The Good Stuff, Episode One
Video at: https://youtu.be/NMH_d8tMiEw
Andy: Welcome to the Good Stuff, with me Andy Farnell...
Kate: ...and me, Kate Brown.
Andy: Kate is a attachment based psychoanalytical psychotherapist from the UKCP...
Kate: And you are a computer scientist specializing in ...
Andy: You can say Andy is a computer scientist with a very big beard
Kate: Yes, an enormous beard, people! You should see it! It's enormous! It's huge.
Andy: It's getting there.
Kate: You are channeling your inner Father Christmas right now.
Andy: I've got my lock-down beard.
Kate: So, Dan has asked us to talk about immunity passports and I want to set the parameters of what I'm able to talk about with some knowledge, and what I'm not able to talk about with much knowledge.
I'm not an immunologist so I don't know about the research that would govern the idea of immunity passports.
I'm also not a computer scientist who understands how such a plan would be implemented and I'm rather reliant on on your expertise in that area.
I think the reason why Dan has asked me to be here this evening and to talk and think about a wider issue of immunity is because what is likely to be the case is that very strong unconscious feelings will be behind the current social discourse about immunity, and whether immunity passports are a good thing or a bad thing.
Andy: I guess we could both go through an almost endless list of things that we are not experts on...
Kate: I think it's particularly important right now, given the fact that what has really characterized a discussion about the current Covid-19 pandemic is just the sheer amount of disinformation.
Andy: Huge amounts of disinformation! Everyone's an armchair pundit.
Kate: Yes!
Andy: We can be armchair pundits because that's what we do in our spare time.
But there are people, there's such a crisis in leadership and there are so many people today who are professional armchair pundits.
Every politician has something to say about economics.
As if they were born with an innate understanding of economics, and almost none of them have ever looked at the theory or read a book on economics, but suddenly being in power seems to imbue you with a factual knowledge of it, you know, and every politician and so-called leader seems to think that they have an understanding about technology because they own a phone, or they type their accounts in on the spreadsheet.
The real experts, as far as I can see have very little voice, are picked, are selected from a very specific pool of ideas, of thinkers, and so we would be in very good company if most of what we were talking was shite.
However, I really hope that we can raise the bar above that level of discourse.
I mean that is what the Liberality channel is supposed to be all about, right?
Kate: I don't think anyone is going to imply that actually it would be a good thing to inject disinfectant or anything, or that light can somehow save us...
Andy: Is that what people have been saying on the Internet...?
Kate: Trump has been saying so, yes, yes.
Andy: Please tell me you are shitting me!
Kate: Absolutely not!
Guys. You heard it here first, actually Dr. Andy Farnell, computer scientist extraordinaire, had not heard what Trump had been saying about...
Andy: I make a great effort to, I'm proud to admit this, I do make a great effort to insulate myself from a lot of the mainstream media.
The mainstream news. Because it is just so disruptive to coherent thought, it is so disruptive to rational sceptical reflection on things.
So tell me more about what your thoughts are on immunity, so-called immunity passports - that sounds a very fluffy way of describing a tech fascist instrument to me.
Kate: I want to start with the fact that there can be no safety without privacy.
And I think that this is something that probably Freud intuitively knew about the practice of psychoanalysis and psychotherapy, that if a safe place was to be created for people to actually talk freely without being inhibited, someone could actually be honest, could actually maybe talk about some really deep-seated fears, anxieties, fantasies....
Andy: Precisely things that they can't do on modern social media because everybody knows in their heart that they're under constant surveillance and scrutiny right?
Kate: I wonder whether people actually have pushed that from their mind and are actually in denial about that.
But I would say that privacy is a real tenet of emotional security, and as an attachment theorist, actually there can be no secure base without privacy.
It is the fundamental reason why I do not, for example, install a Nest doorbell near my consulting room that might trace patients, do video facial recognition, and that when a patient arrives I will turn my smartphone off.
Andy: But Kate, people will say that, well you're a psychotherapist, who deals with patients, and that's a very specific and niche area of human life. What you said to me earlier just really struck a chord - which was that for everybody, there can be no mental health without privacy.
Kate: Yeah, and I think that Snowden in his Christmas address a few years ago really highlighted this, highlighted the idea of "Have you never had just a private thought that you want to remain private"?
Andy: The phrase that sticks in my mind is this: "Psychoanalysis in Reverse", which is the way I think Horkheimer or Adorno, one of those Frankfurt guys describes the process of modern culture, as to take everything that's part of your innermost soul and expose it to the public, and at the same time to take everything which is part of the public, well, which is shared, and force that into your inner psyche.
I think of it as a force of anti-humanism.
It's essentially human to have private thoughts, to have secrets, to have plans for your life, maybe plans for other people, hopes and dreams or whatever, and you cannot exist, there can be no real human life in a world in which that is taken away.
Kate: You're right, and that has real ethical dilemmas. For example, there is an ethical dilemma in psychotherapy of what happens if/when restrictions are lifted in terms of social distancing and psychotherapists return to seeing face to face patients. What would then happen in terms of tracing in terms of consent to share information, for example if the therapist had tested positive for Covid-19, would that therapist be obliged to share the info, of the contact details of their patients?
Andy: Yeah, I do know that the legalities and the best practices, and the things that the professional bodies like the UKCP, and so on, have to say about those kinds of things are very intricate, and I don't quite want to get too far into that discussion. Obviously there are times when you do disclose, if you think someone is at a risk to themselves or to others.
Kate: With the patient's consent.
Andy: With the patient's consent.
Kate: With that having been discussed.
Andy: Let's look at what's happening with this so-called "immunity passport", and I'm repeating myself from earlier comments here, but I don't think that the virus really has very much to do with this! This has been waiting in the wings for a long time.
And the current crisis is an excuse that authoritarians and the tech-fascists have been absolutely rubbing their hands together with glee at the opportunity to roll out much more oppressive and ubiquitous social control, in the form of tracking, of behaviour, of buying habits, associations and this goes right back to apartheid, to me it goes right back to the 1930s.
It's equivalent of people being asked to wear a yellow star, to me, and if you're not prepared to pick a side now, and see what's coming, you'll be like those people were by 1942, you know you'll be dead or in a camp, so I think it's very important to recognize this for what it really is.
Kate: Yes, because security involves freedom and, for example, the freedom to opt out, and the freedom not to share information. You and I have spoken in the past privately about the behaviour of the tech giants being almost like an intrusive partner, and whereas I as a therapist in hearing, for example, someone saying "my partner demands that they know everything about where I go, who I speak to, whatever little bits of information, what I'm thinking, even..." You know, I would say to a patient, that feels somewhat like coercive control.
Andy: That is control. That quote, which I still haven't managed to source yet, but it's stuck in my mind like a splinter, is "One never maps a territory that one doesn't intend to conquer".
Think about how that applies to Google Maps, think about how that applies to all forms of surveillance.
There's no sense in which those things can be benign, they can't be anything but loaded with a future intent to control.
Kate: It raises a question of - what is the appeal of the products of these big tech giants? And my thinking is, the phrase, that again I don't know who to attribute this to appropriately, but feels quite relevant to the discussion now, is the saying that people who think that technology will save them understand neither their problems nor technology very well.
Andy: Very few people understand technology. We've a huge dearth of education in our schools, and universities as well, since the humanities were decimated. To be honest, as a computer scientist I would say that this belongs on the computer science syllabus, certainly for freshmen, is modern Tech Critique.
Not just the stuff of Neil Postman and Marshall McLuhan and Ivan Illich, and all of these... there's a huge, huge body of literature, of ideas, who, for certainly decades, maybe centuries, have had a deeply critical relationship with understanding and trying to direct technology.
Today there's only black and white. There is a camp of people who fetishise technology, are gushingly enthusiastic about it, and they only see others as being Luddites, idiots of some kind. It's very rare and disturbing for them, I think, when they encounter someone like me, well educated and knowledgeable in technology, who has spent their life dedicated to it, and yet it is harshly critical of it.
And one of the problems that we have with Silicon Valley, and with lots of technology today, is that it's "solutions looking for a problem".
It's stuff that has great private economic value if you can foist it on people, if you can get them to use it somehow, but it doesn't really give them much utility. I mean that, when you examine it in depth, there's a lot of technology where not having it it's not much worse than having it.
So, there's always this constant temptation to push it, and push it, and push it into places it just doesn't belong in human life.
Kate: maybe this brings us back to the issue of immunity passports, because an area that you seem to be implying that big tech actually, absolutely does not belong, is in our health records, and in surveillance of our contacts.
Andy: I don't think it does. No. I think it's extraordinarily dangerous to mix those things.
And like voting can be done with paper records, yes we use paper records in this country, a system which is entirely voluntary, entirely elective, and really is based on experts. I would say GP's, I mean they're already heavily overloaded in what they do, but they belong right at the centre of this.
Because I think what we're going to get onto in the moment, is how technology breaks and distorts relationships.
A patient's relationship is with a GP, not with some big data company, not with some private data miners.
Kate: Are secure bases secure?
Andy: No, now they're not at all. Absolutely not.
You have a smartphone, your base is not secure.
It's an always-on tracking and potential surveillance device.
Kate: I am thinking in terms of not just a relationship that we have with technology, and whether we choose or not to have a smartphone, whether we choose or not to use Facebook or Google, but I would say that actually our secure base is, and I'm very deliberately using the language of attachment theory here, are actually our emotional relationships, usually those we have with the people that we talk about, usually with our family, but are also present with the people that we work with, and I'm sure that's definitely present with the medical people that might be treating us, when we are at our most vulnerable, because that experience of vulnerability puts us right back in a position of abject dependence, and so our attachment systems are absolutely activated when we set foot in a place like hospital because we are dependent on the actions of someone else and it is absolutely terrifying, the prospect that people face these days of worrying "is this person, that I am dependent on, whether I choose to be or not, am I a risk to them, or are they a risk to me?"
Andy: Yeah, this is what came up in the interview with Sarah, with Dame Professor Sarah Cowley, you just want to say a word about who Sarah Cowly is for our listeners?
Kate: She is a pioneer of health visiting.
Andy: Yeah, and so what she was saying to me in another interview, that there was a huge problem in being a health visitor, that you have to do this balancing act, on the one hand being an instrument of the state, potentially being intrusive, like social workers can do, into private lives, and having the interests of mothers and families... and what enabled that was selective information-gathering, was the ability to ommit things from records, to interpret them, and to record them in a way that best serves the interests of the patient, well, patient's the wrong word, 'service user' I guess you'd say these days? And the more the technology encroaches into medicine, and into social work, and into all of this stuff, the less it serves the interests of the patient.
Kate: Absolutely! I absolutely had my own experience of that in working with families in mental health services, where I would make judgment calls as to what information I would record, what information I would share, and with whom, and with what information I didn't feel that it was appropriate to.
Andy: Why? Tell me about those patients and what risks they faced?
Kate: Where there were families with domestic violence, and the risk was ongoing, my view was that I would think that it was incredibly important that professionals reading my notes would be aware of what was happening in my work with families...
Andy: Wasn't there "code" in your profession?
Kate: Yes, in the fact that I would mark the records, that I wrote "third party information confidential not to be disclosed"
Andy: I hoped you were going to tell me about the Sri Lankans, and those patients who you knew, their families were at a very real risk of murder and torture.
Kate: There were two starkly contrasting circumstances, one when I was working with Tamil families who were in contact with the Red Cross during the Civil War, and I would want to make sure that the spelling of their Tamil names was absolutely correct, because if I got that information wrong it may mean that someone years down the line looking through records or in contact with the Red Cross would not make contact with a long-lost relative that they might otherwise.
The direct opposite extreme to that, was when I thought that there might be a circumstance where there might be either an oppressive individual or be an oppressive state, bearing in mind that I was working with people who had been tortured in their country of origin by the state, I had no way of knowing whether that state's surveillance system, might be able...
Andy: Well we know that state actors are within other nations, so that the Chinese, for example, have many spies and many back doors and...
Kate: That trauma might be personal, so for example, a survivor of domestic violence might say to me "I do not want this recorded", in which case I would write, "patient did not wish what was to be disclosed to be recorded."
But equally, that person might be be reporting state terror, as well, so there is that need for judgment, human you know.
Andy: Human judgment, for healthcare professionals to choose and to select the information, and interpret the information.
Do you think, or would you agree, that the people who conceive applications like this, and the people who are the drivers, the facilitators of state surveillance, are really very naive about information?
You always imagine that they pick the brightest and best, in communications theory, and semantics, and semiotics, so that they understand implications, and so on, but I think actually, I've got to say, a lot of people in the tech industry and in that area, are intellectual dwarves of the lowest order.
They really seem to not get some profoundly important problems, and the side effects, and consequences, of designing these applications, and when I speak to other security researchers, when I speak to people like Ross Anderson, to people like that, who do get these things, who write voluminously on security engineering, on cyber security, on infosec stuff, they are equally gobsmacked, I think, by the lack of clear vision and careful thought that goes into these kinds of ideas.
What do you think, and you already mentioned that there's an unconscious, a collective unconscious, and I kind of wanted us to maybe, get into this this thing that terrifies me, is that we all go to the window and cheer for the NHS, and at the same time that feels incredibly connecting, it really presses all of those buttons that you will hear people like Jordan Peterson and Stefan Molyneux, and what some people consider right-wing thinkers, they're not at all, they're just smart thinkers, right, but they understand about the human psychology of crowd mentality, and groupthink, and how the NHS could be used semiotically, those lovely blue and white symbol of the NHS, could so easily be hijacked by tech fascism.
Because there is a deep appeal there to our unconscious fears of infection, of disgust, of difference, from other groups of people, and we've all felt it walking in the street in the last few weeks. Those are very, very dangerous sociological forces... What do you think of that?
Kate: Absolutely, I think that. On the one hand I do cheer for the NHS.
Andy: I cheer for the NHS too.
Kate: But I am worried that that sort of atmosphere, a kind of Blitz spirit is going to be a massive distraction from how underfunded and underappreciated and the NHS has been...
Andy: It's in ruins isn't it?
Kate: Absolutely, I would say it is in ruins, it certainly was my experience of working in psychiatry. It was absolutely heartbreaking, things such as referral criteria where the atmosphere, it almost seemed to be communicated, that unless you're suicidal or risk to others, we will not treat you, or offer you any sort of care, by which case it's way too late, often.
We know that this current crisis is going to have a massive mental health impact and there have been massive surges, a two-fold increase in calls to domestic violence support lines. There have been a massive rise in actual murders since lockdown, and ironically, I wondered whether there is something about the lack of privacy, and the lack of volition behind that, that leads to mental health problems, and violence, and that actually the tech companies with very blanket applications are at worst, a very very blunt tool, to you know, for a very very big problem.
It's actually workers such as midwives that know the details of people's lives.
Andy: This is what Sarah was saying.
Kate: Absolutely. Things like whether a child is wanted, whether a child is at risk.
Andy: What a GP would say as well, the "family doctor". Now that role has obviously been corroded now by expedient medicine, and over-systematization, but the relationship you have with the family doctor, of course, is a confidential one, because your GP really knows all of the nitty-gritty and should, and that's the one person, always, like a priest, you know, who you would trust with that level of intimacy, and what a responsibility to carry it when you can't discharge your confidentiality functions anymore, because some tech fascist has taken over your systems and basically hacked the computer that you're forced to use!?
Kate: I think that it's worse and more traumatic than that.
Andy: The BMA should be all over this if there's any professionalism left in medicine, they should be all over this, I don't understand why not...
Kate: Recently I've had phone calls with medics, and the last thing that very experienced GP said at the end of a phone call was "take care", and my inclination was to say to him "no, you take care. You take care because you are more at risk than actually we are", and there being something difficult about that because we want to believe that the people caring for us are somehow immune from human frailties.
Andy: Yeah, I think that's a really good point.
Kate: I've got two questions Andy, the two questions that I wanted to ask you.
I'll start with what you believe a post-Corona world will look like.
Andy: Wow. What would a post-Corona world look like? Well I think it looks very much like it does right now. My worst fear is that nothing changes at all.
I had this thing I said to you before, about doing the moral arithmetic of utilitarianism, and what our grandparents had fought for in the war to stave off fascism, but we're in another crisis at the same time, we're in a crisis of environmentalism, and I'm very torn because part of me thinks this is a golden opportunity for us to change the way that we live, and that would be very painful and very harsh for everybody, that we would all suffer economic loss, but the idea of foreign holidays would disappear, and I would be quite prepared to accept that the government came and said, "sorry guys we've had, you know, 50 years of subsidised air travel... Those days are over now. We're rationing holidays."
Every three years, your family can can travel to Tenerife or wherever, maybe you'd have tokens or something like that, maybe you accrue some kind of air allowance miles that would let you do stuff like that.
I'd like to see private cars off the roads, the way they are now, just people making essential journeys. Wouldn't that be amazing if we could just keep breathing the lovely air, if we can keep hearing the birds singing and the bees return, and things like that, there's so many potentially good things to come out of this as a warning to humanity, to change our ways.
So, what what do I see? My optimistic self sees a post-Corona world as one in which, we've learned lots of the lessons from Donella Meadows, on the limits of growth, and the limits of expansive economies, that we've learned to have zero-growth economies, that we think more about maintenance and sustenance than development all of the time.
The cynical side of me just imagines everything going back to "normal". But worse.
In many kinds of mathematical models, as you have in stick-slip friction and so on, when you interrupt something, it returns, it comes back ten times as bad, and this is one of the fears that the government legitimately have, I think, with the easing of restrictions, is that the moment you take the brakes off people will go crazy. They'll be out partying and you'll have a second wave, a resurgence in infection.
The worst case scenario I think is that it turns out, when we really dig down into this virus, that it's not a pandemic, it's a new endemic, and that there's a a 10 or 20 year period in which diseases are going around which remain transmissible, that you can't really build immunity to, and are always going to be a risk to the health service, and to lots of people's lives obviously, but something that we're not prepared to build a health service to cope with.
In that case, if the biology turns up in that way, what we would need to do is to start the equivalent of an arms race, but a "health race".
My post-Covid world is a health race, like the cold war, in which nations compete to build the best damn health services that they can, that would be amazing, that would be the best outcome.
The worst outcome is that intellectually naive forces within government and intelligence services and law enforcement, and the corporate state, the big-tech, tech fascists, see this as a way to follow a Chinese model, of enacting draconian social control on people for the purposes of continual political and economic manipulation. For them the Covid virus is a great gift, that just accelerates the descent into a dystopia.
There's an amazing possible future, and a really fucking awful one.
And I think that's why I'm feeling the need to answer Dan's question.
Kate: For me, I think that what a post-Corona world might look like, my hopes, are that a post-Corona world would be a society that valued authentic human relationships, and relatedness a lot more, that understood that technology is not necessarily the answer to our problems, that actually valued human interaction, the sort of things that Bowlby was talking about, separation distress proximity seeking, and the idea that our partners and our parents can be a secure base, that we leave from and that we return to. Actually my hope would be that we keep big tech companies, big tech giants - that kind of Silicon Valley sewer - in check, so we actually don't mediate our emotional relationships quite as much as we do through these big data gathering organizations.
Before we say our goodnight, I wonder whether you can say something about comments that you've made in discussions that we've had about whistleblowers, and about the courage that it takes to tell the truth in the face of enormous pressure to do otherwise.
Andy: I've said a lot about courage and that having just finished Snowden's book, and found it full of meaty goodness.. No really! Really enjoyed Edward Snowden's book!
I think I think here's the problem - everybody knows that now is a time that demands great courage yes, nd by that I mean "simple honesty". It's already a tragedy that to speak of honesty is to cloak it in the language of "courage", right? Just to say what are self-evident truths, and the things that are your deeply held values, to feel that you need courage to do that, is already a tragedy, right? With regards to technology I think we haven't reached any kind of critical mass, or even the beginnings, of people being honest with themselves about their relationships with technology.
I think they're utterly dependent, addicted and in denial.
I think we have a huge, huge social problem with computer technology right now, it's an enormous disappointment to me as a computer scientist. It gives me huge pangs of self-doubt that I've wasted my life.
That I've contributed to huge problems and not solutions.
But I do see glimmers of... when courage happens... when I see changes brewing, it's like a flock of birds taking off. You see a few kind of fluttering, here and there, but then there's one moment, and nobody knows why, and none of the birds know why, they all take off. It's an epiphenomenal event, it's an emergent phenomenon, and there are always those warning signs, just before, these little things that tell you that there's going to be a big change.
And when the Economist started to write about the "tech-lash", I kind of thought... "ooh, here it comes". It didn't take the tech fascists long to paint that all with the Luddite brush, to marginalize people who are having second thoughts about their relationships with technology.
But I'm continually seeing signs that people want to retake tech. They're small, even hard to describe things, but they keep me filled with hope, that there's the possibility for that change.
Whistleblowing is a poisonous word. Because a situation in which an institutional society is so broken, all the mechanisms of legitimate change and challenging and bottom-up democratic control are so broken, so dysfunctional, that anybody who sees a problem is silenced for so long, and suppressed for so long, they're eventually forced into a situation where they have to act radically.
That's a really, really broken system, and that's what happened to Snowden. It's tragic, it's really tragic to read the story because there's so many affinities. I see the parallels with his childhood and his father's service record and things like that, and to me it was like "wow, I'm reading the story of somebody who's 20 years younger than me and grew up". Being in those shoes I'd do the same thing, I would not compromise those values, for defending freedom and democracy, and the right to be a free-thinking rational individual. I would not hesitate to do what Snowden did.
So he's an absolute bloody hero.
But the fact that people have to go to those lengths, and therefore there's so few of them, that's a real problem.
I think we need a revolution in that perception of courage and necessity, of clear honest open speech, in a way that just opens the floodgates. We need that flock of birds just taking off, so that there isn't anybody that could be singled out as the whistleblower, you know. Everybody's a Spartacus.
Kate: Yeah.
A final thought before we say goodnight, is that something that was often said to me, and I think was in a line of a poem written by an accident and emergency nurse during this pandemic, was about times where people within the NHS would say to fellow workers who were expressing discontent about certain issues: "Don't make this political".
My view and understanding is that our health, our healthcare system, the NHS, has, will always be, political. The personal will always be political.
Andy: I think the people who say those kinds of things, like "Don't make this political", what is a charitable word for them? One that our listeners can hear, I don't know.....
There's no realm of politics that doesn't impinge on the personal, on the individual and your health.
Kate: And the technology behind that.
Andy: It's everybody's problem.
I would really hope, that everyone in the NHS gets to hear our "Good Stuff", on the Liberality channel.
Kate: Well, this is the Good Stuff saying goodnight!
Andy: Goodnight!
Tags: coronavirus, mentalhealth, privacy, thegoodstuff