The Emotional Eating Kit

There's an ever-growing number of stories in the media about the rise of obesity and related diseases in the UK - hardly anyone can be unaware of the scale of the problem. For most people, this is a serious health issue. For others, it's a marketing opportunity. Bach Remedies have not been slow to milk the cash cow.

According to them, it's not what you eat, it's why you eat.

The Emotional Eating Kit contains 'three flower essences that can help with comfort eating and offer a helping hand with diet and healthy living regimes'. It is 'the first product available in the UK of its type to specifically help deal with the emotions linked to comfort eating'.

What are flower remedies?
Bach's remedies were invented in the 1930s by Dr Edward Bach (pronounced Batch), originally a medically-trained doctor.

He was guided to choose his remedies by his psychic connection to plants, then suspended them in spring water and let sunlight pass through them. There is no part of any plant in any remedy, just its vibrations.

His theory was that by correcting the body's vibrations with plant vibrations, the body would then be able to heal itself. There is no explanation on the web site of the physical mechanism by which the remedies operate, no attempt at science, no placebo-controlled, double-blinded, randomised testing reported in peer-reviewed papers. There is this:

'Each remedy is a correcting vibration for a state of mind or emotion that needs to be gently rebalanced. Since the body is a direct reflection of the mind, transforming negative vibrations into positive good vibrations allows the body to respond naturally with better health'.

In other words, it's a 'cure' based on an idea not dissimilar to a Beach Boys song.

You can read more about each of the 38 remedies here along with a whole welter of New Age nonsense.

This is not herbal medicine

Flower remedies are not the same as herbal medicine based on plants that contain chemicals that have tangible physical effects - and side-effects. There are no side-effects of the Bach remedies because:

'Bach Flower Remedies can be taken by anyone, safely and without fear of side effects, overdosing or addiction. Since flower remedies work on a higher vibrational frequency they will not interfere with other forms of treatment. No harm comes from choosing the wrong remedy as it will cancel itself out if not needed'.

The self-cancelling and lack of interaction with other treatments would be very useful for real medicine (and herbal medicine), but strangely, no research time and money have been given to these remarkable attributes.

Bach experimented with homeopathic remedies in the early days and this claim bears more than a passing resemblance to homeopathic claims, particularly because there is no active part of the plant used, just its vibrations.

In other words, they can't harm you because there's nothing in them. They can't interact with other treatments because there is nothing acting in the first place.

The Emotional Eating Kit

The three remedies in the Kit are Cherry Plum, Crab Apple and Chestnut Bud.

Cherry Plum 'When you fear you might lose control of your diet, Cherry Plum can help you to think and act rationally'.

Chestnut Bud 'When you find yourself repeating the same dieting mistakes, Chestnut Bud helps you gain knowledge from your experience'.

Crab Apple 'When you feel unclean or dislike something about yourself, Crab Apple helps you accept yourself and your imperfections'.

It's a tiny therapist in a bottle!

Just for good measure, the Kit also claims to help with detox, that magic word so beloved of advertisers. Sense about Science say that 'Detox has no meaning outside of the clinical treatment for drug addiction or poisoning' and there is much other evidence that 'detox' is just shorthand for 'a good way to separate people from their money'.

There's no point asking how these three plant vibrations work to alter brain chemistry and the complex physical/mental interactions involved in comfort eating or 'feeling unclean' (whatever that means). There are no rational answers.

Instead, ask if it really matters that people who are genuinely trying to change their eating habits are being gulled into buying them. Of course, the advertising uses the weasel words 'can help' so that if it doesn't, there's no come-back. And it won't.

There is no quick fix
There's nothing wrong with occasional comfort eating. If you're doing it so often that it's a problem, then it's going to take more than a few drops of Dr Bach's magic potion to fix it. If any one diet or dieting aid worked, then we would only need to use it once. The diet industry would be tiny, not a multi-billion pound industry.

Losing weight and keeping it off is hard. If it were easy, we'd all be skinny. It involves commitment to life-style changes, possibly with professional help. There is no quick fix.

Contributing factors to being overweight include lack of exercise, the easy availability of food, constant junk food advertising and the high levels of fat and sugar in many foods, even some we think are healthy.

High fructose corn syrup is in most junk foods; it has an effect on the brain that make us crave them without ever feeling full.

Comfort foods are comforting/rewarding because these were the foods that were in short supply when we were hunter-gatherers. If you craved them and felt good after eating them, you'd put more effort into finding them and be more likely to survive to pass on your comfort-eating genes. In other words, an evolved survival strategy has come back to bite us because our bodies haven't evolved as fast as our societies.

And that's before we even address the complex psychological reasons for overeating.

The placebo effect
If the Kit works, does it matter how it works?

A systematic review published in 2010 by Professor Edzard Ernst concluded: 'All placebo-controlled trials failed to demonstrate efficacy. It is concluded that the most reliable clinical trials do not show any differences between flower remedies and placebos'.

If you use one alternative product, there's a good chance you will use others too. You're not just buying a product, you're buying a whole way of thinking based on magic and faith.

Something that works by placebo, if at all, is a kind of gateway drug to heavier dependency and self-diagnosis of possibly serious conditions. You're more likely to ignore evidence and rely on anecdote (my gran's neighbour took it and felt lots better) not just in this area but in others too.

And that's if it works. Remember the get-out clause 'may help'?

A couple of weeks ago, a full-page advert for the Kit appeared in the Saturday Guardian magazine because the prime market for all things 'alternative' is middle class women.

But who knows, you may be the one person in the history of the universe who proves the entire body of scientific knowledge wrong. If you are the miraculous exception, you may well find yourself stuck full of probes, every bodily fluid and tissue dissected, analysed and written up in scientific journals. Bits of you will end up in specimen jars. A gene mutation may be named after you. Are you feeling lucky?

But, in the end, it's up to you. It's your life, your body and your money.

Dr Jesus in the dock

In May last year I wrote about Dr Richard Scott who was being investigated by the General Medical Council for aggressively preaching at a vulnerable patient. Scott practices at the Bethesda Medical Centre in Margate, which is run by six Christian GPs.

The GMC has now reached a verdict and the findings are published here.

Scott's lawyer, Paul Diamond, works for the Christian Legal Centre and is no stranger to cases like this. He said that 'a degree of deference should be given to an experienced GP who is embedded into the local community, particularly one who has a reputation for the care he provides to his patients.'

Scott didn't give any deference to a vulnerable patient, or his beliefs. Deferring to someone simply because they are a figure of authority is a demand generally made by dictators and Victorian patriarchs. The GMC agreed and said:

In deciding whether to issue a warning the Committee must apply the principle of proportionality and weigh the interests of the public with those of the practitioner.

In other words, there should be no deference if it's harmful to patients. The GMC is not anti-religion or anti-Christian. The findings stated that GMC guidance acknowledges the role of faith issues in medical care and the right of doctors to raise such matters within the consultation provided that it is done with the patient’s consent and with sensitivity and respect for any faith they might have...on this occasion your behaviour in presenting your faith to Patient A had exceeded the boundaries set out in the guidance and, to use his words, “had gone too far.”

Way too far. Scott was found guilty of saying that:

If Patient A did not turn towards Jesus and hand Jesus his suffering, then Patient A would suffer for the rest of his life.

His own religion could not offer him any protection and that no other religion in the world could offer Patient A what Jesus could offer him.

The devil haunts people who do not turn to Jesus and hand him their suffering.

You told Patient A that you were not offering him anything else because there is no other answer and that he will keep suffering until he is ready to hand his suffering to Jesus.

This is way beyond offering to pray with a patient or asking them if they would like to discuss their beliefs. Scott was once a missionary in Africa; his behaviour in the surgery suggests that he is of the fire and brimstone school, threatening and bullying people into accepting his faith, conjuring images of the devil to batter them into submission. So much for 'first do no harm'. What's more, so much for 'God is love'.

The GMC found that Scott's actions also contravened Paragraph 33 of Good Medical Practice: You must not express to your patients your personal beliefs including political, religious or moral beliefs, in ways that exploit their vulnerability or that are likely to cause them distress.

They warned Scott that Further serious or persistent failure to follow GMC guidance will put your registration at risk.

In other words, he could be struck off. But further action relies on further evidence that he is ignoring the ruling. This means that other patients would have to be brave enough to stand up against this figure of authority, know enough to take their complaint to the GMC and be strong enough to give evidence at a hearing. Not everyone may be capable of doing this either against Scott or other doctors who behave in the same way.

The Committee ruled that this warning be attached to Scott's registration:
During a consultation with a patient in August 2010 you expressed your religious beliefs in a way that distressed your patient. You subsequently confirmed, via National media, that you had sought to suggest your own faith had more to offer than that of the patient. In this way you sought to impose your own beliefs on your patient. You thereby caused the patient distress through insensitive expression of your religious beliefs.

The warning will stay on his registration for five years.

Scott called the hearing 'a charade'. This translates as 'I didn't get my own way' or 'How dare they enforce the rules that I agreed to abide by when I became a doctor?'. Possibly, he stamped his feet as well.

Entirely predictably, the Christian Medical Fellowship has responded with its usual wailing about 'the growing marginalisation of Christian professionals and the rise of militant secularism in Britain’s institutions.'

Christian Concern commented that “Our society seems to becoming more and more repressive, with ordinary, decent people being reported to the authorities and disciplined, not for committing any crime, but just for expressing their Christian beliefs.”

Ordinary, decent people do not bully and threaten the vulnerable, they do not abuse positions of authority and they do not expect special exemptions from rules or laws when it happens to suit them. Whether a practice run by six Christian GPs who advertise their faith on the practice web site is serving the whole community in which Scott is 'embedded' is another matter.

ETA: 18 June

Christine Odone writes her usual ill-informed propagandist response in the Telegraph. However, she does make a good point that the GMC 'allows doctors to promote the healing effects of homoeopathy, chiropractic and reiki, also known as palm healing — which are all unsupported by Western, evidence-based medicine but are backed by belief systems'.

Dr Scott would of course claim that there is plenty of evidence that faith heals and has also spoken in favour of homeopathy.

This doesn't mean the GMC ruling on Dr Scott was wrong but it does suggest that they are inconsistent in their approach and need to be more stringent about evidence-based medicine.

ETA: 20 June
There's an interesting take on the story and the alleged efficacy of prayer by Dr Robert Winston.

ETA 22 June

Dr Scott has now told Pulse magazine that he is not going to change his behaviour.

He said: ‘If anything it will make me even more determined to do it. I showed the GMC all the statistics that showed that spiritual care really helps people's health. Doing God is good for your health. That is the message we tried to get across to the GMC, which they abjectively (sic) failed to grasp.'

He also said: ‘We have evidence-based medicine and if doctors are not providing spiritual care they are actually harming patients.'

It appears that Dr Scott and the GMC have a different interpretation of 'evidence'. They also appear to have a different interpretation of what abiding by a code of practice means. Scott appears to be saying that all the generations of doctors who have been keeping their beliefs out of the surgery have in fact been doing harm to their patients. That's a pretty big accusation.

In addition to spending years learning how the body works and how to fix it when it goes wrong, medical students really should be learning how to preach the gospel. And if they're not Christian, they'd better convert pretty damn quick because believing in any other faith is tantamount to gross medical negligence. Atheist doctors are just criminals.

Scott also ignores the difference between having a faith and being bullied. Some people may derive a sense of well-being from their beliefs, and may avoid more harmful behaviours because of them. But being told that your god is inferior and that the devil is after you when you're already ill or in a vulnerable state is not likely to make you feel better.

Dr Scott also said that the GMC had downplayed the severity of the warning. ‘It's a drag, because if someone else complains to the GMC, then it's two yellow cards equals a red.'

Yes, it's a real drag when you're forced to obey the rules. Bummer, dude.

Scott may see himself as a martyr but his reaction is neither scientific nor humane, two of the main requirements of a doctor. It's just plain arrogance.

Niall Dickson, chief executive of the GMC, said: 'Our guidance is clear - doctors must not impose their own beliefs on their patients or cause them distress by inappropriately expressing their own views. This is not about religion, it is about respecting patients and making sure doctors do not use the incredibly privileged position they hold to push their own beliefs, however strongly held they may be.'

Watch this space.

Skeptics Versus Religion

In Nick Cohen's Guardian review of Mark Henderson's book The Geek Manifesto, he suggests that skeptics are being cowardly in not taking on religion.

Is religion a legitimate skeptical target and if so, which aspects of it should we be tackling?

There are already certain aspects of belief that skeptics do take on. For example, the pseudo-scientific claims of creationism or Intelligent Design and its teaching in schools. In September, Alom Shaha will be talking about science versus religion in the classroom at London Skeptics. The 40 Days of Treats campaign was run by two skeptics, who took on religious opposition to abortion. Claims of faith healing are regularly reported to Advertising Standards; one of the more recent was HOTS Bath.

Skepticism promotes rationalism, evidence and scientific thinking. It's not about what or how much we know but about how we know it. If new evidence challenges established thinking, then that thinking changes. This isn't the U turn dreaded by politicians or proof of weakness in the methodology, it is the methodology.

There are skeptics who take on the basic tenets of religion but should this be the basis for a campaign or something we should do more of? I would suggest not. I advocate the generally secular position that beliefs should be a personal matter, that religion should have no special privilege in law-making, healthcare, equalities, education and so on. Beliefs matter less than actions. Yes, actions are founded on beliefs but that's where legislation comes in.

It's easy to find holes in the logic of any religion, flaws in the reasoning, contradictions and scientifically unverifiable claims. It's easy to point and laugh, sneer at and condemn people's genuinely-held beliefs. We need to acknowledge that none of us is as rational as we might like to think. Atheists are not more intelligent than believers and simply pointing out the flaws or evils in religion is not going to make it go away. We need to be humane as well as rational, understanding the many complex reasons people believe what they believe. There is a role for intelligent satire but for some skeptics ridiculing 'truth' claims is a sport that makes them feel good about themselves but what else does it achieve?

What might we want skeptical activism to achieve? One of the first rules of campaigning is to identify your goals.

Do we want an end to all religion? That's not going to happen. Fewer people believe and actively practice religion (in the West) than in the past, but that's not a trend that will carry it into oblivion, largely because of the way the human mind has evolved combined with social factors.

Do we want laws and professional bodies' best practice to be evidence-based and not give in to religious demands for special treatment? Do we want to raise awareness or influence policy-makers (or both)? Do we want to attempt huge campaigns (that may demand more resources than we can realistically provide) or do we want more grassroots activism, tackling individual claims and inequities? These questions all need to be addressed.

We already promote science and evidence-based thinking so that people have access to information about alternatives to belief and its effects should they want them. We do this on a small scale at our meetings and conferences. Brian Cox, Simon Singh and David Attenborough (who might not identify as a skeptic) have been making science programmes for years that have mass appeal, along with many others.

What other areas of religion should we then be tackling?

Should we be involved in clashes between religion and equalities, for example women's rights under sharia law? Should we be running a gay marriage campaign to counter the strong religious opposition or a campaign against the ever-growing number of state sponsored faith schools? There is clear evidence that the majority supports gay marriage and doesn't want more faith schools but is this the kind of evidence we need to take action on or are they purely secular matters?

The atheist bus campaign promoted scepticism about the existence of God but that was scepticism with a C, not with a K, and it was a humanist campaign. It has been suggested that every school should be sent a copy of Origin of Species in response to Gove sending the King James Bible but this would be an empty (and expensive) tit-for-tat gesture.

Secularism and skepticism are obviously not mutually exclusive but it's about the focus of activism, about branding.

One area where skeptics could do more is in the clash between religion and healthcare, where there are usually clear evidence, facts and research as opposed to religious propaganda, unsubstantiated claims and downright lies. The Christian Medical Fellowship and their like (including Nadine Dorries) write propaganda and lies about abortion, mental illness, contraception, doctors' right to proselytize in the surgery and conscientious objections. Add to this pharmacists demanding the right to refuse to sell the morning after pill, therapists claiming to cure homosexuality and medical students refusing to bare their arms to scrub up. And the Vatican (among others) consistently opposing stem cell research. I've written about all of these matters, in some cases more than once, if you want some background.

I suspect that part of the reason we haven't done much in some of these areas is that they cover so-called women's and gay issues and skepticism has historically been very much a heterosexual male domain. But this is changing, as the number of women now coming to Skeptics in the Pub meets and the 40 Days of Treats campaign run by skeptics Liz Lutgendorff and Carmen D'Cruz shows.

Two ways to take direct action are to write to MPs and ministers, and to respond to consultations. This may not seem like a very exciting or high-profile activity, but your MP should respond to your letter and they often assume that for every voter who writes, there are many others who agree, especially if it's a personal, individual letter rather than one obviously copied from an organisation's template. Consultations often inform legislation and best practice. For example, the Secular Medical Forum's recent response to a consultation on Personal Beliefs and Medical Practice, makes some good points.

And then there's good old fashioned talking - to family, friends, people in the pub, at school parents meetings and at work. Not haranguing, not lecturing, just talking. It's what Christians would call bearing witness.

I don't believe that skeptics avoid religion out of cowardice but we do need to think more about what we can do in this area, to define our targets and our responses to them. There is no single skeptic opinion on any one subject but many shades and variations, so I'm not hoping for a mass, homogenous uprising. I am hoping that Nick Cohen's comment and this response will open a debate.

20/20 Vision

The Congregation for the Doctrine of the Faith (formerly known as the Inquisition) have published a guide on how to tell if religious visions are genuine.

The guide was written in 1978 but they are publicizing it now because, they say ‘Today, more than in the past, news of these apparitions is diffused rapidly among the faithful thanks to the means of information (mass media)’. The Congregation is concerned that people will be mislead and that a cult could start around a false vision before they have chance to intervene.

Although they’ve embraced the modern world enough to publish this document online, the criteria in it are thoroughly antique. They note that ‘modern mentality and the requirements of critical scientific investigation render it more difficult, if not almost impossible, to achieve with the required speed the judgments that in the past concluded the investigation of such matters.’

In the past only a few people would initially know about an alleged sighting. The local priest would contact his bishop who would contact the Vatican who could take their time to decide if the apparition was real or not, everyone else would fall into line with the ruling and they’d get on with the important business of building a gift shop and making signs that said ‘Pilgrims please form an orderly queue here’. Or they'd burn the visionary as a heretic and that would be an end of it.

If they did decide the apparition was real, they’d send along someone to make sure that the message was correctly interpreted or kept secret – either because it was such garbled nonsense that no one could make head nor tail of it or so they could stage-manage what bit of propaganda they wanted the message to contain. The Three Secrets of Fatima are a good example.

But now there is pesky science and people who do not take the Vatican’s word without questioning, so they have to come up with a handy guide to ruling on holy manifestations to try and nip any false claims in the bud. They would also find it harder to ignore someone who claims to have seen Holy Mary if the vision was tweeted right round the world before they could intervene. And even harder to get away with burning them as a heretic.

They’ve established a set of positive and negative criteria to help distinguish if it really is the Virgin or one of the thousands of saints popping in for a visit, a deluded or criminal human act or perhaps the Evil One trying to mislead the faithful.

Does this check list include anything even vaguely scientific? It does not.

Positive criteria

Moral certitude, or at least great probability of the existence of the fact, acquired by means of a serious investigation.

This is the equivalent of ‘if it walks like a duck and quacks like a duck, then it must be a duck’. There is no indication of what a 'serious' investigation would entail. Even as a first-stage triage, this list is seriously wanting.

Personal qualities of the subject or of the subjects (in particular, psychological equilibrium, honesty and rectitude of moral life, sincerity and habitual docility towards Ecclesiastical Authority.

Is the person who had the vision a) a good upstanding Catholic b) sane and c) not a trouble maker.

Sanity is obviously a useful metric when someone claims to have visions – assuming that God never chooses to send one of his posse to visit the mentally ill.

He apparently also never sends a vision to anyone who does not lead a moral life (in the Catholic sense) so it would seem that He has changed his modus operandi since sending a vision to Saint Paul to make him change his ways. Presumably someone who thinks it's OK to give an abortion to a nine year old who has been raped would not be an acceptable witness.

Habitual docility means that the person never questions the Church and always does what their priest or the Pope tells them. Preferably someone too dim or poorly educated to understand Church doctrine in the first place, let alone question it. This may be why holy manifestations tended to be seen by peasants, children and nuns in the past.

Healthy devotion and abundant and constant spiritual fruit

If the vision leads to the faithful becoming more faithful, to doubters being converted and the power of the Catholic Church being extended, then it’s a good vision.

God would never send Mother Mary or a saint down to criticize the Church. That would be a false vision, obviously.

Negative criteria

Doctrinal errors attributed to God himself, or to the Blessed Virgin Mary, or to some saint in their manifestations, taking into account however the possibility that the subject might have added, even unconsciously, purely human elements or some error of the natural order to an authentic supernatural revelation.

If you wake up to find Mary at the foot of your bed or in a cave (she's fond of caves), ask her to explain exactly what the heresy of the Cathars was. Make sure you write it all down to rule out human error. Correct spelling and grammar will score extra points.

Evidence of a search for profit or gain strictly connected to the fact.

Tricky one. Even visions that are certified genuine by the Vatican lead to financial gain – mostly for the Church. But that’s probably OK. What they don’t want is some attention-seeker or shyster taking money from the credulous faithful by selling unauthorized merchandise.

Gravely immoral acts committed by the subject or his or her followers when the fact occurred or in connection with it.

Bit of a no-brainer, this one. Mary Magdelene appearing to a group of people telling them to have an orgy would be a bit of a give-away, especially if she provided them all with condoms.

Psychological disorder or psychopathic tendencies in the subject, that with certainty influenced on the presumed supernatural fact, or psychosis, collective hysteria or other things of this kind.

They've already covered this, the fact it appears again suggests that it's their get-out clause of choice for any vision they don't approve of or can't control. They know that these days saying the vision was caused by the devil wouldn't play as well as it did five hundred years ago so they co-opt science to do their dirty work for them. There are some who would argue that seeing visions is a symptom of mental illness.

It is of course, entirely unreasonable to expect the Vatican to have strict scientific criteria for testing divine visions. However, it’s not unreasonable to expect them to know a few basic facts about human psychology. They do mention human error but only in the context of doctrinal errors, not relating to the whole experience. They don't doubt that visions happen, only whether they are the right sort of visions.

For example, there is the unreliability of witness statements. It has been shown time and time again that even the best intentioned people consistently get it wrong. People also have a tendency to say what they think the tester wants to hear. It could be hard to distinguish between an over-zealous follower and a con artist who'd done their homework, for example.

The human mind sees intention and agency where there is only coincidence and patterns where there are none. Human perception is notoriously unreliable. Who hasn't seen the face of Jesus in a piece of toast?

How is collective hysteria defined? Presumably they mean a lot of people getting worked up about an unapproved apparition - if it's one they like, then bring on the mass pilgrimages with thousands of people 'seeing' the same thing (like Medjugorje) or queuing to be healed (like Lourdes).

People constantly think they see ghosts or other supernatural phenomena, which scientific research explain as having natural causes (eg weeping statues) or as artefacts of the way our minds work. Why should saintly visions be any different, unless the Vatican believes that God somehow helps them discern fact from fiction because they're in closer contact with him than the average punter.

This isn't about being more rigorous or scientific, it's not even about protecting the faithful, it's about control and protecting the brand. The invention of the printing press was bad enough but the twentieth and twenty first centuries have presented the Vatican with a series of increasingly tough challenges. Access to information and speed of communication are a threat to Vatican hegemony; this flawed and risible attempt to wrest back some control will do nothing to disarm that threat.

On the other hand, this could all be part of an elaborate advertising campaign. Think you saw the Virgin Mary? Should have gone to Specsavers.

J'Accuse

Labour MP Keith Vaz has tabled an early day motion calling for more stringent government controls on violent video games. In the motion, he mentions Anders Breivik who shot and killed 69 people in Norway last year and who claimed to have prepared for the attack by playing Call of Duty.

In 2010, Vaz called for clearer rating of violent games after a shooting in Sweden when the game Counter-Strike was implicated and last year he tabled a motion about Call of Duty: Modern Warfare 3 and claimed similarities between game scenes set in the London Underground and terrorist bombings in 2005.

Martin Robbins has neatly demolished Vaz's so-called evidence in his Guardian article.

But Vaz isn't doing anything new. In earlier times, whenever something terrible happened, the devil or other supernatural malignancies were blamed. This lead to all sorts of consequences, from throwing salt over your left shoulder to burning 'witches'.

Some people still blame the devil and there are still exorcisms, sometimes of children, sometimes with fatal consequences. Those of us who consider ourselves more secular and enlightened now often blame technology for the evils of society. I wrote here about social networking destroying the fabric of society, causing a loss of empathy, the destruction of the English language and even suicide - and here about how the internet 'causes' depression.

What all of these accusations have in common is that they place the blame on something outside of ourselves, something Other. No normal human could possibly do something so terrible without some outside influence. We saw the same reasoning (for want of a better word) when the media was full of stories about satanic child abuse. We like our photos of Breivik to look sinister and evil.

We like to think that we are mostly well-behaved animals. We may rob a bank, lie to our nearest and dearest or even stab someone in a pub while watching football on TV. These are considered within the comprehensible parameters of human behaviour. But when there is a large-scale horror or something truly 'inhumane', then we look for an external agency.

Everything humans do is part of human nature, even the actions that revolt or frighten us. Human behaviour doesn't just cover the nobler acts, or even the criminal but understandable ones. If a human does it, it is a human act, not an inhuman or inhumane one.

Not everyone is capable of doing what Breivik did. The problem is that we don't know if we are or not, we fear there may be something lurking within us like a hidden cancer that might one day reveal itself. Some people do terrible things. They may be people we know or people we're related to. They may even be us. There will always be acts that apparently come out of nowhere, too close to home for comfort, that we can't neatly ascribe a cause to. This causes a kind of cognitive dissonance, so we displace our anxieties onto the Other, whether that is a supernatural malign influence or technology - which is something most of us don't really understand and many of us are anxious about even though it was invented by humans.

We also fear threats to our society (real or imagined), which is where some of the internet scares come from, as well as our responses to terrorist activities. We like things to stay comfortably the same but they never do so rather than accept that change is part of life, we blame something or someone for forcing it on us. That could be a change to our society or, just as frightening, a change in the way we think about what it means to be human.

When he blames Call of Duty, Vaz is no different from a Mediaeval peasant blaming the evil eye for making his crops fail. The evil eye could be warded off, games can be banned or heavily regulated, giving an illusion of control and understanding.

Blaming outside agencies or freaks of nature is comforting but we need to grow up and put the comfort blanket aside. If we do blame games for violent actions and suppress or heavily regulate them, then the next time there is an atrocity, we'll have to come up with some other cause, some other thumb-sucking excuse.


I wrote about other aspects of passing the buck onto 'evil' here.

Let's talk about sex, baby

To promote his new book How to think more about sex Alain de Botton took part in a live Q&A on the Guardian website.

I’m no porn evangelist. I’m well aware of the darker side both for people who make it and consumers. But de Botton is being far too paternalistic, simplistic and over-general both about porn and about sex. He makes too many assumptions both about porn users and people who work in porn. Even in the restrictive format of a Q&A, there are some serious flaws in his thinking.

The ultimate point of sex is to escape from an otherwise depressing loneliness to which we're all prone. 
What we call 'sexy' are those moments when we're accepted by someone else, leave behind the cold anonymity of the normal world and end up, for example, licking the inside of someone's mouth.

The ultimate point of sex is reproduction. Even leaving aside the biological/evolutionary motivation, the point of sex for most people is … to have sex. Because it’s fun, not as some sort of salvation or escape. Maybe occasionally, but not always, not ultimately. He may find the ‘normal world’ cold and anonymous, but most people have friends, family and other social networks. And what is the ‘normal’ world? That’s a very loaded term. Many of us would say that sex is a normal part of our world. As for ‘licking the inside of someone's mouth’ – he must be a rubbish snog.

We avoid sex not because it isn’t fun but because its pleasures erode our subsequent capacity to endure the strenuous demands which life places on us.

Who avoids sex for those reasons? He provides no evidence, even anecdotal, for any of his assertions. He’s verging on the moral preaching here – life is about earnest toil and struggle and any distraction from it is to be avoided. Most of us can manage to balance putting the bins out and having sex and we don’t neglect our children or our jobs for sex.

We shouldn't have to choose between being human and being sexual (the Ancient Greeks knew this very well).

The Greeks may not be the best role model, given their treatment of women as second class citizens. He doesn't make any distinction between male and female attitudes to porn or even touch on the serious issue of gender politics and porn/sex/sexuality.

Ideally, porn would excite our lust in contexts which also presented other, elevated sides of human nature – in which people were being witty, for instance, or showing kindness, or working hard or being clever – so that our sexual excitement could bleed into, and enhance our respect for these other elements of a good life.

Something like an episode of Frasier, perhaps. He gives no examples of how we might achieve this. He seems to be suggesting a porn scenario where a kind gentleman helps an old lady across the road on his way to do brain surgery on a small child, then some lovely lady or gentleman (or both) sees him, is inspired by his deeds and they have sex while making sparkling conversation about Proust.

Or perhaps a woman delivers a stirring speech at the UN about human rights and then gets her kit off backstage. Or has sex while making a stirring speech at the UN. And there would be kittens.

For BDSM fans, a domme disciplines a sub while reading from improving literature – something by Monsieur Alain, perhaps.

No longer would sexuality have to be lumped together with stupidity, brutishness, earnestness and exploitation; it could instead be harnessed to what is noblest in us.

Who is doing this apparently obligatory lumping? What is stupid sexuality?

He’s conflating porn and sexuality here, especially by mentioning exploitation, which is a serious flaw. It’s true that there is an exploitative element to some porn but he proposes no solution to that. Someone would still have to make his ideal porn. Or is he proposing that it is made by people with high moral ideals and exquisite good taste who want to inspire us to noble acts? Vicars, maybe? Or philosophers? What is noblest in us, anyway?

As currently constituted, pornography asks that we leave behind our ethics, our aesthetic sense and our intelligence when we contemplate it. Yet it is possible to conceive of a version of pornography which wouldn't force us to make such a stark choice between sex and virtue – a pornography in which sexual desire would be invited to support, rather than permitted to undermine, our higher values.

Do we 'contemplate' porn? His language throughout is prissy and even a bit snooty.

Has he never seen any porn that is aesthetically pleasing? He’s been looking at the wrong sort. And who is he to decide what other people consider aesthetic? How does he think our intelligence might be engaged by porn? Perhaps by having a pop-up with a crossword in it.

Sometimes all we want is down and dirty sex – does that make us bad or inferior people? He veering too close to telling us what is good sex and bad sex and not just setting himself up as a moral authority but also an intellectual and aesthetic judge. Besides, do we really care if the lighting lies like dawn on the hills of Umbria?

Does porn force us to make a choice between sex and virtue? Do we suppress our ‘higher values’ while we watch it or is it just another facet of our lives? Not everyone is deadened or brutalised by using it. He is making far too sweeping a generalization here, implying that the effect of porn is the same on everyone and that we are all at risk of becoming brutish beasts.

What are his higher values? Is it impossible to hold them while also being purely physical for a short time? There’s almost a duality being suggested here between our physical, sexual selves and our ‘better’ selves. Or, as some religious thinkers have put it, our low animal selves and our spiritual selves. The brutish self is to be suppressed or, if possible, destroyed.

Philosophies of sexual liberation appeal mostly to people who don't have anything too destructive or weird that that they wish to do once they have been liberated.

He doesn’t say what he considers destructive or weird but he is assuming too much – does he know what every campaigner or liberation philosopher thinks? It’s only when people feel liberated that they can explore their sexuality and discover what he may consider their weird side.

Pornography, like alcohol and drugs, weakens our ability to endure the kinds of suffering that are necessary for us to direct our lives properly.

He doesn’t appear to think that porn can be part of a balanced life and implies that it’s something we turn to as an escape or a distraction rather than engaging with our problems. Alcohol and drugs may be used as an escape but so may curling up on the sofa with a book and a pack of Jaffa cakes. We’re not children who need to be told how to run our lives, prevented from stuffing ourselves with sweeties rather than eating dull but healthy vegetables. He doesn't talk about weakening our moral fibre but he might as well have.

Some people use porn to enhance their relationships. Some people use it because they can’t have sex, for a whole range of reasons.

In particular, it reduces our capacity to tolerate those two ambiguous goods, anxiety and boredom. Furthermore, pornography weakens our tolerance for the kind of boredom which is vital to give our minds the space in which good ideas can emerge, the sort of creative boredom we experience in a bath or on a long train journey.

People are watching porn in the bath when they could be contemplating their existence? Thinking about life and watching porn, even a lot of porn, are not mutually exclusive. For all he knows, if someone isn’t watching porn they could be playing on their PS3. Why single out porn as a way of avoiding Big Issues?

It is at moments when we feel an irresistible desire to escape from ourselves that we can be sure that there is something important we need to bring to consciousness – and yet it is precisely at such pregnant moments that internet pornography has a habit of exerting its maddening pull, thereby helping us to destroy our future.

Yes, we really should be writing a symphony or a book telling other people how to live their lives to give ourselves a rich future.

His criticism of the easy availability of online porn is close to the wailings and warnings of other people that the internet is destroying our minds/children/civilization.

I would like to see porn that he approves of. He really should put his money where his mouth is and make some rather than just handing down moral imperatives from on high. Show us your money shot, Alain.

Always let your conscience be your guide? Part 4

The Christian Medical Fellowship is at it again. This time, it has gender reassignment surgery in its sights. And just like all the other times, its relationship with facts is non-monogamous.

Dr Peter Saunders of the CMF is claiming that doctors risk disciplinary action if they refuse to carry out gender reassignment surgery. He says this is yet another symptom of how Christian doctors are being marginalised and penalised for their beliefs.

However, the Royal College of Surgeons has confirmed that gender reassignment operations are not something a general surgeon would be expected to do. There are many different kinds of surgery involved and like other areas of specialist surgery they require training. A doctor who had objections wouldn’t elect to be trained in this area in the first place.

So where is the problem? Has Dr Saunders read the story of the boy who cried wolf?

Not surprisingly, the Mail has written Doctors 'forced to carry out sex-change ops' under rules meant to 'marginalise Christian medics'.

They got the story from Dr Saunders’ blog Christian Medical Comment where he claims that ‘Legislation and regulations are being used to marginalise Christian health professionals in Britain. British medicine in the 21st Century now involves practices which many doctors regard as unethical. A significant number of doctors do not wish to be involved in sex-change operations or prescribing contraceptives to unmarried couples.’

He gives no evidence for what this ‘significant number’ might be.

The CMF website says things like

God created each of us in his image, male and female, and he doesn't make mistakes… This issue has tremendous implications for society at large and the institution of marriage in particular… the doctor's duty in treating his/her patients is to restore people to what God originally intended … giving sex change treatment goes beyond this remit.

In his rant blog, Saunders refers to the General Medical Council’s current consultation on personal belief and medical practice, including conscientious objections. Draft guidance says

‘You may choose to opt out of providing a particular procedure because of your personal beliefs and values’ and adds ‘The exception to this is gender reassignment since this procedure is only sought by a particular group of patients (and cannot therefore be subject to a conscientious objection)’.

Gender reassignment surgery has been available on the NHS since 1999 and the Equality Act 2010 prohibits doctors from discriminating against people who are undergoing gender reassignment treatment. So this is not just something the GMC has come up with on a whim, it’s the law.

Although his blog mostly relates to surgery, Saunders also mentions GPs with religious objections who would not currently be allowed to opt out of referring a patient to a specialist or providing related treatments.

It appears that he has not read his own web site. For example, one doctor writes:

I would emphasise that I am no expert in this type of problem and would be happy to refer him to a psychologist to explore his request further.

This may be a fudge to avoid being accused of discrimination but it would ensure that the doctor’s beliefs would not affect the patient. It also means that Saunders does not even represent all CMF members or Christian doctors.

The GMC consultation closes on 13 June. The CMF’s response to the consultation is here.