Born Liars (18 page)

Saddam had created a punitive environment; one in which the rational survival strategy for everyone was to lie about everything.
²⁰
In the end he and his country became victims of the insidious symbiosis between deception and self-deception.

* * *

Robert Trivers alighted on evolutionary biology after studying, successively, mathematics, law and American history. Upon falling in love with Darwinian theory, he realised that nobody had yet arrived at a convincing evolutionary explanation of human social behaviour and set about remedying the oversight. In the early 1970s, while still a graduate student, he published a series of five brilliant papers that included radical new theories of altruism, parenting, and self-deception.

Trivers's theory was that human beings developed the capacity to deceive themselves in order to become better deceivers, and thus better competitors, in the Machiavellian arms-race of deception and counter-deception. Those who wanted to persuade a potential mate or ally of their good intentions would be better at it if they could deceive themselves without ‘leakage' of knowledge or intent; and the most efficient way to simulate truth-telling would be to erase internal awareness of the deception. The best liars would be those who were better at lying to themselves because they would actually believe their own deceptions when they made them. They would be more likely to survive and pass on their genes; hence our gift for self-deception.

Trivers's theory is very plausible, and if it seems a little pat – it is, after all, a truism that the best liars are people who believe their lies – it offers a useful way of thinking about the relationship between deception and self-deception in organisations. Each begets the other. People tell their superiors what they think they want to hear, so as to avoid the perception of hesitancy, a lack of conviction, or disloyalty. The ones that are best at doing this get promoted. Their superiors become even more confident in their own convictions. As everyone in the organisation cleaves to the same script, everyone starts to believe it, even when it contradicts the facts. In organisations dominated by an over-confident and over-powerful leader, a virtually seamless alternative reality is formed.

There is an important distinction between illusions and delusions. The normal person might be an unrealistic optimist, but he or she is far from oblivious to reality. Most of us are capable of responding to new facts that dispel our illusions – even if it takes us longer to do so than it should. A person, or an organisation, can be said to be deluded when they manage to exclude all new information, however pertinent or dramatic, that threatens to undermine a cherished illusion. In Shelley Taylor's succinct summary, ‘Delusions are false beliefs that persist despite the facts. Illusions accommodate them, though perhaps reluctantly.'

The historian Christopher Andrew has argued that one of the main purposes of an intelligence service in a one-party state is to reinforce the regime's misperceptions of the outside world. In Saddam's Iraq, every part of the national security apparatus conspired to shut out information that conflicted with Saddam's version of reality, thus creating a vortex of deception and self-deception. The tragedy is that the West became sucked into it too.

* * *

When it came to WMD, Saddam was attempting to juggle two conflicting objectives. On the one hand, he wanted potential rivals within his country and from the region to think of him as the wrong guy to tangle with. He often reminded his advisers that Iraq lived in a dangerous neighbourhood where even the perception of vulnerability drew predators; chemical and nuclear weapons were the equivalent of a BEWARE THE DOG sticker on Iraq's front door. On the other hand, he knew that as long as the West believed he had WMD, he would endure crippling sanctions and face the threat of American military action. So he allowed in the UN inspectors while signalling to his neighbours that he wasn't
really
doing as the Americans wished. But of course, foreign leaders noticed him make the same hints and boasts, which strengthened their suspicion that Saddam was hiding something.

Saddam Hussein was far from stupid or hot-headed. He was a talented reader of other people's intentions and emotions; as Kevin Woods points out, he had to be in order to survive for so long as head of a country riven by tribal, familial and sectarian rivalries, and constantly threatened by external enemies.
²¹
Saddam's ability to read other people, however, deteriorated precipitously the further his interlocutors were from home. By necessity, he was a pronounced Cynic (rather than a Truster), and not nearly as good as he thought at divining the motivations of foreign leaders, especially those outside of the Middle East. Like the participants in Ellen Langer's card game, he too readily allowed his confidence in an area of competence to flow into one of incompetence.

By the time Saddam realised that the Americans were serious about invading, it was too late. As 2002 drew to a close, he accepted that UN inspectors should be given full access and ordered his officers to remove all traces of previous WMD programmes. When the Americans tapped into this frantic clearing-up activity, they viewed it through the prism of a decade of deceit and assumed it was an effort to hide an ongoing programme. When they arrived in Iraq and turned up nothing, they were amazed. (So were Iraqi officials, who had assumed that if Bush didn't find WMD, he would plant them.)

Perhaps part of the reason that Western intelligence agencies were fooled is that they picked up on the genuine beliefs of many in Saddam's government that the programme persisted. Woods asked Iraq's head of research into WMD what he thought was a straightforward question: did he ever think it possible there was a secret supply of WMD he didn't know about? To Woods's surprise, the man nodded. He explained that the regime was too compartmentalised and secretive for any one person – apart from Saddam, perhaps – to know everything. But the main reason he thought that Iraq might possess WMD was because ‘
Your
president said it was so.' He and other senior Iraqi officials couldn't fathom that America would bring itself to the brink of war unless it had very good reasons to believe in the existence of Iraq's illegal weapons. So they came to believe it themselves. After all, the CIA wouldn't get something like this wrong.

Saddam had constructed a hall of mirrors into which all parties were drawn, and within which each saw only what they wanted to see. In the year leading up to war, Saddam loudly declared that he had no WMD, and that he would never back down in the face of American threats. In a collective and calamitous failure of mind-reading, Western leaders and diplomats assumed that the first was a lie and the second a bluff. But, for once, Saddam was telling the truth. As Woods says, Saddam may have been deluded, but ‘so too was the United States in thinking he was
not
deluded.'

One of the underrated virtues of a liberal democracy is that it militates against delusion in its leaders. Democratic leaders are subject to critical oppositions, and to a free press which helps keep their feet on the ground and punctures information bubbles. Dictators, who have no such checks and hear only good things about themselves, are much more likely to cross the frontier that separates a healthy margin of self-deception from dangerous delusion. Of course, democratic administrations are capable of collective acts of self-deception too; some argue that this is what the US and UK governments succumbed to during the run-up to the Iraq war. But the chance of this happening in free societies is lower than in authoritarian regimes. Perhaps the greater problem for mature democracies is that their electorates and media have developed a distorted ideal of honesty. By striving to eradicate all forms of deception from our public life, we may have only ended up fooling ourselves.

For most of the twentieth century, the relationship between the press and its ruling classes was governed by a discreet decorum. It was accepted that politicians had private lives that might contrast with their public image, which was understood as a kind of benign deceit. Then, partly because of political scandals like Watergate and partly because of our growing thirst for and access to information, a culture of radical honesty developed. We demanded, quite rightly, to know more about the activities of our elected rulers; more dubiously, we started to insist that a politician's public mask was ripped off so that we might see the ‘real' person underneath and ensure that their every thought and action was consistent, and seen to be consistent. The end result isn't, as one might have hoped, a better class of political rulers and a healthier polity; we are more dissatisfied with our politicians than ever before, and more likely than ever to think of them as deceitful.

Keeping our politicians honest seems to have become confused with demanding honest politicians. Throughout this book I've tried to show that deceitfulness is a natural part of being human, and that facile distinctions between ‘honest' people and ‘liars' merely obscure subtler truths about our conduct in different environments. The mistake we make too often is in viewing honesty solely as a
trait
– something that individuals have or don't have – rather than as a
state
: something that people adapt to under conducive conditions. Thus we routinely denounce all politicians as exceptionally dishonest, but it takes only a moment's thought to realise how unlikely it is that, by coincidence or otherwise, only sociopathic liars get elected to public office.

If we want a more honest politics, we will have to create conditions that steer our politicians towards honesty. First, we need to be more honest about ourselves. As we've seen, most of us like to think of ourselves as a little more unselfish, virtuous and honest than we actually are. This is as true of us as voters as it is of us as colleagues or friends; polls find time and again that people are willing to pay more taxes to improve public services, yet people usually vote for the party that will lower their tax bill. Politicians understand that we are inveterate self-deceivers. They deliberately appeal to the instincts that voters don't admit to, as well as those to which they do – and we hate them for it. It's a society-wide example of what Freud called ‘displacement activity'. We unload uncertainties about our own probity on to a group that everyone feels comfortable in pillorying.

Second, we need to get used to accepting unsettling political truths. At the moment, it's as if we don't actually want our politicians to be honest. We get uncomfortable or angry when they change their minds, or confess that some problems are insoluble, or exhibit anything other than a pretence of superhuman command. Neither do we like it when they say anything that isn't expected. Sometimes, when presidential candidates or British cabinet ministers find themselves in hot water over an unscripted remark, it's because the remark is stupid or offensive; more often, it's because it's true. In fact, the very definition of a gaffe, according to the American journalist Michael Kinsley, is an occurrence of a politician telling the truth in public. Like the children in School B, our politicians have learned that they will get flayed whatever they say – so they may as well lie, or at least avoid giving you an honest answer. Perhaps we don't need to give our politicians a moral education so much as a better set of choices.

The Medicine of Deceit

The last two decades have seen the emergence of an innovative new treatment for heart disease. Laser surgery has been carried out across the world on thousands of patients suffering from severe angina and related conditions. The NHS doesn't offer it, and even in America, where it originated, it is considered a treatment of last resort. But the doctors who practise laser heart surgery eulogise it, telling stories of patients who have gained relief from what seemed to be incurable suffering.

Dr William O'Neill, of William Beaumont Hospital in Michigan, told a reporter from the Associated Press that ‘in twenty years of medicine, I have never seen anything that gives as much symptomatic benefit for patients.' One of O'Neill's patients was Frank Warren, an auto-worker in his forties. Warren had suffered from heart problems for years. He always felt short of energy, and the slightest exercise brought on a burning sensation. Sometimes the pain came when he was resting. Over the years he had had eight operations; none of them helped. After undergoing laser surgery, however, he experienced immediate results: ‘I felt a warmth in my face. My colour seemed to change.' One year later, Warren finished a marathon in a very respectable four hours, twenty-nine minutes.

When somebody suffers from angina it's because their arteries are clogged, stymieing the flow of blood and therefore oxygen to the heart. As a result they get short of breath very quickly, find it hard to exercise, suffer from debilitating pain, and live with the constant risk of a fatal heart attack. In a routine coronary bypass, the surgeon takes healthy arteries from elsewhere in the patient's body and weaves them into the heart, so that blood can be diverted around the blocked vessels.

During laser treatment, an incision is made in the side of the chest between two ribs. The outer layer of the heart (the pericardium) is pulled back to expose the heart muscle itself (the myocardium). But instead of grafting on a new artery, the surgeon pierces the heart muscle. She takes aim at the patient's heart with a laser gun, which is attached to an expensive, impressive-looking machine. A dot of red light tells her where the laser will hit. She pulls the trigger (actually, a foot-pedal), fires the laser, and blasts a tiny, pinhead-sized hole in the myocardium. This is repeated twenty or more times. Drilling holes in the heart might seem like an odd thing to do when you're trying to save somebody's life, but the idea is that by opening up new channels the surgeon creates the equivalent of a new artery, allowing blood to flow to the heart's oxygen-starved flesh.

Surgeons who practise laser surgery don't have to rely on their own experiences to support their confidence in it. By the late 1990s a number of large-scale trials had been carried out involving patients with serious heart conditions (the term often used is ‘end-stage' conditions). The results were remarkable, with success rates in the range of seventy-five to ninety per cent, comparing very favourably with more established heart surgery procedures.

There is only one problem with this wonder treatment: no-one quite knows how it works. The theory behind it is plausible, and the results are undeniable. But the bloodlines close up within hours of being opened, and there is no evidence that the blood flow to the heart muscle actually increases.

Dr Martin Leon, a professor of medicine at Columbia University in New York, is one of the world's leading cardiologists. He knew that laser heart surgery had performed well in tests versus other treatments. But it hadn't, he noted, been tested against
no treatment at all
. In 2005, Leon oversaw a study of three hundred patients, in their fifties and sixties, with heart conditions. They were very sick: most had previously undergone heart surgery at least once, and all were suffering from continuing problems. The patients were divided into three groups: high-dose (twenty to twenty-five laser punctures), low-dose (ten to fifteen), and a mock procedure that merely
simulated
laser treatment; the patients were shown the machine and had its workings explained. Then they were heavily sedated, blindfolded, and played music to create an effect of ‘sensory isolation'. When they awoke, those who had had the fictional surgery were told it had gone well.

Twelve months later, and most of the patients who had undergone actual laser surgery were in much better shape. They revelled in a rediscovered capacity for physical exercise. They reported that their heart pains had receded and that they were feeling healthier and fitter than they had done in years. A battery of objective tests showed they weren't making this up. But the strange thing was that patients in the third group – the sham group – were also rejuvenated. Despite not having had any surgery, or any physical treatment at all, they too felt years younger and full of beans, and the frequency of their angina pains declined. In fact, in terms of the effects on patients, there was no significant difference between all three treatments.

It would appear that you can enjoy the amazing benefits of laser heart surgery without once coming into contact with a laser.

* * *

Placebo is Latin for ‘I will please'. The words
Placebo Domino
(I will please the Lord) are in Psalm 116 in the Latin translation of the Bible that was used throughout the Middle Ages, and the phrase formed part of the Catholic Vespers for the dead. Perhaps because priests charged fees for performing the rites in which these prayers were sung, the word came to be used pejoratively, to mean an insincere consolation, or an act of sycophancy.
²²
The seventeenth-century philosopher Francis Bacon used it in the course of issuing a warning to rulers not to express their own opinions too openly when taking advice, lest their subordinates tell them only what they think they want to hear: a king's advisers might ‘sing him a song of placebo'. The first known use of placebo in a medical context occurs in 1785: the second edition of George Motherby's
New Medical Dictionary
defines it as ‘a commonplace medicine or method'. Already there is a hint of disparagement, and it soon became a byword for treatments that, rather than being based on sound scientific principles, were dispensed merely to please patients.

Modern physicians know that they can relieve the symptoms of an anxious patient by offering a fake treatment. But most feel uncomfortable about curing with lies. Not only is it seen as morally dubious, but some still regard it as close to nonsensical, in scientific terms. Today's medical establishment was founded on a hard-won separation between science and superstition, a distinction closely related to that between physical and mental phenomena, which the so-called placebo effect seems to resist. In the words of Edzard Ernst, a professor of medicine at Exeter University, placebo effects are the ‘ghosts that haunt the house of scientific objectivity'. As a consequence, they have been dismissed as illusory, unreal and unworthy of study. It wasn't until the second half of the twentieth century that the healing power of deception began to be taken seriously, following a discovery made by a doctor in the frenzy of battle.

On 22 January 1944, British and American troops swarmed ashore a fifteen-mile stretch of Italian beach near the old resort town of Anzio. In a perfectly executed operation that took the Axis powers by surprise, the Allies established a beachhead from which they prepared to break out and advance. Within a week, however, German troops surrounded them in large numbers and began the task of excising what Adolf Hitler called the ‘Anzio abscess'. The next four months saw some of the most savage fighting of World War II. Nearly five thousand Allied troops were killed, and eighteen thousand wounded.

Henry Beecher was among those who landed in Italy that day. Beecher wasn't a soldier. He was a doctor and a Harvard professor of medicine who volunteered to join his country's war effort. He specialised in the science of pain relief. In a makeshift hospital on the beach he tended to wounded American soldiers awaiting evacuation to the safety of Allied territory. Medical supplies were limited, however, and on days when casualties were particularly heavy, the demand for painkillers would outstrip supply. One day, a soldier with particularly horrific injuries arrived just as the morphine ran out. Beecher worried that without it the operation required would be so unbearably painful it might induce cardiovascular shock. But he could see no other option. In desperation, one of the nurses injected the soldier with diluted salt water, allowing him to think it was an anaesthetic.

What Beecher observed next changed his view of medicine forever. The patient, who had been in agony, settled down immediately following his injection, reacting in exactly the same way Beecher had observed previous patients respond to morphine. During the operation his patient seemed to feel very little pain, and displayed no symptoms of full-blown shock. Beecher was amazed. The nurse's benign deception had worked as effectively as one of the most powerful painkillers in the medical arsenal. In the following months, as the battle raged on, Beecher and his team repeated the trick whenever morphine supplies were exhausted. It worked again and again.

Beecher returned home convinced that what a patient
believed
about his treatment could profoundly affect his physical reaction to it. Back at Harvard, he gathered his colleagues and proposed a rigorous investigation of the phenomenon. The papers that Beecher and his colleagues went on to publish, which were based on reviews of clinical drug trials, contended that placebo effects were far more widespread than had been acknowledged. Beecher forced the medical world to confront what it had long tacitly recognised but hadn't, until then, attended to: the real benefits of imaginary medications.

If people's bodies responded to treatments that existed only in their minds then it followed that there was probably an imaginary component to the effects of genuine medical interventions. In a 1955 paper entitled ‘The Powerful Placebo', Beecher argued that clinical trials of new drugs were incomplete and inaccurate unless they took the placebo effect into account. Even with drugs that worked, patients improved partly because of the therapeutic effect of the very act of taking a pill from a clinician. To test a new drug, it was therefore necessary to subtract the improvements in health due to placebo effects from the actual effects of the medication. Beecher proposed trialling every new medicine on two groups of patients: one which received the drug, and one which received what they thought was a drug, but was in fact inert – a sugar pill or similar.

Beecher's work was the catalyst for a fundamental change in clinical practice in America and across the developed world. Now, to win government approval, a new medication has to beat a placebo in two authenticated trials. What's more, the trials must be double-blind. Since the placebo effect seems to be affected by what people believe about the drug, neither doctors nor patients are meant to be able to discriminate between the placebo pill and the real pill. The double-blind clinical trial represents an attempt to strip out the effects of deception and self-deception from the actual effects of a treatment.

Beecher showed that placebo drugs had objectively measurable physiological effects, sometimes matching or exceeding those of powerful drugs. Even so, there remained a sense within the medical profession that such effects were an aberration from the norm, and somehow illegitimate. Explanations were sought in the personalities of the individual patients. Medical researchers, confident as ever in their own vice-like grip on reality, speculated that ‘placebo reactors' were unusually suggestible people – delusional, neurotic, or simply not that bright. A 1954 paper in the
Lancet
remarked that the placebo effect was useful in treating only ‘unintelligent or inadequate patients'. But no substantial evidence has ever been found to support the idea that certain individuals are more prone to placebo effects than others.

In the 1980s, advances in brain science started providing hard, ‘biochemical' explanations for the power of placebos. A psychiatrist called Robert Ader administered saccharin-flavoured drinking water to rats, and at the same injected them with a chemical that suppressed their immune system and made them ill. When a group of the same mice were fed the same flavoured water but without the injections, they reacted the same way. The drink, because originally associated with the injections, now triggered the same illness as the poison. Ader had created a placebo with undeniable physiological effects (strictly speaking he had created a ‘nocebo' – an inert drug or otherwise benign event that triggers illness. Nocebo means ‘I shall harm').

Later studies confirmed the strange ability of placebos to create real physical changes in the human body. Fabrizio Benedetti, a neuroscientist at the University of Turin, has been experimenting with placebo treatments for nearly twenty years, and observed them alleviate physical pain, digestive illnesses, depression, and even Parkinson's disease (by telling a Parkinson's sufferer, falsely, that a surgically implanted electronic module in their brain had been switched to ‘on', he found he could relieve their symptoms, albeit only temporarily). He has closely mapped the biochemical responses of his patients' bodies to their different beliefs about the treatment. According to Benedetti, placebos act as a catalyst for the body's own internal healthcare system. If you hear a fire alarm and see smoke, your adrenalin shoots up and your heart rate increases, preparing you for a quick escape. Similarly, when the act of taking a placebo sends a signal to the brain that it's time to start getting better, the body's healing chemicals go to work.

The placebo effect has its limits. There's no evidence to suggest it can stop the growth of cancerous tumours, for instance. It seems to work particularly well for conditions involving physical pain, or those related to higher-level mental functions, like depression. In those cases, if we expect to feel better, we are more likely to get better, even if this expectation is based on a lie. The pharmaceutical industry now treats placebo effects as significant, and the research of Benedetti and others has gone some way towards establishing that placebo effects involve real physiological actions. Nonetheless, such effects are for the most part still studied through the lens of biology, because this is the sole context in which medical science traditionally thinks about human bodies. But perhaps placebo effects ought to be taken as a hint to broaden the scope of modern medicine. If a lie heals it's because it has meaning – and meaning is made between people, not inside them.