The Amazing World of Psychiatry Blog is a Year Old!

This is the 1st Anniversary of the TAWOP Blog!

Thank you to all the readers that have supported and contributed to the blog over the past year.

I’ve created an Index article which will I will  update periodically. The index should make it easier for people to find their way around the blog.

The blog partly functions as an external memory. Writing must have had a profound effect when it was first created, because it seems to multiply the ability for a society to accumulate knowledge. Suppose for instance that a person reads a book. Maybe a year later the person would remember bits of the book. 2 years down the line it might be even sketchier, remaining as an opinion. The point is that our memories are finite and stored information disappears or gets transformed as time goes on. With writing however, this information has the potential to remain unchanged meaning that we can choose to let it re-enter our consciousness without the distortion that time creates within our own stored memories. I’m primarily thinking of the ability to transform this stored information to produce something new and useful or else to provide a reference. In terms of referencing information there are lots of links on this blog to free online information. This open-access is one of the essential features of Web 2.0 technology. I am hopeful that the open-access material that is found on the web should help to improve health globally although this may never be known for certain, such is the magnitude of available information, the large and undetermined number of interactions that people (and software) have with this information and the use to which this information is put. If all of the relevant health information was accessible online for free this would mean that the health information available to the average person would increase considerably. Much of this information remains hidden from online access because it is either not in digital format or else is available online for a subscription fee. Companies such as Google as well as the Gettysburg Project and a number of databases (for instance PubMedCentral) are systematically placing information online. Subscription databases form part of the deep web, that part of the web that is inaccessible to the casual browser given the subscription model. It can be argued that such subscription fees are necessary for quality assurance purposes as well as reaching a wide reader base and perhaps this might not change. Would things change if all of this information were freely available online? In some senses barriers would be removed. If we were to have access to all of the papers in all of the health journals then meta-analyses and systematic reviews would become cost-free (well not strictly because there would be numerous overheads including time and use of facilities). We might expect to see an increase in the number of systematic reviews and meta-analyses. With increased submissions to journals, there would be greater competition and standards would improve and perhaps systematic reviews and meta-analyses would become more refined in some way. This in turn would impact on clinical care because such articles form the highest rung on the evidence-base hierarchy. Nevertheless, if all of these articles were free then we might also see a reduction in submissions to journals without a subscription fee supporting a wide reader-base. It is difficult to see what the outcome of the trade-off would be. I’ve thought of another concept along the way – the Web 2.0 review. So this is a review that would use only open-access papers. The obvious problem is that there would be a selection-bias in the papers and numerical analyses would be less meaningful because of this selection bias. There would however still be a lot of useful information. There could be a Web 2.0 spin on it however. So if several lay experts on a certain area (without medical training but having an interest in this area) accessed papers on a particular subject they could write part of a review and then would need to collaborate with a supervising trained expert to increase the overall output which could then have benefits in clinical practice if this information is clinically relevant.

Another interesting feature of the blog is the ability to integrate other media formats which takes the external memory a step closer to our own memories which are combinations of different percepts, thoughts and feelings. The advent of YouTube and similar video sites means we are at an exciting time, having a medium that has never before existed in history and which allows us to store and share our collective experiences. In one sense, people are gathering information from the world and presenting it without transformation so that it can be viewed and analysed – a collective scientific endeavour even if it is not intended as such. Of course there are other intentions for the use of videos – sharing clips that are enjoyable, telling the world about oneself and so on but a valuable repository of information for scientific analysis has been accumulated. The integration of these different media sources results in something new which may or may not be greater than the sum of it’s products and this will depend on the skills of the creator. With an ever expanding source of data to select from in each of the media formats, the associations can become ever more esoteric and insightful or else ever more irrelevant.

The Blog has allowed me to develop a number of themes – looking at a model of the Insular Cortex, taking a closer look at Jungian Analytic Psychology thanks to the works of John Betts, looking at Donald Winnicott’s works as well as issues in the analysis of fMRI studies which also crosses over into other types of study. The analysis of the Vul et al fMRI  paper has been necessary to make progress in developing a model of the Insular Cortex as much of the information on the functioning of this area comes from imaging studies. Incidentally the Vul et al paper has demonstrated a number of other Web 2.0 properties. Firstly two other bloggers – the Neurocritic and Mind Hacks have really developed this as a story in a journalistic sense and the ensuing resonance in the blogosphere that they have created has bounced back into the mainstream media. In effect they have created an amplifying blog echo that takes the original paper/story and generates a buzz about it. The buzz happened for a number of reasons. Both Mind Hacks and the Neurocritic have patiently built up a following and the readership responded to the story setting up a chain-reaction which travelled through Nature, Scientific American and New Scientist as well as a number of other established publications. The paper had many properties which were unusual taking the argument from the statistics of analysis to the works of individuals and the resulting responses created a high-profile debate which ultimately may have profound benefits for neuroimaging studies particularly as the Vul et al paper has become established as a landmark paper receiving numerous citations. This is evidence that the blogosphere can become centrally involved in scientific debate and this was discussed in a recent Nature Editorial.

Another issue I that is important for the blog is how information might be relevant to clinical practice. There is often a somewhat artificial debate about the relevance of research to clinical practice but of course research is the lifeblood for clinical practice. Without this there would be no innovation. Research however takes time and may have implications which influence clinical practice many years in the future whereas there is always an immediate clinical demand. Perhaps research that informs clinicians in leveraging time and other resources to meet common clinical needs might be more useful for meeting immediate clinical demands and a corresponding rating system can be created to classify papers in such a way. It is certainly possible to calculate the frequency of common needs at a local level. The Steps to Treatment approach used in looking at papers is at this stage little more than an opinion but sharpens the mind in considering such issues.

Blogging is a state of mind. The blogger builds a relationship with words as does any author and it is interesting to consider how blogging has had an impact on wider culture allowing many people to know become ‘published’ authors and perhaps having an impact on literacy. Blogging requires logistical and other approaches also as well as providing a snapshot of society which will no doubt contribute to historical records. It is possible to consider how historical events can be usefully represented retrospectively as compendiums of bloggers accounts of these events. Blogging is also in a state of flux and changes occur at a phenomenal rate as new software technologies emerge. Even during this 1-year, I have been able to include and transform material on the blog in ways that I had not even considered when I first began the blog (e.g Odiogo). I’m not quite sure what to expect on the 2nd Anniversary but I do know that the journey so far has been enjoyable.


If you have any comments, you can leave them below or alternatively e-mail


The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

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