But then I read the flag, which stated: “NOTE FROM TED: We’ve flagged this talk, which was filmed at a TEDx event, because it appears to fall outside TEDx’s curatorial guidelines. There is limited evidence to support the claims made by this speaker. Please do not look to this talk for medical advice. TEDx events are independently organized by volunteers. The guidelines we give TEDx organizers are described in more detail here: http://storage.ted.com/tedx/manuals/tedx_content_guidelines.pdf”
I was angry and offended. I couldn’t help but take the flag personally, discrediting me as a scientist and challenging my integrity.
Back in October 2014, I had been thrilled and honoured to speak, proud of my TEDx Christchurch (NZ) talk and how well it had done (>900,000 views), and ultimately how many people have benefited from the information.
TED claimed I had stepped outside of the curator guidelines on Science Standards. Understand that TEDx is independent of TED and therefore, even if the local curator is happy with the talk, that doesn’t prevent TED from discrediting it, even years later.
I found this hard to fathom as I had spent countless hours fact-checking every statement that I made, contacting other scientists to ensure what I was saying was an accurate reflection of the state of the field, and reworking the talk to ensure it was accessible without losing accuracy.
I had peer reviewed publications to back my statements, as well as dozens of RCTs from other research centres internationally all showing the same thing — nutrients are relevant to good mental health.
So how did this happen? Why was my talk flagged?
The media people I have been dealing with at TED said a complaint had been made and they concluded, after carefully watching my talk, that “it appears some assertions made by the speaker have limited support from the medical community.”
After sharing with them dozens of peer reviewed publications including an opinion piece I had co-authored in the journal Lancet Psychiatry entitled “Nutritional medicine as mainstream in psychiatry,” they changed their story and said I made too many sweeping statements.
However, the only example they gave me on sweeping statements was one at 14:50, where I said: “Nutrient depleted mothers produce nutrient depleted children. Nutrient poor foods during pregnancy increase the chances that your child will have a mental health problem.”
I was surprised that they queried this statement. After all, decades of scientific research have proven that severely malnourished women produce malnourished children. Perhaps there are exceptions. Perhaps I should have said “Nutrient depleted mothers MAY produce nutrient depleted children.”
But where is the controversy? Even if there are some nutrient depleted mothers producing healthy children, is this the kind of sweeping statement that TED is out to expose? Many TED speakers make sweeping statements in their talks and don’t get flagged. Why was this one singled out?
About a month after my initial protests about the flag, they changed it. Instead of targeting me as the speaker, they now targeted the whole field: “NOTE FROM TED: We’ve flagged this talk, which was filmed at a TEDx event, because it appears to fall outside TEDx’s curatorial guidelines. Given that the intersection of nutrition and mental health is an emerging field of study with limited conclusive evidence, please consult with a mental health professional and do not look to this talk for medical advice.”
This flag was even more astounding. This is not really a new or emerging field with limited evidence. Should I have reminded them of Hippocrates (‘let food be thy medicine’)? Should I have told them that in the 1930s a very frequent cause of hospitalization in a psychiatric facility was psychosis associated with pellagra (caused by niacin/Vitamin B3 deficiency)? Do they know that even the DSM-II (published in 1968) acknowledged the role of nutrition in the development of psychiatric disorders with a category of “psychosis with other metabolic or nutritional disorders (including pellagra)”? Aren’t they aware that lithium, a nutrient, has been a treatment for mood dysregulation for decades?
I continued to request more detail but the only further information I received was that I had oversimplified my science: it wasn’t what I said, but rather, what I didn’t say.
As TED state in the Science Standards, when making talks accessible, “this inevitably means that some scientific concepts have to be simplified. But it’s important that they not be simplified to the point of becoming misleading.” This is hard to do, and in TED’s eyes, I overstepped that boundary.
In other words, they now claimed they didn’t have an issue with my science, just how I presented it. They told me I didn’t qualify enough that this was a really new area of research and so the conclusions to draw are very limited. Recall that only two positive RCTs are required for the FDA to approve a drug and be called evidence-based. This argument did not sway them. I am being held to a higher standard than drug companies.
At this point, I wondered, like the editors at MIA, if a sponsor was involved in the complaint. While it isn’t easy to find TED partners, if you navigate enough through their website, you track down Merck as a current partner. OK, I speak frankly about the state of how well medications are working in psychiatry (i.e., not very well in the long term), and Merck makes Effexor (venlafaxine), an antidepressant, so maybe they were the ones who complained? I have asked, but they won’t tell.
Researching further to get the flag off my talk, I came across a blog written by the “science curator” at TED. He’s David Biello and the blog was titled, “The quiet war on science.”
The penny dropped.
At first you might read his blog and think, YES! David Biello supports scientists. He talks about how “the pursuit of facts is under assault, whether it’s the muzzling of government scientists or the elimination of data itself.” But Biello also talks about the need to defend science and perhaps he sees psychiatry as belonging to that category. Is it possible that through questioning the long-term efficacy of current conventional treatments in psychiatry, I have been lumped by David Biello and TED amongst climate change deniers, anti-vaxxers and the like? And in turn, perhaps TED concluded that I must be speaking beyond the data that we have reported on the effect of nutrients on mental illness, that with time, I (and others) will be proved wrong, and that TED must play the role of public educator to ensure that people see this science as something not to be taken seriously?
When I accepted the invitation to speak, I understood TED to be about new innovative ideas, challenging us to think beyond our current world view. But do their science guidelines really allow for that?
Their current science guidelines require that claims must “be based on theories that are also considered credible by experts in the field.” Claims can’t “fly in the face of the broad existing body of scientific knowledge.” Is it possible to have both? That is, new ideas that are considered credible by the current “experts”?
My TEDx talk started with the story of Ignaz Semmelweis who in 1847 (accurately) suggested that washing hands could reduce the spread of infection to women during delivery, a problem that was leading to high mortality rates. Semmelweis was ridiculed by mainstream medicine for his ideas and ended up in an asylum, where he died two weeks later from septicaemia.
There are many other examples in science where a new idea was completely dismissed by mainstream scientists. Alfred Wegener, the originator of the theory of continental drift (which plays a central role in today’s model of plate tectonics), proposed it in 1912 but the idea was not accepted until the 1950s. Or John Harrison who invented the marine chronometer which was able to calculate longitude out at sea to keep ships on course. Oddly, his ideas were repeatedly dismissed by the British Government and by the Royal Society and it wasn’t until he was in his eighties that he received recognition and a reward from Parliament. And there was Barry Marshall, the Australian physician who identified that H. pylori caused ulcers — it took decades for his idea to be accepted into mainstream medicine.
Some people are even now suggesting that Jean-Baptiste Lamarck, a French “naturalist” and a contemporary of Charles Darwin, might have been partially right with his theory of inheritance of acquired characteristics, now influencing our current ideas on epigenetics.
We now see these people as heroic pioneers. But none of them would meet the current science criteria to go onto a TED/TEDx stage in 2018 as their ideas were misaligned with their contemporaries (and therefore wouldn’t meet the criteria of being “well regarded by other scientists”).
How many other scientists like me are going to be flagged, publicly reprimanded by TED, for challenging current ways of thinking? Is it even possible to be innovative and follow conventional thinking at the same time?
Indeed, the current wording of the flag gives it away: “consult with a mental health professional and do not look to this talk for medical advice.” TED exposes their drift away from innovation in the current wording of the flag. The flag encourages embracing conventional methods, and being wary of an idea that is “emerging.”
Would I do my talk differently with what I know now? Absolutely: more qualifiers, more coulds and mays, more discussion of the limitations. But the essence of the talk wouldn’t change. And, to be honest, I might not do the talk again at all. My experience proves that there is no certainty that even if the talk is well liked and supported by the local curator, TED can’t come along and stamp their thoughts on the talk, even years later.
Finally, I am very grateful to the many supporters of my fight to remove the TED flag. A letter signed by 292 scientists and physicians sent July 18th 2018, outlining clearly the scientific inaccuracy of the flag, finally led them to drop “limited conclusive evidence.” On August 24th they modified the flag to: “Please consult with a mental health professional and do not look to this talk for medical advice as the intersection of mental health and nutrition is still an emerging field of study. We’ve flagged this talk for falling outside TEDx’s curatorial guidelines because it oversimplifies interpretations of legitimate studies.”
However, they refuse to remove the sentence about how I speak outside their guidelines, even though they reluctantly agreed to qualify it. Keeping that sentence in the flag allows them to continue to subtly denounce this field of work. And keeping the flag on the talk continues to detract from my reputation. This flag has already affected opportunities for funding and awards. If there are scientists out there with great new ideas, the TED stage may not be the optimal place to state them.
TED have closed the door to any further negotiations. Now my only recourse to remove the flag is to remove the talk.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.