Picture the scene
I’m not great at telling scary stories.
When I write fiction, it’s usually in a similar tone to most of this blog. Light and snarky, not as linguistically clever as it’s trying to be, that kind of thing. Very rarely am I capable of creating anything deep, or mature, or genuinely thought-provoking in a genre like horror.
But there are some stories that deserve to be profoundly unsettling on the basis of their content alone, regardless of my own inability to conjure much terror.
So imagine that you can’t speak. You can’t write. You can’t move your hands with enough precision to make any intelligible symbols. You can’t reliably gesture to indicate what you want, or reach out to take it. You have no way of letting the people around you know how you feel, or what you want. They don’t understand you. They can never understand anything you do or say or think or feel.
One day a woman you’ve never seen before comes in, sits you in a chair with some sort of electronic screen attached to it just in front of you, and takes hold of your hand. She starts asking you questions. You don’t take much notice, because you can’t tell her anything. Whatever your answers might be, you’ve no way of communicating them to her, and you don’t have much interest in what she’s saying. After asking her question, she starts moving your hand around on the screen, pushing your finger onto some buttons on it.
Then she announces to the room that you’re so happy to be able to talk to people at last.
You’ve no idea what she’s talking about. You’re just sitting there. But she keeps asking you other questions, moving your hand on the screen, and then telling everyone that you think this or that, that you’re happy, that you like someone and don’t like someone else, that you love music, all sorts of things. You don’t know anything about any of this, but you can’t say anything, can’t tell them they’ve got it wrong, can’t even pull your hand away.
You see everyone looking at you differently now, all staring at you as if realising suddenly that there really is a person in there after all. They’re all looking right at you, saying how wonderful it is that you’re talking to them at last, and asking you more questions. But it’s not you they’re talking with. You’re not saying anything, not doing anything. You’re trapped.
This goes on for days, weeks. You don’t understand why everyone’s being like this, as if you’re talking to them all the time, but whatever they think you’re saying, you’re the only one who seems to know they’ve got it wrong. People keep smiling at you, often with tears in their eyes, but it doesn’t seem right. Your parents have never looked at you like this before, your mother seems so happy to hear the things the other woman keeps saying, but you still just want to tell her something real. You can’t.
Then one day they’re not smiling any more. The woman moving your hand around is looking very serious, and your mother is crying. You can’t see the screen that your finger keeps being pressed against, but whatever words are on it are clearly upsetting people. Your mother is coming over to you now, holding you, still crying, asking more questions that you understand even less than before.
Did daddy hurt you, baby? Where did he touch you? What did he do to you? Oh god, how could he do this, I’m so sorry baby, we’ll keep you safe from him, I promise.
Your father stops coming to visit after that. You never learn why. You never hear about the questions he was made to answer by the police, the accusations hurled at him in court, the life stolen from him and his family, as this innocent man is branded a monster and locked away for years.
And you still can’t say a word to any of them. You’re as helpless as ever.
A little perspective
That story ended with the loving father of a disabled child being jailed for sexual abuse. The evidence that put him away was based on the reported “testimony” of the child, but in fact the man was innocent, and the abuse never occurred. The child made no such statements, but someone practising facilitated communication (FC) claimed to be using this revolutionary technique to allow the child to communicate despite the disability. They attributed these untrue statements to the child, and they were believed.
Obviously this is a nightmare scenario. It would be terrible if this exact series of events genuinely came to pass. I’ve deliberately made it about as horrible as it could get. It should be unsettling to imagine this genuinely occurring, at the very least.
But that’s not an argument for anything. Not on its own. It’s just a story. If I just made a post titled “Facilitated Communication”, told a horror story, and told you to draw your own conclusions based solely on the emotions it evoked, I’d be about on the level of people who try to disprove evolution by shouting “HITLER!” a lot.
I’m not doing that. When you encounter a case of alleged facilitated communication, do not simply flashback to this nightmare scenario, decide that some horrifying atrocity is taking place, and start making phone calls to the rest of the angry mob to see who can remember where you stockpiled the pitchforks.
I am not trying to encourage anyone to make a decision, or take some action, based on an emotional response to something upsetting. It would be very manipulative if I were solely trying to influence your opinions by inspiring fear. But you know what? If an emotive and overblown story scares you, not into a rash and irreversible judgment, but into a greater awareness of the horrifying potential to this idea, and a realisation that it’s vitally important that we do everything we can to avoid it…
…then fucking good.
Obviously this exact scenario isn’t the natural consequence of every claim made about facilitated communication – again, I am not asking you to reject any such claims simply on the basis of one worrying hypothetical. But you must accept that no physical laws of the universe would be in any way inconsistent with the above scenario taking place. It’s not a fantastical tale set in a world of elves and pixies. It’s not dependent on unrealistic assumptions to make it possible. People with autism, paralysis, brain damage, and other medical conditions which leave them unable to communicate through traditional means really do exist. And so do people who claim to be able to perform this kind of facilitated communication.
Here’s one of them:
The technique was developed in the 1980s, popularised in the 1990s, and still has a substantial following today. The claim is that the “facilitator” senses tiny movements in the subject’s hand, and allows them to guide their own hand to the buttons on a keyboard that they wish to press, to type out a message. What you’re seeing in the video above, we’re told, is a nurse interpreting very slight muscle activity, in a man mostly paralysed and incapable of holding up his arm to type a complete message himself, and assisting him to make the actions he wants.
So, that’s one explanation of what’s happening. But if something more akin to my nightmare scenario above were actually taking place, it would look exactly the same to an idle outside observer who didn’t look any closer.
One explanation requires an entirely new and remarkable paradigm. The other one just means that people are getting things wrong again, and clinging to the ideas they find most comforting. For which explanation are you going to demand the most rigorous proof before believing it?
It may sound like I’m offering a scaled-down version of Pascal’s Wager, and encouraging you to act in fear of some scary but vanishingly remote eventuality, but there’s no real comparison there. I don’t want everyone to rush out and devote their lives to seeking out any instance where something horrifying might possibly be happening, and completely ruling it out. But this is a very public and noteworthy phenomenon, about which a lot of people are loudly making grandiose claims, and a much simpler explanation – that those people are wrong, and we could be risking a nightmare scenario like the one described above – is entirely plausible.
Let’s say I publicly claim to have built a robotic cat. I hold up a pretty ordinary-looking cat, and tell you that it’s full of electronic parts that I put together, designed to act in every way like a real cat. To prove it, I offer to demonstrate how realistically it responds to pain. I show that, when I twist my cat’s limbs and jab it with pointy things, it screeches and wails and struggles to get away from me, just like a real cat would. I conclude that I’m a technological genius and demand massive government funding for further research.
If I really have built a fully lifelike cybernetic animal, then this would be a phenomenal accomplishment. My fantastic intellect and paradigm-shattering discoveries would truly be a landmark in the scientific development of our species. This should be taken very seriously, and there would be great excitement over the immense ramifications of what I’ve achieved. But before we go rewriting the history books…
…you might want to make sure I’m not just torturing a cat.
Now, most people don’t torture cats. You probably don’t need to be overly concerned about cat-torture in general. It needn’t keep you awake at nights. You don’t need to go out of your way to do background checks into everyone you meet to make sure they’re not a secret cat-torturer. Before today, you’d have had absolutely no reason to suspect that I’d ever even dream of torturing cats.
But when I’m demonstrating to you the realism of my invention… I gotta admit, it looks a lot like I’m just torturing a cat. In this case, you’d have to be very blasé on the subject of cat torture to just take me at my word that it’s an amazingly advanced cyborg, without wanting to check that I’m not just torturing a cat.
You see where I’m going with this?
The facilitators are presenting what may be a revolutionary technique that allows autistic and paralysed people to speak their thoughts in a way never before possible. This would be a hugely beneficial development, and deserves significant attention.
But they’re also presenting something that looks exactly like the nightmare scenario above would look, if that were really happening.
Isn’t it worth trying to make sure these people aren’t just torturing a cat?
Just believe it
The claims of facilitated communication can only earn any credibility once they’ve given us a good reason to reject the nightmare scenario, and proven beyond reasonable doubt that the process achieves what it claims to. Until then, we’re not being paranoid: the nightmare scenario is a legitimate fear that has not been dismissed.
But people have looked for just such a good reason, and they haven’t found much to reassure them. If you X-rayed my cat and saw only a collection of normal feline biological organs and a distinct lack of computer gadgetry, would you be reassured, or even more worried?
Some people object to even testing such a phenomenon. This is only to be expected when people are deeply emotionally invested in an idea which tends to be damaged by scientific scrutiny, rather than supported. How dare you even ask me whether my cat’s really a cyborg? I’m offended that you openly doubt me at all. Just shut up and let me keep testing the AI’s simulated pain threshold.
Someone criticised Steve Novella for expecting a subject using facilitated communication to be able to perform in a situation of “cold and advesarial [sic] testing”. It’s possible this person doesn’t think it’s right that claims of facilitated communication should be tested even in principle. Or maybe she just doesn’t think a reasonable test protocol can be put together, due to the inherent limitations of the phenomenon itself.
But the conclusion she seems to want us to reach is that it should therefore be accepted without question. Yeah, that sounds like a totally safe way to approach reality. What could possibly go wrong? I’m afraid X-rays will fry my cybercat’s circuitry, so you can’t do that. Are you happy to just take my word now? Go on, yank on its tail. It’s fun.
The commenter also misunderstands what science is. Yes, we’re talking about performing a controlled clinical trial. This does not mean that some poor autistic kid is going to be thrown into a harshly white and sterile laboratory somewhere, while a load of test tubes bubble over with dry ice, and people are given sinister injections of experimental virus strains over in the corner. I know you’ve probably seen a film and realised that these are the things that scientists like to busy themselves with, but that’s not actually how it works. Doing a good scientific trial is about removing as many extraneous variables as possible, so that the bare facts can be assessed and analysed as accurately as possible. It’s about trying not to be wrong, by whatever methods most effectively serve that goal. That’s all.
We can and we should test facilitated communication, and any worthwhile test must be potentially able to give us something which rules out the simple, nightmarish option. If I show you the code I allegedly used to program my cat, and some models of the pistons and valves used in the leg joints, this might not do much to put you at ease about Chairman Miaow’s safety. But if I stick a magnet to its side, maybe you’d become convinced. My cybercat is magnetic; real cats aren’t.
So: what would be true of genuine facilitated communication, that wouldn’t be true of an entirely fake performance?
The proof of the pudding
Well, the kinds of platitudes that commonly come out of FC clearly aren’t going to satisfy this demand. If all an autistic kid apparently has to say is that they’re happy to be alive and able to talk to people, or that they love their parents, then this is nothing that anyone else could not have typed for them. This is as pointless as noting that my cat purrs when stroked. Real and animatronic cats act like that. Duh.
But what if we asked the kids about something only they knew? If they could tell us something the facilitator didn’t know, that would prove that the facilitator wasn’t just using the subject’s hand to type. We’d know that they were really helping someone with a disability to communicate. So maybe we could get the facilitator to leave the room, and then show the subject a word, or an object, or a picture, or give them some sort of information, which we can then ask them about when we bring the facilitator back in after a moment.
That sounds fair, right? We don’t have to take the person to a scary laboratory and surround them with intimidating bubbling flasks of Science. They can just be wherever they usually hang out, meeting a new person and being shown, say, a red cup. That sounds like something they could probably handle. I mean, these kids are supposed to be writing poetry. They’re pretty eloquent when they get chatty. “Autism held me hostage for seventeen years but not any more because now I can talk.” I don’t see why they couldn’t handle something like “That man had a red cup”.
And if any FC subject proved to be capable of this simple task, it would leave the skeptics with nowhere to hide. It wouldn’t take much work to prove that the subject really must be communicating themselves, through the facilitator, just as claimed. It seems like the proponents and practitioners of facilitated communication would be dying to try this out.
People have tried it out. This exact protocol, and others like it.
It’s never worked.
To see what they found, let’s look at the question the other way round. What would be true if FC were a total sham, which would not be true if it were genuine?
One thing you would expect, in the case of a sham, is that it wouldn’t matter whether or not the subject supposedly “communicating” was paying any attention to the keyboard, or seemed aware of what was going on around them as their fingers were pressed against the buttons. You would also expect that the facilitator would have to be paying very close attention to exactly where they were moving the subject’s hand – something that surely wouldn’t be that important if they were genuinely only responding to the subject’s own movements.
And this is exactly what we find. Watch this video, and see if you can tell which is the person carefully scrutinising the keyboard, and which is the one with their eyes closed.
In the case of a sham, you might also expect to find that there are no real limitations on how fast the facilitator can type. If they’re doing everything themselves, they won’t need to carefully and delicately respond to very slight physical cues from the hand they’re holding, slowly and tentatively moving where they think they’re being led. They’ll be able to blast away, typing whatever they like at whatever rate they prefer.
And this is exactly what we find. This video of “Coma Man” Rom Houben is a fine example. When I first wrote about this, I noted that I’d probably have trouble matching that kind of typing speed with just one finger myself – and I’m a professional typist who’s not even in a coma.
In the case of a sham, you might also expect that what the facilitator knows should make much more of a difference than what the subject knows, when it comes to the responses you get. In other words, if the subject is given different information from the facilitator, you would expect that only the facilitator’s information is reflected in the responses.
I’m just going to quote one example of this being tested, from a study reported on an episode of Frontline on PBS:
NARRATOR: All the parties agreed to invite an expert in communication to come and assess Betsy. They chose Dr. Howard Shane from the Boston Children’s Hospital. Shane had devised a double-blind test, like this, to objectively determine who was authoring the messages, Betsy or the facilitator who transcribed the allegations. He showed both a series of pictures and asked them to type what they saw. When both Betsy and her facilitator saw a picture of a key, the letters K-E-Y were typed. But Shane wanted to discover what happened if each saw a different picture. When Betsy saw a cup, she didn’t type “cup,” she typed “hat,” what the facilitator saw.
Dr. SHANE: Here we go. Now take a look at this one. I want you to tell me what you see, okay?
NARRATOR: When Betsy was shown a picture of a dog, she didn’t type “dog,” but “sneakers,” what the facilitator saw.
Dr. SHANE: Okay. Want to take a look at that one?
NARRATOR: When Betsy was shown a boat, she didn’t type “boat,” but “sandwich,” what the facilitator saw.
Dr. SHANE: Betsy, now I’m going to show you something. Take a look at this. You take this. Now, what is that? Give it back to me. We’re going back in. I want you to tell everybody what I showed you.
When we went back into the room, she was unable to type the word “key.” I then took another key out of my pocket and said, with the facilitator present, “What is this?” and she immediately typed, “key.” So again it suggests that when the facilitator is aware of the information, we get the answer, but when the facilitator is unaware of the information, we don’t get an answer.
Yep. This is exactly what we find. It could not possibly be more obvious that Betsy is not providing any input here, and the words being ascribed to her are coming from the facilitator.
Oh, and as for the reason this test was being done, those “allegations” the facilitator had previously transcribed? They accused Betsy’s parents, brother, and grandparents, of sexually abusing her.
I wrote that nightmare scenario way back up there deliberately to be as hyperbolic as possible. This actually fucking happened. These innocent people were publicly accused of raping a 17-year-old autistic girl. The brother was taken away from his parents and put into foster care.
Have you ever been accused of raping a disabled child? It can seriously fuck up your social life.
That particular family avoided any truly horrendous consequences, not least because of the scruples and good skeptical sense of the local attorney appointed as Betsy’s legal guardian while the allegations were being investigated:
If the communications were real and she was being abused, the idea that on a legal technicality we might send the children back would be just absolutely horrible. On the other hand, if these were not real communications, the idea that all this would happen to this family and these children on a bogus idea was also unacceptable. So to my mind, the stakes were extremely high on both sides and it was very important that we reach a quality decision based on the truth.
I cannot fathom why this isn’t similarly obvious to everybody else involved. But some people don’t see that this is something worth checking carefully. People have gone to jail over cases like this. If you want us to believe that there’s something to this facilitated communication thing you’re bringing us, and that you’re not just cruelly branding a loving father as a child molester, then you need to make fucking sure you’re not full of shit.
There’s something hugely important I haven’t covered yet. If all this communication really can be explained by the actions of the facilitators themselves, then what the hell are these people doing? What’s their agenda? Why are they moving coma patients’ and autistic kids’ hands around to type fake messages? Is it a power trip? What do they hope to achieve?
Here’s another quote from that PBS show, talking about the aftermath of Betsy’s case:
The facilitator, devastated by the test results, stopped using facilitated communication and persuaded Betsy’s school to stop using it, as well.
This is where the hopeful part of the story starts, I guess. That doesn’t sound like the action of a fraud. And, in fact, conscious fraud is not necessary for completely bogus facilitated communication to take place. When you see this going on, it is not fair to assume that anyone is pulling a deliberate scam. Sometimes it can be the result of people just getting things wrong. And sometimes they can learn what they got wrong, and start getting things right.
If you attack alternative medicine to someone who’s a fan of it, you need to be careful they don’t take it personally. Many people who buy into homeopathy or acupuncture do so because they seemed to have a positive experience with it, and just aren’t critically judging the value of their one anecdote against the weight of clinical data. If they think you’re telling them they’re stupid to believe what they do, or they’re wrong about what they know happened to them personally, then they’re likely simply to become further entrenched in their opinions and decide that skeptics are just obnoxious.
Similarly, many facilitators know that they’re not just making all this stuff up, and they don’t like being unfairly called liars any more than the rest of us. So if your criticism of facilitated communication seems like you’re simply accusing them of being full of it, they’re likely to become even more staunch in their position. And then they’ll be even less inclined to listen to, say, actual evidence, or be able to analyse the facts reasonably, and understand how experimental data undermines what they’re saying. If it feels like acknowledging this data will amount to admitting to lying, they’re not going to go for it.
But they don’t have to have been consciously lying at all. Just like a lot of people who specialise in many different fields of being wrong, a lot of facilitators really aren’t flat-out lying, or trying to con anyone, or insensitive to anyone’s feelings, or being overtly and deliberately dishonest. There are ways in which your brain can trick itself into believing all sorts of things, and the ideomotor effect is just one of them.
I wrote a whole separate article about that already, just so that I wouldn’t have to go into great detail here and make this post even longer. I’ve experienced it myself, in the swinging of a pendulum that I knew I wasn’t moving. And it can – at least partially – explain how someone can move a person’s finger all over a keyboard, convinced that they feel a guiding force that isn’t actually there.
Sure, an outrageous lie also explains the same thing. But that’s a whole lot of very blatant lying they must have been doing, and I’m not convinced there’s enough motivation there that so many facilitators would go along so eagerly with so much cruel and heartless deception. A lot of them are probably very sincere, but very defensive about it – not unnatural when they perceive that they’re being accused of something appalling. They may find themselves digging deeper and entering the dangerous but comforting world of self-delusion, but it’s vital to remember that this sort of nonsense can start from people just being wrong, and innocently failing to understand the full nuance of the situation – it doesn’t require that anyone be a horrible, immoral monster.
This also reminds us that the sincerity of anyone’s account of their own personal experiences with facilitated communication, however genuine, means nothing when it comes to the matter of whether or not it’s true. Even if they do firmly believe in what they’re doing, be skeptical of the conclusions they’re drawing. People were openly weeping with sincerity and honesty and Michael Jackson’s séance, for fuck’s sake. And that was a pile of horseshit so big that a 30C homeopathic dilution might actually still contain some particles of active horseshit.
You’re not calling anyone a liar by being doubtful. You just want to know if things are really as they seem. Remember the nightmare scenario. Knowing this is important.
1. A situation where one person claims to speak, with absolute authority, for someone else who is unable to deny or clarify their claims directly, has terrifying potential for abuse or misinterpretation. It is dangerously negligent to suggest that there shouldn’t be intense scrutiny of such a process, to make sure that such abuse or misinterpretation does not ensue.
2. When people have looked into examples of supposed facilitated communication, to try and make sure that there isn’t something terrible going on, they have never found reassuring evidence that the phenomenon is genuine. Not once have we actually made certain that it’s definitely real.
3. In fact, the evidence we’ve found during such checks has tended to directly contradict the claims of FC. In controlled conditions, the facilitators can’t provide the communication they ought to be able to. The excuses offered – like that the subject was made nervous by these controlled conditions – are offered post hoc and are wholly unconvincing. And they don’t change the fact that we’ve still not found a shred of positive evidence, so we still cannot safely take these claims seriously.
4. We have a better explanation, which is entirely consistent with everything that’s been observed, and which doesn’t require us to make any massive assumptions, or leap to any fantastical and unexpected conclusions that we’d never have guessed before. FC drastically changes our worldview. Of course that’s not an insuperable barrier; if the evidence supported it anyway, then we mustn’t let the size of this change of worldview stop us from accepting it. But the evidence doesn’t support it. And our alternative explanation requires no such massive shaking-up of everything we thought we knew. Sometimes people are wrong but desperately want to be right. That assumption isn’t much of a stretch at all.
5. Maybe it’s real. Maybe some cases have been genuine. But if you buy into it too quickly, before you’ve ruled out that you might be wrong… then the potential consequences if you are wrong are horrifying. If you haven’t ruled out yet that it all might be a mistake, look harder.
Sources and further reading