Heroes Not Zombies

David Corfield posted about an interesting study of the placebo effect. It describes a piece of research into the power of language to effect physical change. Hotel maids burn up a lot of calories through the very nature of their work which is physical from start to finish. But interestingly most of them reckon they do no exercise and their body size and shape isn’t much different from the average woman. The researchers took a group of hotel maids and divided them into two sub-groups, one of which received information in an interview about how many calories they were using up in their different chores. The other sub-group received no information. They found that all the maids’ body fat, waist-to-hip ratio, blood pressure, weight and body mass index measurements were consistent with their perceived level of exercise. One month later they found that in the educated group there was a decrease in their systolic blood pressure, weight, and waist-to-hip ratio — and a 10 percent drop in blood pressure. Observations by the team hadn’t shown any changes in the maids’ routines or physical exercise. So it was changing the state of mind which changed the state of the body.

In the report of this study, the writers find a critic who says that such a placebo effect cannot effect a physical change as placebo can only effect subjective changes. That’s such nonsense! And the article concludes with a great example of asthmatics being given a drug which would make their asthma worse, but being told it would make it better. They not only claimed their asthma was better but the objective lung function readings improved.

Words were originally magic

— Sigmund Freud

Read Full Post »

I just came across a paper about “Post-traumatic Embitterment Disorder”. Apparently “embitterment” is a new term in psychological classification and this study aims to demonstrate that by using new questionnaires (what psychologists call “scales” to introduce a sense of measurability to what is a purely subjective phenomenon) they can show  “Post-traumatic Embitterment Disorder” is a “sub-type of adjustment disorders”. What they are trying to show is that some people who are so severely psychologically injured by a life event that they become “impaired” by it exhibit more bitterness about their experience than others do and the claim is that this constitutes a definable category of disorder.

I am so in two minds about this.

Here’s the positive side. I think everyone tries to make sense of their lives. It’s what we do. We want to understand our experience, to make some sense of it, and, unless we do that, it’s hard to be an effective “agent” of your own life. In other words, first we need to understand a situation, then we can make some choices to engage with it differently and so develop our own particular paths forward. If we can’t do that for ourselves, we need to get the help of others. Those others might be friends or loved ones, or might be other people in the community who have different skills and who might be able to help. One of those groups of people in the community is the professional health carers – a doctor, a nurse, a psychologist or a counsellor for example. If you take your story to one of these people, they’ll try to interpret it from a medical perspective.  A doctor, for example, is skilled at making a diagnosis – finding out whether or not you have a disease. But, diagnosis is about more than naming a disease. It’s a kind of understanding. It’s a kind of making sense of a patient’s experience. Without a diagnosis, a doctor can’t treat you effectively. So, if this new “diagnosis” helps some people to be better understood, then it’s useful.

Here’s the downside. First of all, a diagnosis declares an experience as a disease or illness. It’s not a healthy experience. Once the experience becomes classified as a disease or illness, then the way to change it, the way to provide help becomes one of treatment. Treatment of psychological illnesses tend to involve either prescribing a drug, or undertaking a talking therapy of some kind. A talking therapy which releases someone from a stuck way of thinking and therefore helps them understand their situation can well help that person to make different choices and so have a different experience. A drug solution makes sense if you can explain the experience materially – by showing some imbalance of chemicals in the brain for example – in such a situation a drug can be part of a solution too. It can help a person to find new ways of thinking by changing the way the brain functions. But when you take every experience of life and try to classify it and declare some of it as disorder or disease then you risk medicalising life and you risk reducing human experience to chemical imbalances which can be addressed with drugs. I don’t find that either life-enhancing, or a personally empowering way to live.

Bitterness? Is this a medical disorder? Is this a disease to be treated? Or is it part of an experience which needs to be understood in order to release someone from a stuck place? If someone is bitter, they are usually stuck. And without help they can find it hard to see things differently. So bitterness needs to be addressed, but do I need something like the “Bern Embitterment Scale” to be able to see this?

What do you think?

Read Full Post »

Here’s an interesting study which looks at the influence of meditation on patient care. It wasn’t the patients who did the meditating however. It was the therapists. The researchers took a group of trainee psychotherapists and split them into two groups. One group practiced mindfulness meditation and the other didn’t. The patients they were treating showed improvements as follows –

the [patients treated by the meditation] group showed greater symptom reduction than the [no meditation] group on the Global Severity Index and 8 SCL-90-R scales, including Somatization, Insecurity in Social Contact, Obsessiveness, Anxiety, Anger/Hostility, Phobic Anxiety, Paranoid Thinking and Psychoticism.

So, who therapist is, and how they learn to focus their attention seems to matter. I’ve never learned meditation but I do think that care is a human activity and the current drive to homogenise medicine as if human individuality is not important is misguided. It is important who your therapist is and it is important that the therapist learns and practices focussed attention and active listening whatever the actual therapy being used.

Read Full Post »

Research recently showed that ADHD drugs don’t sustain their short term benefits in the longer term and demonstrated the case for more complex interventions such as parenting classes, psychological and social training and support for the children, and so on.

One interesting element in the whole ADHD story is the environment. Here’s an interesting approach. Scientists at John Carroll University have developed devices for screening out blue light. What this does is to stimulate the production of melatonin which is an important element in setting an individual’s circadian rhythms. They’ve found that if someone puts on the blue filter glasses, or sits in a room with blue-screened lightbulbs, for a couple of hours before bedtime, that the melatonin kicks in earlier than usual (usually it’s induced by darkness). This seems to result in improvements in ADHD symptoms and also helps those who have trouble getting off to sleep.

I wonder if these are benefits which are sustained over time?

Read Full Post »

There’s an enormous literature these days on happiness, and pretty much all of it pushes some variety of positive thinking. The Happiness Hypothesis is one of the most thoughtful of these books, and Stumbling on Happiness is a fairly good read too, and Professor Layard’s Happiness is worth reading if you want to understand why the English NHS is about to spend millions on CBT.

But I’ve never been a fan of either bandwagons or one-size-fits-all treatments so I read this study about optimism with interest.  Two professors at Duke University’s Business School have come up with an interesting way of measuring optimism – they asked people how long they expected to live and then compared these estimates with actuarial tables of life expectancy. Optimists were classed as those whose self assessment of longevity was beyond that of the statistical predictions and 5% of them were classed as super-optimists – people who reckoned they’d live a good 20 years longer than the statistics would predict! Interesting method, huh?

What they then did was interview people about their behaviours (being a business school they were most interested in financial behaviours). They found the following –

Puri and Robinson find that optimists:

• Work longer hours;
• Invest in individual stocks;
• Save more money;
• Are more likely to pay their credit card balances on time;
• Believe their income will grow over the next five years;
• Plan to retire later (or not at all);
• Are more likely to remarry (if divorced).

In comparison, extreme optimists:

• Work significantly fewer hours;
• Hold a higher proportion of individual stocks in their portfolios, and are more likely to be day traders;
• Save less money;
• Are less likely to pay off their credit card balances on a regular basis;
• Are more likely to smoke.

In other words, while a dose of optimism might be good for you, too much optimism was associated with riskier and less healthy behaviours. I guess it’s this kind of thing that makes it very difficult to do health education with teenagers – trying to tell them smoking will shorten their lives means nothing to most of them – they think those problems are highly unlikely to happen to them.

I think that all coping strategies in life are good if they work for you, but that any coping strategy which is pushed to an extreme will start to harm you. So a little optimism is no doubt a good thing but optimism which is way beyond the probable can disengage a person from reality.

Read Full Post »