The Persistence of Error

There is an embarrassing, unanswered question about theories and models in Psychology that is screaming to be answered. If the evidence in support of Psychology’s models and theories is so meagre and feeble, how have they survived for such a long time?

The scientific method is intended to be a fail-safe procedure for abandoning disconfirmed hypotheses and progressing with hypotheses that appear not to be disconfirmed. The psychologists who dream up these theories and test them claim to be scientists, so what the heck is going on?

One reason that theories and models become semi-permanent features of textbooks and degree programmes is that simple rules at the very heart of science are persistently broken. If a theory is tested and found wanting, then one of two things happens: either (1) the theory is revised and retested or (2) the theory is abandoned. The history of science suggests that (1) is far more frequent than (2). Investigators become attached to the theories and models that they are working with, not to mention their careers, and they invest significant amounts of time, energy and funds in them, and are loath to give them up, a bit like a worn-out but comfortable armchair.

We’ve all been there – seen it, done it, even have the T-shirt:

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Nothing dishonest is happening in most such cases, simply an unwitting bias to confirm one’s theoretical predilections. This is the well-known confirmation bias studied by, yes, you guessed it, psychologists (e.g. Nickerson, 1988).

The process of theory or model testing is illustrated in the diagram. The diagram shows how the research process insulates theories and models against negative results, leading to the persistence of error over many decades. Continuous cycles of revisions and extensions following meagre or negative results protect the model from its ultimate abandonment until every possible amendment and extension has been tested and tried and found to be wanting.

Screen Shot 2018-09-07 at 08.51.32What textbooks don’t tell you: the persistence of error – the manner in which a model or theory is ‘insulated’ against negative results

Several protective measures are available to insulate investigators from ‘negative’ results:
(1) Amend the model and test it again, a process that can be repeated indefinitely.
(2) Test and retest the model ignoring the ‘bad’ results until some positive results appear that can happen purely by chance (a type 2 error).
(3) Carry out some ‘statistical wizardry’ to concoct a more favourable-looking outcome.
(4) Do nothing, i.e. do not publish the findings, and/or:
(5) Look for another theory or model to test and start all over again!

Beside all of these issues, there is increasing evidence of lack of replication, selective publication of positive findings, and outright fraud in psychological research, all of which militate against authentic separation of fact from fantasy (Yong, 2012).

Little attention has been paid to the cultural, socio-political and economic conditions that create the context for individual health experience and behaviour (Marks, 1996). Thousands of studies have accumulated to the evidence base that is showing that socio-cognitive approach provides inadequate theories of behaviour change. Any theory that neglects the complex cognitive, emotional and behavioural conditions that influence human choices is unlikely to be fit for purpose. Furthermore, health psychology theories are disconnected from the known cultural, socio-political, and community contexts of health behaviour (Marks, 2002). Slowly but surely these issues are becoming more widely recognized across the discipline and, at some point in the future, could become mainstream.

As we have seen, critics of the socio-cognitive approach have suggested that SCMs are tautological and irrefutable (Geir Smedslund, 2000). If this is true, then no matter how many studies are carried out to investigate a social cognitive theory, there will be no genuine progress in understanding.

Weinstein (1993: 324) summarized the state of health behaviour research as follows: ‘despite a large empirical literature, there is still no consensus that certain models of health behaviour are more accurate than others, that certain variables are more influential than others, or that certain behaviours or situations are understood better than others.’ Unfortunately, there has been little improvement since then. The individual-level approach to health interventions focuses on theoretical models, piloting, testing and running randomized controlled trials to demonstrate efficacy.

It has been estimated that the time from conception to funding and completing the process of demonstrated effectiveness can take at least 17 years (Clark, 2008). Meta-analyses, reviewed here, suggest that the ‘proof of the pudding’ in the form of truly effective individual-level interventions is yet to materialize.  Alternative approaches for the creation of interventions for at-risk communities and population groups are needed. A fresh approach requires a general theory of behaviour that encompasses human intentionality, desire and purpose within an ontology of change.

Psychology Bankrupt?

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Is Psychology a bankrupt science? The majority of theories are wrong, the majority of methods do not work and the majority of studies cannot be replicated. In A General Theory of Behaviour I argue for a complete redesign of the discipline.

There are several reasons why the most popular techniques used by psychologists to help people change are ineffective. The evidence does not justify any confidence in the theories, in the methods used or in the explanations provided. Meta-analyses of theory testing studies paint a gloomy picture. The overall pattern of findings suggests that current psychological theories and models cannot provide a viable foundation for effective interventions.

One core limitation with many theories and therapies is their use of the ‘Social-Cognitive Model’ (SCM). The SCM holds that a person’s ability ‘get better’ or to change is a social-cognitive problem, i.e. the person is said to have the ‘wrong’ thoughts and beliefs. According to the theory, these ‘unhelpful’ cognitions must be changed to produce a change in behaviour. But what if the beliefs are correct, or are only a small part of the whole picture, and what if they have little relevance to the behaviour or symptoms that the person is wishing to change?

Other reasons for the failure of the SCM in real-world behaviour change are briefly described below.

Individualistic Bias
Choice and responsibility are internalized as processes within individuals similar to the operating system of a computer. The human ‘operating system’ is assumed to be universal and rational, following a fixed set of formulae that the models attempt to describe. Yet even within its own terms, the programme of model testing and confirmation is failing to meet the goals it has set.

Lack of Ecological Validity and Questionable Statistical Methods
Thousands of published studies have used null hypothesis testing with small samples of college students or patients. The power, ecological validity and generalizability of these studies is questionable. We do not really know their true merit because of uncertainties about representativeness, sampling, and statistical assumptions. Rarely are alternative approaches to theory testing utilized, for example, Bayesian statistics and power analyses, to assess the importance of the effects rather than their statistical significance (Cohen, 1994).

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Self-report measures
Most studies use self-reported measures of intention and behaviour rather than objective measures. Always a huge problem! It means that the academic studies have little contact with the universe of real-world, objective behaviour.

Neglect of Culture, Religion and Gender
Religion, culture and gender are neglected by most socio-cognitive models. The models aim at universal application that is unachievable.

Unfalsifiable
Some strident critics have suggested that the models are tautological and, therefore, unfalsifiable (Smedslund, 2000). A tautology is a statement that is necessarily true, e.g. ‘Jill will either stop or not stop smoking’ or “The earth is round (p<.05)” as one famous paper would have it (Cohen, 1995). Whatever data we obtain about Jill’s smoking, the statement will always be true – a very safe prediction. Smedslund (2000) deduced that, if tautological theories are disconfirmed or only partially supported by empirical studies, then the studies themselves must be flawed for not ‘discovering’ what must be the case!

Bad models can only be supported by bad research. Others have argued that behavioural beliefs (attitudes) and normative beliefs are basically the same thing. Ogden (2003) analysed empirical articles published between 1997 and 2001 from four health psychology journals that tested or applied one or more social cognition models (theory of reasoned action, theory of planned behaviour, health belief model, and protection motivation theory). Ogden concluded that the models do not enable the generation and testing of hypotheses because their constructs are unspecific. Echoing Smedslund (2000), she suggested that the models focus on analytic truths that must be true by definition.

Unsupported Assumptions
The transtheoretical model has received particular criticism. Sutton (2000b) argued that the stage definitions are logically flawed, and that the time periods assigned to each stage are arbitrary. Herzog (2008) suggested that, when applied to smoking cessation, the TTM does not satisfy the criteria required of a valid stage model and that the proposed stages of change ‘are not qualitatively distinct categories’.

Procedural Issues
Studies measuring social cognitions rely upon questionnaires which presuppose that cognitions are stable entities residing in people’s heads. They do not allow for contextual variables which may influence social cognitions. For example, an individual’s attitude towards condom use may well depend upon the sexual partner with whom they anticipate having sexual contact. It may depend upon the time, place, relationship and physiological state (e.g. intoxication) within which sex takes place.

French et al. (2007) investigated what people think about when they answer TPB questionnaires using the ‘think aloud’ technique. French et al. found problems relating to information retrieval and to participants answering different questions from those intended and they concluded that: ‘The standard procedure for developing TPB questionnaires may systematically produce problematic questions’ (p. 672).

Neglect of Motivation
Another problem with the SCMs is that they do not adequately address the motivational issues about risky behaviours. Surely it is their very riskiness that in part is responsible for their adoption. Willig (2008) questioned the assumption that lies behind behind much of health and sex education ‘that psychological health is commensurate with maintaining physical safety, and that risking one’s health and physical safety is necessarily a sign of psychopathology’ (p. 690).

Redesign of the Discipline
Many people love taking risks; they find taking risks enjoyable, exciting, and exhilarating. If you doubt this fact, take a stroll into any casino or race track, or wait at the bottom of Mount Everest for the body bags.

Until psychology addresses the causes of behaviour, it will never succeed in helping people to change. For this, we need a complete redesign of the discipline. For an in-depth analysis, see my book A General Theory of Behaviour.

Changing Behaviour

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The vast majority of people change their behaviour with no external help. They just do it. ‘Change experts’ include psychologists who advocate behaviour change techniques in their interventions. A behaviour change technique (BCT) is any systematic procedure (or a category of procedures) included as an active component of an intervention designed to change behaviour. The defining characteristics of a BCT are that it is:

• Observable
• Replicable
• Irreducible
• A component of an intervention designed to change behaviour
• A postulated active ingredient within the intervention (Michie et al., 2011).

The description, classification and investigation of BCTs has become a cottage industry. Places like UCL, Aberdeen and Cambridge Universities, together with IBM, have received several millions of pounds from the Medical Research Council and Wellcome Trust to construct an ‘ontology’ of behaviour change.

According to the project website, “Behavioural Scientists are developing an ‘ontology’: a defined set of entities and their relationships” which will be used to “organise information in a form that enables efficient accumulation of knowledge and enables links to other knowledge systems.”

bs-diagramdetailedThe top level of the ‘Behaviour Change Intervention Ontology’ (project website)

An ontology is a set of concepts and categories in a subject area that shows their properties and the relations between them. An ontology can only be helpful when nothing of importance to the system as a whole is left out.

A ‘BCT Taxonomy’ has been employed to code descriptions of intervention content into BCTs (Michie et al., 2011, 2013). The taxonomy aims to code protocols in order to transparently describe the techniques used to change behaviour so that protocols could be made clearer and studies could be replicated (Michie and Abraham, 2008; Michie et al, 2011). A taxonomy also can be used to identify which techniques are most effective so that intervention effectiveness could be raised and more people would change behaviour.

The production of a structured list of BCTs provides a ‘compendium’ of behaviour change methods which helps to map the domain of behaviour change and inform practitioner decision-making. However it also risks becoming a prescriptive ‘cook-book’ of what therapeutic techniques must be applied to patients presenting with a specific behavioural problem.

Another problem with the compendium approach is that BCTs are not all optimally effective when combined in ‘pick-and-mix’ fashion. There needs to be coherence to the package that is provided by a theory that offers power and meaning and connects the components into a working set.

I can illustrate this point by considering an intervention for smoking cessation, Stop Smoking Now (Marks, 2017). This therapy is an effective method for clearing the human body of nicotine. The desire to smoke and any satisfaction from smoking are abolished using different forms of CBT and mindfulness meditation. Stop Smoking Now includes 30 BCTs integrated within a coherent theory of change based on the concept of homeostasis. In Stop Smoking Now a structured sequence of BCTs is provided that takes into account the nesting of BCTs such that guided imagery works best in combination with relaxation and both of these work best following enhancement of self-efficacy, achieved using self-recording, positive affirmations and counter-conditioning.   In addition, our field evidence shows that the outcome is enhanced by having a personable delivery from a charismatic person who builds a positive therapeutic alliance.                  

bs-diagramdetailedWith so many missing elements, this an Incomplete Model of Behaviour Change

Where is the client person in the ‘Behaviour Change Intervention Ontology’, and what about their feelings and their own striving for new balance and equilibrium?  Where is the therapist and the therapeutic alliance?  The quality of the change agent, their clinical and interpersonal skills and the quality of the therapeutic alliance can be more important than the BCTs (Hilton & Johnston, 2017) .With so many missing elements, this is beginning to appear like a top-down model of behaviour change. One may be excused for wondering whether the people designing the ‘ontology’ have any real-world hands-on experience of delivering interventions.

Hagger and Hardcastle (2014) suggest that “Interpersonal style should be included in taxonomies of behavior change techniques”. The whole point is that the therapeutic alliance is something the therapist and the client need to strive for. The alliance creates a more equal power balance between therapist and the client. It is more important than another technique, another item on the list. It is more about the ‘chemistry’ of the client-therapist relationship than about a finely polished set of BCTs. The trouble is that the advocates of the BCT compendium/ontology appear unwilling to engage with the problem. Somewhat ironically, they are resistant to change. However, the problem will not just go away, but rears its head each and every time a therapist swings into action.

Behaviour change involves a collaboration between the client wanting to make the change, with their own desires and feelings, and the change agent/therapist. The therapeutic alliance between the two parties is crucial to the project’s ‘outcome’.  Therapist’s attributes such as being flexible, honest, respectful, trustworthy, confident, warm, interested, and open contribute to that alliance. From all of this it can readily be seen that the situation is far more complex than the proposed ‘Behaviour Change Intervention Ontology’. It is never as  simplistic as an ‘Intervention’,  ‘Mechanisms of Action’ and ‘Target Behaviour’.

To use an analogy, there is so much more to baking a cake than a set of ingredients. Of course one needs a set of ingredients (the BCTs) but one also needs a baker – the behaviour change agent (BCA). The BCA/therapist must be fully trained to prepare, mix and cook the ingredients, to be fully competent to deliver the BCTs in a stylish manner. The qualities of effective therapists have been studied for at least 50 years. The stock piling of a compendium of BCT ingredients without attending to the mixing and ‘baking’ of the ingredients by the BCA on the front line is a recipe for disaster.

smart chef character cooking behind kitchen table with various o

Including therapist attributes of flexibility, authenticity, respect, trustworthiness, confidence,  warmth, interest, and openness, along with the client’s goals, desires and striving provides a more accurate and comprehensive approach to behaviour change.

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“Milestone text of the 21st century”

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In ‘A General Theory of Behaviour, David Marks has applied scientifically established theory to conceptualize disparate areas of Psychology in a manner that both unifies and brings greater insight, establishing this book as a milestone text of the 21st century.

Dr David A Holmes, Senior Lecturer in Psychology, Founder of the Forensic Research Group, Manchester Metropolitan University

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“Inspiring book…compelling read”

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This inspiring book applies the seemingly simple biological concept of homeostasis to human behaviour.  There is beautiful historic detail about key researchers, whilst considering modern issues such as stress, lack of sleep and addiction. A compelling read, which feels like an engaging lecture, by a passionate and considered speaker.

Janine Crosbie, Psychology Lecturer, University of Salford,

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“Exceptional insights and a driving logic”

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‘In A General Theory of Behaviour, David Marks embarks on the rare journey of creating a central theory of human behaviour, the things that underpin how we think, what we do, how we affiliate with others, and who we become.  Marks brings exceptional insights and a driving logic to bear to navigate through many fragmented theories of behaviour that are by their nature partial and limited.  It is not that these more fragmented theories are not often important, but that we need the grander theory to hold disparate ideas together.  Marks does so convincingly and in a way that is testable, refutable, and often even entertaining.  He demands that the reader think, question, and grasp a broad framework, and doing so will require the kind of thought that our internet-based, 140 character thinking has been reversing.  His ideas are truly worth the effort to sit back with a cup of coffee, and if necessary even a scotch, and think through, ponder, go back over, and incorporate into our appreciation of the eternal question of “what drives human behaviour.”  In A General Theory of Behaviour Marks has made a true contribution to psychology that comes from his careful listening, watching, and thinking over a decades-long career. It is his major contribution and one everyone interested in grasping the essence of human behaviour should tackle.’

Stevan Hobfoll, Rush University Medical Centre

Thank you most kindly Stevan E. Hobfoll!

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Enjoying the Heat

My new book, A General Theory of Behaviour, begins with a story…

It is a hot summer’s day. A couple are on holiday at a hotel with an outdoor swimming pool. After breakfast, the couple decide to spend a lazy morning beside the pool sunning themselves, reading and swimming. They go to the far end of the pool, where they spot a quiet area about five metres from the only other couple by the pool. They align two recliners a few inches apart and place a small table on either side to mark ‘their’ area of occupation. They carve a niche for themselves by distributing towels and personal objects such as magazines, books, mobile phones, tablets, sun-cream, insecticide lotion, and bags on the tables. They discretely change into swimming costumes and place their clothes on the tables to avoid the ants that quickly gather around objects on the boardwalk. They apply sun-cream, helping each other at the more difficult-to-reach bodily regions. They apply an insecticide to deter any passing mosquitos. They wear sunglasses and sun hats. A large parasol is adjusted by a pool attendant to provide shade from the penetrating sun. As the angle of the sun changes, one of them rises to adjust the parasol so that their recliners remain in the shade.

The couple converse sparingly and rarely speak to the other couple. A ‘Good morning’ here and ‘The water’s nice’ there, but nothing else. They do not wish to invade the other couple’s ‘space’, nor do they wish ‘their’ space to be invaded. After half-an-hour acclimatizing, they take a leisurely 10-minute dip in the pool to ‘cool off’. They swim slowly and quietly, avoiding vigorous movements. After returning to their parasol, drying themselves off, re-applying the sun-cream and insecticide, they order iced cola drinks using a buzzer on one of the tables.

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After a few minutes, they take another dip, splash around, tease and joke. They make a little more noise and splashing than on the first occasion, but remain within appropriate limits. They terminate this visit to the pool when the other couple enters the pool because the pool is not large and they wish to avoid ‘over-crowding’. After a few polite comments about the water temperature, they swim to the steps and climb out, walk back to ‘their’ parasol in a gingerly fashion, because the board walk has by then grown so hot that they must step only where there can find shadows or expose their feet to burningly hot boards.

Standing in the shade, they dry themselves, re-apply the sun-cream and insecticide, put on their sunglasses and hats, lie down on their recliners and, flicking away an occasional fly, push the buzzer to order another iced drink, this time two gins and tonic. As the hour turns towards midday, the ambient temperature is become too hot to bear even in the shade and, after finishing their drinks, they pack their things and return to the tranquillity of their air-conditioned, freshly cleaned hotel room. Thirty degrees outside – but not a single droplet of sweat the whole morning.

Exactly what is going on in this story? How can Enjoying the Heat help us to understand universal principles of behaviour? Let’s consider these issues:

We know a lot of intimate detail about the couple’s behaviour. The couple are close. They mark out a niche of territory using the tables and their belongings. They lie out in the sun to be tanned but not burned, to be warm, but not too warm, to be out in the open air and close to nature, but not to be bitten by insects or run over by ants, to be as peacefully relaxed as possible but not wishing to fall asleep, to be stimulated but not taxed, to exercise their bodies but gently and not strenuously, to be refreshed by a drink or two but not to be intoxicated by alcohol, to be polite to neighbours but not overly familiar, and so on and so forth – you are getting the drift. The couple are striving for a state of equilibrium, a state of ‘moderation in all things’, a ‘tiny piece of paradise’, as it says in the hotel brochure. The couple’s every action and reaction as individuals and as a couple are governed by one universal principle that guides all of behaviour. Their behaviour illustrates the power and truth of a single idea, the hypothesis that, at root, all behaviour is an expression of homeostasis. The couple have never been aware of the idea, never even heard of it, yet it is a process that affects every single thing that they, you and I say, think, feel and do.

How can this possibly be so? A joke? A feat of magic? Or, worse yet, the author, publisher and reviewers are all living in la-la land?

None, some or even all of these ideas may be incorrect, but please bear with me and hear me out. This is the story of one particular hypothesis, a dangerous idea –a story with a plot, characters and an unexpected twist. I build the case as we go along, all I ask of you is that you ‘hang in there’…

An extract from: A General Theory of Behaviour

To be continued…

A Redesign for Psychology

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Science is beautiful when it makes simple explanations of phenomena or connections between different observations.

Stephen Hawking

It has been said that advances in science come not from empiricism but from new theories. With this thought in mind, A General Theory of Behaviour has the potential – or so I aim to convince the reader – to advance understanding of human nature and to integrate the discipline of Psychology. In A General Theory of Behaviour I explain why this is (a) necessary, and (b) possible.

I think the majority of psychologists agree that integration is necessary. Fragmentation has been a longstanding and difficult problem for Psychology. Over more than a century, fragmentation has been called a ‘crisis’. The problem has been described thus: “a nexus of philosophical tensions, which divide individuals, departments, and psychological organizations, and which are therefore primarily responsible for the fragmentation of Psychology.” In many years’ experience as a student, researcher and professor of Psychology, I can testify to persistent and intractable tensions in every quarter of the discipline, worse in some places than others, but the fragmentation is evident everywhere.

The discipline can sometimes feel like a medieval country split into fiefdoms by moats, walls and a haphazard set of paltry roads, odd rules and customs (Figure P1, left panel). As the visitor approaches the border of the country, a smart road sign reads: “Welcome to the Science of Psychology”. Full of expectation, one passes through the guarded gates at border control (sniffer dogs, disinfectant spray guns, x-ray machines and millimetre wave scanners).

After screening by unsmiling officers in peaked caps, the traveller explores what excitement exists inside this guarded place. Each fiefdom provides glossy brochures, catalogues, and travel guides in which skies are always blue, buildings chateaux, and fountains high reaching with crystal waters.

Fountain, chateau, blue sky

Each area invites the visitor to drive over the draw bridge and take a detailed look. However, on close inspection, one senses a deep-seated problem. Something strange and slightly sinister appears to be going on. The locals appear defensive and ill at ease when one makes inquiries and asks even the simplest of questions such as “What does X mean?” As we travel around the country, barbed wire fences of ‘no-man’s land’ are everywhere and the few connecting roads are potholed and ill-made.

No man's land

In each sub-area, there is evidence of industrialisation with companies of artisans ploughing long straight furrows, planting pest-resistant seeds, spraying fields with Roundup®, harvesting their crops and filling rodent-proof silos with carefully sifted data, e.g. long-eared corn tastes better that short-eared, short-eared corn tasted better than oats, oats tastes better that long-eared corn (!) in cycles of planting, harvesting, testing and analysing.

Ploughed fields

Producers with the largest silos rule. In spite of all of the graft, one senses tension, disharmony and technical disputes is causing ill-feeling. If somebody breaks the famine with a bold new idea, s/he risks being pilloried, dunked or quarantined in the cut-off region called “Critical Psychology”. One wonders if Psychology really were a Science, would there be so many sub-regions, stretches of ‘no-mans-land’ and unrewarding customs?

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Figure P1.The Science of Psychology. In its fragmented state (left panel), each sub-field acts as a defended niche with its own specific theories and data. In a unified state (right panel) the discipline would consist of a single General Theory that encompasses the entire field with a minimum number of assumptions, a large set of falsifiable hypotheses, and a body of empirical studies aimed at falsification of the General Theory.

Most commentators agree that a major redesign is long overdue to re-engineer the discipline. Travel between sub-areas needs to be made more navigable, moats emptied, walls razed and bridges built. It’s an Isambard Kingdom Brunel the science needs as much as another Charles Darwin.

BRUNEL

The objectives of A General Theory of Behaviour are to take a few measured steps towards advancing Psychology as a natural science and, in so doing, to unify it (Figure P1, right panel). This brief introduction of 40,000 words offers twenty principles and eighty auxiliary propositions, 100 empirically falsifiable propositions. The principles and multiple auxiliary propositions make the General Theory fully and transparently capable of falsification. In embracing intentionality, purpose and desire, the General Theory is non-reductive while, at the same time, drawing upon principles from other sciences, in particular, Biology and Physiology. Following in the footsteps of Claude Bernard, Walter B Cannon and others, I try to convince the reader of the usefulness of the metamorphosed concept of behavioural homeostasis and, in so doing, explain the implications for the Science of Behaviour.

My thesis is that organisms are not adapted to each other and the environment because natural selection made them that way, but they are made that way owing to an inbuilt striving towards stability and equilibrium. A General Theory of Behaviour is an introductory ‘User’s Guide’ aiming towards a reconfigured Science of Psychology – the target in the right-hand panel of Figure P1. In Chapters One and Two I describe the core elements of the theory. Chapters Three, Four and Five contain additional parts of the theory concerning biological rhythms, concepts of behaviour, Consciousness and the central Behaviour Control System. The remaining five chapters each cover three core topics from the perspective of the theory. These 15 topics indicate the ability of the theory to cover a broad cross-section of the discipline.

Heavy traffic

In building roads and bridges, one must neither over-design nor under-design. Nobody knows how sturdy the structure is until it is tested with a fleet of trucks. Should cracks occur (or worse), other ‘engineers’ might be persuaded to renovate the project. Surely it should be worth the effort. However long it takes, our broken discipline needs to be put together into one beautiful whole.

Book cover