Penn on crazy

A recent episode of the always-good Penn’s Sunday School podcast, was a recording of a speech given by Penn back in April – you can listen to the whole thing (episode 176) here. Penn’s speech covered a range of topics – politics, show business, art, creativity, science, religion and atheism.

There’s a wonderful section of the speech on passion, science, crazy, and the “collision between the intellectual and the visceral” starting around the 23 minute mark:

“The crazy people have passion, and if you aren’t particularly talented at putting together radio or TV or film… passion is all we live for…

A lot of times I’ll watch people on my side, people who are pro-science and do not believe in the paranormal, or the supernatural, arguing with someone on the other side, who believes that UFOs visited them in the back yard, or that they can bend spoons with their minds, or can read minds, or that their cat can talk to somebody, or there’s stigmata on a statue in their backyard. Every time I have watched one of those arguments, the person who is wrong is always more interesting, the person who is wrong, always has more passion… 

So the whack jobs, the crazy people, the ones who are wrong, speak in these beautiful absolutes, they sound like beat poets, they sound like Allen Ginsberg, they sound like Bob Dylan, with all this beauty, they get answered by someone who is calculated and measured and very very careful…

But you have to be very careful that you still keep your heart in the equation and your heart has to be crazy, and wild and out of its mind and you can still be correct, but you’ve got to yell and you’ve got to cry and you’ve got to scream and say stuff which is half assed, you’ve got to go off half cocked, and you have to be wrong, because that is the thing that shows people you are human…

You’ve got to be crazier than a shit house rat and what I tried to give with all my heart and all my soul, and my mind was to research these topics as carefully as I could, lay everything out with our researchers, make sure that our position was as close to correct as we could possibly get it (we got some things wrong) and go out there like a whack job, like the craziest person you’ve ever seen because I wanted to show people that after I had done the research I still had my heart, and still had the passion, and I still had the crazy. And that is the hardest thing you can do in life, and in art and in show business, is to have the visceral and the intellectual collide as fast as they possibly can, that is the reason that we are alive.” (emphasis added and apologies for any errors in the author’s transcript)

The analogy to health sciences seems obvious – the snake oil sales men and women were always, and continue to be, the most eloquent, the most lyrical and the most persuasive – and these days it is probably easier than ever to hide under a veneer of pseudoscience. With a deafening chorus of quick fixes, miracle cures and dodgy science blowin’ in the wind, a quiet voice of reason is easily drowned out.

But science at large has shown that the intellectual and visceral can collide with spectacular results. A growing number of scientists are sharing knowledge and reason with passion, with heart, and with even just a little bit of crazy. Neil deGrasse Tyson, Lawrence Krauss, Bill Nye, Brian Cox and Karl Kruszelnicki come to mind as modern examples, standing on the shoulders of giants such as Carl Sagan and Richard Feynman.

These days there are an  increasing numbers of health science bloggers, lambasted and ridiculed at times, but leading the way in our neck of the woods by trying to take modern health science to the world with passion and heart. Of course they have biases, and  they don’t always get it right, but give them credit, who else but a ‘crazier-than-a-shit-house-rat whack job’ would decide to work all day in a hospital, clinical or home health care setting, and then spend their nights researching and writing blog posts, and in so doing have their hearts and minds collide in the most public of forums.

 

– Tim Cocks

 

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18 Responses to “Penn on crazy”

  1. EG Physio

    “the person who is wrong is always more interesting, the person who is wrong, always has more passion”.

    Is that so?

    Well, I learned something today.

    Reply
    • timcocks0noi

      Hey EG
      Always exceptions to the ‘rule’ (or the bombastic musings of a juggler) I guess…

      But I think the broader point Penn was making was in regards to debate and argument – and I take his point, I see it every day on the many health science blogs I scan to keep a sense of what’s going on ‘out there’.

      A recent example that has had a bit of ‘airtime’ on the interwebs over the past few days that I’ve been keeping an eye on:

      1. Two physios, active in social media, publish a Viewpoint piece in the American PT Association publication PT in Motion on acupuncture (full disclosure – I haven’t read it as it’s behind a member paywall) in which they critique the *work* a vocal advocate of acupuncture/dry needling – Dr James Dunning.

      2. Dr Dunning responds via a blog post here – https://osteopractor.wordpress.com/2015/08/07/effectiveness-of-acupuncture-for-pain-management-and-knee-osteoarthritis-the-evidence/ with absolute confidence that acupuncture/DN works, without a doubt and lists all the amazing effects of sticking needles in people including
      – eliciting localized twitch responses to reduce pain and inflammation in the short-term
      – activating opioid-based pain reduction that is mediated by endogenous cannabinoids and the sympathetic nervous system
      -activating non-opioid pain relief via serotonin and norepinephrine pathways in the brain stem
      – triggering the HPA-axis centrally and the CRH-POMC-corticosteroid axis locally inhibit cox-2 and reduce inflammatory cytokines.
      (all fully referenced but never is the question as to whether any number of other interventions all have the same effect, is considered)

      And further confidently claims that acupuncture has been shown to be effective for for reducing pain and disability in patients with-
      -knee osteoarthritis
      -hip osteoarthritis
      -piriformis syndrome (whatever that is)
      -carpal tunnel syndrome
      -migraines
      -tension type headaches
      -temporomandibular disorder
      -shoulder pain
      -neck pain
      -low back pain
      -plantar fasciitis
      (is there anything it can’t fix!!)

      And of course there is the as-hominen attacks on the authors-
      “To our knowledge, Venere and Ridgeway have no formal training in acupuncture, would not be considered as academic or clinical experts in the use of acupuncture for the treatment of pain and disability in musculoskeletal conditions—i.e. they work in home health and acute care settings, respectively—and have yet to publish a single article in a peer-reviewed journal on the topic.”

      3. The original authors respond with a measured, very thorough response and deconstruction, admirable in its constraint and reasoned tone here – http://physiologicalpt.com/2015/08/09/needle-in-the-hay/

      “Dunning et al write that the “the purpose of this article is to directly respond to these claims in a public forum”, however after reading their reply it would seem their idea of directly responding to the claims in our article are to craft an argument from authority, attempt to demonstrate proof by verbosity, mischaracterize the points we made and to shift the goal posts away from the actual acupuncture data towards ad hominem attacks on our personal and professional credibility. We see no part of Dunning et al’s reply that adequately addresses the crux of our PT in Motion article — The fact that Dunning et al misrepresented the findings of the Manheimer (2010) and Vickers (2012) systematic reviews, which include many of the trials Dunning et al cite in their original article and their recent blog post.”

      I contend that if you were to ask an individual to read both pieces of writing, a majority would be swayed by Dr Dunnings piece given the absolutist, declarative statements, the arguments from authority and seeming avalanche of evidence provided as irrefutable fact.

      I have no doubt that Kenny Venere and Kyle Ridgeway have bucket loads of passion for their profession (they no doubt fit the category of “crazier-than-a-shit-house-rat whack job” – meant with only absolute admiration and respect), but reasoned scientific writing just doesn’t always grab you by the balls and take you for a ride (to borrow some of Penn’s style).

      I think that was Penn’s point – at least that’s how i understand it.

      Thanks as always for stopping by and taking the time to comment (glad we are edumacating you ;)
      Tim

      Reply
    • timcocks0noi

      Thanks David
      You’ve long advocated introducing some passion and ‘heart’ into therapy, here on our little blog and elsewhere. It’s a challenge to the profession for sure – have you read (don’t bother…) some of the latest texts on ‘clinical reasoning’ – absolutely boring as batshit and as cold and clinical as a forensic pathologist’s table….
      TC
      Trying to keep the rabble in line at HQ

      Reply
  2. davidbutler0noi

    Hi Tim,

    Your post really resonated with me (and I note it was retweeted by Penn). As he says “it is the hardest thing to do, to have the visceral and the intellectual collide.” I humbly try my best, but I will admit that teaching a course leaves me exhausted for days and a keynote talk will take me about 40 hours of planning to try and get the visceral and science blend right. Penn’s thoughts really help.

    Go the bloggers! We need more of them.

    David

    Reply
  3. Gerry Daly

    Some tentative validation there, in the direction of the ‘ bloggers’ who are attracted to joining in the discussions with little threat of reputational downsides, or little impact on ‘hands on’ application. I don’t think there should be any doubt that those who are involved in the day to day application of treatments should have their opinions at the top of the hierarchy of options before any consideration of alternative concepts. But, it’s good to see it’s not a closed book, and there’s room to consider less mainstream ideas. With some puzzling issues, it’s maybe all about seeking a consensus of opinion, before settling on definitive means to move things forward, rather than settling on incomplete arguments to underpin the need to be doing something positive.

    There’s little harm, and perhaps some good, to continuing debates in the background, when definitions and concepts lack certainty. A broader range of input can be useful there, ensuring little is overlooked. An open door approach to new ideas indicates a ‘sense of realism’ within the ranks to not assume that everything is cut and dried, and that’s appreciated. The subject matters being discussed, alone, are usually enough to deflect any snake oil peddlers….and keep the quest relevant.

    Reply
  4. EG Physio

    The difficult thing about Physio is that if you investigate a little, you very quickly come into contact with Psychology. If you dig a litte deeper, you come in contact with Philosophy. If you dig any further there’s a risk of getting ensnared in thought loops. I feel like I can negotiate that terrain safely, however the need to completely switch off the mind and act from the heart provides an essential balance. Without that, there’s a risk of ending up like Nietzsche. He was aboslutely brilliant except for his inability to move from the heart, and he ended up his life in an asylum.

    Physio is a profession so full of bullshit that it actually takes me an effort *not* to speak up. The main reason I contribute here is that I have this compulsion to take to untruths and destroy them. I cannot stand the bullshit. The other reason is that I enjoy writing; for me it’s a SIM. Boosts my ego. Makes me feel smart.

    Precise and logical thinking requires a huge amount of energy, which is why most don’t do it. Then again, such thinking is not necessary in life. Most people go through life quite happily without having a single deep thought, and that in itself is worth remembering.

    To properly act from the heart requires that the mind switch off. This is what I do when I paint. Painting cannot be done using the mind. The brush must be moved by something other than thought if the work is to have any value whatsoever. Physio is the same. Makes me think of Dorko’s work on ideomotion. Ideomotion is deeply congruent movement. Ideomotion is moving from the heart.

    Reply
    • timcocks0noi

      Hey again EG
      Are you sure that there is such a rigid dichotomy between heart and mind – that one has to be switched off for the other to function?

      Is it possible to have intellectual art that has value? What about artistic “intellectualising” (for want of a better term)? Why can’t creativity, art, wonder, intellectual thought, analytical mind, and movement all emerge from a human being together, at the same time? Some forms of Dance come to mind, design as well…

      Reply
      • EG Physio

        Hey Tim,

        I get the feeling you want me to stop making bold statements on here.

        Am I sure? I could quote many creative geniuses on the way inspiration comes in moments of reverie and departure from the mind, but I don’t think it would satisfy. It’s true in my own experience, but I can’t prove that to you.

        The mind is primarily concerned with betterment and survival. The desire for betterment/survival belies the fear of inadequacy/death – it can’t be otherwise. So when the mind interferes with anything, it has to carry some of that ugliness. If the mind interferes with art, then you get something like Ken Done’s work. Ughhhh! When the mind is silent, you get something like Vermeer’s work. Having said that, it’s the individual who ascribes value, and wherever you see value…. well, there’s value. But there’s levels, you know? I don’t know how to say that and not sound snobby.

        “Why can’t creativity, art, wonder, intellectual thought, analytical mind, and movement all emerge from a human being together, at the same time?”

        I’m sure they can emerge together in fully actualized people, but for the other 99.9999999% of the population, the mind seems to provide nothing but interference. It’s the not the mind per se, but the fact that the mind has certain survival/betterment themes that it struggles to let go of.

        Like this post of mine – does it have value? I’d say it has a value to me, but the value to you and others would be negligible. Really, I’m under no illusions that anything I write, however insightful, will be valued by anyone. If I write from that *other* place (which I was planning to do before I forgot!), then it would be quite a different matter. If I wrote with warmth, compassion and kindness, the response would be very different.

        So here, we’re at odds. I say one thing, you say another, and there is ABSOLUTELY no way that my argument here will convince you to abandon your position. Just… none. And you would probably say the same about me. So where’s the value in intellectual debate? Really… is there any at all?

        Reply
  5. EG Physio

    I remember learning some dance moves at EP3. I remember thinking “Why have I been grinding away on intellectual pursuits for 3 days straight when I could have been doing this?? This is much more fun!”

    The best part was seeing Dave and Lorimer getting into it. A scientist who can’t dance (or is unwilling to try) is probably stuck in intellectual mode, and therefore lacking flexibility and creativity. To push the limits of the heart and mind takes courage. The heart more so.

    Here’s a nice quote from Osho on this subject:

    “You are in a good space. If the mind is saying, ‘I don’t know’, the mind is closing up shop. And here, when the mind closes the shop, immediately the doors of your heart start opening. They are two sides of the same coin. That’s why when you hear me contradicting myself, you have a good laugh”.

    Maybe I’ll step out of intellectual mode when I post here and give everyone a break! : ) Just for a change.

    Reply
    • timcocks0noi

      Perhaps it’s just semantics, but for me the notion that the mind closes shop for the heart to open feels too dualistic – too either / or. The suggestion that heart and mind have to contradict one another also doesn’t fly for me.

      When I watch heroes of mine such as Christopher Hitchens, Neil deGrasse Tyson, or Brian Cox argue highly intellectual points with absolute passion and heart I don’t think their minds have shut up shop for their hearts to open.

      Neil deGrasse Tyson has a great line about changing your mind – something along the lines of “It’s ok to completely change your mind in the face of new evidence”. To some this might appear as contradiction but it also reminds me of the words of Emerson “a foolish consistency is the hobgoblin of a small mind”. Contradiction doesn’t necessarily have to come from a heart/mind dichotomy – can’t both be fully invested in an idea and both change in the presence of new evidence?

      Finally, I always sense a great deal of heart and passion in your comments here, as well as reason and deeply considered thought – perhaps your own writing here is a contradiction to Osho’s thoughts?

      Thanks as always for sharing your heart and mind here
      Tim

      Reply
      • EG Physio

        Tim, I gotta tell you that the only thing I’ve shared on NOIJAM is my mind!

        Passion is of the mind – it’s an ego thing, and as much as I try to keep it out of my posts, something will invariably trigger me… some inane comment or useless research project! But passion – yeh, any fool can do passion. I use it because it gets me noticed, and that goes back to your first point – so I concur, in part.

        Anything heart-felt will carry a very different vibe to passion. You know this!! Whereas passion tends to stir adrenaline and cognition, heart stuff quiets the mind and makes the heart relax. As a diagnostic criterion, heart stuff can be known by the way it makes the girls sing: awwwww…that’s so sweeeeeet! My posting doesn’t attract that response, but I’ll try a new approach and see how we go.

        Reply
  6. timcocks0noi

    Hey EG

    “I get the feeling you want me to stop making bold statements on here.”
    Au contraire. With bold statements I know exactly where you stand. You know where I stand and something interesting can follow.

    Have you seen Tim’s Vermeer? (http://www.imdb.com/title/tt3089388/) Interesting that you raise Vermeer as Penn made this film about inventor Tim Jenison’s attempt to recreate Vermeers process and results…

    I suspect much of wht we potentially disagree on is the meaning of certain words – mind, heart, passion to name a few. Wittgenstein tried to sort this out a long time ago, I’m not sure if he did.

    “So here, we’re at odds. I say one thing, you say another, and there is ABSOLUTELY no way that my argument here will convince you to abandon your position. Just… none. And you would probably say the same about me. So where’s the value in intellectual debate? Really… is there any at all?”

    I reckon it depends on the intention of the debate – is it to change the other’s mind (heart??)? Or is the intention to learn. I think we can absolutley disagree, and neither move any closer to the pother position (or maybe we do) but in debating, in thinking, at least for me, there is a sharpening of thought, as well as a stretching of thought to new shapes, and learning. I didn’t who or what Oshow was/is, I had to look it up – I learnt something, will I ever use it – I don’t know, but even so I think I’m the better for learning it.

    Please don’t change anything on account of any of my rambling response – unless you want to.
    Stay bold
    Tim

    Reply
  7. davidboltononoi

    Sitting at the supper table this evening here in Sardenia Papa added to a discussion that “If you never believe the Saint” you will never “See the Miracle” How true is that and there lies the dilemma……..
    We need the intellect AND the passion to captivate our patient and help them to believe the Saint – knowledge. Without the belief they will never experience the miracle – the possibility to TREAT chronic pain. If the head and the heart can’t work in unison we will struggle to pass on our knowledge and the patient will never see the change that knowledge can bring about ……..let’s not let dualism back in please !!!!!!!!!
    DB
    On location 😎👼⛪️

    Reply
  8. davidboltononoi

    I was once married to a psychotherapist…….
    One day when I asked “Can you pass the salt please” she replied “Why?” I realised , then that I was on a losing wicket……..
    Intellectual mastibation -spiritual flight – leads to a place where the head and soul divide and dualism returns ……….
    DB
    On location 🙈🙉🙊

    Reply
  9. kridgeway

    Tim,

    I much appreciate your post generally, and your mentioning of recent “discussions” specifically.

    I struggle consistently when writing and speaking on how to balance the hedging of scientific doubt with the power of harnessing the emotional, the visceral, and the personal. How to balance data and story telling?

    Speaking, it’s my sense, is a better medium for the blend. My favorite is quotes, especially by patients, interjected throughout a presentation. As well as the creation of a story line that is narrated by the knowledge we attain via data (and other means) as well as the emotive connection of the personal narrative (patient, provider, etc).

    Thanks for a thought provoking piece and topic.

    Another discussion relating to the debate you cited:
    http://ptthinktank.com/2015/08/03/what-are-the-issues-with-therapeutic-or-trigger-point-dry-needling-9-considerations-to-ponder/

    Cheers.

    Reply
    • timcocks0noi

      Thanks Kyle
      As it happened, I was listening again to Penn’s speech, thinking of an idea for a post and reading your’s and Kenny’s piece all at about the same time and thought it was a perfect example of those who are wrong spouting all kinds of crazy in the face of reasoned argument. Looking back a little while later, I hoped that my comments didn’t come across as somehow critical, as somehow suggesting that your writing wasn’t interesting, because I think we need really high quality, referenced, researched, concise, no-bullshit scientific writing from passionate people.

      Thanks for dropping by and taking the time to comment.
      My best
      Tim

      Reply
  10. kridgeway

    Tim,

    Not at all, I found your points quite salient in fact. I’d agree we need well referenced logical pieces. A question I often ponder is “can we deliver it in a more lively way?” Still have the science, still have the references, the strong reasoning, but give it that stickiness and reader appeal. Again, a tough task.

    I listened to the podcast a few times and in conjunction with your post I’ve thought and learned much that I hope to use later!

    I reflected on the need for debate and dissent:
    http://ptthinktank.com/2015/09/05/debate-and-dissent-do-we-need-contrarians/

    Thanks again!

    Reply

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