The Art of Manliness - March 23, 2022


The Dangers of ＂Concept Creep＂


Episode Stats

Length

39 minutes

Words per Minute

184.04135

Word Count

7,300

Sentence Count

377

Misogynist Sentences

3

Hate Speech Sentences

5


Summary

Nick Haslam, a psychologist at the University of Melbourne, describes a phenomenon he calls concept creep, which refers to the tendency of concepts having to do with harm to broaden their meaning over time. In this episode, Dr. Haslam describes how concept creep happens in two ways, vertical and horizontal, and argues that the way we use words matters, and has consequences.


Transcript

00:00:00.000 Brett McKay here, and welcome to another edition of the Art of Manliness podcast.
00:00:11.000 Trauma, violence, bullying, addiction, the range of things that these words encompass
00:00:15.880 has expanded over time.
00:00:17.320 And while my guest today would say that changes in how language is used are natural and inevitable,
00:00:21.440 he also argues that the way we use words matters, has consequences, and that we need to better
00:00:25.480 grapple with what those consequences are.
00:00:27.220 His name is Dr. Nick Haslam, and he's a professor of psychology at the University of Melbourne,
00:00:31.240 who studied a phenomenon he calls concept creep, which refers to the tendency of concepts having
00:00:35.400 to do with harm, from trauma to depression, to broaden their meaning over time.
00:00:39.600 Nick describes how concept creep happens in two ways, vertical and horizontal, and occurs
00:00:43.360 both amongst clinicians and the general public.
00:00:45.540 He explains what he thinks is behind concept creep, and how the way we talk about harm-related
00:00:49.380 concepts changes how people experience themselves in life, bringing new kinds of identities and
00:00:53.560 new kinds of people into existence.
00:00:55.180 Nick argues that while there are upsides to concept creep, it also carries potential dangers
00:00:58.900 that can negatively impact our lives.
00:01:00.860 After the show's over, check out our show notes at aom.is slash concept creep.
00:01:17.660 Nick Haslam, welcome to the show.
00:01:19.800 Hey, Brett.
00:01:20.560 Glad to be here.
00:01:21.240 So, you are a psychologist who has researched and written about an idea that you call concept
00:01:27.240 creep in psychology, and we're going to get into the details about this, but broadly speaking,
00:01:32.540 how would you describe concept creep?
00:01:35.620 Well, concept creep is just the tendency for concepts to do with harm, that is concepts to
00:01:40.420 do with suffering or pain or damage or destruction, to broaden their meanings over time so that they
00:01:46.980 start to refer to a wider range of things than they once did.
00:01:51.280 Okay.
00:01:51.540 So, we'll talk about one, for example, an idea that we hear a lot in the popular cultures,
00:01:56.280 this idea of trauma.
00:01:57.800 A decade, two decades ago, it had a very specific meaning.
00:02:00.580 We'll talk about what that was.
00:02:01.480 But over time, it is broadened to encompass larger psychological things that happen in life,
00:02:08.440 right?
00:02:08.640 It covers more than besides that specific meaning it originally was designed to describe.
00:02:12.880 Yeah, and that's a great example.
00:02:14.940 And in fact, trauma, as you know, goes right back centuries, and it used to refer to a physical
00:02:20.480 wound.
00:02:20.940 And then about 100 years ago, it started to refer to a psychological wound instead, and
00:02:25.120 that's now the dominant meaning.
00:02:26.240 But also within psychiatry, a trauma, a traumatic event used to be something that was seriously
00:02:32.880 life-threatening.
00:02:33.800 But over time, in successive editions of psychiatric classifications, that idea has loosened, which
00:02:40.080 is a great example of concept creep, so that it refers to a wider range of bad things that
00:02:44.860 can happen.
00:02:45.680 And of course, everyday people have taken that further, so that in some circles, a traumatist
00:02:50.660 now refers to pretty much any kind of adversity, not just the really severe ones it used to mean.
00:02:56.460 When did you first start noticing this idea of concept creep in your work as a psychologist?
00:03:02.340 My memory is really vague on that.
00:03:04.080 So, I started thinking about this seriously about 10 years ago, and I first wrote about it
00:03:08.020 in 2015, but I have friends in grad school who said that they used to hear me banging
00:03:13.520 on about it back in the 90s.
00:03:15.620 So, look, I think it's been around for a while, but I just started noticing what I thought was
00:03:19.960 a pattern around about 10 years ago.
00:03:23.220 So, the clinical psychology side of me was saying, there's all this work on how our ideas
00:03:28.880 about mental illness have broadened massively over the last century, and the trauma example
00:03:35.020 is another fine example of that, how I started to notice people talking about trauma in a
00:03:39.180 much looser, more expansive kind of way.
00:03:42.220 And then the social psychology side of me also noted similar things going on in relation
00:03:47.000 to, for instance, bullying or prejudice, how social psychologists started to talk about
00:03:51.660 prejudice in ways that included things well beyond the kinds of blatant bigotry that they
00:03:56.740 used to exemplify prejudice back in the old days.
00:04:00.680 And so, I thought, well, maybe there's a pattern going on here.
00:04:02.640 Maybe this is a general tendency for harm concepts to expand and inflate over time.
00:04:09.860 And you argue that concept creep in psychology can happen in two ways.
00:04:13.520 There's vertical expansion and horizontal expansion.
00:04:17.000 Walk us through, what does vertical expansion look like?
00:04:20.640 Vertical expansion is just the tendency for a term to come to refer to milder and milder examples.
00:04:26.800 So, that trauma case you just mentioned is really a terrific example of this, where initially
00:04:32.140 trauma referred to things that were really severe, life-threatening, damaging to life and limb,
00:04:38.300 and over time come to refer to things much milder, less severe, less damaging, while still referring
00:04:45.800 to the more severe things as well.
00:04:47.400 So, it's a vertical creep in the sense that there's a kind of downward movement in the
00:04:52.800 range of things that the concept refers to, whereas horizontal creep is more when a word
00:05:00.220 starts referring to qualitatively different things in addition.
00:05:04.660 So, to give you an example of this, bullying is a good case study, I think, here as well.
00:05:09.060 And the idea of bullying has really broadened over time.
00:05:11.320 So, if you'll allow me to go off on a little bit of a excursion here, you know, bullying
00:05:16.740 was introduced to psychology by this Norwegian psychologist back in the 1970s.
00:05:21.360 And he was really specific that it was a kind of peer aggression that occurred among school
00:05:26.240 children that had to be intentional, it had to be repeated, it had to be carried out in
00:05:31.940 the context of a power differential where a bigger or more powerful or older bully terrorized
00:05:38.260 a smaller, weaker, younger victim.
00:05:41.860 And over time, of course, this idea of bullying has been expanded to refer to some milder kind
00:05:47.320 of examples.
00:05:47.900 And all of those criteria have been relaxed in the bullying literature.
00:05:52.720 But an example of horizontal concept creep here, I think, is how we're increasingly using
00:05:58.940 the word bullying to refer not just to things that happen in playgrounds, but also things that
00:06:03.040 happen in boardrooms.
00:06:03.840 So, this expansion of the idea of bullying from something that occurs with children to
00:06:09.120 something that occurs among adults is what I'd call a horizontal creep.
00:06:12.640 It's an expansion, not of severity.
00:06:15.260 No one's saying that adult bullying is milder than childhood bullying, but it's to a different
00:06:20.100 range of experiences, a different range of contexts.
00:06:23.320 So, I would call that an example of horizontal creep.
00:06:26.440 Or if you want to go back to the trauma case, the fact that trauma used to refer to physical
00:06:31.660 wounds and then it expands to refer to psychological wounds is another example of this sort of
00:06:37.360 horizontal creep where the concept broadens out to refer to qualitatively different sorts
00:06:42.880 of phenomena.
00:06:44.580 I want to dig more into some of these examples so we can flesh out, so people can see how
00:06:48.900 different psychological concepts have experienced vertical and horizontal expansion.
00:06:53.480 So, let's dig into this trauma idea more because you just see it anytime you open up a magazine
00:06:57.860 or a website article, there's just like trauma.
00:07:00.780 Everything's trauma.
00:07:01.860 You mentioned that it originally started out, trauma was a physical harm, right?
00:07:05.060 If you lost a limb or you had a big wound in war, that was trauma.
00:07:10.400 And then it shifted that you could also experience psychological trauma.
00:07:14.180 And that was often the result of something very severe.
00:07:16.980 Like what was like the example?
00:07:18.160 Like what was psychological trauma originally described as?
00:07:21.760 Well, I think there wasn't a single kind.
00:07:25.400 And again, also there's this ambiguity here because often people use trauma to refer to
00:07:29.300 the event, the traumatic event, but sometimes they also use it to refer to the psychological
00:07:33.720 response.
00:07:34.520 So, there's a kind of ambiguity in here.
00:07:36.020 But when trauma made the jump from the physical to the mental, it was in the time of Jeanne and
00:07:42.460 Freud and the like.
00:07:43.320 And so, often it was sexual trauma.
00:07:44.560 Often it was sexual abuse, rape, various kinds of sexual harm done to people supposedly causing
00:07:51.700 hysteria and other things like this.
00:07:53.580 So, trauma was events that weren't necessarily causing physical damage to the person, but
00:07:58.020 were in some ways of rupturing their mind or soul in some fashion.
00:08:02.220 And then you'd also see it, you started seeing it a lot in the 70s and 80s.
00:08:06.440 Describe like PTSD.
00:08:08.220 That was, you know, it was caused by a traumatic event.
00:08:10.260 You experienced what, I guess they would call moral trauma, like, and it really harmed you
00:08:14.360 psychologically.
00:08:15.640 Yeah.
00:08:16.140 I mean, the whole advent of PTSD, PTSD didn't exist until 1980 when DSM-III was published.
00:08:22.900 I mean, there'd always been shell shock.
00:08:24.240 There'd always been a recognition that there were psychological casualties of war, but there
00:08:29.360 hadn't been this recognition that a traumatic event could cause a particular kind of mental
00:08:34.380 illness.
00:08:34.680 And so, when DSM-III was published in 1980, it was pretty much in response to the Vietnam
00:08:40.380 War and the kinds of symptoms that were people, that people were facing there.
00:08:45.080 And DSM-III said that trauma was something which was, as I indicated, a life-threatening,
00:08:52.100 damaging situation where the person was at risk of death or serious injury.
00:08:57.280 And look, the word trauma had been used in the physical sense in the early psychiatric
00:09:01.580 classifications where it was referring to physical or chemical or electrical damage to
00:09:08.720 the brain.
00:09:10.140 But only in 1980 did we start talking about trauma as being some sort of psychologically
00:09:15.400 meaningful event that caused harm.
00:09:18.280 And in the case of PTSD, that harm would include flashbacks, would include hypervigilance, high
00:09:25.120 levels of anxiety, and a range of deeply unpleasant and often hard to treat symptoms.
00:09:31.540 And so, you're seeing, again, this vertical creep, right?
00:09:33.880 It moves from the physical, then it moves to psychological.
00:09:36.820 But even at the psychological, when it made that jump, the psychiatrists and psychologists
00:09:41.440 were very adamant, like, this is, trauma is only something like, it has to be like really
00:09:44.360 severe.
00:09:44.800 It's like you were raped or you saw someone die or you did something in war that went
00:09:50.920 against your colleague.
00:09:51.540 It was like, the stakes were really high for there to be considered a traumatic event.
00:09:57.660 Yeah.
00:09:57.920 And look, I think that's where it was in 1980.
00:10:00.840 And then progressively over the next few revisions of the DSM-III, that got relaxed.
00:10:05.540 And look, it didn't get relaxed in some sort of willy-nilly, unprincipled way.
00:10:09.700 There were reasons for it.
00:10:10.840 So, for instance, a psychiatrist often noticed that people showed post-traumatic symptoms,
00:10:16.940 just full-fledged PTSD, but in response to witnessing rather than directly experiencing
00:10:22.300 some sort of traumatic event or through some sort of event which wouldn't quite have met
00:10:27.280 the criteria for being traumatic, according to DSM-III, but nevertheless was pretty severe.
00:10:32.660 And so, over a period of time, and this was arrested a little bit in DSM-5 in 2019, there
00:10:38.800 was this loosening of what counted as a trauma.
00:10:41.720 So, it could include indirect experiences, vicarious experiences, witnessing things rather
00:10:46.880 than having them happen to oneself, sexual experiences which weren't necessarily assaults, but which
00:10:52.200 were developmentally inappropriate.
00:10:53.400 And in various ways, this idea of trauma broadens.
00:10:57.180 And it broadens, you know, as I say, for often quite good reasons, you know, namely that some
00:11:02.700 people show full-fledged post-traumatic stress disorder having experienced something that fell
00:11:07.820 short of the original definition of what a trauma was.
00:11:10.600 So, this idea of vicarious, like this could be if you just saw something like on the news,
00:11:13.920 this could cause trauma.
00:11:16.060 Yeah, yeah, yeah.
00:11:16.920 I mean, I think that kind of indirect experience was allowed.
00:11:21.720 You no longer had to be the person to whom it happened.
00:11:24.160 You just simply had to be aware of it.
00:11:25.820 And of course, the more you do this, the more you broaden these concepts, the more people
00:11:29.840 are potentially being traumatized.
00:11:32.360 And of course, the rates of post-traumatic stress disorder therefore go up because more
00:11:36.600 people are eligible for it, as it were.
00:11:39.920 There's also another thing.
00:11:40.640 There's the expansion by clinicians that's going on.
00:11:43.340 But there's also kind of an expansion going on with popular culture, with just people
00:11:48.060 themselves, where they start, take that idea.
00:11:50.500 They're not like psychologists, but they've heard about it.
00:11:53.080 And then they continue the expansion even more.
00:11:55.120 And as you said earlier, you know, trauma could be just something like just normal frustration
00:11:58.480 for regular people.
00:12:00.600 Absolutely.
00:12:01.200 And I think when I talk about concept creep, I'm not only talking about what professionals
00:12:05.240 are saying.
00:12:06.220 It's just as much what's going in the culture at large.
00:12:09.380 And you're quite right.
00:12:10.440 There is this tendency to grab a concept and run with it.
00:12:14.300 And I mean, that's just the nature of psychology, because there really are no bright lines between
00:12:18.000 what is trauma and what is rather just an unpleasant event.
00:12:21.640 There is gradations of these things and where you draw the line isn't clear.
00:12:25.400 But yeah, lay people, I think for an assortment of reasons, will tend to expand concepts, use
00:12:30.960 concepts more broadly, not just concepts of trauma.
00:12:33.840 But I mean, you can call someone a narcissist just because they're a little bit unpleasant.
00:12:37.340 There's a wholesale borrowing of psychological concepts and using them in a little bit of
00:12:41.700 a promiscuous way.
00:12:43.240 No, you can see how it creeps into the popular culture.
00:12:45.900 A couple months ago, my daughter was having this frustration.
00:12:48.920 She's like, I'm so traumatized.
00:12:50.100 And I was like, what?
00:12:51.580 Where did you hear that, that you're traumatized by that?
00:12:55.400 Because for me, the definition of trauma is like you had to like, it's like PTSD.
00:12:58.300 You had to experience something that gave you PTSD.
00:13:00.500 And that was, you know, the severe stuff, the really heavy stuff.
00:13:03.080 And I was like, where did you learn?
00:13:04.040 It's like, oh, YouTuber talks about that.
00:13:05.680 And I was like, oh, okay, that's interesting.
00:13:08.460 Yeah, look, this happens all the time.
00:13:09.980 And it's interesting.
00:13:11.360 We do some research on this sort of thing.
00:13:13.040 And we find that people have very widely discrepant understandings of what these words mean.
00:13:17.960 So some people like you might have relatively narrow concepts of trauma.
00:13:21.200 Others, maybe like your daughter, or at least the YouTubers who are giving her these ideas
00:13:25.040 might have much broader ones.
00:13:26.840 We aren't using these terms with common meanings.
00:13:29.080 We often mean very different things by them.
00:13:30.940 And as I say, we've done research on this and we find huge variations in the breadth of
00:13:36.100 people's concepts of trauma, of bullying, of abuse, of mental illness.
00:13:40.900 We find that there are systematic differences in the sorts of people who have broader versus
00:13:44.800 narrower concepts.
00:13:45.720 So people who are more politically liberal tend to have broader concepts.
00:13:49.260 Women, on average, tend to have broader concepts of harm.
00:13:52.300 More empathic people have broader concepts of harm.
00:13:55.080 There's an array of different personality characteristics.
00:13:57.700 People who are somewhat more personally vulnerable tend to have broader concepts of harm.
00:14:02.280 It's not about age, incidentally.
00:14:03.940 So often people think it's just these youngsters who have these broad concepts of harm.
00:14:07.780 Actually, age is not the main determinant at all.
00:14:10.840 So you mentioned bullying, and you gave that as an example of horizontal expansion, where
00:14:15.020 it went from schoolyard to boardroom.
00:14:17.500 But you also talk about in your research paper that it's also expanded horizontally by, you
00:14:22.100 can now cyber bully someone, right?
00:14:24.020 So it's like, it goes from the physical world to the virtual world.
00:14:27.700 Yeah, look, I think, you know, bullies and humans in general are versatile, right?
00:14:31.980 So if you've got a new medium for doing something horrible to someone, we'll take it.
00:14:35.620 And again, that obviously couldn't have occurred back in the 70s, because there was no cyber
00:14:40.100 to bully with.
00:14:41.340 And, you know, this is nevertheless a broadening of the meaning.
00:14:45.120 You used to, bullying required you to be in the physical presence of someone in the old
00:14:48.720 days, and now it doesn't.
00:14:49.900 You can do it digitally.
00:14:50.660 And again, no one is saying that cyber bullying is less severe than in-person physical bullying.
00:14:58.520 There's no intrinsic greater mildness of it, but it is a different phenomenon.
00:15:03.400 And I think it's really important here to be clear that I'm not saying this is necessarily
00:15:06.640 a bad thing.
00:15:07.500 I think some people, when they hear the idea of concept creep, they think, ah, this individual
00:15:11.420 is saying we shouldn't be broadening our meanings and it is wrong, or that it's a sign
00:15:15.460 of weakness or vulnerability or fragility or something like that.
00:15:19.720 I'm not saying that at all.
00:15:20.680 I'm saying once bullying expands to include cyber bullying, it's broadened its meaning.
00:15:25.620 And that's a thing that's neither intrinsically good nor bad.
00:15:28.860 How has bullying experienced or has had vertical expansion?
00:15:34.520 Well, I think, again, going back to what Olius, the Norwegian, said about bullying, it had to
00:15:39.000 be behavior that was repeated, intentional, and carried out downwards in some sort of power
00:15:45.800 hierarchy.
00:15:47.180 And over time, all of those things have been relaxed so that we can now say someone's bullying
00:15:50.980 someone else, even if they only did it once.
00:15:53.100 Now, that's intrinsically a vertical expansion, right?
00:15:56.180 Because it means now you don't need to do something multiple times to be called a bully,
00:16:00.060 you just need to do it once.
00:16:01.220 So that's a milder understanding of what bullying might be.
00:16:05.120 You can be a bully through unintentional behavior, according to some ways of thinking.
00:16:10.960 That's, again, arguably a vertical expansion.
00:16:14.960 You could argue with that.
00:16:16.200 I mean, often bullying as well, the focus in the old days used to be on physical acts of
00:16:22.060 commission where you do something bad to someone else.
00:16:24.660 But more and more, bullying is including acts of omission where you just fail to include
00:16:29.680 someone in your social group and things like that, which I think ostracism hurts.
00:16:34.140 I'm not saying that's intrinsically milder, but I think once you start including acts of
00:16:39.880 omission among acts of commission, you are essentially making the behavior more mild.
00:16:45.320 And the other example, I think also in terms of the hierarchy idea, once upon a time, bullying
00:16:50.420 was always downwards in a hierarchy.
00:16:52.200 But then when I do my human resources module at my university, I'm told that you can be bullied
00:16:57.040 by someone below you in the hierarchy or by a peer at the same level.
00:17:00.860 And I think once you start talking about bullying as something that two co-workers do to one
00:17:05.480 another when they're at the same rank, or when an underling bullies someone who's higher
00:17:09.980 up the chain, that's probably in most cases a vertical expansion.
00:17:14.320 That's a milder kind of behavior than when someone in power is bullying someone with less
00:17:18.200 power.
00:17:19.540 Is it also like, you know, just like teasing?
00:17:21.480 That would be sort of good nature.
00:17:22.880 Teasing can be labeled bullying now.
00:17:24.920 Is that like a vertical expansion?
00:17:26.900 Yeah, it would be.
00:17:28.740 And again, no one's saying that teasing is fun necessarily.
00:17:32.360 But that's the other thing I think you see in many examples of concept creep, that it's
00:17:36.800 more and more seen as being a matter of the victim or target's perceptions, not necessarily
00:17:42.640 the intentions of the person who's doing the bullying.
00:17:46.060 So if you experience my teasing of you as being bullying, then it probably is bullying.
00:17:51.320 So there's a kind of subjectivizing of the concepts as well, rather than trying to define
00:17:57.500 the concepts in terms of actual objective behaviors.
00:18:00.420 You also about addiction has gone through concept creep.
00:18:02.440 How so?
00:18:03.980 Well, I think this is another story which, you know, I didn't invent this.
00:18:07.720 A lot of people have observed this before me.
00:18:09.420 But at one point in time, addictions were to ingested substances.
00:18:13.680 So you chewed up your heroin or you smoke your cigarette, and over time you develop a physiological
00:18:19.820 dependency to the substance, which you require more and more of to get the same sort of hit.
00:18:26.840 And there is a physical dependency on this ingested substance, which strictly your body
00:18:31.480 doesn't need.
00:18:32.920 But then over time, we've developed this idea of behavioral actions, where you can be addicted
00:18:37.080 to pornography, to eating, to sex, to love, to gambling, and a range of other behaviors.
00:18:43.120 Some of which, you know, you have to do.
00:18:44.780 I mean, you do have to eat.
00:18:46.060 So it's not as if, like heroin, you don't actually need it to survive.
00:18:49.760 So there's been this general inclusion of acts, some of them merely just bad habits, and
00:18:55.100 describing them in terms of an addiction dynamic, as if you're addicted to the behavior rather
00:18:59.560 than addicted to some substance.
00:19:01.420 And again, no one's saying this is necessarily a bad idea, because there's lots of neurobiological
00:19:06.680 evidence that similar processes are going on when you're addicted to a substance as when
00:19:11.380 you're addicted to a video game, let's say.
00:19:13.880 But nevertheless, it's still an expansion of the idea.
00:19:16.680 Addiction wasn't in the past used to refer to these sorts of habitual compulsive behaviors,
00:19:22.380 and now it is.
00:19:24.540 And I guess an example, too, of a vertical expansion with addiction is that, you know,
00:19:29.540 clinically addiction is, you know, it's a repetitive behavior that gets in the way of
00:19:33.660 your life, right?
00:19:34.500 That just causes problems.
00:19:35.740 Sometimes some people might call something they do repetitively an addiction, but it
00:19:39.720 doesn't really get in the way of their life, right?
00:19:42.200 They might check their phone more than they like, but it doesn't, they can still pay their
00:19:46.940 bills, they go to jobs, not get in the way of their marriage, et cetera.
00:19:50.400 But they might call it that an addiction, even though clinically they might say, well,
00:19:54.060 it's not an addiction.
00:19:56.440 Yeah, quite right.
00:19:57.040 And I think a lot of people say this, and sometimes they say it, you know, kind of flippant
00:20:00.420 way without really meaning it.
00:20:01.580 They're not claiming that they're suffering from a mental illness when they say that they
00:20:04.940 check their phones too often, but they're using this word, which has these connotations
00:20:10.060 of dependency, which also imply that these things might be hard to get out of or that
00:20:14.100 you have limited control over them.
00:20:16.160 So I think the words we use to describe our experiences matter.
00:20:19.780 And if you start using those words in loose, relaxed, inflated kind of ways, that can have
00:20:24.940 consequences.
00:20:26.300 We're going to take a quick break for your words from our sponsors.
00:20:29.760 And now back to the show.
00:20:31.580 Have any other mental disorders like maybe ADHD, anxiety, depression, have those experienced
00:20:37.380 concept creep over the years?
00:20:38.960 Have any not experienced it?
00:20:40.260 I think it's really so common, pretty much any disorder you can think about has probably
00:20:44.660 undergone some change at some point.
00:20:46.900 Now, it hasn't always necessarily been in one direction.
00:20:49.220 So often there's a broadening from one edition of a diagnostic classification to the next, and
00:20:55.460 then it retreats the one after.
00:20:58.320 But for sure, these things have happened.
00:20:59.780 So attention deficit hyperactivity disorder has certainly broadened.
00:21:05.540 And the reason why these things broaden in part is because they're on a spectrum.
00:21:09.400 They're on a continuum.
00:21:10.380 And so where you carve the continuum between those who have the disorder and those who are
00:21:14.060 merely a little bit inattentive or rambunctious is quite hard to do.
00:21:19.300 But certainly you see very large increases over certain periods of time in the diagnosis of
00:21:24.920 attention deficit disorder.
00:21:26.480 And one reason for that is that the diagnostic boundary has shifted downwards so that more
00:21:31.560 people meet the criteria.
00:21:33.780 So that's happened.
00:21:34.700 I think in depression, there's definitely work that people are using the word more loosely
00:21:40.060 than they once did.
00:21:41.240 Everyday people.
00:21:41.840 And there's also some evidence that the professionals have as well.
00:21:45.840 So there's a great book called The Loss of Sadness by Alan Horwitz and Jerry Wakefield, which
00:21:51.380 discusses how the idea of depression at one point referred to very severe melancholia, where
00:21:57.280 the person was essentially often suffering from delusions of rotting from the inside or wasn't
00:22:03.040 simply unhappy.
00:22:03.880 And over time, we've started to refer to what used to be just everyday sadness as depression.
00:22:09.420 We've brought in clinical language to refer to everyday emotions to some degree.
00:22:14.140 Now, that's not to say that in psychiatry, depression has radically changed its meanings.
00:22:20.240 Often these changes in meanings are more how everyday people use these words inappropriately,
00:22:26.620 if you like, compared to professional language, rather than how psychiatry uses these words.
00:22:31.940 But yes, depression has broadened over time.
00:22:34.620 You can say the same thing about some anxiety conditions.
00:22:36.720 You can certainly say the same thing about the autism spectrum, how that is certainly
00:22:40.680 broadened out over time, often in fits and starts rather than in sort of one linear kind
00:22:47.760 of way.
00:22:48.820 But it's really, really common.
00:22:50.880 And look, I'm not the first person to point out diagnostic expansion or concept creep.
00:22:55.700 A lot of people have talked about it.
00:22:57.220 There was a lot of chatter prior to the publication of the last issue of the DSM in 2013, when
00:23:04.920 people were saying normality is endangered because everything is now considered abnormal
00:23:09.680 because our idea of mental illness has just billowed out to become something enormously inflated.
00:23:17.960 With regards to anxiety, I have a friend who's a college professor.
00:23:21.760 And he was, he kind of, he was telling me something like, oh, that's after I read your paper, like
00:23:25.420 that's concept creep in action.
00:23:27.340 He was saying how, you know, maybe 10, 15 years ago when he was teaching, he'd have one
00:23:32.240 or two students that would need some sort of testing accommodation.
00:23:35.640 And usually it was for, you know, they were dyslexic or something like that.
00:23:38.240 And now he says, it's like 30% of my students get some sort of test accommodation because
00:23:43.220 they have a test anxiety.
00:23:44.940 And he's like, it's really interesting to see that happen in just 10 years.
00:23:48.240 Yeah, some of these things happen very rapidly.
00:23:51.500 Some of them happen more slowly.
00:23:53.040 And I think that experience that the professor had is something we see here in Australia as
00:23:57.640 well.
00:23:57.860 It's not a uniquely US phenomenon.
00:24:00.380 And it doesn't necessarily mean that the professional concept of an anxiety disorder
00:24:05.360 has broadened over that time.
00:24:07.460 I mean, we've done some research on this and shown that the tendency for mental disorders
00:24:12.620 to expand over time has been weak overall, present but weak.
00:24:17.340 But how people use those concepts or people's willingness to see their own experience in
00:24:23.000 terms of these concepts and often get a compliant doctor to sign off on them has definitely increased.
00:24:28.880 So more and more people are describing their experiences, not as normal worry or normal anxiety,
00:24:34.940 but more as clinical anxiety, which therefore needs some sort of accommodation or need some
00:24:39.680 sort of treatment.
00:24:40.620 And again, that's not necessarily something you lay at the foot of the psychiatrists.
00:24:44.520 That's really just how everyday people are starting to understand their own experience.
00:24:49.800 And it's having real effects at universities.
00:24:52.680 What's your theory about what's behind concept creep?
00:24:55.580 I mean, do you have an idea?
00:24:57.720 I mean, I guess it's completely theoretical, but what would encourage concept creep, you
00:25:02.140 think?
00:25:03.340 Well, I think there's a pattern here in that there are a lot of concepts which are creeping.
00:25:07.600 There are a lot of these ideas that we've talked about so far that are broadening their
00:25:11.480 meanings, and they're actually quite diverse.
00:25:13.900 So trauma and mental illness and addiction are all to do with clinical psychology and
00:25:19.260 mental health problems.
00:25:20.940 But then there are others like bullying and abuse, which aren't specifically about mental
00:25:24.840 illness.
00:25:25.120 And then there is others like violence and hate and prejudice, which are different yet
00:25:30.020 again.
00:25:30.340 And I think maybe there's some sort of single underlying dynamic for all of these.
00:25:36.180 And what I say, without huge amounts of evidence, I have to be clear, is that there's just been
00:25:41.520 a rising sensitivity to harm within many Western cultures.
00:25:46.020 There's just a greater concern for harm, a concern for caring for others who have been harmed.
00:25:52.580 Harm has just sort of become a more dominant cultural theme.
00:25:56.080 And we are therefore more attentive to it than we used to be.
00:26:00.700 And I'm not just saying that from my armchair.
00:26:03.120 We've actually done some work looking at changes in moral language over the last century.
00:26:07.960 We do find starting in about 1980, after the prominence of harm-related moral concepts had
00:26:14.340 declined throughout the 20th century, you see this fairly steep rise since then.
00:26:20.420 At roughly the time when I think a lot of concept creep is happening, people are becoming more
00:26:24.940 concerned about harm, they're becoming more concerned about the ways in which people are
00:26:29.800 harmed and the way in which people harm others.
00:26:32.220 And the changing meanings are simply a reflection of that rising cultural concern about harm,
00:26:37.540 which I think is quite ambivalent.
00:26:39.280 I mean, being more concerned about harm is a great thing, right?
00:26:41.800 You no longer tolerate bad behaviour, you no longer tolerate sexual harassment as much as
00:26:46.420 you used to, you no longer tolerate bullying as much as you used to.
00:26:49.580 You identify people who might have been languishing without treatment and say, here, here are some
00:26:53.800 treatments for your problems, which we'll now call a mental illness.
00:26:57.020 But maybe also there are some negative aspects as well.
00:27:00.100 So I would say at a broader kind of cultural, societal level, what is going on is this rising
00:27:05.580 sensitivity to harm and the changes in concept meanings come out of that.
00:27:10.860 Now, of course, there are other things which might lead people to broaden the meanings of concepts.
00:27:15.780 So sometimes people do it quite deliberately.
00:27:17.860 People broaden the meaning of a concept in order to achieve some sort of political end.
00:27:22.800 Concepts creep for an assortment of reasons, which we've talked about in some of our academic papers.
00:27:29.060 But I think the dominant thing, as I was saying, is just rising concern with harm in our cultures.
00:27:34.760 Is it the rising sensitivity due, do you think, to the fact that, you know, since about the 1980s,
00:27:39.320 like Western societies have been relatively affluent and safe.
00:27:43.560 And so you become more sensitive to things that, you know, in a previous generation, you would have just ignored because, you know, you were starving or your family was going off to war, etc.
00:27:54.120 So you didn't have the luxury to be sensitive, right, to harm.
00:27:58.240 So now that we are a little more safe, we can be more sensitive to those, to harm.
00:28:03.600 Yeah, look, I think that's a large part of the story.
00:28:06.320 And again, you have to be careful how you say this, because you don't want to create the impression that you think that no one is suffering out there.
00:28:12.280 Of course, there's lots of rotten things happening in the world.
00:28:15.500 But yeah, I think the sort of people who do studies, the sort of people who use the words trauma and bullying and addiction in their understandings of their own experience,
00:28:24.340 tend to have grown up in contexts where there is less harm and damage, where we do live longer, where there is more affluence.
00:28:30.500 And so, of course, it stands to reason that milder things will seem harmful if you are accustomed to less harm.
00:28:36.920 And we do find some pretty good evidence that that's one of the drivers of what's going on with concept creep.
00:28:42.800 So part of it, I think you're right, is just people adjust to the level of risk and threat and danger in their world.
00:28:50.160 And if you've experienced less of it, smaller harms will be more salient to you and more problematic to you.
00:28:55.920 So I think it's partly a story to do with just the objective rising comfort overall of our lives.
00:29:03.460 And it's also a change in our values.
00:29:05.200 So I think there's this rise in what some people have called post-materialist values,
00:29:09.400 where people seek fulfillment and well-being for its own sake, rather than just struggling to get by materially.
00:29:17.380 And that, I think, also contributes to this rising focus on the things that can go wrong in your life and a greater attention to, in the scheme of things, milder problems.
00:29:28.320 You also bring in this idea, this philosopher, Ian Hacking, that might provide some idea about concept creep.
00:29:32.640 What did he have to say that can help us understand concept creep?
00:29:36.800 Yeah, look, Hacking is one of my heroes.
00:29:38.780 He's a philosopher based in Toronto.
00:29:41.700 And, I mean, he has this idea of looping kinds and what he calls dynamic nominalism, if you care about that.
00:29:49.960 But essentially the idea is, he says, as concepts evolve, and he wrote some wonderful stories about evolving ideas of autism and multiple personality and things of this nature and child abuse.
00:30:00.960 Concepts change through time.
00:30:02.740 We all know that.
00:30:03.460 You don't need to be a historian to know that.
00:30:04.900 But what Hacking adds to that that's interesting is that these changing concepts actually change your identities.
00:30:10.400 They bring new kinds of person into existence.
00:30:12.740 Once you start using some sort of concept like autism or like bullying, once you start using these words in different ways, you actually change how people experience themselves and how they identify themselves as being bullied or as being victims or as being traumatized.
00:30:28.640 And those changing concepts through history bring about new senses of personal identity and social identity, which really matter.
00:30:37.140 So it's not as if just the concept changes in some sort of abstract way.
00:30:40.500 It actually changes people, makes new kinds of people exist.
00:30:43.760 You get a greater range of new traumatized people who see themselves as traumatized as a class.
00:30:50.420 And historical changes in concepts sort of find their way inside us to create new identities.
00:30:55.980 So, look, that was probably a little bit waffly.
00:30:57.780 In fact, I'm sure it was waffly.
00:30:59.980 But hacking is sort of giving us a way of showing how concept creep at a cultural level, that is, changes in how the culture at large defines concepts, can have impacts on the individual members of those cultures.
00:31:12.000 No, that makes sense.
00:31:13.160 I mean, so if you were before, if you were just like a worrier, now you say, oh, I have anxiety.
00:31:18.060 And that changes the way you think about yourself and how you interact with the world.
00:31:21.040 Yeah, and how others react to you and how you seek certain kind of treatments and how you receive certain kind of treatments and has all sorts of flow on consequences.
00:31:29.340 And the very same experience at some level suddenly becomes different because the label isn't just a label.
00:31:34.400 The label creates your sense of self, allows others to see you in a certain way as someone who's experiencing a disorder rather than someone who's just experiencing everyday worries.
00:31:44.180 So we've mentioned how there's been concept creep going on from the clinician standpoint with the DMS-5.
00:31:49.600 Like they've been changing it over the years.
00:31:51.400 And, you know, they've, for good reasons, like as you said, maybe we need to, it makes sense to expand trauma in certain ways.
00:31:57.840 But as we also have talked about, there's also an expansion going on with lay individuals.
00:32:03.040 And I've noticed, I would say in the past year or two, this increase of like, I guess we call them like mental health influencers on social media.
00:32:12.940 I don't know if you keep, follow that much.
00:32:16.120 Do you think, I mean, do you think social media is accelerating the idea of concept creep in different ways?
00:32:21.760 I don't follow it too much, but I'm sure you're right.
00:32:23.780 I think it turbo charges everything, right?
00:32:26.260 So the rate of change is just so much more rapid now in part because there's just this instantaneous circulation of new ideas and words get used in new ways all the time.
00:32:37.000 And of course, at some level, this is all good, you know, democratization of ideas and people can, of course, borrow and use these words any way they like.
00:32:45.620 But I do think it does become a bit, you know, to use what I used earlier, promiscuous.
00:32:49.540 So I think you're using words too freely.
00:32:52.100 The words, the clinical words especially get, you know, detached from their actual, you know, professional meanings.
00:32:59.460 And I think at some level you could say, well, who cares?
00:33:02.040 Who cares if someone's talking about being traumatized when it was just some minor romantic breakup?
00:33:07.040 Who cares what language they use?
00:33:08.540 And I think it does kind of matter because if you're framing your experience in clinical language, in terms of diagnostic language, that has implications for how damaging you think the experience will be, what sort of interventions you might need for it.
00:33:22.200 And it changes the whole complexion of what the problem is in your world.
00:33:26.960 So the short answer to your question is, yeah, I'm sure influencers and many others who are using psychiatric sorts of terms in new and broader inflated ways, I'm sure that's occurring a lot.
00:33:40.060 And I do worry a little bit about the consequences of that.
00:33:42.660 So, I mean, there's consequences of concept creep.
00:33:45.180 We'll talk about the negatives, but first, like, let's talk about the positive.
00:33:47.280 Like, what do you think are the benefits of concept creep?
00:33:48.940 What have been the benefits of concept creep, you think?
00:33:52.200 Well, I think, you know, in the abstract, you could just say if you are identifying new harms, which you previously didn't identify as being problems, then you allow them to be dealt with and taken seriously and respected.
00:34:07.180 So if, for instance, in terms of bullying, if in previous times we just thought that nasty behavior by superiors to their underlings in workplaces was just ordinary office politics and you should just harden up and deal with it.
00:34:20.500 I think if you start to use the label of bullying to refer to this, maybe that allows you to control, reduce, deal with, and punish bullying in workplace context, which is a good thing.
00:34:33.140 So that's just an example, I think, where broadening the concept allows you to problematize things that were previously tolerated.
00:34:38.820 You could probably say the same thing about some kinds of abuse or harassed violence, pretty much any concept, if you just lower the threshold for when you identify that concept, it allows you to care for people who have been harmed, harmed in ways that weren't previously considered to be important enough to deal with.
00:34:57.700 So, I mean, that's all a bit abstract, I'm sorry, Brett, but I think it pains to say that there are both costs and benefits.
00:35:04.040 And I think the benefits are problematizing and taking seriously forms of harm that were previously neglected.
00:35:10.400 What about the negative consequences, both for the individual and as a society?
00:35:14.300 Well, I think as a society, you just have to wonder whether it makes good sense if anyone thinks they've been traumatized or if everyone thinks they've got a mental health condition.
00:35:23.580 Or occasionally, of course, lowering the threshold for when some bad thing has happened can be oversensitive.
00:35:29.680 We can, in the case of bullying, for instance, criminalize behavior that really might be unintentional, unrepeated, and really not so bad at all in context, especially if we allow the person who's being victimized to define what counts as bullying to them.
00:35:46.740 I think it can lead to sort of overly harsh punishments for people who've maybe done things that aren't as severe as the term might suggest.
00:35:54.300 I think in terms of the clinical world, again, you have to be really careful how you say this because you do want people to go and seek help when they've experienced some kind of mental illness and not enough people, especially men, do seek help for mental health problems.
00:36:10.120 But then if you define mental health problems so broadly that just about everyone has them, I think you run the risk of people feeling that they're unable to deal with their own problems themselves.
00:36:19.200 They have to seek professional treatment when perhaps they could do pretty good self-help without professional intervention.
00:36:25.320 You see people defining themselves as harmed or as victims when maybe that's not a very helpful identity from the standpoint of recovery and getting better.
00:36:35.740 So I think generally speaking, again, being somewhat abstract here, broadened concepts of harm lead more people to identify themselves as victims and as harmed.
00:36:46.080 And that, if it becomes part of your identity, I think is problematic because it often stands in the way of you getting out of those problems.
00:36:53.620 Harvard psychologists, Peyton Jones and Richard McNally, have done some amazing work on trauma where they experimentally manipulate people's concepts of trauma to give them broader versus narrower concepts of trauma.
00:37:05.240 Then they expose them to a very unpleasant video clip with IRB approval, of course.
00:37:11.940 And they show that those who have a broadened concept of trauma tend to respond worse with more post-traumatic symptoms to the gruesome video, showing that the breadth of your concept of trauma in this case has real emotional consequences for you.
00:37:27.800 And I think much could be said and much could be said about how broadened concepts of mental illness might have, as Hacking would have said, implications for our well-being.
00:37:37.460 Well, Nick, this has been a great conversation.
00:37:38.940 Is there some place people can go to learn more about your work?
00:37:42.740 There's lots of academic papers.
00:37:44.540 I haven't written anything really popular on it.
00:37:47.300 You can find an article by Connor Friedensdorf in The Atlantic from 2016 when the first paper came out.
00:37:53.900 If you want to see what I've been doing and my colleagues have been doing, I've got a ResearchGate page where you can find some of my papers and you can recommend a review paper we have called Harm Inflation that was published a couple of years ago in the European Review of Social Psychology.
00:38:09.440 It's all kind of technical.
00:38:11.240 So if you're into social psychology, you'll love it.
00:38:13.260 If you're not, it might not be right.
00:38:15.020 But look, check out my ResearchGate page and get in touch if you'd like to.
00:38:19.520 All right.
00:38:19.680 Well, Nick Haslam, thanks for your time.
00:38:20.680 It's been a pleasure.
00:38:21.980 Me too.
00:38:22.320 Thanks so much.
00:38:23.720 My guest today was Nick Haslam.
00:38:25.060 He's a professor of psychology at the University of Melbourne.
00:38:27.260 You can find all of his research on concept creep at researchgate.net.
00:38:30.860 Just go to researchgate.net and look up Nick Haslam.
00:38:33.280 Also check out our show notes at aom.is slash concept creep where you find links to resources and we delve deeper into this topic.
00:38:39.440 We'll see you next time.
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00:39:18.840 Until next time, it's Brett McKay.
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