies Report More Positive Findings Than Their Numbers Can Support. This Is Fishy". Goldacre's medical/research background offer deeper experiences with the realities of "Big Pharma" (whose crimes are more abstract and structural than what is sensationalized by bad media, see later).
...That said, I still think Hari's topic of social addiction is a gem, unlike standard bad “pop psych� extraordinaire Malcolm Gladwell...

b) Why psychology is a mess and heavily criticized in academia: the difficulties quantifying a social science:
-
-
-
-
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...plenty of ideological fiends that emerge from this swamp, misusing science's initial reductionist steps of discovery by not re-synthesizing with real-world complexities in making conclusions (esp. considering psychology crosses over so much with social sciences, unlike physical sciences). I'll need to continue reviewing these culprits:
-Jordan B. Peterson: 12 Rules for Life: An Antidote to Chaos
-Steven Pinker: The Better Angels of Our Nature: Why Violence Has Declined
-Sam Harris: The Moral Landscape: How Science Can Determine Human Values

c) “because doctors are not fucking idiots!�: if you read Hari more carefully, you’ll see he reviews the fascinating world of for-profit medical trials (referencing meta-research legend John Ioannidis), which are unpacked here:
-I Think You'll Find It's a Bit More Complicated Than That (“because, you know, the brain is complex�)
-Bad Science: Quacks, Hacks, and Big Pharma Flacks
-Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients: in particular the numerous ways to rig trial results.
…If you’re actually serious about evidence, you’ll realize “the evidence […] is complicated�. Indeed, legend John Ioannidis himself has gotten into controversies in his interpretations of COVID-19 research:
…Rigidity in evidence-based-medicine paradigm:
...How this applies to COVID research: hierarchy of evidence? Missing social structures? Dead Epidemiologists: On the Origins of COVID-19

3) The book:
--Unpacking the bad review helped contextualize this book, so here’s a quick overview:
a) Lost connections with:
...meaningful work (Yes! Political economy is my interest; check out Bullshit Jobs: A Theory, Democracy at Work: A Cure for Capitalism, The Invisible Heart: Economics and Family Values), other people (loneliness, “self-help� culture)
...meaningful values (intrinsic vs. extrinsic), lack of authenticity from childhood trauma (defensive mechanisms; many references of Gabor Maté (In the Realm of Hungry Ghosts: Close Encounters with Addiction; Maté has since broadened the scope in The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture), status/respect (stress of insecure status/subordination), as well as brain changes (neuroplasticity) and gene changes (environmental activation, stigma)
...nature (Braiding Sweetgrass: Indigenous Wisdom, Scientific Knowledge, and the Teachings of Plants), and hopeful/secure future (another big topic in political economy, esp. Neoliberal cannibalism of Western post-WWII industrial boom, not to mention existential ecological crises)
...You can see how much “NDZ� plays into lost social connections, symbolized by Thatcher's “There is no society� and “There is no alternative�. This also relates with boogeyman Marx's “aԲپDz�.

b) Re-connections with:
...other people, social prescribing (“what’s the matter with you?� becomes “what matters to you?�), meaningful work, meaningful values, sympathetic joy (vs. envy)/overcome addiction to self (meditation, psychedelics), acknowledge/overcome childhood trauma, and restoring a future.
…T last point (restoring a future) is of course a big political economy topic! The author cites Bregman regarding UBI (Utopia for Realists: How We Can Build the Ideal World) which can be a useful conversation-starter for novices (just as The Shock Doctrine: The Rise of Disaster Capitalism popularized the critique of "Neoliberalism"), but many structural economic issues are unaddressed (let's not forget market fundamentalists like Milton Friedman supported variations of UBI, to help dismantle welfare services).
...I much prefer Varoufakis unpacking the structural crises (Talking to My Daughter About the Economy: or, How Capitalism Works—and How It Fails) and proposing structural alternatives (Another Now: Dispatches from an Alternative Present). In fact, Varoufakis interviews Hari on social alternatives!
...Another excellent pairing, now on the global situation, is Hickel on global inequality (The Divide: A Brief Guide to Global Inequality and its Solutions) and on solutions to the existential ecological crises (Less is More: How Degrowth Will Save the World). Also useful and accessible: Doughnut Economics: Seven Ways to Think Like a 21st-Century Economist
...Once again, this cannot be treated as a cheap self-help book; social problems require social solutions. Hari quoting Jiddu Krishnamurti:
“It is no measure of health to be well-adjusted to a sick society.�
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Reading Progress

February 8, 2018 – Shelved
August 27, 2021 – Started Reading
September 19, 2021 – Finished Reading

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message 1: by Maggie (new)

Maggie Unsolicited recommendations of writers/researchers who push these ideas even further (in case you might not have gotten to them yet): David Smail's "Power, Interest and Psychology: Elements of a Social Materialist Understanding of Distress" and "The Origins of Unhappiness: A New Understanding of Personal Distress" and Joanna Moncrief's "De-Medicalizing Misery: Psychiatry, Psychology and the Human Condition" and "The Bitterest Pills: The Troubling Story of Antipsychotic Drugs"


message 2: by Night (new) - added it

Night Thank you very much Kevin!


Kevin Maggie wrote: "Unsolicited recommendations of writers/researchers who push these ideas even further (in case you might not have gotten to them yet): David Smail's "Power, Interest and Psychology: Elements of a So..."

Your recommendations are never unsolicited :) Very helpful as I've avoided this topic so was relying on external critiques from other sciences (based on evidence-based medicine paradigm with all its limitations within liberal institutions) and social sciences (both sides dissing psychology lol), and other than that Colin A. Ross who is a bit off topic ("The C.I.A. Doctors: Human Rights Violations by American Psychiatrists" and "The Great Psychiatry Scam: One Shrink's Personal Journey")...


Kevin Night wrote: "Thank you very much Kevin!"

My pleasure :)


message 5: by Gustav (new) - added it

Gustav Osberg Interesting review, Kevin! The overlap between well-being and sustainability is a growing field (of which the research project I work for is part of). It challenges the instrumental way of approaching sustainability as a technical and technological challenge that merely preserves the status quo by 'greening' its facade. This is, I think, why it's so much more at stake when we talk of abandoning the GDP measurement in favour of e.g. wellbeing. Were people to have the agency and capacity to strive for what makes them feel well instead of e.g. successful (and stressed), much of our current structures would collapse I'm sure.


Kevin Gustav wrote: "Interesting review, Kevin! The overlap between well-being and sustainability is a growing field (of which the research project I work for is part of). It challenges the instrumental way of approach..."

Cheers Gustav!

Definitely strong parallels with Hickel's "Less is More", which indeed takes it up several notches with decolonization/degrowth frameworks ...whereas Hari is less clear on political economy (esp. global), thus hovering around Bregman's UBI (and even referencing Obama, ouch!). That's why I was delighted with the Varoufakis/Hari discussion, where Varoufakis injected Marxist alienation/exchange value vs. use value/modern capitalist property rights etc.

Speaking of "GDP", I've wanted to bring this up with you: how to synthesize:
1) Hickel's drivers of growth: GDP (tied to raw materials use) + private sector 3% investor returns
2) Hudson's Finance Capitalism driven by M-M' capital gains rather than M-C-M' productive corporate profits (of course, even if the West is cannibalizing its production, clearly production is outsourced and still occurring via debt-fueled growth).
...Hudson has drilled into my head how US National Income and Product Accounts (NIPA) manipulate their stats to hide wealth (esp. finance, real estate). So, I'm curious:
1) How this affects GDP as a reliable measure for productive output in the age of Finance Capitalism's massive distortions (ex. asset prices)? By definition, GDP is supposed to measure "the production of goods and services" and exclude "flows of financial capital (such as stocks, bonds, and bank deposits)".
2) If (a big if!) we assume GDP has mostly evaded financial distortions, then the next question is how much does it actually drive state policy or capitalism as a whole in the age of Finance Capitalism? (I definitely agree it is a powerful symbol for progress).
-NIPA GDP reference: there's a useful PDF from US Bureau of Economic Analysis's "Measuring the Economy: A Primer on GDP and the National Income and Product Accounts" webpage, which I cannot link smh.


message 7: by Gustav (new) - added it

Gustav Osberg Kevin wrote: "Gustav wrote: "Interesting review, Kevin! The overlap between well-being and sustainability is a growing field (of which the research project I work for is part of). It challenges the instrumental ..."

You are again catching me slacking on my Hudson homework, but those are two interesting questions worthy of a research project in themselves.
The spontaneous reflection I get ties back to a conversation regarding crypto-currencies I had with a person working at a bank. She was obviously sceptical, and this was because capital, unlike cryptocurrencies, is still rooted in material assets somewhere down the line, even if these obligations are traded and such. Stocks, bonds and bank deposits still represent investments in real productions and consumption of goods and services (and thus GDP); however, I might be failing to grasp the deeper levels of this due to my lack of understanding of the financialisation literature...


Kevin Gustav wrote: "Kevin wrote: "Gustav wrote: "Interesting review, Kevin! The overlap between well-being and sustainability is a growing field (of which the research project I work for is part of). It challenges the..."

Hmmm, this does get messy given the blurring of "currency", "assets", "capital", etc. from varying uses in accounting, academic social sciences, popular speech, political ideologies, etc.

1) Currency: I'd pluck out this concept first regarding the cryptocurrency debate.
a) Speculation: please tell me this person works for a major commercial bank because the irony would be delicious lol, since their vast money creation via loans is responsible for the overwhelming speculation on assets (real estate/stock/bonds) in the age of Finance Capitalism.
b) But yes, bank money can be used more productively, and here I'd return to the "state money" vs. "commodity money" distinction, where currency gets its value from being recognized by state to pay taxes etc. vs. commodity speculation.

2) Financial Assets (stocks/bonds) and their relations with GDP from accounting perspective, then relations with actual material use: I'm slowing wading through financial accounting, and it's frustrating knowing Hudson's warnings of accounting shenanigans smh...


message 9: by T (new)

T You should read some of the reviews on this, it's based on very shoddy and misrepresented data


message 10: by Kevin (last edited Jun 19, 2022 03:23PM) (new) - rated it 4 stars

Kevin T wrote: "You should read some of the reviews on this, it's based on very shoddy and misrepresented data"

Good topic! You mean, for example, the Dean Burnett "Is everything Johann Hari knows about depression wrong?" Guardian article?

As most debates go, there is actually more agreement in the contents, while the headlines reflect the same mistakes critiqued.

The actual premise of Burnett's article is:
(i) Mainstream healthcare already knows Hari's "discoveries" (i.e. in agreement, this part is not "based on very shoddy" data)
(ii) Hari misrepresents mainstream understanding and advertises the agreements as heterodox (this advertising hype is curiously then reflected in Burnett's own article title).

"The NHS, whose website lists several possible therapeutic options for depression, may disagree with this [disagree with Hari's allegations of mainstream misunderstanding offering only one option of drug treatment... thus agrees with Hari's actual solutions]. Also, Ben Goldacre was addressing the problem with SSRIs and the serotonin model of antidepressants 10 years ago. And yours truly summarised the many factors and variables of antidepressants in this very section of the Guardian not too long ago."

As you know I follow Ben Goldacre, including the pieces he has done on SSRIs and "medicalization" of social issues in general. I do prefer Goldacre's writings on this topic, given his "it's more complicated than that" nuances. But Goldacre's core message is closer to Hari's than "Is everything Johann Hari knows about depression wrong?", which is where I'm coming from in my review with its references of Goldacre.


message 11: by Carol (new)

Carol Great review on a topic in which my interest is insatiable, but my tolerance for reading crappy non-fiction low. Thanks for all of the effort and detail you put into your initial review as well as your follow-on comments. Highly valuable and appreciated.


Kevin Carol wrote: "Great review on a topic in which my interest is insatiable, but my tolerance for reading crappy non-fiction low. Thanks for all of the effort and detail you put into your initial review as well as ..."

Cheers Carol and same! The process of reading content (social addiction) I find fascinating (thus biasing me to overlook some surface flaws) and then reassessing after reading various negative interpretations was definitely valuable, thus worth sharing!

P.S. Ben Goldacre is still my gold standard on this topic ;)


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