1) “In My Room” by Jim Lucey
Jim Lucey is a psychiatrist in Dublin. The room in the title refers both to the room in which Jim Lucey sees his patients but also to the idea of creating a space for our own mental health. The book focuses on the stories of individual patients: Lucey explains in the introduction that these stories are often the amalgamation of the stories of real people. It intersperses these stories with broader commentary on mental health issues and, unusually, extracts from poems.
When we do Psychology in a classroom, we aim to be rigorous and scientific. We summarise theories and studies, we identify and explain strengths and limitations of theories and evidence, we make links, we develop lines of arguments based on issues, debates and approaches. That’s what gets you a good exam grade. It is too easy to forget that in some senses Psychology is a humanity. Without being interested in people in all their complexity, our work becomes dry and pretty worthless.
What marks this book out is that it encompasses both the science and the humanity of the psychiatrist’s work. The people in this book are not reducible to a set of symptoms. They have a past, a present and a future in which they actively engage. They get better because they want to. The book makes a powerful case for Psychiatry as a profession which can bring about change and, more broadly, for Psychology as an academic discipline which enables us to understand and to empathise.
Here’s a link to tell you more.
If you’re reading this and you’re a student at DHSG, Jim Lucey is Mrs. Salkeld’s cousin.
2) Obesity Research Confirms Long-term Weight Loss Almost Impossible
This news story comes from Canada. It focuses on research from several researchers which suggests that long term weight loss is almost impossible. There are, of course, people who do manage sustained weight loss but these can be regarded as outliers, exceptions who challenge a very strong statistical trend.
The one positive solution that this article holds up is surgery which shrinks the stomach. We can contrast this with the work of, among others, Gary Taubes and Peter Attia who suggest that there may be some hope for dealing with weight loss if we can understand better what the food we eat does to our bodies and our brains.
3) Time To Change – Wolfpack
We’ve been looking at Time To Change in lessons as part of our research project on attitudes to mental illness. Here’s their latest.
There’s a clear focus here on male mental health. I’ve posted before here about campaigns in Australia which target male mental health and male attitudes. I keep finding myself in lessons saying that suicide is the biggest killer of males under 35. I’m never quite sure about this but here is a news story which backs this up.
For some sort of context on this, here’s a story from the Guardian.
While we are on Time To Change, here is the latest research from Evans-Lacko and colleagues.
4) Spurious Correlations
We learn early on in Psychology that correlation and cause are not the same thing. Just because two variables are related statistically does not mean that one causes the other. That can be a pretty dry point which people don’t always understand first time. In this audio, Tyler Vigen explains it in a more interesting way.
You can go to his website and see many more spurious correlations.
5) Effectiveness Of Anti-Depressants
The PSYA4 exam was yesterday so it will be a while now before I come back to Depression and, in particular, the controversy surrounding anti-depressants. It is all very confusing, with so many claims and counter-claims made. Here’s a blog post by Phil Hickey.
This starts off with reference to a Lancet article by two German psychiatrists, Adli and Hergerl, which suggests that we actually underestimate the effectiveness of anti-depressants. Hickey then suggests that most of this is wrong, claiming that as with much literature in this area, what is disguised as serious scientific enquiry is really promotional material for the pharmaceutical industry. What’s most interesting here is that the article ends up being about classification and diagnosis. Hickey points out that DSM 5 has got rid of a distinction between reactive depression and endogenous depression. Reactive depression was seen as a reaction to bereavement and other critical life events whereas endogenous depression was something that came from within. It was endogenous depression which was treated with tablets. That distinction no longer exists. In DSM5, if you have the symptoms, you have the illness regardless of how the symptoms got there. The key thing to decide is what you think of that. One argument says that if people have the symptoms, we need to get to them quickly. The other argument says that giving people medicine for dealing with the ups and downs of life is both misguided and dangerous.
When we look at effectiveness as an evaluation issue, we consider the question of whether understanding how something works is an important element of judging the effectiveness of that thing. I’d argue that it is. You can’t say that a car works well unless you understand how it works. The big problem with anti-depressants is that the action for which they were developed, preventing the re-uptake of serotonin and noradrenaline, works immediately but the anti-depressant effect of these drugs takes two or three weeks. We need to explain the something else which anti-depressants do which makes them effective against depression. This Mental Elf article explains what that might be
This can be put with other work we have looked at on synaptogenesis, the development of new neurons, to give ourselves a clearer picture about how these drugs work. Once we know that, we can have a better idea about their effectiveness.
6) Are Children Overmedicated?
I tell a story about meeting a Year 8 student almost 20 years ago who had a diagnosis of ADHD. In those days, such diagnoses were very rare. There was something very unusual about his behaviour. Now diagnoses are much more common. It is a short leap from this observation to suggest that diagnoses of psychological disorder are given out far too easily. Children who are just a bit unhappy or misunderstood get labelled and medicated. Thomas Insel challenges that idea here.
There are two points. An increase in the number of diagnoses of, for example, Type 1 diabetes does not make us question whether the diagnosis is wrong. The second is that there is increase diagnosis because there is increased need. For some reason, more people are getting ill. Insel goes on to suggest that there may in fact be a problem of under-prescribing. Children need medication but don’t get it either because medical services are not accessible or because of the longstanding bias against diagnosing and treating mental disorders in children.
7) How Bright Is The Future For Neuroscience?
Here are two articles which consider this. They centre on the proposal made by President Obama to spend 4.5 billion dollars on the BRAIN project: Brain Research through Advancing Innovative Neurotechnologies.
In this article, Thomas Insel explains that we are only just now starting to develop the tools to do the job and the ways of collaborating which will enable researchers to share what they know.
This article, a transcript of a radio report linked on the same page, further explains some of the grounds for optimism and what the goals of the research might be.
If we can get inside the brain and understand what is going wrong , we can give people targeted and directed treatments. Along the way, we can deal with the issues of overmedication, underdiagnosis and false claims about effectiveness with which this week’s post has been concerned. The trouble is that we are a long way off. Obama’s proposal for the BRAIN project is sometimes compared with Kennedy’s plan to put men on the moon. That was essentially a problem of engineering. They had to adapt the technology they had developed for missiles and aircraft to the problem of how to fly in space. For the work on the brain, we need to invent the technology first.
If you’re in Year 12, you are about to learn how to do inferential statistics. We identify the probability of making a Type 1 error: saying that there is a difference, association or correlation in a data set when really anything which is there is just down to chance. That implies that if you did the study again, you would get the same results. Psychology has a problem because famous studies sometimes do not replicate well. I posted a couple of weeks ago a proposal from Daniel Kahneman to deal with this problem. This area, however, remains controversial.
Here’s Chris Chambers arguing for a different way out of this dilemma.
9) Rewriting Traumatic Memory
Over time, we are moving away from the idea of our memory as a machine for recording experience to a process which involves reconstructing experience. If that’s true, it opens up the possibility of people reconstructing past experiences in more helpful ways. There is a lead article in New Scientist which deals with that this week. It is hard for us to access that digitally. Here however is an article from the New Yorker which covers similar ground.
10) Thinking About University
It’s the time of year when people are starting to think about university. Some of you will be thinking about Psychology. Psychology can be regarded as a STEM subject: Science, Technology, Engineering and Maths. This article by Julie Hulme, whose background is in Psychology, makes a powerful case for doing this sort of degree. It moves beyond the idea of employability and global citizenship to the idea of life-wide learning, being able to apply the skills you learn to a whole range of situations and problems. The best learning I see in my classroom aspires to that ideal.
In connection with that, here is an article by Peter Kinderman.
It’s about a lot of things but one important idea is that people often read the news article about a piece of research but don’t go back to the original article. If you want to be the sort of person who reads the original article, do a Psychology degree.