It began in 2011, a “mysterious illness” among teenage girls at the high school in Le Roy, New York (Figure 1) (Asztalos 2011). Six cases were reported, then twelve, then fifteen and counting as the story captured attention across the United States and beyond (“Doctors baffled” 2012). The story’s development included significant coverage on NBC’s Today show and CNN’s Dr. Drew’s Lifechangers. I twice visited Le Roy (just fifty miles from my office) on behalf of the Skeptical Inquirer, to talk with parents and others involved, visit relevant sites, and otherwise investigate this strange outbreak.

Failed Theories

Beginning with at least one case as early as May 2011 and increasing to twelve by early January 2012, the phenomenon originally struck only teenage girls, who exhibited the symptoms of a strange Tourette-like condition with tics (involuntary twitches) and uncontrolled verbal outbursts.

Tourette syndrome is an inherited neurological disorder, and it is not caused by environmental conditions. It is some three to four times more likely to affect boys than girls and tends to occur sporadically in a given population, so the odds against a dozen girls at one location suddenly developing Tourette syndrome are astronomical (Mink 2012; Tan 2012a). Indeed it was not that disorder that assailed the Le Roy teens.

But if not Tourette syndrome, then what could it be? Health professionals considered a variety of possibilities:

Autoimmune disorder. A Health De­part­ment report pointed to a lack of evidence for one touted theory, an autoimmune disorder known as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). While four of the six girls tested did have elevated levels of a strep antibody, the levels were not high enough to involve PANDAS. Besides, for a diagnosis of PANDAS to be made five criteria must be met, and not one of the Le Roy cases met all criteria (New York 2012; Orr 2012). Moreover, PANDAS occurs three times more often in boys than in girls (Swedo 2012).

Vaccines. Some persons suggested vaccines—especially the Gardasil human papillomavirus vaccine, which is given to young females to prevent cervical cancer and is now also approved for use by males—as a potential cause of the outbreak. How­ever, according to a New York State Department of Health report, while seven of the twelve girls had received one or more injections of that vaccine, they were at different stages in the vaccination process; for six of the seven the onset of their symptoms came over a year after their last injection. Moreover, the scientific literature does not show any links between the Gardasil vaccine and tic disorders (New York 2012; Orr 2012).

Drugs. That the symptoms might be caused by something the students ingested—including stimulants, prescription drugs, or other substances—was discounted as unlikely by Jonathan Mink, chief of child neurology at the University of Rochester Medical Cen­ter. (Mink is also cochair of the Tourette Syndrome Association’s scientific advisory board.) Mink noted that it would take a significant dosage of a drug—whether prescribed or not—to cause tics, whereupon other behavior changes would become ap­parent (Mink 2012). The Health Depart­ment noted that toxicology screens for five of seven of the students were negative, while two were positive for prescribed medications (New York 2012).

Environmental causes. Some environmentalists, such as high-profile activist Erin Brockovich, have suggested that toxic substances may be responsible for the girls’ symptoms. In particular they have referred to a site some three-and-a-half miles away (outside the nearby village of Lime Rock) where, on December 6, 1970, a train derailment resulted in the spill of one ton of cyanide crystals (which were promptly removed) and 30,000 gallons of trichloro­ethene (TCE), which still contaminates the site (En­viron­mental Protection Agency 1999) (Figure 2). Brockovich (2012) referred to reports of “an orange-yellow substance oozing up from the ground” in a Le Roy school field. I talked with one afflicted girl’s father, Jim DuPont (2012), who also called attention to the possibility of incomplete combustion of natural gas from four wells drilled on school property.

Figure 2. U.S. Representative Kathy Hochul investigates the site, about 3.5 miles from Le Roy school, where a 1970 train derailment caused a serious toxic spill.

I spent more of my time on environmental concerns than on any other theory—speaking with parents, an environmental activist visiting from Toronto (Tarr 2012), an environmental tester (Rumrill 2012), and beleaguered school superintendent Kim Cox (2012a); twice visiting the toxic-spill site, where I met investigating U.S. Repre­sentative Kathy Hochul; and more. Ms. Cox exhibited grace under fire, especially at a raucous community meeting (Figure 3). She has worked for months with numerous medical professionals and other relevant agencies (the state’s Department of Health and En­vironmental Conser­va­tion and the U.S. Environmental Protection Agency). Professionals from these agencies provided assurance that the school is safe, and an independent firm is conducting ongoing research. So far, tests of air quality and drinking water confirm that conclusion (New York 2012; Holvey 2012; Cox 2012b; Tan 2012c). The alarming “orange ooze” was simply rust fungi, which is common to the Ken­tucky bluegrass sod used for the field. The Health Department’s report (New York 2012) concluded that “the occurrence of symptoms in only female students and the range of time of symptom onset are not consistent with an environmental cause.” Kim Cox (2012a) stressed that point to me, stating that environmental causes would not discriminate between girls and boys, that a wide range of people—younger students, more boys, teachers, staff—would also have been affected.

Figure 3. Panel of school officials and environmental experts hears criticisms at an often heated community meeting held at the school, February 4, 2012.

Conversion Disorder

In time, neurologists diagnosed the students with conversion disorder, “a group of symptoms suggestive of organic disease but without an identified cause in a group of individuals with shared beliefs about the cause of symptoms.” Conversion disorder is, there­fore, a psychological condition whose cause is, typically, “significant life stressors,” the brain “converting” severe mental stress into actual physical symptoms, such as blindness, paralysis, numbness, fainting, and mutism. While conversion disorder (formerly called “hysteria”) is the diagnosis for an individual, the group diagnosis is mass psychogenic illness (popularly called “mass hysteria”) (New York 2012, 7; Goldenson 1970, 260–63). Much additional evidence in the Le Roy outbreak appeared to confirm both individual and group diagnoses.

Of the twelve girls, three had previous medical illnesses associated with tics—one of them “a pre-existing Tourette’s diagnosis” (New York 2012, 4, 6). One of these could have served as an “index” case that produced subconscious mimicry in the other girls. Of the remaining eight (one girl did not seek medical attention), each was discovered to have had a major stress in her life—such as parents divorcing—according to a pediatric neurologist in nearby Batavia, Jennifer McVige, who has seen ten of the girls (Stobbe 2012). Not only had some of the teens’ own physicians diagnosed them with conversion disorder, but McVige and colleague Laszlo Mechtler, MD, also confirmed the diagnosis (Tan 2012b). Neurologists are able to distinguish between movements caused by neurological conditions and those due to conversion disorder. For example, one girl was observed in a video to have a flailing right arm that she was able to later use to carefully apply eyeliner (Tan 2012d).

Some of the parents, however, refused to accept the conversion disorder and mass psychogenic illness diagnoses. Jim DuPont (2012) told me that he instead suspected “a combination of things”—such as some students’ predisposition toward illness, as well as anything that could impair the im­mune system and, of course, any of the various environmental causes—was to blame. Another parent, Beth Miller (2012), told me that she suspected a toxin or other cause, possibly a strep virus. She said the authorities have not looked at other children who report migraines and stomach conditions. (To play Devil’s advocate, I suggested to her that probably some students at any school anywhere would exhibit some such common symptoms.) David G. Lichter, MD, a clinical professor of neurology at the University at Buffalo, observes that it is not uncommon for parents in such a situation to refuse to accept a psychological cause and to “doctor shop” for another diagnosis, which delays proper treatment (Tan 2012a). As for others, Mechtler notes that some will not accept such a psychological diagnosis because “they live a conspiracy life in a bioterrorist world” (qtd. in Tan 2012b).

Yet cases of conversion disorder and mass psychogenic illness are well known: in 2002, ten teenage girls at a rural North Carolina high school exhibited epileptic-like seizures and fainting spells. In 2007 some 600 girls at a Catholic boarding school in Chalco, Mexico, suffered fever and nausea and, in some instances, an inability to walk. Later in 2007, at least eight girls at a high school in Roanoke, Virginia, exhibited twitching symptoms like those that afflicted the girls in Le Roy. In none of these outbreaks was a physical cause found. Mark Hallett, MD, who helps field calls for the National Institutes of Health (NIH), states that the NIH averages two individual reports of conversion disorder per week. But while those cases are common, actual outbreaks involving several people are unusual. And why these outbreaks typically in­volve females is unclear. Some believe it is because of the manner in which girls are socialized to deal with stressful situations (Stobbe 2012). Those susceptible to conversion disorder tend to be “highly smart, vulnerable to suggestion, and very sensitive,” according to a child and adolescent psychiatrist (Tan 2012d).

Figure 4. Le Roy Outbreak, 2011–2012. The original three cases had pre-existing conditions; school was out during the summer; then cases resumed at an accelerating rate.

Meanwhile the Le Roy numbers had increased. By February 2, as many as fifteen cases were reported, including one boy and a thirty-six-year-old licensed practical nurse and mother, Marge Fitzsimmons, whom I met at a community meeting at the school. She accepts her doctor’s diagnosis of conversion disorder (Schenek 2012). By February 4 the number had increased to eighteen students—still only one boy among them (Tan 2012c). (See Figure 4.) Added to this were reports of two girls with similar symptoms in Corinth, New York, some 250 miles away. Interestingly, the Corinth girls are members of a softball team that had stopped in Le Roy during a road trip in July 2011, though this was after one girl’s symptoms had appeared (Roman 2012). While two Le Roy students had reportedly recovered after treatment, a few others regressed somewhat following the publicity and controversy (Mrozek 2012).

Although cases like those at Le Roy sometimes provoke allegations of fakery (indeed one restaurant employee there told me she thought the girls were just looking for attention), most experts think otherwise. Using the analogy of stage fright—which can produce shortness of breath, nausea, and other physical symptoms—experts believe the patients have actual symptoms that they cannot consciously control (Tan 2012a; Stobbe 2012).

Corroborative Evidence

A preponderance of the evidence tends to corroborate the diagnosis of conversion disorder/mass psychogenic illness in the Le Roy outbreak: (1) Medical examinations of the students failed to show any organic disease; (2) expert scientific investigations of the school and its environs failed to disclose any credible infectious or environmental sources for the cases; (3) the sufferers are mostly females, and conversion disorder is more prevalent among fe­males than males; (4) the diagnoses were made by physicians, including neurological specialists, who actually examined the patients; (5) neurologists noted the difference between patients’ imitative movements and those caused by an actual neurological condition; (6) three students had pre-existing illnesses associated with tics (one with a Tourette syndrome diagnosis), which could have sparked cascading cases of subconscious mimicry; (7) a bandwagon effect may be evidenced by the increased number of cases, the off-site case of an adult female, and the cases of two teenage girls in distant Corinth, New York; (8) students who accepted the diagnosis and treatment began to improve; (9) two students treated for conversion disorder were considered re­covered; (10) overall, the Le Roy outbreak fits the profile of other cases of mass psychogenic illness that have been investigated elsewhere; and (11) the diagnosis has been supported by numerous knowledgeable medical and psychological professionals who re­viewed the evidence.

Such an outbreak eventually runs its course. Lichter points out that suffering from a psychogenic illness does not mean that one is mentally deficient or otherwise unhealthy (Tan 2012a). It is important to understand that al­though the teens’ symptoms may have a psychological origin, they are none­theless real and painful. Accord­ing to psychologist Gail Saltz (2012), the sufferers “need a psychiatric or psychological treatment. Treatment does work.” And the neurologist Mechtler assured, “The bottom line is these teenagers will get better” (Jaslow 2012).

Acknowledgements

I am grateful to the many persons in and near Le Roy, New York, who assisted me in my efforts (including several who spoke with me confidentially). Thanks are also due my wife, Diana, CFI Executive Direc­tor Barry Karr, CFI Libraries Director Timothy Binga, Librarian Lisa Nolan, and others, including Roe Giambrone and my assistant, Ed Beck, for research assistance.

References

Asztalos, Jaclyn. 2011. Mysterious illness at Leroy High School. WKBW News (Novem­ber 8). Available at www.wkbw.com/home/Leroyjac-133424788.html.

Brockovich, Erin. 2012. Appearance on Anderson Cooper 360 on CNN, January 30 (cited in Michel 2012).

Cox, Kim. 2012a. Personal communication at press conference. February 4.

———. 2012b. Letter to community, January 31; address at community meeting, February 4.

Doctors baffled as Tourettes-like syndrome spreads. . . . 2012. Daily Mail (UK) (January 27).

Du Pont, Jim. 2012. Personal communication, February 4.

Environmental Protection Agency. 1999. Lehigh Valley Railroad Derailment Site, New York, report NYD986950251 (January 19).

Goldenson, Robert M. 1970. The Encyclopedia of Human Behavior, vol. 1. Garden City, NY: Doubleday.

Holvey, Mary Ellen. 2012. Public presentation as certified industrial hygienist (February 4).

Jaslow, Ryan. 2012. Mass hysteria outbreak reported in N.Y. town . . . cbsnews.com (January 19).

Michel, Lou. 2012. Brockovich’s efforts in Le Roy halted. The Buffalo News (January 31).

Miller, Beth. 2012. Personal communication, February 4.

Mink, Jonathan. 2012. Cited in Owens 2012.

Mrozek, Paul. 2012. Doctor treating 10 Le Roy students says media saturation not helping. The Daily News (Batavia, New York, February 2).

New York State Department of Health. 2012. Investigation of Neurologic Symptoms among Le Roy Jr/Sr High School Students, October 2011–January 2012, Interim Re­port, January 31.

Orr, Steve. 2012. More Le Roy details emerge. Rochester Democrat and Chronicle (February 4).

Owens, Howard. 2012. Expert to discuss tic outbreak in Le Roy. . . . The Batavian (January 10).

Roman, Dayelin. 2012. Girls’ illness still a puzzle. Available at www.timesunion.com/local/article/Girls-illness-still-a-puzzle-2830889.php.

Rumrill, Michael P. Personal communication, February 4.

Saltz, Gail. 2012. Speaking on NBC’s Today show, January 17.

Schenek, Dan. 2012. NY medical mystery: Woman showing same symptoms as Le Roy teens. Available at www.hlntv.com/video/2012/01/31/medical-mystery-adult-shows-symptoms.

Stobbe, Mike. 2012. Associated Press release by AP medical writer, reprinted in ABC News online, “Mass Hysteria Rare, but Usually Seen in Girls,” February 3, 2012.

Swedo, Susan. 2012. As investigator for the National Institutes of Health, cited in Tan 2012d.

Tan, Sandra. 2012a. Mass hysteria cited as cause of problems in Le Roy. The Buffalo News (January 13).

———. 2012b. Le Roy students, public still seek answers. The Buffalo News (January 29).

———. 2012c. Le Roy residents air concerns. The Buffalo News (February 5).

———. 2012d. In search of answers to the many questions in Le Roy. The Buffalo News (Febru­ary 9).

Tarr, Charley. 2012. Personal communication, February 4.

See also Steven Novella’s “The Science of Medicine” column »

The discovery of antiretroviral therapy (ART) transformed HIV infection from a death sentence into a manageable chronic disease.¹ Yet a small group of “AIDS denialists” rejects the science underlying ART, believing it rests on rotten foundations and that the therapy is toxic. These ideas have had deadly consequences. Most infamously, South African president Mbeki set up a panel of AIDS denialists and HIV scientists to debate the issue while delaying the use of ART in the public sector. Over 330,000 South Africans died unnecessarily as a result.²

In an earlier article³ for the Skeptical Inquirer I described the different varieties of AIDS denialism, highlighting the views of Berkeley virologist Peter Duesberg, who believes—despite never having done any clinical research on HIV—that it is a harmless “passenger virus” and that AIDS is caused by recreational drugs, malnutrition, and even antiretroviral therapy itself. He and the other AIDS denialists on Mbeki’s panel recommended that HIV testing be halted and that immune deficiency be treated through “massage therapy, music therapy, yoga, spiritual care, homeopathy, Indian Ayurvedic medicine, light therapy and many other methods.”⁴

This article draws on my recent work revisiting the problem of AIDS denialism, this time focusing on its organized character.⁵ I argue that the symbiotic connection between AIDS denialism and alternative healing modalities is facilitated by a shared conspiratorial stance toward HIV science, which has had powerful community-building effects. AIDS denialism gains social traction through four symbolically and organizationally important roles: the “hero scientists” (notably Duesberg) who provide a patina of scientific legitimacy for the movement; the “cultropreneurs” who offer fake cures in the place of ART; the HIV-positive “living icons” who seem to provide proof of concept by appearing to live healthily without ART; and the “praise singers,” sympathetic journalists and filmmakers who publicize the movement.

Figure 1 shows the organizational connections between the key AIDS denialists. Duesberg is particularly in­fluential. He sits on the boards of Rethinking AIDS (an organization that promotes his views about HIV) and Alive and Well (founded by HIV-positive “living icon” Christine Mag­giore to promote alternative therapies). He also served on Mbeki’s Panel and received extensive coverage in House of Numbers, a recent “documentary” funded in part by Rethinking AIDS.

Figure 1. AIDS denialist networks. Names marked by an asterisk (*) are also linked to Mattias Rath (The Rath Health Foundation); name marked with a pound sign (#) was invited onto Mbecki's panel but did not attend; names in italics are journalists/filmmakers.

Duesberg does more than merely question or rethink HIV science: he actively publicizes his unfounded claims. Mark Wainberg, a microbiologist and past president of the Inter­national AIDS Society, called him “probably the closest thing we have in this world to a scientific psychopath.”⁶ Duesberg’s supporters, however, interpret such criticism as evidence of his unfair oppression by a corrupt “AIDS establishment.” Accord­ing to Celia Far­ber, Duesberg’s leading praise-singer, “As AIDS grew in the 1980s into a global, multibillion-dollar juggernaut of diagnostics, drugs, and activist organizations, whose sole target in the fight against AIDS was HIV, condemning Duesberg became part of the moral crusade.”⁷

David Rasnick, who writes with Duesberg, is also a hero scientist of sorts. He assisted the Rath Health Foundation with its illegal South African trial (which resulted in several unnecessary deaths) in which AIDS patients were taken off antiretroviral therapy and put onto high-dose vitamin products in­stead. The Alive and Well website claims he is the creator of protease inhibitors, but his name does not ap­pear on any of the relevant patents. More important is Kary Mullis, an eccentric chemist who won the Nobel Prize for inventing the polymerase chain reaction. Mullis, who openly discusses his experimentation with hallucinatory drugs and alleged encounters with extraterrestrials, has never worked on HIV; however, precisely because he won a Nobel Prize, he is a symbolically important hero scientist.

Robert Leppo, a venture capitalist who sits on the board of Rethinking AIDS, funds Duesberg’s laboratory as well as Rethinking AIDS. Farber describes Leppo as the “reluctant hero of the underground” who “saved Dues­berg from utter dissolution” after his federal funding was supposedly cut off “as punishment for advancing a scientific hypothesis that differed from that of the establishment.”⁸ Leppo was also the executive producer of an AIDS denialist film, The Other Side of AIDS, the promotional material of which describes him as “deeply involved in researching new medical protocols and alternative therapies, many of which are AIDS related.”

The link between AIDS denialism and alternative medicine is embodied by what I term “cultropreneurs.” Cul­tro­preneurs use AIDS denialism and related conspiracy theories to undermine the credibility of antiretroviral therapy—a convenient marketing device for their alternative therapies. For example, the Rath Health Founda­tion describes antiretroviral therapy as a form of genocide inflicted on society by the “pharmaceutical drug cartel.”⁹ Gary Null, who sells a variety of books and alternative healing products, makes similar conspiratorial suggestions and often features AIDS denialists on his radio show.

A common notion promoted by cultropreneurs is that AIDS symptoms are caused by stress and harmful mental states. For example, Michael Ellner, the president of HEAL (Health Education AIDS Liaison), runs a “medical hypnosis” service and claims¹⁰ that it is the shock of an HIV diagnosis that kills people because such a diagnosis creates “very toxic emotional states,” which supposedly “knock out and undermine” the body’s natural defenses. Repairing the victim’s mental state is thus his solution to AIDS—a convenient prescription given Ellner’s line of work.

Roberto Giraldo, another member of HEAL who sits on the boards of organizations such as Rethinking AIDS and Alive and Well, describes himself as a “natural health counselor” and runs a clinic of “integral psycho immunology” in Brazil. Infamous for advising Mbeki’s health minister on nutritional alternatives to ART, Giraldo subsequently went on to promote organized AIDS denialism in Latin America.

Cultropreneurs, and indeed all alternative therapists, rely on anecdotal evidence and testimonies of people who were pleased with their treatments. The “living icon,” the person who through his or her very existence “proves” that HIV disease can be fought with alternative remedies, thus plays a crucial role in the cultropreneur’s success. The most important of these icons for the AIDS denialist movement was Christine Maggiore, who not only actively promoted the cause of AIDS denialism but tragically also put her own health and that of her family on the line.

In the preface to her widely distributed book, What if Everything You Thought You Knew about AIDS Was Wrong?, Maggiore says she lost faith in HIV science after a series of inconsistent HIV tests. This prompted her to conduct her own investigation “outside the confines of the AIDS establishment” and to start her own organization, Alive and Well, to “share vital facts about HIV and AIDS that are unavailable from mainstream venues.” Writing in 2000, she observed that her HIV status had been “decidedly positive” for five years, but that she was enjoying good health and was living “without pharmaceutical treatments or fear of AIDS.”¹¹

The saga of Maggiore’s test results is a crucial foundational narrative for her as an AIDS denialist and features prominently in House of Numbers. Indeed a central AIDS denialist claim is that because different HIV tests can deliver different results, the entire edifice of AIDS science is flawed. Mag­goire’s test results are presented as a case in point.

The laboratory report shown in House of Numbers purporting to be Mag­giore’s first HIV test result is a positive Elisa test (for the presence of HIV antibodies) and a positive Western blot test (for HIV antigens) showing reactive bands for the p24 and gp120/160 antigens but not for p31. The absence of p31 suggests either a relatively new HIV infection or a 4.8 percent chance of a false positive test—thus the correct procedure in such a scenario is to counsel patients that the result is inconclusive and further testing is necessary.

Maggiore states that the second test came back “indisputably positive” and she was told that she had “five to seven” years to live and that her only treatment options were the eventual use of ART. Maggiore’s response was to find another doctor who “didn’t routinely fill people with toxic pharmaceuticals and lethal predictions” and to conduct further tests. These were apparently indeterminate, positive, negative, and positive. Evidence for the negative test result is unclear, however, as the clip shown in House of Numbers focuses on a fragment of the test result that shows nothing demonstrative of a negative result. But when the film shows the final test result, it is clear that all bands on the Western blot are positive for HIV antigens—an unequivocally positive result.

Maggiore concludes from her experience that HIV tests are “unreliable and inaccurate.” Yet the progression of her HIV tests from indeterminate to positive is consistent with her first test having been conducted soon after she became infected with HIV and sub­sequent tests being performed in line with clinical practice and culminating in an unambiguously positive test result.

Maggiore’s book, endorsed by Dues­berg, Rasnick, and Mullis, is a good illustration of AIDS denialist tactics. The first tactic is to deny the evidence. Thus, in her section on ART, Maggiore makes the baldly false statement that four years into the era of highly active antiretroviral treatment “there are still no reports in scientific journals that provide evidence for health improvement in patients taking these powerful drugs.” The second tactic is to dismiss the evidence that does not suit the case; for example, to reject studies showing that CD4 counts (an indicator of immune functioning) im­prove for people on ART because they are “surrogate markers” of the presence of HIV.

When she was pregnant in 2002 with her second child, Maggiore was featured on the cover of Mothering (a now-defunct pro-alternative healing and anti-vaccination magazine) with a red circle slash symbol over the letters “AZT” (an antiretroviral drug used to reduce the chances of transmitting HIV from mother to child) emblazoned across her abdo­men. After the baby, a daughter called Eliza Jane, was born, Maggiore in­creased the risk of transmitting HIV to the baby yet further by breastfeeding her. Tragically, Eliza Jane died at age three of what the Los Angeles coroner ruled to be AIDS-related pneumonia. Seven weeks earlier, Maggiore had stated on a radio show that her children had “excellent records of health,” yet the coroner reported that Eliza Jane was under-weight, under-height, and had pronounced atrophy of her thymus and other lymphatic organs. He found Pneumocystis jirovecii, a common AIDS-related opportunistic infection that is the leading cause of pediatric AIDS deaths, in the baby’s lungs and protein components of HIV (p24) in her brain.

Maggiore and her supporters, however, denied that HIV had anything to do with the death, relying instead on a rival report by Alive and Well advisory board member Mohammed Al Bayati, an animal toxicologist who is neither a medical doctor nor board-certified in human pathology and who consults on “health issues related to AIDS, adverse reactions to vaccines and medications” for $100 per hour.¹² According to him, Eliza Jane died because of an allergic reaction to an antibiotic.

Maggiore also raised questions about the autopsy tests and dismissed the presence of p24 capsid protein in Eliza Jane’s brain (a clear indication of HIV infection) as being the result of a medical “scavenger hunt” designed to make an HIV diagnosis. Farber agreed, writing that the coroner had gone out of his way to make the death look like it was AIDS-related simply because she was Maggiore’s child. Farber attributed public anger against Maggiore for Eliza Jane’s death—manifested in angry emails, web postings, and even printed flyers—to “the impossibly censorious and even brutal treatment one can expect if one is branded an ‘AIDS denialist.’” She observed:

I started to see the story as one that was less and less medical, more and more psycho-social—a story of an almost crushing kind of mob rule, where the victims have no rights. Few could resist the delicious temptation to condemn a “denialist” mother, or to appropriate EJ as their own tragic little girl. It was all done in the pitch-perfect tones of the AIDS morality play some of us know so well.¹³

Farber’s argument is remarkable for its failure to consider that Eliza Jane was the victim in this instance, and that the “AIDS morality play” she sneers at is rooted in genuine social concern about the wellbeing of children. As Wain­berg put it, “Maggiore was so mis­guided in believing this concoction of bullshit, that it cost not only her life, which is her business, but also the life of her three-year old kid, and that is everybody’s business.”¹⁴

John Moore (a virologist) and I made a similar point, arguing in a New York Times op-ed (“Deadly Quackery,” June 4, 2006) that those who stand in positions of authority, be it president of a country (Mbeki) or a parent, should not indulge their own intellectual questionings and rejection of the scientific consensus when it is others who pay the price. This prompted a subsequent email exchange with Maggiore—later posted by Rethinking AIDS on the Internet¹⁵—which is illuminating for the way in which scientific evidence is immediately deflected by AIDS denialists with further questions as if the questions themselves are sufficient to dismiss the evidence. Maggiore questioned our conclusion (based on the coroner’s report) that Eliza Jane had died of AIDS and asked me to explain “how does Eliza Jane’s eight-year-old brother, raised in the same manner as his sister, test HIV negative?” She also disputed our observation that she was spreading “dangerous views” by claiming she was simply raising “unanswered questions” in the hope of being provided with “answers and references.”

I subsequently provided her with references showing high death rates among untreated HIV-infected children and pointing to the benefits of ART in extending life (and she predictably responded by raising problems with the design of the trials, including their reliance on “surrogate markers” and denying that there had been any scientific advance showing how HIV causes AIDS). When I argued that not all children born to HIV-positive mothers test negative, and hence that her son Charlie was one of the “lucky ones,” she responded by asking for a “more cogent explanation.”

I also expressed the wish that

When you reach the stage when HIV has undermined your immune system sufficiently to start causing you serious health problems, I sincerely hope that you start taking antiretroviral therapy. By all ac­counts, you are a good mother to Charlie, and it would be sad for him to lose you unnecessarily early. Three of the survey fieldworkers who work in my research centre started antiretroviral treatment in the past two years and they are all doing very well—and one of them even gave birth to a (HIV-negative) child. This is all great cause for celebration and hope in this horrible epidemic.

She responded by pointing out that she was in her fourteenth year of living with HIV “with no medications and no health problems” and asking rhetorically, “How long do you suppose I might expect to continue in this way?”

(Although Maggiore lived longer than average, she eventually progressed to AIDS and died three years later. Most people progress from HIV infection to AIDS within ten years, but 5 to 15 percent are able to fight off the infection for much longer—a feat scientists believe is genetic.) With regard to my fieldworkers, she said:

How do you measure “doing well”—clinical health, lab markers? I know a great number of HIV positive women who have given birth to HIV negative children without taking anti-HIV meds. The common factors among them are natural good health prior to testing positive, excellent nutrition, regular use of vitamin supplements, regular exercise, no use of AIDS meds, prescription drugs or street drugs, no smoking or drinking. Why are their experiences not “cause for celebration and hope” for a healthy, low cost alternative to toxic drugs whose long-term effects on mother or child remain unknown?

In other words, our exchange was clearly fruitless. It illustrates how people in denial can, as psychologist Seth Kalichman observes, construct a reality that is “impenetrable by facts.”¹⁶ When Eliza Jane died, Maggiore told re­porters: “I have been brought to my emotional knees, but not in regard to the science of this topic. . . . I am not second-guessing or questioning my understanding of the issue.” Maggiore remained in denial to the end, dying in 2009 at the age of fifty-two of bilateral bronchial pneumonia and disseminated herpes viral infection, each of which is a common AIDS-related opportunistic infection. That she was prepared to endanger her own life, and that of her family, speaks volumes about the passion and sincerity with which AIDS denialist beliefs can be embraced and to the powerful psychological forces at work within those beliefs.

A professional independent pathologist conducted an autopsy on Mag­giore, but the report was never released by the family. Instead, Al Bayati offered a predictable “interpretation” of it—namely that despite the presence of AIDS-defining conditions, Maggiore, like her daughter, had died of antibiotic poisoning. Clark Baker, a retired traffic cop and active AIDS denialist, came up with a variation on the typical AIDS conspiracy theory, stating that “it is clear that corrupt officials from within the LA County Department of Health have pressured officials into making false claims that Maggiore and her daughter died of HIV so that pharmaceutical marketers could induce useful media idiots to perpetuate the myth on their behalf.”¹⁷

The death of this important living icon was obviously a hard blow for organized AIDS denialism. Maggiore’s organization Alive and Well posted a memorial notice when she died, but visitors to the website today are still greeted with a “message” from Christine Maggiore on the “about us” page that gives no indication that she is dead.¹⁸ Anti-AIDS denialist sites respond to such attempts to obscure and downplay the deaths of living icons by publicizing them—see for example www.aidstruth.org/denialism/dead_denialists. Other at­tempts have been made to create new “living icons”—for example, the people profiled on a website called We Are Living Proof¹⁹—but none of them comes close to being able to replace Mag­giore’s symbolic and organizational power.

The symbolic importance of Mag­giore—and now of her death—is illustrated in this posting by a one-time AIDS denialist. He talks about how his “dissident” beliefs encouraged him to ignore his positive HIV test result, but that when he heard that Maggiore had died, alarm bells started ringing for him for the first time:

In 2008 I had bumped into the website aidstruth.org and, while reading it in a “yeah blah blah whatever” kind of attitude, I saw the “denialists who have died” and “who the denialists are” sections. Something clicked. And very soon after I paid one of my usual visits to the Alive and Well site and found the memorial text about Maggiore’s death. It didn’t mention the cause (of course) so I Googled away thinking “please, let it be a traffic accident or something,” and bam! Pneumonia. . . .

You know how denialists usually say it’s just a coincidence, like “why not? Anybody can have pneumonia,” but having recently read the list of dead denialists and wondering if those weren’t too many untimely coincidences, for me Maggiore’s death is where I drew the line. For me it was the “one too many” coincidence. That’s where I secretly started to wonder if I had been wrong.²⁰

Medical science is more trustworthy than alternative medicine precisely because the former is built on randomized controlled trials, whereas the latter rests on anecdotes and individual testimonies. It is thus somewhat ironic that a single death—Maggiore’s—has possibly done more than scientific rebuttals to fight AIDS denialism. Precisely because this death was that of a living icon who rejected HIV science in favor of alternative therapies, it carried disproportionate weight for those tempted by AIDS denialism. It illustrates how the battle for science and reason is not always just about “the facts,” as some facts are symbolically more important than others.

Notes

1. For a recent readable summary of the evidence, see Volberding, P., and S. Deeks. 2010. “Antiretroviral Therapy and Management of HIV Infection.” The Lancet 376: 49–62.

2. Nattrass, N. 2008. “AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa.” African Affairs 107 (427): 157–76.

Chigwedere, P., G. Seage, S. Gruskin, T. Lee, M. Essex. 2008. “Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa.” Journal of Acquired Immune Deficiency Syndrome 49: 410–15.

3. Nattrass, N. 2007. “AIDS Denialism versus Science.” Skeptical Inquirer 31 (September/October): 31–37.

4. http://www.info.gov.za/otherdocs/2001/aidspanelpdf.pdf

5. Nattrass, N. 2012. The AIDS Conspiracy: Science Fights Back (Columbia University Press, New York). Additional references and citations for this article can be found here.

6. www.whale.to/a/wainberg_h.html.

7. Farber. C. 2006. “Out of Control: AIDS and the Corruption of Medical Science.” Harper’s Magazine March: 37–52.

8. Farber, C. 1999. “Ignoring the Flames.” Impres­sion August. Available at www.virusmyth.com/aids/hiv/cfflames.htm.

9. http://www4.dr-rath-foundation.org/THE_FOUNDATION/the_truth_about_arvs/index.html.

10. www.ellner.info.

11. Maggiore, Christine. 2000. What If Everything You Thought You Knew about AIDS Was Wrong?, fourth edition revised. American Foundation for AIDS Alternatives, Studio City, CA.

12. http://www.toxi-health.com/consult.html.

13. Farber, C. 2006. “A Daughter’s death, a Mother’s survival.” LA City Beat (June 8). Available at http://justiceforej.com/Farber-CityBeat-EJ.pdf.

14. quoted in Law, S. 2009. “In Denial.” McGill Daily (November 16). Available at http://www.mcgilldaily.com/2009/11/in_denial/.

15. http://www.rethinkingaids.com/challenges/moore-maggiore-scovill.html.

16. Interview with Seth Kalichman: http://www.thebody.com/content/art52090.html.

17. http://www.pinknews.co.uk/?comments_popup=14994.

18. http://www.aliveandwell.org/html/top_bar_pages/aboutus.html.

19. http://wearelivingproof.org/.

20. http://denyingaids.blogspot.com/2010/07/how-aids-denialism-can-kill-you-part.html

If many sources on cable TV and the Internet are to be believed, the world is currently under attack by a variety of supernatural forces, apparently acting in concert.

Such reports are ubiquitous. Aliens appear at night on deserted country roads. The ghosts of hoary and defunct Scottish peers turn up on castle battlements, demanding retribution for ancient defeats at the hands of the Sassenach. Bigfoot, all eight or nine feet of him, runs past a given cabin on his way to some cryptozoological tryst—and all of it winds up on television.

What, exactly, is going on?

There is a difficulty in explaining many of these paranormal “sightings.” At first, one might expect that the witnesses to these phenomena would be residents of the wilder shores of psychological instability; however, many of the people who report these things are sober, educated, reasonable individuals. Many are ac­tively adverse to publicity, and an ap­preciable fraction of them passes polygraph tests. In short, many of these witnesses—in fact, probably the majority of them—are neither lying nor mentally ill. They have normal nervous systems, and they are convinced that they have experienced something extraordinary.

Logically, therefore, there are only two viable explanations for the events these people claim to experience. Either Bigfoot, the ghosts, and the Gray aliens actually exist, or the individual witnesses to these exotic beings have actually observed and misinterpreted relatively prosaic phenomena. If the latter is the case, then these misinterpretations are very literally eyewitness errors and, as such, are governed by the same psychological principles that operate in eyewitness processes in the forensic world.

Eyewitness Memory and the ‘Paranormal’

On average, most of us think of eyewitness memory in relatively narrow terms, such as criminal identification via police lineups. In fact, the eyewitness field has much broader significance both in the criminal justice system and beyond. Every human phenomenon involving reportage—from recall of childhood memories in psychotherapy to the observation of a planetary transit—coalesces around some kind of account of some variety of human experience. This means that the processes involved in eyewitness cognition per se are continually operating, albeit at a relatively subtle level, through the entire fabric of human existence.

Unfortunately, eyewitness memories are frequently wrong. In my own work I have found that people, including and perhaps especially jurors, tend to think of the human nervous system as some kind of digital recorder, faithfully reproducing what we’ve actually seen when, in fact, nothing could be further from the truth. Eighty years ago (Bartlett 1932) it was demonstrated that human memories become reconfigured—changed in terms of gist, brevity, and personal belief. Our memories lose detail; they become shorter; and what we think we’ve seen frequently replaces what we’ve actually seen. These aspects of human memory have been reconfirmed by modern studies (e.g., Ahlberg and Sharps 2002) and have been shown as far back as the 1970s to be directly important for eyewitness memory; for example, Loftus (1975) showed that witnesses will typically “remember,” and confidently re­port, the color of a barn in a given scene as red even when there is no barn in the scene to be observed. This illustrates the effect of personal belief on an individual’s memory. People generally expect barns to be red; therefore, when Loftus asked experimental witnesses for the color of the barn they had seen, their imaginations obligingly provided the most typical color even though no actual barn had been presented to them.

Our recent experimental research has underscored this effect (Sharps et al. 2009; see also Sharps 2010). In studies of witness errors derived from a violent crime scene, the most prevalent error
(an average of nearly two errors of this type per witness) was a mistake in the physique or clothing of a gun-wielding perpetrator. However, the second most prevalent error (an average of 1.25 errors of this type per witness) was one of “inference, extrapolation, or imagination”: in other words, the average witness simply made up, out of whole cloth, one and one-quarter nonexistent “facts” about a given violent crime.

‘Seeing’ the Supernatural

Human memory, therefore, is malleable: what you see is not necessarily what you get. This concept has obvious relevance to sightings of the “unexplained.” It is clearly possible for a human being—for example, at twilight when visual acuity is reduced—to see an angry cow behind a bush but come out of the situation with a clear memory of a menacing Bigfoot. A wisp of fog or smoke seen in the indirect glare of a streetlight becomes a ghost; the bright lights of a factory, seen at night through an industrial haze, become a UFO.

Yet how does a given witness transform the prosaic into the miraculous? What are the psychological processes operating in a normal person by which this transmutation is to be accomplished? In other words, what psychological factors would be likely to turn prosaic reality into a supernatural or paranormal representation in the mind?

The Psychology of Atypical Perception

My students and I (Sharps et al. 2006) focused on three specific psychological characteristics—depression, dissociation, and tendencies toward attention deficit hyperactive disorder (ADHD)—in a study of seventy-eight adults. This study employed standardized instruments for the measurement of ADHD, dissociation, and depression in each respondent and evaluated these measurements against respondents’ self-ratings of paranormal beliefs of various types. We chose these characteristics for two reasons.

The first reason is that while none of these conditions is something you’d want to have, none constitutes mental illness per se. Although these conditions may, at their higher levels, become classifiable as symptoms of mental illness, at their lower, everyday levels, virtually everyone experiences depression or dissociation at times. Even symptoms of ADHD are distributed normally in large populations (Buitelaar and Van Engeland 1996). In other words, you don’t have to have a diagnosable condition of ADHD to have a little ADHD. Subclinical, non-diagnosable levels of these three conditions are highly prevalent in the human population.

The second reason we focused on these three conditions is that they make sense as potential predisposing agents for belief in and perception of the paranormal. Consider ADHD, especially those forms that involve a degree of hyperactivity. Individuals with these characteristics tend to be attracted to active, ex­ploratory activities and lifestyles (Bark­ley et al. 2008) similar to those often de­picted in science fiction. There­fore, it makes sense that people with subclinical levels of ADHD might find themselves thinking about, wishing for, and believing in strange and menacing animals such as Bigfoot and the Loch Ness monster, or in UFOs and space aliens, which would provide evidence of adventurous possibilities beyond the Earth.

Similar considerations apply to the de­pressed, although these involve different paranormal objects. While we could find no reason why a depressed person would be attracted to Bigfoot, ghosts are another matter—they represent the prospect of an afterlife in which things might get better. Also, the depressed might be more likely to believe in aliens and their UFOs as well: an abundance of movies and TV programs preaches the joys of being selected for a benevolent alien abduction, removed from earthly torments, and presented with exotic new cosmic possibilities.

What about dissociation? People with some level of dissociation tend toward a diminished critical assessment of reality. Dissociated people may feel “strange” about themselves, even to the extent of feeling that they are undergoing out-of-body experiences. They may have anomalous perceptions of the passage of time or of their own experience. The world may appear to be “not quite real or … diffuse” (Cardena 1997, 400). This disconnection with reality might incline those with even subclinical levels of dissociation to view impossible or highly improbable things with an enhanced level of credulity. For this reason, it was anticipated that people with dissociative tendencies would be prey to paranormal beliefs at higher levels than the general population. However, here we see no thematicity as we did with depression or ADHD; in short, we would not expect individuals with dissociation to focus on any specific area of the paranormal.

Therefore, we hypothesized a higher degree of belief in “cryptids” (unknown animals such as Bigfoot) and in aliens for those with ADHD tendencies; a higher degree of belief in aliens and ghosts for those with depressive tendencies; and a generally higher level of nonspecific belief in the paranormal for those with dissociative tendencies.

Experimental Confirmation

These hypotheses were entirely supported by the empirical results of our study (Sharps et al. 2006). We found this result exciting because, for the first time, we had proof of the involvement of specific psychological processes in paranormal beliefs. Very specific hu­man psychological characteristics can be used to predict belief not only in supernatural prospects generally, but also in specific kinds of paranormal “beings.” In view of abundant research demonstrating the malleability of memory in the face of personal beliefs, this research clearly brings belief in the paranormal into the realm of predictive scientific psychology. What you are like as a person contributes in scientifically predictable ways to what you’re willing to believe.

However, this initial study addressed belief, not perception. While we would theoretically expect belief to drive perception, the question of perception itself is another matter. There is, after all, a significant difference between believing that there might be a Bigfoot and seeing one in your yard. What evidence is there that specific psychological characteristics drive the tendency to see paranormal things, to misinterpret the prosaic as if it were the fantastic?

Why We See Things That Aren’t Really There

My students and I addressed this issue in a second study (Sharps et al. 2010) of ninety-eight adults, using the same standardized instruments for the measurement of dissociation, ADHD, and depres­sion. We acquired from public-domain Web sources a series of digital photographs purporting to depict Big­foot, space aliens, or ghosts, which we then presented in counterbalanced series to our respondents via PowerPoint. Re­spondents were asked to rate the probability that the given photograph actually depicted the Bigfoot, ghost, or alien in question.

This study, then, tested directly the effects of psychological characteristics on the tendency of an individual to identify a stimulus item as paranormal in nature. In this study, dealing with effects on perception as opposed to belief, the in­fluence of neither ADHD nor depression was sufficiently powerful enough to influence perception. How­ever, dissociation strong­ly predicted the tendency to perceive a given photograph as actually depicting a paranormal being. More specific analyses demonstrated that this influence of dissociation was significant for Bigfoot and for aliens but not for ghosts. Thus, although the effects of psychological characteristics were shown to be different and more limited for perception than for belief, the overall effect was confirmed: those with dissociative tendencies were more likely to identify “beings” as genuinely paranormal or supernatural than were those without these tendencies. Since the majority of human beings report some dissociative experiences (DePrince and Freyd 1999), this result may be of substantial interest in explaining the burgeoning numbers of paranormal beings infesting our cable television.

Experiments in Context

These studies showed us two things. First, people with identifiable psychological profiles are not only more likely to believe in the paranormal or supernatural, but their psychological tendencies may also be used to predict the exact types of “unexplained” phenomena in which they are likely to believe.

Second, one of these psychological characteristics—a tendency toward dissociation—allows us to predict individual proclivities toward seeing a given stimulus item as a paranormal creature, whether Bigfoot or an alien.

Seeing Is Not Believing

It should not be surprising that the influence of psychological factors on perception is different from that influence on belief. Beliefs in the paranormal can be “gestalt” (Sharps 2003, 2010), lacking immediate direct challenge from the physical environment; people can believe in Bigfoot, for example, without actually expecting to see one. However, perception of a given paranormal being is much more immediate and feature-intensive; therefore, some psychological tendencies that influence belief may not be powerful enough to alter feature-intensive perception of immediate reality—to actually transform a bear into a foraging Sasquatch. Only dissociation, we found in our experiments, is sufficiently powerful to influence both belief and perception, to propel a real-world stimulus into the realm of the paranormal.

Why Don’t the Dissociated ‘See’ Ghosts as Well as Cryptids and Aliens?

Bigfoot and alien perceptions were subject to the effect of dissociation, but ghost perceptions were not. Why? In Western culture, cryptids and aliens are largely perceived as “fringe” constructs. Ghosts are less so; for example, many sober individuals, the late novelist Michael Crich­ton among them (1988), feel and report a strong conviction that a dead loved one is “present” in the mortuary or at that person’s funeral. In short, “seeing” or “feeling” a ghost may be more socially legitimized than the same perception of a cryptid or a space alien, with a resulting enhancement in feelings of credulity. If so, this phenomenon points to the need for further research on the intersection of culture with individual psychology in this area.

A person need not, in any technically accurate sense, be mentally ill to “see” a paranormal “being.” This is a crucial caveat. Our respondents were not in any sense “crazy” or mentally ill. All three of the conditions addressed are those that many people in the normal population experience at subclinical levels. These were normal people, yet their proclivities in these regards made them particularly susceptible to beliefs and perceptions of a paranormal or supernatural type. Since normal people in their everyday lives are not typically subjected to psychological analysis of their subclinical tendencies, we are faced with an interesting fact: anybody could be the person who sees Bigfoot or a space alien emerging from his UFO. The unfortunate individual who sees such a thing is vanishingly unlikely to know of the psychological quirks that rendered the given observation—or rather its interpretation—possible.

Why do we characterize such a person as unfortunate? This is a critical point, more important than it may at first appear. If searching for Bigfoot, looking for the Loch Ness monster, or delving after little green men from the planet Grak were merely a pleasant diversion, an excuse to hike in the woods and deserts or to buy a really good telescope, there would be little reason to extend scientific anathema to these concepts. These ideas obviously don’t elevate the level of scientific discourse; but beyond that, for most people, what’s the harm?

Unfortunately, these ideas can prove harmful. Much of the evidence is anecdotal or derived from popular sources, but it appears that an encounter with the perceived paranormal can be a life-damaging if not life-destroying experience. Social, marital, and economic harm can readily accompany the obsessive interest of a “contactee” whose life, relationships, and career are derailed by the conviction that “the truth is out there.” The author alone has known intelligent individuals whose lives of semi-employment and solitude have resulted at least in part from the search for nonexistent beings from beyond; none of this is necessary, for the simple reason that we now understand what brings human beings, with human nervous systems, to paranormal perceptions and beliefs. We can now demonstrate, using well-established methods of experimental psychology, that the human mind is perfectly capable of constructing the beliefs and the perceptions that frequently lead to a profitless search for the creatures of the Twi­light Zone. We hope these findings will help lead intelligent, educated individuals to pursue the genuine mysteries of neuroscience, zoology, and astronomy to the exclusion of the useless pursuit of the phantoms that reside in the interstitial spaces of our infinitely inventive minds.

References

Ahlberg, S.W., and M.J. Sharps. 2002. Bartlett revisited: Reconfiguration of long-term memory in young and older adults. Journal of Genetic Psychology 163(2): 211–18.

Barkley, R.A., K.R. Murphy, and M. Fischer. 2008. ADHD in Adults: What the Science Says. New York: Guilford.

Bartlett, F.C. 1932. Remembering: A Study in Experimental and Social Psychology. Cam­bridge, United Kingdom: Cambridge Uni­versity Press.

Buitelaar, J.K., and H. Van Engeland. 1996. Epidemiological approaches. In S. Sandberg (ed.). Hyperactivity Disorders of Childhood. Cambridge, United Kingdom: Cambridge University Press, 26–68.

Cardena, E. 1997. Dissociative disorders: Phan­toms of the self. In S.M. Turner and Michel Hersen (eds.). Adult Psychopathology and Diagnosis, third edition). New York: Wiley, 400.

Crichton, M. 1988. Travels. New York: Alfred A. Knopf.

DePrince, A.P., and J.F. Freyd. 1999. Dissociative tendencies, attention, and memory. Psycho­logical Science 10(5): 449–52.

Loftus, E.F. 1975. Leading questions and the eyewitness report. Cognitive Psychology 7(3): 560–72

Sharps, M.J. 2003. Aging, Representation, and Thought: Gestalt and Feature-Intensive Process­ing. Piscataway, New Jersey: Transac­tion.

———. 2010. Processing Under Pressure: Stress, Memory, and Decision-Making in Law Enforcement. Flushing, New York: Looseleaf Law.

Sharps, M.J., J. Janigian, A.B. Hess, et al. 2009. Eyewitness memory in context: Toward a taxonomy of eyewitness error. Journal of Police and Criminal Psychology 24(1): 36–44.

Sharps, M.J., J. Matthews, and J. Asten. 2006. Cognition, affect, and beliefs in paranormal phenomena: Gestalt/feature intensive processing theory and tendencies toward ADHD, depression, and dissociation. Journal of Psy­chology 140(6): 579–90.

Sharps, M.J., E. Newborg, S. Van Arsdall, et al. 2010. Paranormal encounters as eyewitness phenomena: Psychological determinants of atypical perceptual interpretations. Current Psychology 29(4): 320–27.

Suspicious Acts

The events began on August 30 in the Enfield home of Margaret Hodgson. The divorced Hodgson lived there with her four children—Peggy, thirteen; Janet, eleven; Johnny, ten; and Billy, seven—whose names, in early accounts, were fictionalized. Two of the children, Janet and Johnny, attempted to convince their mother that their beds were unaccountably shaking. The next night brought mysterious knocking sounds and the sliding of a chest of drawers in the girls’ room. There were more knockings, and soon Hodgson had a police car making a call to 284 Green Street (Playfair 1979; 1980, 12–33).

A female police constable witnessed a chair wobble and slide but could not determine the cause of the movement. By the next morning, marbles and Lego toy pieces began to “zoom out of thin air and bounce off the walls.”

“Janet, did you throw that?” Her mother’s question began a long series of witnesses’ suspicions—or outright accusations—that Janet was the cause of the trouble that centered on her. According to Guy Lyon Playfair—who, with colleague Maurice Grosse, observed and recorded much of the phenomena over their course—Janet was the “main focus” or “epicentre” of incidents. “She was always near when something happened, and this in­evitably led to accusations that she was playing tricks, although Grosse was already fully convinced that she could not be responsible for all the incidents” (Playfair 1980, 37).

Was her sister, Peggy, partly to blame? Although Janet was by far the most frequently present suspect, with disturbances even following her to school, her older sister was also central to some events. Once, for example, when Peggy shouted, “I can’t move! Something’s holding me!” she was found on the stairs with one leg extended behind her in a manner that could easily be explained as play-acting. She was also involved in other incidents, and when on one occasion the girls were separated (with Peggy sent to a neighbor’s home), the antics continued at both houses; moreover, when neither girl was present—for example when Playfair spent a night alone in the house—there were no disturbances at all (1980, 80). Were both girls playing tricks, or could the poltergeist be in two places at once? When Janet was in the hospital for six weeks for evaluation, some incidents occurred only at home (Playfair 1980, 69, 90, 102, 263).

Still, says Playfair,

Janet was all energy, big for her age, jumping up and rushing around on the slightest pretext, and talking so fast that I had some difficulty at first in understanding her. She had an impish look, and I could understand why some visitors to the house in the later months would suspect her of playing tricks. (1980, 44)

Children’s Tricks

Even Playfair himself, who chronicled the events in his book This House is Haunted: The True Story of a Poltergeist (1980), had occasional doubts. After a chest of drawers tipped and jammed at an angle against a wall, Playfair played his tape recorder and heard suspicious creaking noises, as if someone like Janet had slipped up to the chest. “Could they have been made by her?” Playfair asked. “I was beginning to have my doubts again” (1980, 52).

There were reasons aplenty for suspicion. The poltergeist, a.k.a. “The Thing,” tended to act only when it was not being watched. Stated Grosse: “It’s smarter than we are. Look at its timing—the moment you go out of a room something happens. You stay in the room for hours, and nothing moves. It knows what we’re up to” (Playfair 1980, 53). Indeed, when Janet knew a camera was on, nothing occurred (1980, 53). Incredibly, Playfair and Grosse found that the children were sometimes “motivated to add to the activity with some tricks of their own.” When members of the Society for Psychical Re­search (SPR) made visits, the children’s trickery was the main feature of their interest, whereas, says Playfair, “it did not bother us very much. We had already seen incidents with our own eyes that the children could not possibly have done deliberately” (1980, 70). (More on this presently.)

The incidents involving “curious whistling and barking noises coming from Janet’s general direction” suggest the extent of Playfair and Grosse’s credulity. In time, the entity began to voice words, including obscenities, and although Playfair wondered if it were really Janet acting as “a brilliant ventriloquist,” he did not think so. His faith in Janet continued even though “the Voice” refused to speak unless the girls were alone in the room with the door closed (Playfair 1980, 138, 146). More­over, the credulous investigators noted that, when the growling voice occurred, “as always Janet’s lips hardly seemed to be moving” (1980, 190).

Evidence of ventriloquial fakery was even taken as proof of authenticity! Ac­cord­ing to Playfair, “The connection between Janet and the Voice is obviously very close. There have been several occasions when she says something it obviously meant to say, and vice versa. Would she slip up like that if she was faking the whole thing?” (1980, 173).

Is he kidding? Even after professional ventriloquist Ray Alan visited and concluded that the girls were producing the Voice because they “obviously loved all the attention they got,” Playfair and Grosse were not persuaded that the girls were faking. In fact, they were quick to claim that even if the girls faked the Voice, the other mysterious happenings remained un­explained (Playfair 1980, 233).

This remained Playfair’s and Grosse’s defense even when Janet was caught at trickery (Playfair 1980, 196–7) and when Janet and Peggy confessed their pranking to reporters. The two investigators soon elicited a retraction from the girls (1980, 218–21). Others, such as the professional ventriloquist, were not so quick to rationalize.

Anita Gregory, who was investigating for the SPR, reported on the events in the Journal of the Society for Psychical Research. She suggested that the case had been overrated, describing several episodes of behavior on the part of Janet and Peggy that were revealing. Gregory concluded that the girls were nonpsychically responsible for many of the incidents that were attributed to “poltergeist” phenomena. Although she thought the outbreak might have originated paranormally (Gregory was a British parapsychologist inclined to believe in the paranormal), she concluded it had turned quickly into a farcical performance for investigators and reporters desiring a sensational story (Gregory 1980; Clark 1981).

Even more skeptical was American magician Milbourne Christopher, who investigated briefly at the house. On one occasion, when Janet claimed she was unable to open the bathroom door to get out, Christopher stated that he could not determine paranormal causality if he could not see an incident. Playfair writes, “It almost seemed that the poltergeist was out to incriminate her, by producing third-rate phenomena in the presence of a first-rate observer” (1980, 170). Another time, when Janet was sent to her room and the Voice manifested, Christopher slipped upstairs to observe. He saw Janet quietly steal out of her room to peer down the stairs as if to make sure she was not being watched. Seeing Christopher clearly flustered her. Christopher would later conclude that the “poltergeist” was nothing more than the antics of “a little girl who wanted to cause trouble and who was very, very, clever” (1984–85, 161).

Paranormal investigator Melvin Har­ris also weighed in on a fast photo sequence that supposedly “recorded poltergeist activity on moving film for the first time” (Playfair 1980, 106). Harris (1980) demonstrated how the photos actually reveal the schoolgirls’ pranking. While demonologist Ed War­ren claimed that Janet at least once was “sound asleep, levitating in midair” (Brittle 1980, 223), the photographs did not record these levitations nor did independent witnesses see them. War­ren was notorious for exaggerating and even making up incidents in such cases, often transforming a “haunting” case into one of “demonic possession” (Nickell 2009). Harris dubbed the pho­tographed levitations “gymnastics,” commenting, “It’s worth remembering that Janet was a school sports champion!” (1980, 554). (See Figure 1.)

Figure 1. An eleven-year-old girl is supposedly levitating during the poltergeist outbreak of 1977–79 in Enfield, England. (Forensic illustration by Joe Nickell based on a photo in This House Is Haunted, 1980.)

History’s Verdict

By 1979, the Enfield “poltergeist” had left the Hodgson home “inexplicably,” except for an occasional isolated incident. The motivating force—we may suspect tension in the household following the parents’ divorce—eventually ran its course. But the question re­mains: Is it true that Janet and the other children really could not have caused certain disturbances, as Grosse and Playfair insisted? Let us look at just one instructive incident. Maurice Grosse reported that “[the poltergeist] just threw a slipper while we were all in the room. It was not within the reach of the children, it was down near the end of the bed” (Playfair 1980, 82).

However, all that would have been necessary would be for Janet, say, to have earlier gotten hold of the slipper and then waited for the proper moment—when Grosse was not looking at her—to toss it. Time and again in other “poltergeist” outbreaks, witnesses have re­ported an object leaping from its resting place supposedly on its own, when it is likely that the perpetrator had secretly ob­tained the object sometime earlier and waited for an opportunity to fling it, even from outside the room—thus supposedly proving he or she was innocent.

As a magician experienced in the dynamics of trickery, I have carefully ex­amined Playfair’s lengthy account of the disturbances at Enfield and have concluded that they are best explained as children’s pranks. The principle of Occam’s razor—that the explanation requiring the fewest assumptions is the best one—well applies here. Inter­viewed by the Lon­don Daily Mail (Brennan 2011), Janet at age forty-five (living in Essex with her husband, a retired milkman) ad­mitted that she and her sister had faked some of the phenomena. “I’d say 2 percent,” she admitted. The evidence suggests that this figure is closer to 100 percent; however, as another eleven-year-old girl insisted after confessing to playing poltergeist to attract attention in an earlier case: “I didn’t throw all those things. People just imagined some of them” (Christopher 1970, 149).

Acknowledgments

Barry Karr, CSI’s executive director, tipped me to the forthcoming 2012 movie being made about this case (which I had discussed briefly in my book Entities), and Timothy Binga, director of CFI Libraries, assisted with research.

References

Brittle, Gerald. 1980. The Demonologist: The True Story of Ed and Lorraine Warren, the World-Famous Exorcism Team. New York: St. Mar­tin’s Paperbacks.

Brennan, Zoe. 2011. What is the truth about the Enfield Poltergeist? (October 28). Online at www.dailymail.co.uk/news/article-2054842/Enfield-Poltergeist-The-amazing-story-11-year-old-North-London-girl-levitated-bed.html.

Christopher, Milbourne. 1970. ESP, Seers & Psychics. New York: Thomas Y. Crowell, 124–31.

———. 1984–85. A final interview with Mil­bourne Christopher, by Michael Den­nett, Skeptical Inquirer 9:2 (Win­ter), 159–165.

Clark, Jerome. 1981. Update . . . Fate. July: 94.

Gregory, Anita. 1980. Letter to the editor. Journal of the Society for Psychical Research 50(786) (December): 538–41.

Harris, Melvin. 1980. Letter to the editor. Journal of the Society for Psychical Research 50(786) (December): 552–54.

Nickell, Joe. 2009. Demons in Connecticut. Skeptical Inquirer 33(3) (May/June): 25–27.

Playfair, Guy Lyon. 1979. Poltergeist on a rampage. Fate. June: 74–81.

———. 1980. This House Is Haunted: The True Story of a Poltergeist. New York: Stein and Day.

In response to the media attention, several groups and individuals came forward to publicly hypothesize about what might be causing this rash of symptoms. Antivaccinationists suspected that it was a vaccine—or environmental toxin, at least—that had caused the illness. Chiropractor Russell Caram speculated that

The other possibility here are HPV vaccines, Gardasil and Cervarix. The timing becomes more easily ex­plained—as most children “get their shots” (and boosters, such as DTaP and the flu shot) before enrolling in school in the fall. It also satisfies the girls-only attack (even though they’re trying to convince boys to get the Gardasil shot also), as well as the age group. (Caram 2012)

Caram’s hypothesis suffers from more than the fact that it is pure speculation. Half of the children affected by the illness did not even receive the Gardasil or Cervarix vaccines, nor is there any evidence to suggest that either vaccine can cause such neurological symptoms in the first place. (Similarly, no evidence supports the claim that Tourette syndrome can be caused by vaccines or toxins.) When Caram wrote the article, only girls showed signs of the illness, but later one boy also developed symptoms, which further suggests that the HPV vaccines are not to blame.

Those who have made it their mission to expose the risks of environmental toxins see in this case a possible environmental toxin. Apparently, some of the parents of the affected children called upon famous activist Erin Broc­ko­vich, who sent her team to investigate. She has speculated about “. . . whether students have been ex­posed to contaminants from the train derailment that occurred within a few miles of the school in December 1970. That derailment spilled cyanide crystals and leaked carbon tetrachloride” (Ciavarri 2012).

Of course, an environmental toxin such as carbon tetrachloride would not explain the timeline of the illness or its predilection for girls. Why would a forty-year-old spill suddenly have an adverse effect on people living in the general area? The results of a search for environmental toxins in the area have already turned up negative, and the students themselves have tested negative for toxic exposure. However, this poses the problem of proving a negative. Brockovich claims that the search has not been thorough enough, but such a claim can be made arbitrarily without limit. You can keep searching for toxins with lower and lower thresholds until you find something. Toxins are ubiquitous in the environment in background concentrations generally too low to worry about, but if you look hard enough you can find something—especially if it’s something you want to find.

Rosario Trifiletti, MD, PhD, is an expert in a rare condition known as PANDAS (pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection), and she has come forward to claim that this is what these children have (Swedo et al. 2012). I cannot get into a thorough evaluation of this complex condition, but suffice to say that Trifiletti, who claims to be personally treating some of its patients, is a major promoter of this diagnosis. There is a tendency to see what we know, and experts in a narrow illness often see their pet disease everywhere. The National Institute of Mental Health’s (NIMH) definition of PANDAS does not seem to fit this case well. Age of onset for PANDAS is supposed to be between three and puberty, but the Le Roy children are between the ages of twelve and eighteen. There is no indication that PANDAS is a selective illness, affecting girls more than boys. Furthermore, PANDAS is a clinical diagnosis without laboratory confirmation; part of that clinical diagnosis is that symptoms are triggered by a streptococcal infection (such as strep throat), which does not appear to be the case here. PANDAS also involves more than tics—it can include mood changes and obsessive compulsive symptoms, too. Altogether, based on publicly available information, PANDAS does not seem a great fit for answering the question of this “mystery illness.”

The “mystery illness” has become a Rorschach test of sorts: people see in the illness a diagnosis that fits their worldview or pet cause. But now that the dust has settled somewhat on this outbreak, what can we reliably say about it? To review the facts of the case, eventually fifteen children were af­fected with involuntary tics, which are sudden “jerk-like” motor movements, between October 2011 and January 2012. All fifteen of the children attend the same junior-senior high school and range in age from twelve to eighteen; all but one of them is female. All of the children have been examined by pediatric neurologists—twelve of the fifteen at the Dent Neurological Institute by the same two neurologists, includ­ing Laszlo Mechtler, MD.

Mechtler—and, in fact, all of the pediatric neurologists who have examined any of the children—has come to the diagnosis of conversion disorder and mass psychogenic illness. A conversion disorder occurs when psychological stress manifests as physical symptoms. We take this for granted to some degree; when people feel anxious they may get sweaty, nauseated, or short of breath and have palpitations. People who experience panic attacks can have these symptoms along with difficulty swallowing and episodes that may resemble certain types of seizures with feelings of being separate from reality or from themselves. These are physical symptoms resulting from purely emotional stress. But in some cases, psychological stress can also lead to neurological symptoms—pretty much any neurological symptoms, such as weakness, difficulty speaking, loss of vision, and involuntary movements.

It is important to note that this is a known and well-established syndrome (Stone et al. 2011). Neurologists see patients with conversion disorder frequently, and many cases positively demonstrate that the neurological symptoms are not due to any damage or lesion in the nervous system but rather to psychological stress. For example, it can be demonstrated in someone with psychogenic blindness that their visual system actually works. Similarly, many patients with psychogenic seizures display features that are neuro-anatomically incompatible with actual seizures.

It is always challenging to deal with conversion disorder. We medical professionals try very hard to accurately and constructively convey to patients and their families what is happening, but unfortunately our culture attaches an undeserved stigma to psychological ailments, and many patients resist such a diagnosis. We tend to focus on the positive—psychogenic symptoms can completely cure themselves (and usually do with encouragement and reassurance to the patient) because there is no irreversible damage to the nervous system.

The diagnosis of psychogenic illness, however, is also partly a diagnosis of exclusion. It is often the case that a physical ailment underlies the psycho­genic symptoms and has, in fact, triggered them. The diagnosis, therefore, is usually made only after a thorough workup to rule out other causes.

In the case of the children in Le Roy, doctors report that they have thoroughly evaluated the children—in­cluding screening them for any toxins, infections, or signs of a physical illness—with completely negative results. The school has been examined also, and no environmental toxins or chemicals have been discovered.

Here we are probably dealing with not only a psychogenic illness but also a case of mass psychogenic illness, which is also a known phenomenon that can even be induced experimentally (Broderick et al. 2011). In cases of mass psychogenic illness, the appearance of symptoms in other people, which causes anxiety about a contagious illness or a toxic exposure, can be the stressful trigger. In susceptible individuals this can induce a psychogenic illness that mimics the symptoms of those already affected. Media coverage only enhances this phenomenon; in fact, some speculate that social media increased the spread of the Le Roy children’s illness.

The Le Roy case has all the hallmarks of a mass psychogenic illness. Most of the symptomatic individuals are women who are part of the same small, close-knit community and have social contact with each other. The diagnosis is therefore not based en­tirely on the exclusion of other causes; the case also has a natural history and epidemiological features that fit a mass psychogenic illness. Al­though the available details of this case point to a mass psychogenic illness as the culprit, there may be one or two index cases of true Tourette syndrome that triggered the outbreak. It is an important lesson, as most people underestimate the ability of our brains to generate physical symptoms.

On the one hand, there are the neurological experts who have presented what seems to be a sound diagnosis. On the other, there is a circling of those who want to promote their causes or ideology. In the middle of all this are the students and their families who have to deal with a delicate neurological ailment before the public eye. We can certainly hope that science and reason win out, but often the most alluring and media-friendly answers come from the cranks who would manipulate the diagnoses of experts to weave a sinister tale.

References

Almasy, S., and J. Spellman. 2012. N.Y. town still baffled by teens’ mysterious tics. CNN (Febru­ary 4). Available at www.cnn.com/2012/02/03/us/new-york-students-illness/index.html.

Broderick, J.E., E. Kaplan-Liss, and E. Bass. 2011. Experimental induction of psycho­genic illness in the context of a medical event and media exposure. American Journal of Disaster Medicine 6(3) (May/June): 163–72.

Caram, R. 2012. Le Roy, N.Y. mystery continues and frustrates. . . . Available at http://drcaram.com/the-LeRoy-n-y-mystery-continues-and-frustrates/.

Ciavarri, A. 2012. Erin Brockovich’s team in town, Le Roy reluctant to allow access. WHEC.com (January 28, updated January 29). Available online at www.whec.com/news/stories/s2473055.shtml.

Stone, J., W.C. Lafrance Jr., R. Brown, et al. 2011. Conversion disorder: Current problems and potential solutions for DSM-5. Journal of Psychosomatic Research 71(6): 369–76.

Swedo, S.E., J.F. Leckman, N.R. Rose. 2012. From research subgroup to clinical syndrome: Modifying the PANDAS criteria to describe PANS (Pediatric Acute-onset Neuro­psychiatric Syndrome). Pediatrics and Therapeutics 2(2).

Quick as you can, read the following sentences and answer the question. Observe your mind as it fumbles to its conclusion.

Kim buys one bat, and one ball. Kim spends $1.10. Kim’s one bat cost $1 more than Kim’s one ball. How much did Kim spend on the bat?

An apparently instinctive human reaction drives many people to blurt out the (wrong) answer, “One dollar!” Others pause before speaking, think for a moment, probably frown, break eye contact, and eventually respond (correctly), “One dollar . . . and five cents.” Professor Daniel Kahneman be­longs to a third group of people who start thinking just as the rest of us stop. They pay attention to the mind at work and ask themselves, “Hello. What’s going on here, then?” Kahneman’s book Thinking, Fast and Slow is instructive to rationalists and skeptics because of what it tells us about the nature of human error.

The little gedankenexperiment above is just one of a great many that anchor the ideas of Kahneman’s book to the empirical bedrock. Much modern psychology—or cognitive science if you prefer the fashionable term—relies on experiment to pick apart our mental machinery. Re­searchers assemble a group of people in a room to ask them a list of cunningly designed questions. They time their subjects’ responses and compare their answers with what is “reasonable” or “rational.” What we’ve learned from all this science is that while human beings don’t all respond in precisely the same way, as a species we exhibit quite a few counterintuitive quirks and habitual, or instinctive, cognitive biases. In other words, our answers are wrong in systematic and predictable ways.

How does all of this work? Kahne­man offers the following explanation: Brains evolved to be pattern-seeking machines. Biologically speaking, our brain’s primary function is to make sense of the overwhelming mess of sensory stimuli to which our environment ex­poses us. In Kahneman’s telling of it, brains aren’t passive receptors. Rather, our grey matter is constantly trying to construct a coherent model of the world “out there” in order to guide our reactions to it.

But there’s a problem. A brain is a terribly expensive organ to run. Pri­mate brains consume 20 to 25 percent of the body’s energy budget. So what’s a poor organ to do? The answer appears to be that our brains use mental shortcuts (heuristics) that allow for massive reductions in brain-power at the cost of the occasional error. If you think about it, even with these shortcuts our brains are pretty astounding. Stand up, walk to the bathroom, open the door, adjust the shower heat, apply soap—consider the sea of unconsidered action upon which our relatively tiny consciousness floats. Mental heuristics are many and mostly trivial, but they can be tremendously potent. Mental shortcuts are what “tell” an experienced surgeon when his patient is about to hemorrhage, or a fire captain to pull his crew from a building just before it collapses, or a cook when the salmon is grilled to perfection. Sophisticated, learned responses often cannot be rationally justified. They just “feel right.”

Kahneman refers to this large collection of heuristics as “System 1.” System 1 “operates automatically and quickly, with little or no effort and no sense of voluntary control.” In short, System 1 is a sense-making machine, and we rely on it almost exclusively to get through our days. Alas, System 1 isn’t perfect. Error is built into its design. It is far, far better that our minds “detect” or “construct” a nonexistent snake a hundred times than overlook a real snake just once.

Now, as we saw in the example of Kim’s bat and ball, there is also a second mode of mental operation. Kahneman refers to it as “System 2,” but you’ll also see it elsewhere referred to as “executive function” or “cognitive control.” It’s the part of our brain that steps in from time to time, overriding System 1. “System 2 allocates attention to the effortful mental activities that demand it, including complex computations,” Kahneman writes. “The operations of System 2 are often associated with the subjective ex­perience of agency, choice, and concentration.” System 1 thinks fast; System 2 thinks slowly.

System 1’s heuristics are fine as re­sponses to our everyday environment, but they are poor guides for reasoning about subjects expressed in terms of quantities, time periods, or probabilities—all more properly the province of System 2. Thinking, Fast and Slow is in part a catalog of the ways we slouch into error: circumstances where we opt for a quick, low-cost, and coherent worldview over mental hard labor. Kahneman shared the 2002 Nobel Prize in Economic Sciences for the application of these psychological in­sights to the way human beings make economic decisions and, while not strictly within the scope of a review with skeptical and rationalist readers in mind, this book’s critique of the shambles and shenanigans that characterize financial markets is pretty withering.

Skeptics will find that the ideas in Kahneman’s book arm them with both sword and shield. If you’re ever exasperated at the way some human beings manage to remain sublimely indifferent to evidence, Kahneman offers an explanation that plea-bargains any charge of malevolence down to mere laziness. Mental work is hard, and monkeys don’t like it. Thinking about abstractions such as numbers or general laws of nature reduces the amount of energy and attention we can invest in more practical and immediate problems like gathering fruit, not standing in fire, avoiding bad meat, or figuring out when another monkey is up for a cuddle. If your worldview includes superstitious or irrational beliefs, your System 1 will go to extraordinary lengths to weave your experiences to­gether to tell you a coherent story that is consistent with those beliefs—and since on a day-to-day basis there’s little penalty for believing in things that don’t exist, why change?

But the book also reinforces the idea that skeptics are human beings too, and human beings are never more prone to error than when we are overconfident. Hubris yields error, and Kahneman and his colleagues have famously shown how few human specimens display more hubris than “experts.” It’s apparent that even when we know we’re in error, even when we’ve been alerted to the nature of the mistake, even after we’ve made the mistake and it’s been pointed out to us and explained to us, it takes tremendous effort on our part to rewire our brains.

Kahneman makes that point with another of his experiments. Based on the following thumbnail biography, which of the two subsequent statements is most probably true?

“Wendy is young, of average ap­pearance, and socially awkward. From a young age she excelled at school and went to an elite university, completing her doctorate. She is married with a daughter.”

1. Wendy works as a librarian.

2. Wendy works as a librarian and is an active feminist.

Confronted with a version of this puzzle, no less a rationalist and skeptic than Stephen J. Gould wrote, “A little homunculus in my head continues to jump up and down, shouting at me.” For those of you puzzled by the problem, it helps to retell the story in stark, mathematical terms. Given any two probabilistic propositions, A and B, which is more likely? A? Or A and B? If the mathematics of probability means anything, it means that “Wendy works as a librarian” must be more “probably true” than “Wendy works as a librarian and is an active feminist.” Every librarian who is an active feminist is still a librarian, and there are surely librarians who are not feminists! But our lazy brains prefer the more detailed, coherent, and more plausible story to the energy-intensive work needed to arrive at the truth. Kahneman provides several examples of large-scale mistakes that required entire communities of highly trained professionals—himself included.

For readers interested in personal error—both understanding and avoiding it—the book isn’t especially comforting. Kahneman explains that hu­man beings are terrible at perceiving their own errors and worse at learning from them. Consciously changing our own beliefs by considering the evidence is ap­parently terribly hard—never mind the beliefs of others. So what’s a rationalist to do?

Well it turns out that for all our failings at self-regulation, we’re actually pretty decent at spotting mistakes made by other people. Anyone who has spent any time in a collaborative work environment will instantly recognize the phenomenon. It might never occur to me to examine each step along the path from insight to conclusion, but fortunately other people can typically be relied upon to tell me I’m wrong and why. Rationalists can take some comfort in the thought that the institutions of scientific practice and peer review exploit this aspect of human nature.

What about changing the minds of others? Here, Kahneman’s view is at first glance rather bleak, but it offers a curious kind of hope. If you ask people, “Do you believe X?” they will answer either “Yes” or “No.” If you ask them, “Have you always believed X?” they will typically respond that they’ve never changed their minds. Enquire of their opinions on a scientific or political controversy and they’ll explain them to you. Then supply new information (pro or con), repeat the questions, and what you find is that Lo! their minds have changed . . . hardly at all.

However, if you ask people at different times what they think, you will find that their minds have in fact changed. Psychologists have noticed that evidence not only changes our current beliefs but also our memory of what our beliefs were before we acquired the new information. Gradual evolution of public sentiment is apparent in survey re­sponses to questions about religious be­liefs, the existence of satanic cults in daycare centers, or the wisdom of the Raiders’ second round draft choices. Minds, it seems, aren’t changed abruptly through reason but gradually as the heuristics by which our minds construct their coherent worldviews adjust. And we typically fail to perceive how much change we’ve undergone.

Kahneman uses this System 1/System 2 framework to examine questions about how people arrive at decisions with uncertain information, how we think about risk, and how we construct our lives through a combination of experience and memory. Through­out the book readers will find memorable, pithy pronouncements such as, “Language implies that the world is more knowable than it is” or “Nothing in life is as important as you think it is when you are thinking about it” or (quoting another psychologist) “Sub­ject’s unwillingness to deduce the particular from the general was matched only by their willingness to infer the general from the particular.”

Anyone who has followed recent public policy debates about behavioral finance or prospect theory will find little in the book that goes beyond recapitulating the greatest hits of one man’s very productive career as a working re­search psychologist. Kahneman also stays mute on the kinds of big questions skeptics would like answered, such as why people persist in irrational and even self-destructive beliefs. He prefers to report the evidence and provide softer, more personal advice on how best to grapple with our own biases and guard against errors when pricing bats and balls.

For readers interested in deepening their understanding of what is going in their own minds (and how to guard against their own errors), it’s hard to pass up a book with such a combination of persuasive power and pedigree.