Author: akshay

It was just yesterday that I read a book on behaviour change through positive reinforcement. Today I put aside all work and read another book: How to Talk with People: A Program for Preventing Troubles that come when People Talk Together by Irving J. Lee. It was recommended by Parth Sharma in response to my sharing Marshall Rosenberg’s video on nonviolent communication in my WhatsApp status with this note: “This is an old video on nonviolent communication. It’s been instrumental in my first steps towards using language carefully.”

Language has always been a problem for me. More specifically, language used in interacting with people. That is, talking with people has been a problem for me. In my extended family I was the “adhikaprasangi” (a word that’s surprisingly common in Kannada and Malayalam — meaning “the quality of having too high an opinion of your own importance, and being too eager to tell people what to do”). In school I used to get into quarrels with teachers. In internet forums people have gotten so angry at me that I’m used to writing “I apologize profusely”. Even many of my close friends have sometimes felt I’m rude.

There are people on twitter I know who proudly wear such attitude and continue to be assholes. But I’m in no way indebted to my past. And so, I keep looking for ways to improve the way I interact with people. The challenge, though, is that I don’t buy the “respect” argument. I consider it dishonest to use language to show fake respect. At the same time I have seen excellent videos like “The Art of Semantics” and the nonviolence communication one above which all talk about using language to move towards a better world. So the missing link for me was the logic that connects respectful expression with social justice.

And that logic clicked in my head when observing people I care about disagreeing with each other on the wrong things. In some occasions I was also involved, in some I was passively observing. Either way, it has become a felt need for me — using language for productive communication and getting our acts together for social justice. On Monday, I had a conversation with Akshay who is part of a very well run organization and whose experience I trust and admire. He also convinced me that using the right words is worth it.

And that’s where this book comes in. How to talk with people.

About three-quarters of it had become clear to me through my own life experience even before reading this book. But a well-written book validating our experiences is immensely valuable to our learning. And in that way, this book is a must read. It also means I have one less book to write myself. I’m thankful for this book’s existence.

The first chapter itself summarizes all the different problems we have in our conversations and what to do about them. It is a very great tl;dr for this book. But the whole book is around 134 pages and you can read it in one evening (at least with speed reading). I will quote from the first chapter to pique your interest.

So as to indicate something of the scope and character of what is involved in this interest, the major findings and suggestions are here summarized.

1. Misunderstanding results when one man assumes that another uses words just as he does. People are so eager to reply that they rarely do enough inquiring. They believe so surely (and wrongly) that words have meaning in themselves that they hardly ever wonder what the speaker means when he uses them.

Suggestion: Committee members need exercises in listening. They must learn not how to define terms but how to ask others what they are intending to say. Our advice: Don’t blame the speaker alone for the misunderstanding. The listener is involved, too. It takes two to make communication.

2. Trouble comes when somebody contradicts somebody else without seeing what the first man was talking about. The speaker says, “You can’t trust the Abibs.” The listener says, “Yes, you can.” Then they go at it. When the Speaker was asked to specify, he told about Samo and Har and Myri. And, of course, they were untrustworthy. When the listener specified, he told about Mil and Janx and Car. And without a doubt they could be trusted. If the contradictor had asked first, the contradictee might not have had his feelings hurt.And the committee might have come to conclusions without that waste of time. The trouble mounts when nobody bothers about specifying. 

Suggestion: Both leaders and members need to learn how to spot temperature-raising contradictions. They must ask, ever so politely: Are you differing on the details or on the conclusion? Does your generalization refer to what his does?

[…]

 

And so on it goes till 14 points. Each one putting into words the troubles that we see around us all the time. It makes a fun read for those who are tired of the debates on twitter.

The only disappointment I have with this book is that it assumes the presence of a leader to solve many of these issues. The frustration I have with all the groups I mentioned above are that there is no clear leadership structure. Perhaps this book thereby unearths a critical challenge that anarchist systems face. Perhaps my disappointment is for me to resolve.

Nevertheless, the leadership traits that are written about in chapter XIV (On Preserving Human Warmth) was particularly useful. It talks about our own leadership styles. There is The Director (like a movie director), The Councilor (an egalitarian participant), The Parliamentarian (the one with the “the Rules of Order” at their elbow), The Quiet One (who is just there), The Good Host (who sets positive mood), and The Chief Clerk (who’s the guardian of the group’s virtue). It was quite fascinating to see various people I interact with and myself showing many of these traits in many meetings.

The book is from 1952. The language of “man”, “him”, “his” is quite striking. At the same time, it is very interesting to note that many of the problems that we see today where exactly the same then as well. In a meta way, therefore, this book teaches more than what it talks about.

A modern counterpart of this book might be Adam Grant’s Think Again. But unlike Think Again, HTTWP is focused more on the practical methods of the conversation than about the larger reasons behind it. It might be good to read this book after Think Again if you’re planning to read both.

Over the course of my life a realization slowly dawned on me about feedback. Negative feedback rarely worked. And positive feedback worked magically!

I started noticing this in myself first. I was learning rapidly and growing in environments where all I received was positive feedback. And wherever people were very cynical, I was just lost in thoughts and not growing.

Then I took this observation seriously and did experiments. In JeevaRaksha trainings, for example, instead of giving the recommended “sandwich feedback” (in which you start with a positive feedback, then talk about something to be improved, and then wrap up with another praise) I switched to a “positive-only feedback” technique. And it worked well. People who were not very confident as trainers and made a lot of mistakes where becoming very confident and trying really hard and staying on as trainers. Over time they fixed their mistakes on their own.

I have to admit that I was very hesitant to do this. I used to think I was “lying”. When other people did this to me I considered them “manipulative”. And I used to pride myself on being very balanced with my views — talking about positives and negatives — sometimes even balancing others’ positive views by talking more about negatives.

And I still find it insincere when people are just praising an act in general without being specific on why they are praising it. “Great job”, “Great news”, “Fantastic” — all of this sounds insincere to me.

And therefore I wasn’t sure about what this observation-experiment-result meant. That all changed today.

I was watching videos of button pressing dogs and then a response video by KP, in which KP recommended this book called “Don’t Shoot the Dog”. That book confirmed everything I was vaguely thinking about feedback.

It is written by Karen Pryor who used to train dolphins. The thing about dolphins is that it is really hard to punish dolphins. If you try to do anything, the dolphins will just swim away. So, to get dolphins to change their behaviour and do something that you want it to do, your only option is to give them fish. Reward. Positive feedback is all you have with dolphins.

This, apparently, works very well for dolphins. And dogs. And cats. And all kinds of animals. Including humans. Including adult humans.

In fact, the book makes no distinction between dogs and humans in its chapters. It gives you lessons on positive reinforcements, shaping, negative reinforcements, and a lot of theory on how to think about all this. Including on why this is not “manipulation”.

I won’t spoil the whole book, but it basically says that positive reinforcements are much better than punishments. It forces you to switch away from the “traditional” training style of shouting at people or punishing them, and move to a style that actually works.

The book was written much before “like” buttons were invented. But, if you read it carefully you can see that it explains much of how technology has been shaped to harness this kind of “manipulation” as well.

If you are a “manager” of anything, or a parent, or a pet-owner, you should read this book. In general, if you want to change others’ behaviour, this is a must-read.

It blends well with a theory of anarchic organizations which I’m developing. I think a theory on semantics which I want to start experimenting with will also connect. Those will be future posts.

Yesterday in a journal club at SOCHARA, we were faced with many challenging classification questions.

The paper we were discussing was titled “Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17)“. The second classification question was in the title. What is a “metabolic NCD”? Are there non-metabolic NCDs? The paper was only discussing diabetes and pre-diabetes, hypertension, obesity, and dyslipidaemia. What about things like stroke? MI? Cancer? Does the paper mean that these are not metabolic?

My explanation was that the study started out as a diabetes study, but expanded to others, and, to fit the word restrictions that journal format puts out, they came up with a word called “metabolic NCD” to refer to the subset of NCDs that were studied.

I searched on google scholar for any other reference to metabolic NCD and couldn’t find any other place where such a classification was being made. But on the WHO website, they classify the risk factors into two:

Modifiable behaviours, such as tobacco use, unhealthy diets, physical inactivity, and the harmful use of alcohol, all increase the risk of dying from an NCD.

Metabolic risk factors contribute to four key metabolic changes that increase the risk of NCDs: raised blood pressure; overweight/obesity; hyperglycemia (high blood glucose levels); and hyperlipidemia (high levels of fat in the blood). In terms of attributable deaths, the leading metabolic risk factor is elevated blood pressure, followed by raised blood glucose and overweight and obesity.

This language is repeated in Table 2 of the paper too where it refers to the prevalences of diabetes, prediabetes, hypertension, etc as: “Weighted prevalence of cardiometabolic risk factors among the study population”

What becomes clear is that categorizing NCDs into binary categories (like metabolic, not metabolic) is next to impossible. After all, nature doesn’t fit into neat categories. Every disease has metabolic risk factors. Every disease has behavioural risk factors. All things contribute to a disease to varying degrees. Rather than categorizing, it is better to think about how much the contribution of each is.

The next discussion was on the BMI cut-off used. In Europeans, only BMI above 30 is considered obesity, with BMI between 25 and 30 considered only as “overweight”. But WHO Asia-Pacific region recommendation based on studies from China, Singapore, India, etc is that cutoff 25 and above should be “obesity” in India. Above 23 can be considered overweight.

It was unclear why the cutoff of overweight could not have been used in this survey. At least, like “prediabetes” is quantified in the study, overweight could be quantified too such that we can anticipate an increase in obesity in the future.

Similarly for abdominal obesity, waist circumference of 90 cm above for “males” and 80cm above for “females” were used.

All these cut-offs are creating binary categories. The challenge with binary categories is that it does not account for the differences between people. By using different cut-offs you can account for some differences. (Like they account for race and sex above). But, those are not the only differences.

(more…)

For plenty of reasons, Ambedkar never considered Gandhi as “Mahatma”. And “naturally”, Gandhi rarely understood Ambedkar. In my experience of understanding how my privileges influence how I act, I believe that I’ve been able to appreciate where the difference between Ambedkar and Gandhi arise from. This is perhaps obvious to many scholars. But it was a shower-thought for me.

Gandhi comes from privilege. Gandhi’s thoughts and ideas are all related to those privileges. That Gandhi chooses to wear lungi is because Gandhi wants to shun those privileges to be able to be able to feel right. I had/have the same thought process when it comes to clothing. I don’t like dressing up smart. Because I think from the privileged position of Gandhi. For me, losing my privilege is what gives me mental satisfaction. 

When mfc was organizing the annual meeting on discrimination in healthcare, there was this debate on whether to put “Dr” prefix on people’s names. The philosophy that drives mfc is mostly Gandhian. They consider calling each other by first name and stripping titles as natural. I also think like this. I never put “Dr” next to my name. Shunning privileges.

In another group, in Dalit History Month, there was a poster shared about an event related to remembering Ambedkar. It referred to Ambedkar as “B. R. Ambedkar” and not as “Dr. B. R. Ambedkar”. And some people rightly pointed out how stripping Ambedkar of the “Dr” title is a deliberate act. Ambedkar has to be referred to as “Dr”. And Ambedkar will always appear well dressed with a suit and a tie. These are revolutionary acts with immense meaning to Dalits.

When there is no privilege to shun, what point is shunning privilege going to make?

The same philosophy appears in a few other places too. At the mfc meet Anoop Kumar spoke about their life journey and gave incredible examples on how to change things for Dalits. Among the questions posed was a mediocre one as to what his thoughts on “Dalit Capitalism” were. Anoop brushed the question aside saying how not every battle can be fought at once and how Dalits should also get a chance to oppress now — obviously exposing the caste insensitive framing of the question.

On the next day, the moderator of the concluding session, out of nowhere, made a comment saying how they disagreed with Anoop’s point. And Gandhi was quoted for assistance — “An eye for an eye will leave everyone blind.” Setting aside the fact that this was a misrepresented position being argued against, one can look critically at non-violence as Gandhi professed.

Fasting, one of the most used “weapons” of Gandhi, makes no sense to people who are already starving. Imagine people being denied PDS through Aadhaar going on a fast unto death! They’re already starving to death. In non-violent methods, essentially, one can see people with privilege converting the every day violence faced by others into a method of protest.

Non-violence also requires infinite tolerance of the status quo. If you’re frustrated with the way things are and lash out, that’s not Gandhian. If you are tired of the bullshit and call out the crap, you’re being violent. Again, the methods of patience are easier for those who aren’t mentally or physically affected by the problems.

Ambedkar and Gandhi could never have been friends. Because Gandhi spoke the language of privilege. And Ambedkar spoke from the lived experience of oppression. If Gandhi would acknowledge privileges and own up the influence of those in the Gandhian methods, Ambedkar might have been okay to be friends. But Gandhi’s insensitivity towards caste would never make that possible. And neither would Ambedkar’s methods be okay for Gandhi. And that’s why they couldn’t have been friends. Because of Gandhi’s ignorance.

I have read only one book of Gandhi – “My Experiments with Truth“. I read this when I was 13 or 14. I haven’t re-read the book after that. But Gandhi’s thoughts influences me to this day.

“I have nothing new to teach the world. Truth and Non-violence are as old as the hills.”

Today Gandhi is remembered whenever there is violence. Gandhi is used as a symbol of peace and love. We remember Gandhi mostly for non-violence.

But Gandhi’s life was devoted to truth. Truth is a very important (if not the most important) message from Gandhi. “Devotion to this Truth is the sole justification for our existence. All our activities should be centered in Truth. Truth should be the very breath of our life.” wrote Gandhi.

Gandhi teaches us that truth has great power. And in this post I will draw a direct connection between the power of truth and how a culture of dishonesty is ailing our society.

***

Sonali Vaid had posted a thread with tips for people starting off in a public health career. The points 6 & 7 are especially illustrative of how many of us stray away from truth in our daily lives.

7. We can be polite & respectful without being deferential. You don’t have to put yourself down – even if its someone senior.
On the flip side some tend to disrespect boundaries if someone is friendly & not imposing seniority – don’t be this person!

— Dr. Sonali Vaid (@SonaliVaid) March 21, 2023

If I were an academic sociologist, I would do a paper on this topic connecting how the misguided Indian notion of “respect” is at the root of all things evil in India. Here is what happens. At a very young age, Indians are indoctrinated into “respecting” various things including elders, religious stuff, ancient stuff, and in general anything and everything. Now, there are two kinds of respect. There is the actual respect defined in dictionary as “A feeling of appreciative, often deferential regard; esteem” which is a deep emotion. And then there is a fake respect which is an act of showing someone “respect” by calling them honorific titles (like “sir”, “madam”) or by bending in front of them, touching their feet, etc. When young Indians are forced to “respect” people whom they do not respect in reality, they imbibe and internalize the fake respect. They touch the feet of the old relative while hating them. They call the teacher they hate “sir” or “ma’am”. They go to the religious institutions without knowing why. 

This causes Indians to be greatly separated from truth in three very dangerous ways:

1) They learn to ignore their feelings
2) They learn to lie through their teeth
3) They learn that truth does not matter

When one learns to ignore their feelings, they can no longer be struck by conscience.
When one learns to lie, it becomes easier for them to cover-up the truth.
When one learns that the truth does not matter, truth dies.

This affects us in every single field.

India’s elite scientific institutions engage in scientific fraud (and retract papers when caught). Nobody keeps these institutions accountable for the sub-standard work they do. And truth doesn’t matter.

India’s health system is not interested in Indian’s health. Hospitals are the most violent places. Nobody keeps our healthcare system accountable for poor quality healthcare. And truth doesn’t matter.

Judiciary, engineering, social science, film industry, sports, infrastructure, urban planning, environment, finance, … Take any field. Truth doesn’t matter.

Every Indian knows that Adani is just the most successful among businesses that do the same kind of unfair business practices in India. Everyone knows that there is a great deal of corruption in Indian politics and money is made by corrupt politicians and bureaucrats in various corrupted ways. Everyone knows that Indians are lying. And we gladly join the lie. Because truth doesn’t matter.

And it all starts with us learning to lie by showing “respect” to people.

***

It is possible to reverse this dishonesty in our individual lives. We need to follow just one principle:

A radical commitment to truth

Truth is very much misunderstood. What is truth? Is it something written down somewhere? Is it the same for everyone? Are there multiple truths?

Gandhi can be helpful here too: “WHAT…is Truth? A difficult question; but I have solved it for myself by saying that it is what the voice within tells you”

I concur with Gandhi on this. Truth is a very personal thing. Truth is when your thoughts, your speech, and your action are in 100% agreement with each other. Truth is when you don’t lie.

Let me make it more practical. A radical commitment to truth requires the following:
1) Being in touch with your emotions and feelings, and showing commitment to try to label them accurately.
2) A commitment to yourself to not invalidate your own feelings. To not act in ways that go against your feelings.
3) A commitment to follow-up on things that you are uncertain of – so that you can arrive at the truth.

We often fail in all the three.

When we feel sad or annoyed, but don’t recognize that we are so, we are being out of touch with our emotions.

When we tell ourselves that we should be grateful while we’re actually disappointed, or when we act calm while we are furious, we are invalidating our feelings.

When we are uncertain of what our inner voice is telling us and we give up on reflecting, without experimenting to understand the truth – we’re breaking our commitment towards truth.

Psychotherapy often helps with 1 & 2 above. It helps us to label our feelings. And it trains us not to invalidate our feelings. Although the very act of therapy can be a pursuit of truth, point 3 is deeper than that. A commitment to follow-up on things that we are uncertain of – is essentially about what we do with our lives. It is about deeply engaging with questions and finding “truth” through our engagement. 

Gandhi did this through politics. “To see the universal and all-pervading spirit of Truth face to face one must be able to love the meanest of creation as oneself. And a man who aspires after that cannot afford to keep out of any field of life. That is why my devotion to Truth has drawn me into the field of politics; and I can say without the slightest hesitation, and yet in all humility, that those who say that religion has nothing to do with politics do not know what religion means”

It is why I’m committed to interdisciplinarity and generalism. If you’re drawn to truth, you can no longer visualize the world in isolated subjects and topics. The curiosity will make you read, listen, travel, experience, and understand people. The commitment will make you a truth-seeker, a “scientist”, it will make you devise your own methodologies. The positive energy of truth-seeking will force you to build, create, teach, write, and share.

Truth is as spiritual as it is science. It is as abstract as it is real. It is as hard as it is simple.

It takes nothing to start seeking truth, it takes everything to start seeking truth.

I first saw this book in the Internet Freedom Foundation thread on which books people there were reading. Then I saw it on Scott Young’s blog which I have been following since childhood. I never got around to reading it till yesterday when I got into a 19 hour train ride to reach Sevagram for medico friend circle’s annual meeting.

There was no better time to read the book because mfc’s meeting this year is on caste; caste is one of those sociological phenomenons that defy common sense thinking every day; and this book is about “how common sense fails us” and why sociology is not  merely common sense.

What Duncan Watts has done is write a book specifically for a particular niche of people. This niche includes those people who become so used to straightforward deterministic sciences that they start seeing the limitations of it and look at larger and more comprehensive studies of human kind. Duncan went from learning physics to becoming a sociologist. This is exactly the route that Nihal is taking (from law to policy). And the route I’m taking from medicine to history. And the biggest issue that we face when we take this route is this unprecedented predominance of uncertainty.

That sociology is more complicated than rocket science. That there are no grand rules waiting to be discovered which will solve all questions. That there are no silver bullets. This is a hard realization. Not one that’s impossible. With enough interdisciplinary exploration and generalization people like Nihal and I do discover that the world is full of uncertainties. But it’s just so difficult to settle for that. “It feels wrong”. 

And this book makes it feel right. Well, not exactly. But at least it makes it a palatable truth that the world is extremely complicated. It also protects us from common sense thinking that makes us settle for simplistic explanations that push us into silver bullet solutions. This book, you must read, if you have asked this question “What on earth does a sociologist do?” Once you read it, you’ll feel like the contents of the book itself is obvious. And that’s the whole point of the book. Everything is obvious, once you know the answers.