Do Not Read This Blog

There are certain advantages to being as old as me.
In the general classification of generations apparently I'm a millennial.
I have serious issues with this.
My younger brother is a millennial, and it’s just not me.
I’m not Gen X either, as my existential angst only applies to my taste in music, not my outlook on life in general. The world is fucked, but I’m having a good time.
So there is this gap in generations between X, and millennials that grew up with technology.
So I’m young enough to have some optimism, but old enough to have not had a computer til I was close to an adult (age only, still not there in practice)
It’s a tight window, but I have always thought I was special and the rules don’t apply to me, so it fits.
The other thing the Gappers dodged is social media. Not forever, but at least until we were in the workforce.
So all the dumb shit I did, ALL of it, has never been recorded, uploaded, commented on and has passed into nostalgic reminiscence round the haze of a campfire and fading memory.
And it’s the greatest thing in the world.

So this blog is about why I’m flipping the bird at the social media algorithm.

Now, cards on the table.
The only reason you are reading this, apart from my cutting wit and story telling wizardry, is social media.
It, more than anything else, has allowed connection between colleagues, who have become friends, and the expansion of my professional network, which has improved my business and my life. The upside is the exposure to a vastly greater number of people and clinicians, the ease of communication (albeit subpar and written) and the exposure to more ideas, more research and more stuff generally, which can no doubt can accelerate professional and personal development.
It has allowed me to help people I’ve never met. To have them reach out for help and support and to provide advice and assistance.
It has helped me no end - I have discussed things with world leading clinicians, have had my thoughts poked and prodded and refined in a way that I am unable to do myself. Owning a clinic and being as old as I am, and living where I live, it can be hard to have the regular cognitive ass-kicking necessary to continue to evolve.
My online/social media network has facilitated this.

But somewhere in the world, right now, there is a neonazi writing exactly (well, fuck, hopefully not EXACTLY) the same blog about how happy he is to have found a following amongst fellow fascists.
So while there is an upside, both for me and hopefully others, it comes with consequences.
Some are obvious.
Trolls, haters, rando commenters.
Luckily, as per the age discussion above, what some asshat that I have never met thinks about me is relevant. The fact that they are scrolling the internet looking for things to sling shit at actually makes me feel sorry for them. How many social media accounts or individuals am I insulting remotely? Or even looking at enough to care what they are doing? Exactly, zero.
However I know all too well that the effect of those things on me is very different to the effect on others.
I’m old enough and nerdy enough to have had real bullies at school. The tangible kind with various shit haircuts who were bigger than me and, as you grow to know, unluckier in me in that their version of regional Australia in the 80s left them thoroughly sad and unloved.
But my bullies stayed at school, I didn’t have to take them home and hear from them in my room at night. The faceless anonymity of social media allows the worst in all of us to move forward and be directed at others with whom there is conflict. All the shit human tendencies - jealousy, bitterness, animosity, pettiness - are so much more prevalent without the in person social pressure of not being a complete fuckwit.
The threshold is just lower. In person, a part of you may want to ridicule someone and feel the schadenfreude in all its glory. But it’s harder because everyone knows it’s you and there are social consequences. Plus you can get punched in the face.
Online lowers the input of the frontal cortex.

Next is how your brain works. The fact it isn’t real isn’t obvious to your brain. Both on the negative and positive ends. Having 5000 likes doesn’t mean these people actually care about you or what you say. Similarly 5000 trolling comments doesn’t mean the world hates you. But when your attention tunnels into the narrow online world, you can forget that.
It is also why extremes proliferate. As well as being encouraged by the algorithm, extreme views get pushed further to the edge, then get “rewarded” for it.
It is in group/out group mechanics, but magnified a million times.

But even with all that, it wasn’t the thing that really had me shaking my fist into the wind.
It’s how fucking stupid we are getting.
Attention is finite. But also responsive to input.
Noticed your ability to read a book, or have a long conversation, or just sit in the sun and absorb your surroundings, has decreased recently?
The endless scroll, flashing lights and social media algorithm appeal heavily to your dopamine reward system. Like a poker machine in your pocket, your phone calls to you, changing the default function of your neurons, pushing you further towards short, sharp information bytes, and making the opposite more difficult. Like any body part you train, it responds. So the opposite, slow intentional thoughts, wandering cognitive pathways of analysis, and long, meditative silence, gets harder.
The really shit thing is, the way we are put together, the more we see something the more we think it’s true. Rather than triangulating with other sources, referencing what we know or have read elsewhere, asking questions and poking at assumptions, the loudest dominates and most of us step in line. So we are getting worse at understanding important things while simultaneously thinking we are better at them.
In every domain in which we inhabit, this effect is more and more evident.
The rise of total bullshit pseudoscience, antivax sentiment, even regressing backwards in public health policy is a direct result of more people thinking they know more because they see things more frequently.

The point, however, rather than ranting about how everyone else is shit (like on social media) is actually talking about how shit we have become in physio and allied health. I have noticed this in myself, I have noticed it in the clinicians I have had conversations with. The drive and priority for continued development in the physiotherapy profession has dwindled.
Now everyone talks a big game. Including their own inner voice. Everyone says they want to develop and become the best physio possible. But that is not matched, in my opinion, with the behaviour that is necessary for such a path.
There are many influences on this, particularly in a private practice setting, including wage structures and career pathways in a post Covid world.
But the other, perhaps less obvious factor, is information prevalence and the inverse proportional relationship with quality.

An example. I have many conversations with clinicians about pain. They will reach out to me because, while they “get the whole pain science thing” they have trouble with patients and helping them get better. Particularly when they are difficult and don’t do everything the physio suggests they need to.
My suggestion - that this is what it is to be a clinician, particularly one that is regarded as an expert - and to work on getting better, is normally contemplated for a millisecond before being discounted.
As they have another source of help, one that tells them that it’s not them, it can’t be. It must be the “noncompliant” patient, or their boss, or “the system”, or capitalism, and in the face of such systemic flaws, they can’t be expected to help everyone. Or to do any extra work outside of their paid hours. Or to do any more reading besides the IG infographic they saw, which was so fucking blurry they probably didn’t even read that.

Engaging in deep, lengthy reading and learning is hard.
Discussing topics in detail and having disagreements (rather than emoji wars) is hard
Having another person challenge your thinking, your practice and your knowledge gaps is hard
Helping someone that has been in pain for a long time unravel their path and follow them along is hard.
But like pretty much everything in the entire fucking universe that’s hard, it’s also worth it, and better things are on the other side.

SO!

After all this raving, what am I doing about not being a complete hypocrite.
I’m not abandoning social media.
I’m just expanding my “not giving a fuck” to include it’s inner workings and algorithms.
No more short, sharp videos to fit the feed.
All I'm going to do are things worth doing. Where I hang out is in the grey, the difficult. So it takes time to talk this shit out.
Whether it’s written down or on video, it will be long, and demand your effort to be involved. I completely understand less eyes will see it, but that is the point. I’m not here for everyone.
So please keep reaching out with your difficulties. Just expect an honest assessment of how much effort you are directing towards real, effective knowledge acquisition. The only path to a credible message is, the standards to which you hold others, particularly in an online world, first have to be applied to yourself.
So for your favourite online accounts, forget what they say, unless it is what they do.