Tag: psychology

"Nobody is safe from psychosis"

Have you ever believed that you are already dead or the star of a Reality-TV series? Psychiatrist Joel Gold has seen his fair share of delusions and believes that our culture has more impact on it, than we might think. A conversation about Donald Trump copycats and our vulnerability to insanity.
In your book Suspicious Minds, you describe how culture shapes madness. How does it?
Throughout the history of mankind, our culture has influenced the content of our delusions. There are many forms of delusions such as paranoid or religious delusions. The forms stay largely the same but the content of the delusions changes over time. In post-revolutionary France, many people that suffered from the grandiose delusions that they were Napoleon. Today a person with a grandiose delusion might believe he is a TV celebrity. Thirty years ago, some paranoid people might have believed that they were being targeted by the CIA or KGB, today it might be ISIS or the NSA.

Photo by Elizabeth Graham
Dr. Joel Gold is the author of a new book, “Suspicious Minds, How Culture Shapes Madness.” He’s giving a talk about the book at Greenlight Bookstore on the 24th.

Madness is always updated?
Yes, but the more controversial question is: can the environment actually induce madness when it would not have otherwise manifested itself in a different environment? Are there circumstances or environments that are likely to cause psychosis? These are fundamental questions.
Distressing situations are obviously fostering mental illness but can they induce it then?
There is actually evidence that shows that the opposite can be true, that in very stressful or painful situations like war, some people with mental illnesses actually do better. They pull themselves together. There are a lot of theories about this but I think that if somebody’s external and internal world match, things make more sense to them. In situations like these, your suspicion or your fears are legitimate, not irrational. But of course in many people war can induce anxiety or depression. In our book, my brother and I argue that environments like the surveillance state and our culture in which seemingly anybody can become a star without any special talents, might be prone to induce delusions. I think the Truman Show delusion could be such a manifestation.
You coined the term the Truman Show delusion which is the belief that one is the star in a reality-TV series and that the world surrounding you is completely fake – just like in the famous movie The Truman Show.
It might be an old delusion in a new guise but the content is new. That specific belief did not exist 200 years ago. But I don’t think that the movie caused the delusion. Some people with this delusion had it before they had ever seen the movie – if they had seen it at all. But many people who have this experience feel it confirmed when they see the movie. It perfectly encapsulates their feelings. The movie is a scaffolding around which the delusion is built.

“Delusions are social in nature”

Delusional people often share the same stories or beliefs. What is it about a certain narrative that makes it so credible for delusional people?
My brother and I believe that delusions are social in nature; our minds are wired to negotiate the social world. There is a part of our brain that we have labelled for descriptive purposes the suspicion system. The suspicion system is meant to monitor the environment for social threats. When the suspicious system is disconnected from the reflective system of our brain, the part that analyses a situation and counterbalances the suspicion system, then delusions can form. Another factor is social interaction. We are not suspicious of furniture but of other people and today there is a huge variety of ways in which we are connected to others. At the core of most delusions is the belief in the malignity of other people. Police, co-workers and family can be the perfect cast for such scenarios. That’s why certain themes recur in delusions.
Is the form of delusion a decisive factor in choosing the adequate narrative?
I think so but as I pointed out, most of them are linked to our social surroundings. That is the common denominator. Take the Napoleon delusion: It is not necessarily a paranoid delusion but more a delusion of grandeur. But it is also social in a way: if you think you are superior, you are less likely to be in danger. You put yourself in a position of power to escape social threats. Today we are surrounded by some people who are famous for no particular reason. That can give the impression that power and fame are easy to acquire.

I hope there won’t be too many cases of Donald Trump copycats.

It would not be surprising if more people with grandiose delusions report that they are Donald Trump. In fact, a colleague of mine told me that he has had some patients of late that believed just that or that he is spying on them. He is the most famous person in the world right now and he is ubiquitous.

“Madness is an experience we are all capable of having”

Delusions are a different perception of reality. Usually that reality is an isolated and unique perception but if a delusional reality spreads and enough people believe it, it can quickly become an alternative reality all together.
That is a valid point. We have criteria to diagnose certain mental illnesses. The problem however is that if a large enough number of people believe something, it is not necessarily recognized as a delusion. Conspiracy theories are good examples. Some of these theories are completely fact-free but we don’t categorize them as delusions but as conspiracy theories because many people hold the same beliefs. The line between the two is very thin.
Myths are another thing that could qualify as delusions but are considered important narratives for our existence.
It’s often said that if you can prove something, it is not a delusional idea. But you can “prove” a lot to back your claims. People can be led to believe a lot, so myths and conspiracy theories are extremely hard to debunk.
Myths not only influence the delusional mind. There are also a lot of myths when it comes to how to cure madness. People used to believe that the “stone of madness” caused insanity or that “black bile” – a humor of medieval physiology believed to be secreted by the kidneys or spleen – caused melancholy and depression.
This is not just true for mental illnesses. There were a lot of medical myths at the time because people didn’t know about viruses or bacteria and so came up with other explanations. Instead doctors used things like leeches to cure patients. Today that would be considered malpractice. When knowledge is absent, people come up with ideas that might seem strange later on. But if many people believed it, it was considered science. Consider the example of vaccinations: A British researcher published an article in the renowned medical journal The Lancet that stated that vaccines could cause or at least increase the risk of autism. People still hold on to that idea well after it has been debunked. Now there is a highly charged controversy surrounding vaccines and his theory is still gaining traction.
Society has a very strange view on mental illnesses, it seems to me. On the one hand, people don’t want to interact with mentally ill people but on the other hand, we cherish the myth of the manic genius or the tormented writer. It could be concluded that we only accept mental illness if it enables you to produce something good from it, if it propels you to another level of creativity.
That’s true. Madness is something we are very afraid of because it is an experience that we are all capable of having. Nobody is safe from psychosis. On some level, possibly unconsciously, we realize that. The right conditions can drive almost every sane brain into madness. If we see a person with mental illness on the street, we find it uncomfortable because we know on some level that it could happen to us. On the other hand, we almost envy some people with mental illness because we believe that their illness has enabled them to do something we are not capable of. Think about somebody like the brilliant mathematician John Nash who suffered from schizophrenia. We tend to think that because of his alternative view of reality, this geniuses realized things that are beyond our imagination. And sometimes that is true, but there is a price you have to pay for that. People with bipolar disorder can show great creativity and productivity during their manic phases but that is by no means guaranteed. In most cases, you pay the price without getting the benefit.
Over the years, you have seen and heard about so many delusions. Is there one in particular that still fascinates you?
Two actually: The Truman Show delusion of course because it was such an important influence on my work. But I also find the Cotard delusion fascinating. It is the nihilistic belief that one is dead but still walking the earth. It is amazing to me because it is such a wild contradiction. Somebody is telling you that he is dead. “But Sir, you are talking to me. How can you be dead?” The belief sticks regardless. New delusional contents might be added to the list but the old forms remain. Still, the list grows.

"Psychedelics offer us life in high-definition"

Amanda Feilding is a leading advocate for the use of psychedelics to cure mental illnesses. She told us why LSD is not a party drug but should be taken while visiting the pyramids.

When talking about psychedelics, vivid colors immediately come to mind – is that the most intense sensation one gets from it?
Colors are certainly a very important part of the hallucinogenic experience, possibly the strongest sensation even.

Description. Photo by Robert Funke.

Amanda Fielding is the Founder and Director of the Beckley Foundation. Photo by Robert Funke.

How come?
Our research has shown that psychedelics – in particular LSD –  reduce the inhibiting properties of the default mode network. You can think of it like the ego: A network that senses impulses coming from the sensory system. Normally, instead of getting the pure sensation, you are getting a reduced version. But after taking psychedelics, what we have seen is that there’s a much greater flow of blood and connectivity between the visual center of the brain and other centers. That makes the visual experience much more informed by our personal memories, or images from the past and hence much more intensive.
Psychedelics are known for being another way of seeing the world, of creating a different reality…
That comes from removing the normal, day-to-day repression. Due to conditioning, we filter out most of what we could see. That filtering system – which happens through the default mode network – is reduced or even eliminated when we take psychedelics. Psychedelics offer us life in high-definition.
Following that logic, it would mean that the bright colors one sees when taking LSD are actually real, but we don’t perceive them in everyday life…
Exactly. We sensor them down to manageable components. Seeing a flower after taking psychedelics will make you see it breathing and living – it’s so beautiful you can hardly believe it. Whereas in daily life, you would just go “That’s a lovely rose and very pretty.” When the visual centers have unrestricted connectivity to other parts of the brain, the results are richer – both in memory and in emotion.
That reminds me of something Aldous Huxley once wrote: That chemical substances can make us see colors and beauty that – as he put it – transports us to our antipodes.
It’s a beauty felt with a kind of emotional context. And that is what is wonderful about psychedelics: They give fresh emotion to the experience of seeing, hearing, or thinking. It is fresher, brighter, and more filled with richness from memory and possibility. Ordinary life is just a reduced version of that.
Is that why they are so widely used for art?
Absolutely. To get the greatest enjoyment of beauty, say at a historical site in Egypt, or when admiring a beautiful monument, you should really expand your awareness to feel it in a deeper, more vibrant way. Psychedelics are wonderful enhancers of the normal senses, leading to much richer experiences. Watching the pyramids on LSD is not something you forget.
By now, when we see a certain pattern or painting that includes bright color combinations, we say “oh, this looks psychedelic”. It has already become a label for something that cannot be grasped within the normal ways we describe art.
Right, it seems to be more poignant. Some prehistoric cave art in France, which is 40.000 years old, has the same intensity of the line and energy in the depiction of animals that a drawing by Picasso has. The people drawing it were clearly intensely into it – and probably on a psychedelic substance when drawing.

“LSD opens up reality without censorship”

Why do artists become so engaged when taking these substances?
First of all, there’s added intensity, which makes the art more exciting and also, there’s a tendency towards synesthesia. Another finding in our research is that the different networks in the brain are normally very integrated within themselves. They don’t communicate much with one another. Whereas LSD leads to much more communication between different networks, even between some that don’t normally communicate with one another. Lines of communication get opened up, and it makes the whole brain much more of a unit.
In the perception of many people, the things you see under the influence of drugs – especially psychedelics – aren’t real. They are hallucinations. Whereas you say that what we see is an augmented reality…
…a richer reality! One without the censorship. You can think of hallucination as seeing with eyes closed. And we have also done the research on that: We compared the experience of people with their eyes closed on LSD with those of others on placebo. The impression in the visual center of the people on LSD is as strong as those of a person seeing something with their eyes open. They are seeing with eyes closed. So hallucination stems from the memory or emotion, and the imprint is as strong as other peoples’ reality. I am sure we will discover a lot more in this field, when we further explore the breakdown of the Default Mode Network that I have mentioned, which causes the normal censorship.
We know all these art pieces that have been created under the influence of certain substances. And I feel that society very much cherishes not just those works but the overall hippie era. Yet using these drugs is still widely frowned upon.
Absolutely. The use of psychedelics became taboo in the late 1960s. But I think the taboo is slowly lifting; with the realization of how incredibly valuable these substances can be in a therapeutic context. They can be a treatment for many intractable modern illnesses – like in depression, anxiety, or addiction. Or, indeed, against chronic headaches. Society has trouble with a whole lot of illnesses: 20% of people suffering from depression never start treatment. In studies of our synthesized therapy, the success rate of treating people suffering from depression has been very high, much higher than normal treatment – a success rate of 67 per cent in the pilot study.
Does this work because you give the patient access to insights or memories they didn’t previously have? A clinically depressed person struggles to get that access in therapy, since there is a kind of blockage. Psychedelics may be able to lift that – but isn’t there a danger of them opening a gate to something harmful?
With our depression study, we have taken the greatest care: People have been carefully screened before doing the research, to determine that they are suitable. And then there are two psychiatrists present. The person is looked after with great care, and under those circumstances, the danger is minimal. People can have a bit of a panic attack, but that is much more dangerous if they take psychedelics in uncontrolled, unsuitable circumstances. Which is not what we’re abdicating at all.
Isn´t it hard to precisely dosage LSD? How do you know how much to give to someone?
Absolutely. That’s the problem of the criminalization of a legal market. Ideally, people should be able to access psychedelics in therapy with trained therapists, and we should’t really be depriving patients of these forms of treatment if the research is showing a high rate of success. But we’re obviously in the early days of it, and although we’re heading into the right direction, we have to move forward with great care. The LSD study is testing safety of different dosages. It can teach us an awful lot about how the substance can be used to treat different disorders. Our studies suggest that it can efficiently reduce the function of the Default Mode Network…
…The intra-networks of different brain regions
In depression, the default mode network is hyperactive, and people feel like they are stuck in a circuit. Psychedelics break that network so that a new kind of setting, which can shake the chronically negative thought pattern and make a more positive one replace it. It seems as though these substances aid healing by getting to a deeper access of the personality. Normally, trauma and unhappiness are protected by repressive networks, by the Default Mode Network – which is another way of saying ego. But with psychedelics, the censorship breaks down. You get full access to your inner self.

“LSD is not a party drug”

So far, we have only talked about psychedelics as a therapeutic drug – you are certainly pioneers in that field. But to most people around the globe, they are still a recreational drug.
I’m afraid that has come from 40 years of inaccurate press coverage and misuse. LSD is not a party drug.  Historically, these substances have always been used as part of a religious, spiritual healing ceremony. With rather tight control and the support of the group – which seemed like a very sensible way of taking them.
Such as Ayahuasca?
Exactly, the famous brew from the Amazon. There, they have a way of taking it that makes the people feel like they are in a protective environment. Where they can open up to their inner travels, which can help people overcome trauma. And we saw the same with our study on depression. People who had been depressed for 18 years or more suddenly felt that they were, for the first time, able to enjoy themselves.
But were there lasting effects? In depression, the use of therapeutic methods might just be a short-term fix…
Remarkably, from our research, after a week it was rated as a 76% rate of overcoming depression. And after three months, the rate was 42%. Which is a lot more than ordinary forms of treatment. Not only is the effect felt immediately, it also leaves an afterglow of changed perception.
How many sessions do your patients have?
In this little part of the research, there were two sessions, first with a small dose, the second one with a medium dose. And people who have a deep experience of ego loss and spiritual awakening are very often the people who have optimized the benefits of overcoming depression or addiction, or whatever they were trying to cure.
Would you say that since your research center focusses exclusively on psychedelics, that other drugs, such as MDMA, have the same potential?
We actually also do research with MDMA and cannabis. And I would say they all have the same potential, but in a different way. MDMA has a special kind of flooding the brain with empathy, because it stimulates oxytocin. The effect is akin to what a mother experiences when she has a child, or when you are in love. So it makes the person love themselves – and the therapist, and everyone else.
…which aids therapy.
It makes it easier to face a terrible memory within themselves. That’s very good for post-traumatic stress disorder. But it doesn’t include the psychedelic experience of overcoming of the ego that I just mentioned. They have slightly different qualities, but can all be beneficial. Researching these and other substances, which we have only become able to recently, is opening up entirely new avenues of treatment – and can be very healing for society. We can treat illness, expand awareness depth of hearing and vision, and further understanding.
You have personally experimented with trepanation, where a hole is drilled into the skull to expand the consciousness. You have said that this was an experience even more intense, the next step from using psychedelic.
I didn’t really say it was the next step, but as far as I know – and we haven’t done enough research – it gives back to the brain the full experience of the heartbeat by removing a piece of bone. The heartbeat can express itself fully within the brain. It improves the circulation of cerebral spinal fluids, which wash out the toxins that can build up and produce the plaque underlying Alzheimers. But the experience is much less intense than taking LSD for example. Just like psychedelics, trepanation is an old healing technique.
So it is about returning to a prior knowledge that our society has forgotten, or criminalized?
Even breathing can get people very high. Meditation can have the same effect as a psychedelic. There are different ways of manipulating the brain in order to attain a less rigid state in our daily consciousness. And it can be healthy for the individual to experience these different states. There are serious conditions that need all the help they can get. Sadly, the altering of consciousness has a bad name – but is a part of the human experience and something we should learn more about.
More on Amanda’s work at: http://beckleyfoundation.org/

"Isolation isn't the biggest problem"

It’s hard to imagine a more solitary place than space. How do astronauts prepare for it? We spoke with researcher Jack Stuster, who has helped NASA develop a training.

You research and counsel astronauts in outer space. Judging from your experience: is space a lonely place?
Let me go back one step before answering: I study conditions on earth analogous to those on a spacecraft – Antarctic research stations or expeditions for example – and I study the behavior of astronauts working in isolation and confinement on board the International Space Station (ISS). That research was conducted in two phases. Between 2003 and 2009, members of two-or three-members crews participated in the study and from 2011 up to this year, members of six-person-crews participated in the study. Neither the first nor the second phase revealed that loneliness is a problem for the astronauts.

Jack Stuster is President and Principal Scientist at Anacapa Sciences. For NASA, he has contributed to the development of training of astronauts concerning the behavioral issues associated with isolation and confinement.

Jack Stuster is President and Principal Scientist at Anacapa Sciences. For NASA, he has contributed to the development of training of astronauts concerning the behavioral issues associated with isolation and confinement.

How come?
Even with small crews, as phase one has revealed, astronauts do not get very lonely. They might be alone all day but they are busy working and meet the others over dinner later. Every minute in space is programmed in advance so that there is relatively little free-time and when there is some, the astronauts tend to spend it together with their crew-mates. I ask astronauts to write a sort of diary to see how they feel and I have only very rarely read about loneliness or lack of personal space. Between phase one and phase two, private sleep quarters were added and so the astronauts always have the possibility to interact with others but they can also withdraw to their own sleeping chamber. I think the main reason why astronauts don’t get lonely is because they are too busy. However, there have been occasions where a supply spacecraft was severely delayed and the astronauts would have to wait for the material it was supposed to bring them. Then all of a sudden, astronauts have relatively little to do and that can become a problem.
Because they have the time to allow for loneliness?
From their journals, I learned that during such incidents, the astronauts felt under-challenged, bored and useless. But even here, loneliness is not the biggest problem. Let’s also not forget that the astronauts have e-mail and a phone with which they can call their friends and family. This helps a lot with the negative effects that separation from the loved ones can entail. Now on an expedition to Mars, this will not be possible. Astronauts will have e-mail but there will be no possibility for phone calls when the time delays increase beyond a few minutes.
Allegedly, the Norwegian explorer Roald Amundsen did not take a pocket knife with him on his polar expeditions but only the parts required to build one because he said that boredom is the greatest enemy of the explorer. Your findings seem to confirm that.
Boredom was the number one enemy of the polar explorers and when Amundsen traversed the North-West passage, he only took with him the raw materials to make trade items with the Eskimos rather than pre-manufactured items because he knew that he had to keep himself and his crew busy. When Fridtjof Nansen attempted to reach the North Pole, he had on board a library of a thousand volumes, music and wonderful food to fill the free time. The engineers even disassembledand re-assembled the engines on board twice to keep busy when the ship was locked in the ice., Nansen reported in his journal that the saddest day of the expedition was the day they ran out of beer.

“Being behind schedule is stressful, but having nothing to do would be worse.”

So work is the best remedy against negative feelings on such expeditions?
As I said, the only time that astronauts report negative feelings is when they have nothing to do. So NASA puts them on a very tight schedule so that there is always something to do. Astronauts are constantly running behind schedule which is an awful feeling for a person with high achievement goals which all astronauts are. Being behind schedule is probably the most stressful thing for astronauts but having nothing at all to do would be even worse.
How do the astronauts schedule their day in an environment that is not regulated by sunrise and sunset?
The ground crew schedules the day for the astronauts and trains their body clocks. They go by Greenwich Mean Time and wake up at the same time every morning except on weekends. Even though they have many sunrises and sunsets throughout the day – every 90 minutes basically – because they circle the globe, they do have a day schedule because of their work schedule. But some astronauts have problems adjusting to this because of the excitement. I mean it is a unique experience to look down at Earth! It is something that almost nobody will ever experience and it is so exciting that they sometimes forget to go to sleep at the set time. If they have problems sleeping, there are also sleeping aids on board that can be taken in special cases when sleep schedules change. So there are a lot of things that help them adjust to a regular day and night schedule.
Obviously there are many things you can do to prepare astronauts for issues like sleeping disorders but are there things you can do to prepare them for the distress of solitude?
The astronauts are almost never in complete solitude, unless they wish so. I am not aware that there is formal training but there are or have been simulations. In Russia, six test subjects were locked in a small module for 520 days to study the effect isolation has on their mental state and body. NASA is currently conducting 30 day simulations with four member crews. But these simulations cannot train the crew members for the special conditions on board of the ISS, they can only prepare them to a certain extent. Just knowing that you will experience certain conditions like isolation and confinement can help you a lot to deal with them later on. Because these conditions can cause some severe problems.
Like what?
Because of the pressure of isolation, trivial issues can become very serious issues and this can lead to arguments and fights between the crew members which must be avoided at all cost. Knowing about this helps you to cope with it.
So there is no way to predict how astronauts will react to certain conditions?
No, they are humans and we humans are too complex to be predictable. Especially in environments like outer space. But behavioral psychology teaches us that the best predictor of future behavior is past behavior. So if you plan a long and difficult exploration, you should of course pick crew members who have demonstrated that they are capable of living and working in isolation and confinement.

“Going to Mars would be a challenge to even the most experience astronaut.”

That is where the simulations overlook a crucial question: can you simulate solitude here on Earth and predict future behavior in space when the conditions of these environments are so different? Solitude on Earth surely is different than solitude in space.
I believe that solitude on the ISS is easier to deal with than solitude or isolation at a small Antarctic station, because work is performed at a high tempo and the scenery is beautiful and constantly changing. One astronaut wrote in his journal that no matter how bad things are going on board or how stressed one might be, the view fixes everything. On an expedition to Mars, where your destination is just a little dot in the sky and ultimately your home becomes just a little dot in the sky, that will make things very different. The solitude that interplanetary explorers will experience will be qualitatively different from what ISS astronauts experience.
How so?
A few years back, I gave a lecture about expeditions to Mars and a distinguished and experienced astronaut walked up to me afterwards and told me that he has always been comfortable being in the Earth-moon-shuttle system, but that he might not be the correct person to leave low Earth orbit and head to Mars. That, to me, revealed a self-awareness that astronauts have and that goes both ways: they know how capable they are but they also know their limitations. Going to Mars and having Earth so far away for two or three years would be a challenge to even the most experienced astronaut.
In his essay “On Solitude”, French philosopher Michel de Montaigne writes that we should have family, friends and property but that we should never make them the masters of our well-being, that we should be able to be happy on our own. Following his reasoning, the perfect astronaut would be a loner.
Not a loner, because interpersonal skills are essential to getting along in isolation and confinement. However, I have recommended that astronauts on an expedition to Mars should not have small children because they would probably regret the separation. I am an advocate of selecting husband-and-wife-teams, but this definitely is a minority opinion.
Would that not be a possible source of conflict?
Yes and no. There could be conflict between married people, but if they have been married a long time it demonstrates their compatibility and fidelity to a cause, two essential personal qualities. Also, people who have been married for 25 years probably know how to deal with conflict situations. There would, of course, be other advantages.
Are there astronauts who value the solitude in space because they enjoy having that time on their own?
Yes, absolutely! The astronauts are there to work and they often consider too much personal contact to be a burden. Sometimes, when the crew of the ISS gets visitors or when new crew members arrive, they feel happy at first but it can quickly turn into an annoyance because it disrupts the rhythm and work flow.
You have said that in the extreme conditions that astronauts find themselves, food becomes extremely important. Can you tell us why?
Food assumes added importance when usual sources of gratification such as family, friends, or hobbies are denied,. So the astronauts learn to cherish what they have up there. Their exercise machines become extremely important and so does food. Unfortunately, food has become kind of a disappointment to them in the sense that the options are very limited. But ground control is very busy making the food experience as pleasant as possible. Often, the people packing the food include small hidden messages, wishing the crew a good mission. Something like that can really cheer a person up after a long day of work. This has tradition: even during the early Polar expeditions, explorers would find little notes in their food to console and cheer them up.

“Solitude binds astronauts together.”

Is there a food that astronauts crave in particular?
Tortillas – by far. Astronauts never get enough tortillas. They train in Texas so they get used to eating Mexican food. But the other thing is that food starts to float away in space. So you need something that keeps the food together. What better than a tortilla?
Popular culture often paints the picture of the lonely astronaut such as David Bowie’s Major Tom, Elton John’s Rocket Man or Matt Damon in the movie The Martian. How accurate are these portrayals or descriptions?
It’s not very accurate because astronauts are always in groups, but it would be a completely accurate description if an astronaut were to be stranded somewhere, which is not very likely but possible. The Martian depicts a solitude that is not completely unrealistic in that sense. When a person is all by him- or herself, the things around start to change. You no longer perceive your environment the same. We know for example from prisoners in solitary confinement that all they need is the assurance that somebody is close to them. Even the noises coming from other people are enough to feel like you are not completely alone.
Is there one concluding observation that you can share from your research?
I have found that solitude and the extreme conditions in space have had a very positive effect on how the crew members deal with each other. There is sometimes a bit of friction among the American crew members or among the Russian crew members, but there has never been conflict between the Americans and Russians, the Americans and Europeans, or the Russians and Europeans – or with the Japanese. There have been several crews composed of former American and Russian fighter pilots. They had trained for years to kill each other but there they were, 230 miles above the Earth, working together in complete harmony under arduous conditions. The solitude and their common goals bind them together. If they are able to do that in space, we should also be able to do so here on Earth.