Jane Haddam’s WordPress weblog

Do What Works. Or, You Know, Not.

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Here’s the thing.  I’m a firm believer in the idea that everything that survives serves a function, even if it’s not the function we think it’s supposed to be serving. 

But the fact remains that a lot of what we do does not serve the function we say we want it to serve, and not just education as a skills-credentialing system.

Take, for instance, “rehab.”  Drug and alcohol programs, including AA, have a success rate of something like 3% after one year.  If only 3% of heart surgery patients survived after one year, we’d call that a failure, say we didn’t know how to do heart surgery, and go back to the drawing board to figure out something new.

But the news is even worse than it seems to be.  Among alcoholics and drug addicts who receive no treatment at all, approximinately 3% get sober and stay that way for a year, each year.

In other words, as far as we can tell, based on every verifiable, falsifiable and fully disclosed study ever done, rehab and twelve step programs have no effect at all on drug and alcohol use.

And yet, this society puts enormous resources into rehab programs.  Government and private insurance systems par for them.  Courts order participation as a condition of probation and parole boards insist on participation as a condition of granting parole.  

What’s more, every form of entertainment–movies, television, books, even comic books–puts out an endless stream of propaganda about how rehab and only rehab ever “cures” the “disease” of addiction, and all the stories and plays and films leave the impression that everybody who really puts their mind to the twelve steps will succeed.

To be fair, of course, the old system–blame the addict for his lack of self control and insist he lie up to his responsibilities and stop behaving badly–didn’t work either.  In fact, in those days, the number of alcoholics and addicts who managed to get sober and stay that was for a year was…3%. 

We know less about addiction than we know about cancer, and we know frighteningly little about cancer.  But that brings me to something else that we do even though it doesn’t work the way we say we think it does.

Anybody who has ever spent time in a facility giving chemotherapy or radiation treatments for cancer knows that success and survival rates are abyssmally low.  In some forms of cancer, they’re as low as those rates for successful rehab.  

Some forms of  cancer respond to the things we know how to do about cancer.  some forms do not.  We’re not really sure of why that is.   We go on doing what we do, even when we know it isn’t effective, because we want to feel we are doing something.

But cancer treatment has an advantage that neither educational credentialing nor rehab shares.  For whatever reason, it just isn’t enough for cancer researchers to feel that they’re doing something.  They keep insisting on finding a way to actually do something.

In education and rehab,  however, we have situatoins where we not only aren’t doing what works, but where what we’re doing is preventing us from finding something that does work.  Having reache our officially accepted “answer,” we have largely stopped asking the question.

With educational credentialing, I think that part of the problem is that any serious attempt to ask the question would require us to discard assumptions that we feel are not just true–actually, I think that large whacking hunks of us suspect that they’re not true–but morally imperative to hold.

One of those is the idea that ability, intellectual and athletic and artistic and anything else, is almost entirely a result of nurture, not nature. 

Part of the reason we hold so desperately to this assumption, which seems demonstrably untrue on its face, is that we fear that if we accept that ability is heritable, we will find that such heritability differs by race. 

What’s going on here is complicated.   I think that for a small percentage of the people clinging desperately to the “it’s all nurture” paradigm, the problem is that they already think that heritability differs by race, and that black and brown people are inherently stupider than white and Asian people.

This lands them in a terrifying position.  First, they think if it became socially acceptable to acknowledge what they believe to be true, then it would have to be legally acceptable to discriminate against people–to deny them opportunities in employment and education–by race.   Second, they’re fairly sure that the first thing would lead inevitably to the establishment of legally “superior” and “inferior” races, where slavery (at best) and genocide (at worst) would have to be redefined as morally and politically acceptable.

Part of the problem here is that these are people who cannot understand mathematical distributions–that is, they don’t understand that saying that “group X tends to be Y” tells you absolutely nothing about any individual member of group X.  Group X may tend to be Y, but this particular member of group X may be Z instead, and there’s no way to predict that from his membership in any group at all.

In other words, discrimination on the basis of race would still be a) incredibly stupid and b) morally wrong even if the heritability of abilities differed on the basis of race, because we would still have to approach every individual on the assumption that we couldn’t know, from his race, what his own particular abilities were. 

If we accept Kant’s most important categorical imperative–that we must treat every human being as an end in herself and not as the means to the ends of any other person–then we would still be obliged to treat Chuck and Nigel and Mark and  Su  Ling as Chuck and Nigel and Mark and Su Ling, not as black and white and Latino and Asian.

Nor would we be even pramatically justified in putting fewer resources into the education and training of any one race.  Distributions are distributions, but geniuses are wild cards, and the guy who’s going to finally actually be able to cure cancer could be born purple for all we know.

The other reason there’s so much resistance to accepting that abilities are largely heritable is less apocalyptic, but maybe more insidious–none of us wants to accept that we can’t “be anything we want to be” if we just put in enough time and effort.

The idea that it’s effort and not talent that counts, that all of us are born capable of achieving whatever we can imaine to achieve, is so deeply engrained in the American psyche that it can almost be said to be one of our founding principles.  It is, in fact, one of the basic assumptions of the entire Englightenment project, the idea that human beings, if they applied reason to the world and to themselves, could better both it and themselves.

There’s a lot of juice in that assumption, and holding it has a lot of upside.  If you honestly believe you “just can’t” do something chances are good that you won’t even try to do it.  And it’s people trying what they don’t know they can do that gets us democracy, antibiotics and the use of perspective in painting.

Progress comes from refusing to believe that we have to accept what is.  And yet, sometimes we do have to accept what is.  Neither the world nor the individual human being is infinitely malleable.   Nature sets limits on us all.  I could have worked my butt off for all my life, practiced and trained and done everything available to me, and I still would have ended up playing basketball less well than Michael Jordan would have if he’d spent all of his life in bed.

We’re not going to reform education unless we learn to accept that–and it’s possible that we can’t reform schools-based education at all.

Written by janeh

May 14th, 2009 at 10:30 am

Posted in Uncategorized

5 Responses to 'Do What Works. Or, You Know, Not.'

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  1. When someone says “you can do anything you want if you try hard enough!” my husband retorts, “yeah, flap your arms and fly.”

    It’s demonstrably not true. What you say about fearing being racially bigoted regarding inborn talent may be true for some or most people. In addition, though, I think there’s a huge component of fear that if there’s an acknowledged hierarchy of intellectual giftedness, we as individuals will fall somewhere south of the best.

    Americans, though, actively resent a hierarchy of *opportunity* based on anything but hard work. Used to be hard work and being a white male, but we’re getting over that, somewhat.

    Then there’s that “regular folks” thing. If someone else is the Big Brain Big Cheese, then not only do they THINK they’re better than us, they KNOW they’re better than us, and so do we. That’s intolerable to many people. Heroes are allowed to better, in fact we demand it. But not others who haven’t done anything to earn hero status.

    So we’re left with a situation in which we want to and try to encourage the best of us without discouraging the rest. It fails most of the time, ending up discouraging and underserving the gifted and propping up the vast majority with paper “achievement certificates” to get them job interviews.


    14 May 09 at 12:47 pm

  2. I completely agree with everything Jane said. Particularly her comments on individuals and distributions.

    But Lymaree wrote “If someone else is the Big Brain Big Cheese, then not only do they THINK they’re better than us, they KNOW they’re better than us, and so do we.”

    I do recognize that attitude and the resentment it causes. But I find it hard to understand it. The field I know best is Physics and that has long been divided into Experimental and Theoretical. The people who are good at one are very rarely good at the other and all physicists are aware of that.

    I’m watching a house being built in the lot behind me. Its interesting to see skilled tradesmen turn a plot of grass and weeds into a well built house. I can’t drive a nail straight, I doubt if they can explain how the sun produces its energy.

    I just don’t understand why either of us should think of ourselves as better. Maybe someone can explain the psychology to me.


    14 May 09 at 5:46 pm

  3. Nah. People pay for what works. People donate large sums of money to politicians because it’s a very good return on investment. The rehab program pays off for the courts, for the police and for the government. Of course it doesn’t pay off for the addict: they don’t have a choice. The educational system pays off for the government, the educators and (somewhat) for large businesses. That it doesn’t pay off for the students really isn’t a major concern. They don’t have a lot more choice than the addicts. In some of the technical fields, there IS a choice, and amazingly enough those programs run very well indeed. You won’t see change until the present system is intolerable to businesses–and maybe not then. You notice that even now, when the system can’t provide basic literacy, they’re supplementing it, not trying to reform it.

    As for those who are concerned that various abilities are not equally distributed among races–and their fellows, the “multiculturalists” who by the nature of their arguments wind up claiming that all cultural traditions are equally beneficial in all careers–the notion of treating people as individuals is as far beyond their comprehension as rewarding ability and merit. You’ll have to raise a generation which thought differently, and wait for this one to die off.


    14 May 09 at 8:23 pm

  4. Ronert, I even more pessimistic then you are. Both my parents were born about 1900. They went through WW1 as adults, had their children during the depression and went through WW2 and the Korean War. They did not believe that good economic times were guaranteed or that peace was the normal state of affairs.

    I have a few vague memories of WW2. But I remember the Berlin blockade and the Korean War. I also remember the family’s first car and TV set. I do not take a prosperous economy or peace for granted.

    I fear its going to take hyperinflation caused by printing trillions of dollars and Chicago or San Francisco going up in a mushroom cloud to bring the US public to its senses.

    The following article left me with a sense of despair – the author was supposed to be an expert on economics.



    14 May 09 at 10:36 pm

  5. Where did you get the 3% recovery rate for addicts (including alcoholics)? I’ve never seen anything so low, although figures tend to be all over the place since different studies include different definitions of what it means to be an addict and different definitions of what it means to recover. And the longer the time period, the greater the assurance that ‘recovery has occurred – but the more difficult and expensive it is to carry out a study. AA in particular is difficult to study given the anonymity, the lack of follow-up on those who leave, and the lack of tracking of how often people return.

    The question of what constitutes ‘recovery’ is open, too. Movies and some experts do claim that addiction can be cured. AA and other experts don’t – they say it can be held in abeyance for a while.

    Again, with cancer treatment, how to you define ‘success’? Ideally, it would be full recovery. In practice, I know people now who’d like to have that – but are enjoying literally years (well, OK, in one case, just over a year so far) more than they’d have had without modern treatment. It’s not that patients either recover or don’t from cancer. They may recover entirely. They may die almost as quickly (or even more so) than they would have without the treatment. They may have a partial recovery during which they lead a more or less normal life.

    Your main argument – that on nature vs nurture – seems to be overstated, but I’m not writing from the US. I’d say ability is based on both, I understand the basics of population distributions, and I long since realized that there are things I do not have the ability to do. But I also don’t have much confidence in most people being able to treat all groups of people as having an equal chance to produce the next genius. I’ve heard too many dismiss entire groups as unable/unwilling/culturally unsuited to learn. I think I’d put less of the emphasis on nature than you do, and I’ve known too many cases where children were slotted into ‘appropriate’ educational settings which actually reinforced whatever the experts thought their nature was rather than actually considering the child’s actual abilities and the influence of his situation on his ability to demonstrate them. At least the people who do this no longer have official excuses in the form of “children from X don’t do well on Y” however true that may be for MOST children from X, and that result can excuse some of the excessive boosterism of the form ‘Everyone can do anything they want to’.

    Education, like addiction and cancer treatments, can certainly be improved, but the actual situations on the ground is not exactly as you have described them.


    15 May 09 at 7:05 am

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