How To Sell An Idea

You've got an idea: a new way of doing things; a change; a paradigm shift. It might work, it might be no better than what we've got already, or it might end up being a disaster.

The honest way to present your proposal would be to admit its novelty, and hence the uncertainty: this is a new idea I had, I can't promise anything, but here are my reasons for thinking it's worth a try, here are the likely costs and benefits, here are the alternatives.

However, let's suppose you don't want to do that. That's hard work, and if your idea is crap, people could tell. How else could you convince them? By making it seem as though it's not a new idea at all.

You could dress your idea up as:

• the glorious past. Your idea is nothing more than how we did things back in the golden age, when everything was great. For some reason, people strayed from the true path, and things went bad. We should go back to the the good old days. It worked then, so it'll work now. You'll use words like: restoring, reviving, regaining, renewing... "re" is your friend.
• the next step. Your idea is just the logical progression of what we're already doing. Things used to be bad, and then they started to change, and get better. Let's make them even better, by doing more of the same. It's inevitable, anyway: you can't stop history. You'll use words like: progress, forward, advance, build, grow...
  
• catching up. You're just saying we should bring stuff into line with the way things are done elsewhere, which as we know, is working well. It's not even a matter of moving forward, so much as keeping up. It would be weird not to change. We don't want to be dinosaurs. You'll use words like: modernization, rationalization, reform...
  
• keeping things the same. Things are fine right now, and don't need improving. But in order for things to stay great, we must adapt to changing circumstances, so we'll have to make a few adjustments, but don't worry, fundamentally things are going to stay just as they are. You'll use words like: preserving, maintaining, protecting, upholding, strengthening...

The point in every case being to make an innovation seem like it's not one. New means untested, and uncertain, and risky. No-one likes that. Passing off ideas as already proven is a way of gaining acceptance for ideas that wouldn't stand up on their own merits. I'm sure I don't need to point out that this trick is a mainstay of politicians, ideologues and managers everywhere.

Of course, there are plenty of changes that really are these things, to various degrees. Sometimes the past was glorious, relatively speaking (France 1942 springs to mind); sometimes we do need to catch up.

But every new idea still has an element of risk. Nothing has ever been tried and tested in the exact circumstances that we face now, because those circumstances have never existed before. Just because it worked before, or elsewhere, in a situation that we think is similar, is no guarantee. There are only degrees of certainty.

This doesn't mean we can't decide what to do, or that we shouldn't change anything. Not changing things is a plan of action in itself, anyway. The point is that we ought to be willing to try stuff that might not work, our guide to what's likely to happen being the evidence on what's worked before, critically appraised. "I don't know" is not a dirty phrase.

How To Sell An Idea

You've got an idea: a new way of doing things; a change; a paradigm shift. It might work, it might be no better than what we've got already, or it might end up being a disaster.

The honest way to present your proposal would be to admit its novelty, and hence the uncertainty: this is a new idea I had, I can't promise anything, but here are my reasons for thinking it's worth a try, here are the likely costs and benefits, here are the alternatives.

However, let's suppose you don't want to do that. That's hard work, and if your idea is crap, people could tell. How else could you convince them? By making it seem as though it's not a new idea at all.

You could dress your idea up as:

• the glorious past. Your idea is nothing more than how we did things back in the golden age, when everything was great. For some reason, people strayed from the true path, and things went bad. We should go back to the the good old days. It worked then, so it'll work now. You'll use words like: restoring, reviving, regaining, renewing... "re" is your friend.
• the next step. Your idea is just the logical progression of what we're already doing. Things used to be bad, and then they started to change, and get better. Let's make them even better, by doing more of the same. It's inevitable, anyway: you can't stop history. You'll use words like: progress, forward, advance, build, grow...
  
• catching up. You're just saying we should bring stuff into line with the way things are done elsewhere, which as we know, is working well. It's not even a matter of moving forward, so much as keeping up. It would be weird not to change. We don't want to be dinosaurs. You'll use words like: modernization, rationalization, reform...
  
• keeping things the same. Things are fine right now, and don't need improving. But in order for things to stay great, we must adapt to changing circumstances, so we'll have to make a few adjustments, but don't worry, fundamentally things are going to stay just as they are. You'll use words like: preserving, maintaining, protecting, upholding, strengthening...

The point in every case being to make an innovation seem like it's not one. New means untested, and uncertain, and risky. No-one likes that. Passing off ideas as already proven is a way of gaining acceptance for ideas that wouldn't stand up on their own merits. I'm sure I don't need to point out that this trick is a mainstay of politicians, ideologues and managers everywhere.

Of course, there are plenty of changes that really are these things, to various degrees. Sometimes the past was glorious, relatively speaking (France 1942 springs to mind); sometimes we do need to catch up.

But every new idea still has an element of risk. Nothing has ever been tried and tested in the exact circumstances that we face now, because those circumstances have never existed before. Just because it worked before, or elsewhere, in a situation that we think is similar, is no guarantee. There are only degrees of certainty.

This doesn't mean we can't decide what to do, or that we shouldn't change anything. Not changing things is a plan of action in itself, anyway. The point is that we ought to be willing to try stuff that might not work, our guide to what's likely to happen being the evidence on what's worked before, critically appraised. "I don't know" is not a dirty phrase.

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Genes for ADHD, eh?

The first direct evidence of a genetic link to attention-deficit hyperactivity disorder has been found, a study says.

Wow! That's the headline. What's the real story?

The research was published in The Lancet, and it's brought to you by Wilson et al from Cardiff University: Rare chromosomal deletions and duplications in attention-deficit hyperactivity disorder.

The authors looked at copy-number variations (CNVs) in 410 children with ADHD, compared to 1156 healthy controls. A CNV is simply a catch-all term for when a large chunk of DNA is either missing ("deletions") or repeated ("duplications"), compared to normal human DNA. CNVs are extremely common - we all have a handful - and recently there's been loads of interest in them as possible causes for psychiatric disorders.

What happened? Out of everyone with high quality data available, 15.6% of the ADHD kids had at least one large, rare CNV, compared to 7.5% of the controls. CNVs were especially common in children with ADHD who also suffered mental retardation (defined as having an IQ less than 70) - 36% of this group carried at least one CNV. However, the rate was still elevated in those with normal IQs (11%).

A CNV could occur anywhere in the genome, and obviously what it does depends on where it is - which genes are deleted, or duplicated. Some CNVs don't cause any problems, presumably because they don't disrupt any important stuff.

The ADHD variants were very likely to affect genes which had been previously linked to either autism, or schizophrenia. In fact, no less than 6 of the ADHD kids carried the same 16p13.11 duplication, which has been found in schizophrenic patients too.

So...what does this mean? Well, the news has been full of talking heads only too willing to tell us. Pop-psychologist Oliver James was on top form - by his standards - making a comment which was reasonably sensible, and only involved one error:

Only 57 out of the 366 children with ADHD had the genetic variant supposed to be a cause of the illness. That would suggest that other factors are the main cause in the vast majority of cases. Genes hardly explain at all why some kids have ADHD and not others.

Well, there was no single genetic variant, there were lots. Plus, unusual CNVs were also carried by 7% of controls, so the "extra" mutations presumably only account for 7-8%. James also accused The Lancet of "massive spin" in describing the findings. While you can see his point, given that James's own output nowadays consists mostly of a Guardian column in which he routinely over/misinterprets papers, this is a bit rich.

The authors say that

the findings allow us to refute the hypothesis that ADHD is purely a social construct, which has important clinical and social implications for affected children and their families.

But they've actually proven that "ADHD" is a social construct. Yes, they've found that certain genetic variants are correlated with certain symptoms. Now we know that, say, 16p13.11-duplication-syndrome is a disease, and that its symptoms include (but aren't limited to) attention deficit and hyperactivity. But that doesn't tell us anything about all the other kids who are currently diagnosed with "ADHD", the ones who don't have that mutation.

"ADHD" is evidently an umbrella term for many different diseases, of which 16p13.11-duplication-syndrome is one. One day, when we know the causes of all cases of attention deficit and hyperactivity symptoms, the term "ADHD" will become extinct. There'll just be "X-duplication-syndrome", "Y-deletion-syndrome" and (because it's not all about genes) "Z-exposure-syndrome".

When I say that "ADHD" is a social construct, I don't mean that people with ADHD aren't ill. "Cancer" is also a social construct, a catch-all term for hundreds of diseases. The diseases are all too real, but the concept "cancer" is not necessarily a helpful one. It leads people to talk about Finding The Cure for Cancer, for example, which will never happen. A lot of cancers are already curable. One day, they might all be curable. But they'll be different cures.

So the fact that some cases of "ADHD" are caused by large rare genetic mutations, doesn't prove that the other cases are genetic. They might or might not be - for one thing, this study only looked at large mutations, affecting at least 500,000 bases. Given that even a deletion or insertion of just one base in the wrong place could completely screw up a gene, these could be just the tip of the iceberg.

But the other problem with claiming that this study shows "a genetic basis for ADHD" is that the variants overlapped with the ones that have recently been linked to autism, and schizophrenia. In other words, these genes don't so much cause ADHD, as protect against all kinds of problems, if you have the right variants.

If you don't, you might get ADHD, but you might get something else, or nothing, depending on... we don't know. Other genes and the environment, presumably. But "7% of cases of ADHD associated with mutations that also cause other stuff" wouldn't be a very good headline...

N. M. Williams et al (2010). Rare chromosomal deletions and duplications in attention deficit hyperactivity disorder: a genome-wide analysis The Lancet

Genes for ADHD, eh?

The first direct evidence of a genetic link to attention-deficit hyperactivity disorder has been found, a study says.

Wow! That's the headline. What's the real story?

The research was published in The Lancet, and it's brought to you by Wilson et al from Cardiff University: Rare chromosomal deletions and duplications in attention-deficit hyperactivity disorder.

The authors looked at copy-number variations (CNVs) in 410 children with ADHD, compared to 1156 healthy controls. A CNV is simply a catch-all term for when a large chunk of DNA is either missing ("deletions") or repeated ("duplications"), compared to normal human DNA. CNVs are extremely common - we all have a handful - and recently there's been loads of interest in them as possible causes for psychiatric disorders.

What happened? Out of everyone with high quality data available, 15.6% of the ADHD kids had at least one large, rare CNV, compared to 7.5% of the controls. CNVs were especially common in children with ADHD who also suffered mental retardation (defined as having an IQ less than 70) - 36% of this group carried at least one CNV. However, the rate was still elevated in those with normal IQs (11%).

A CNV could occur anywhere in the genome, and obviously what it does depends on where it is - which genes are deleted, or duplicated. Some CNVs don't cause any problems, presumably because they don't disrupt any important stuff.

The ADHD variants were very likely to affect genes which had been previously linked to either autism, or schizophrenia. In fact, no less than 6 of the ADHD kids carried the same 16p13.11 duplication, which has been found in schizophrenic patients too.

So...what does this mean? Well, the news has been full of talking heads only too willing to tell us. Pop-psychologist Oliver James was on top form - by his standards - making a comment which was reasonably sensible, and only involved one error:

Only 57 out of the 366 children with ADHD had the genetic variant supposed to be a cause of the illness. That would suggest that other factors are the main cause in the vast majority of cases. Genes hardly explain at all why some kids have ADHD and not others.

Well, there was no single genetic variant, there were lots. Plus, unusual CNVs were also carried by 7% of controls, so the "extra" mutations presumably only account for 7-8%. James also accused The Lancet of "massive spin" in describing the findings. While you can see his point, given that James's own output nowadays consists mostly of a Guardian column in which he routinely over/misinterprets papers, this is a bit rich.

The authors say that

the findings allow us to refute the hypothesis that ADHD is purely a social construct, which has important clinical and social implications for affected children and their families.

But they've actually proven that "ADHD" is a social construct. Yes, they've found that certain genetic variants are correlated with certain symptoms. Now we know that, say, 16p13.11-duplication-syndrome is a disease, and that its symptoms include (but aren't limited to) attention deficit and hyperactivity. But that doesn't tell us anything about all the other kids who are currently diagnosed with "ADHD", the ones who don't have that mutation.

"ADHD" is evidently an umbrella term for many different diseases, of which 16p13.11-duplication-syndrome is one. One day, when we know the causes of all cases of attention deficit and hyperactivity symptoms, the term "ADHD" will become extinct. There'll just be "X-duplication-syndrome", "Y-deletion-syndrome" and (because it's not all about genes) "Z-exposure-syndrome".

When I say that "ADHD" is a social construct, I don't mean that people with ADHD aren't ill. "Cancer" is also a social construct, a catch-all term for hundreds of diseases. The diseases are all too real, but the concept "cancer" is not necessarily a helpful one. It leads people to talk about Finding The Cure for Cancer, for example, which will never happen. A lot of cancers are already curable. One day, they might all be curable. But they'll be different cures.

So the fact that some cases of "ADHD" are caused by large rare genetic mutations, doesn't prove that the other cases are genetic. They might or might not be - for one thing, this study only looked at large mutations, affecting at least 500,000 bases. Given that even a deletion or insertion of just one base in the wrong place could completely screw up a gene, these could be just the tip of the iceberg.

But the other problem with claiming that this study shows "a genetic basis for ADHD" is that the variants overlapped with the ones that have recently been linked to autism, and schizophrenia. In other words, these genes don't so much cause ADHD, as protect against all kinds of problems, if you have the right variants.

If you don't, you might get ADHD, but you might get something else, or nothing, depending on... we don't know. Other genes and the environment, presumably. But "7% of cases of ADHD associated with mutations that also cause other stuff" wouldn't be a very good headline...

N. M. Williams et al (2010). Rare chromosomal deletions and duplications in attention deficit hyperactivity disorder: a genome-wide analysis The Lancet

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Soneto da separação

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Silencioso e branco como a bruma
E das bocas unidas fez-se a espuma
E das mãos espalmadas fez-se o espanto

De repente da calma fez-se o vento
Que dos olhos desfez a última chama
E da paixão fez-se o pressentimento
E do momento imóvel fez-se o drama

De repente não mais que de repente
Fez-se de triste o que se fez amante
E de sozinho o que se fez contente

Fez-se do amigo próximo, distante
Fez-se da vida uma aventura errante
De repente, não mais que de repente

Vinicius de Moraes

"Cada pessoa que passa em nossa vida, passa sozinha,
é porque cada pessoa é única e nenhuma substitui a outra.
Cada pessoa que passa em nossa vida passa sozinha, e não nos deixa só,
porque deixa um pouco de si e leva um pouquinho de nós.
Essa é a mais bela responsabilidade da vida e a prova
de que as pessoas não se encontram por acaso."

(Charles Chaplin)