The football cure / addiction

A psychologist from the University of Alabama says American football can absolutely heal the trauma that the deadly April tornados left behind but be careful because there is a risk you could suffer from football addiction.

Clearly true because he says so in a priceless TV interview and the university backed it up in a hard hitting press release.

Media science – saving YOU from deadly sports addictions.

Outside the criminal mind

ABC Radio National’s All in the Mind recently had a fascinating programme on the science behind offender profiling and whether it lives up to its ‘inside the criminal mind’ image.

If you’re not familiar with the debates about criminal profiling you may be surprised to hear that a fair few forensic psychologists think it’s a waste of time.

Even while studies can show a statistical link between certain psychological characteristics and crime features, it’s not clear whether applying this to individual criminals gives us reliable enough results to guide police investigations.

This edition of All in the Mind explores the various types of criminal profiling and the evidence behind their accuracy.

Although it is somewhat annoyingly cut with scenes from Silence of the Lambs (which has about as much to say about criminal profiling as One Flew Over the Cuckoo’s Nest has to say about psychiatric nursing) it is still a fascinating and insightful look into a little understood practice.

And if this isn’t enough criminology for you, a recent Radio 4 documentary (podcast here) discussed the evidence behind ‘miracle’ crime and violence reduction schemes.

Link to All in the Mind on ‘Profiling the Criminal Profilers’.
Link to streamed BBC doco on ‘crime cutting miracles’.
Podcast for same because putting the mp3 on the same page is hard.

Shifting between the worlds of Carl Jung

The New Atlantis has a wonderful article giving an in-depth biography of Carl Jung, perhaps one of the most interesting, infuriating and brilliant thinkers in the history of psychology.

Variously a pioneering experimental psychologist, a depth-analyst, an asylum psychiatrist and a man submerged in his own psychosis, he had a massive influence on both our understanding of the mind and 20th century culture.

…Jung never slackened in his pursuit of the ultimate — both ultimate good and ultimate evil, which he tended to find inseparable. He was frequently off in the empyrean or down in the bowels of hell, consorting with gods and demons as ordinary men do with family and friends. Few persons conducted such conversations, and most of them were inmates of lunatic asylums. For a time the thought that he might be insane terrified him.

The fear dissipated, however, as he became convinced that his visions were genuinely revelatory and belonged to the primordial psychic reality that all men have in common: the collective unconscious, he called it. Poets and such may get away with beliefs like these, for their madness is pretty well taken for granted, but it was a most unorthodox way for an esteemed psychiatrist to think.

Jung is also probably one of the most misunderstood figures in psychology, largely owing to his tendency to swing between science, poetic genius and outright flakery.

The New Atlantis article is a fantastic exploration of the man and his ideas and one of the best short introductions you could find. Well, as short as you could get with Carl Jung.

Link to ‘Psychology’s Magician’.

Masters on the mind

Edge has just kicked off their 2011 Master Class with a fantastic course on ‘The Science of Human Nature’ delivered by an impressive line-up of leading cognitive scientists.

Princeton psychologist Daniel Kahneman on the marvels and the flaws of intuitive thinking; Harvard mathematical biologist Martin Nowak on the evolution of cooperation; UC-Santa Barbara evolutionary psychologist Leda Cosmides on the architecture of motivation; UC-Santa Barbara neuroscientist Michael Gazzaniga on neuroscience and the law; Harvard psychologist Steven Pinker on the history of violence; and Princeton religious historian Elaine Pagels on The Book of Revelations.

The first part is already online, where Daniel Kahneman gives a fantastic presentation on the counter-intuitive psychology of intuitive thinking, while the others will appear in the coming weeks.

And as always, I’m sure you’ll be pleased to hear the details of the expensive and exclusive location where the talks take place, lest you worry that the science was being toned down by sub-standard canopés, or God forbid, a pub.

Link to Edge Master Class 2011.

A whiff of madness

For a short time, the scientific community was excited about the smell of schizophrenia.

In 1960, a curious article appeared in the Archives of General Psychiatry suggesting not only that people with schizophrenia had a distinctive smell, but that the odour could be experimentally verified.

The paper by psychiatrists Kathleen Smith and Jacob Sines noted that “Many have commented upon the strange odour that pervades the back wards of mental hospitals” and went on to recount numerous anecdotes of the supposedly curious scent associated with the diagnosis.

Having worked on a fair few ‘back wards of mental hospitals’ in my time, my first reaction would be to point out that the ‘strange odour’ is more likely to be the staff than the patients but Smith and Sines were clearly committed to their observations.

They collected the sweat from 14 white male patients with schizophrenia and 14 comparable patients with ‘organic brain syndromes’ and found they could train rats to reliably distinguish the odours while a human panel of sweat sniffers seemed to be able to do the same.

Seemingly backed up by the nasal ninja skills of two different species, science attempted to determine the source of the ‘schizophrenic odour’.

Two years later researchers from Washington suggested the smell might be triggered by the bacteria Pseudomonas aeruginosa but an investigation found it was no more common in people with schizophrenia than those without the diagnosis.

But just before the end of the 60s, the original research team dropped a scientific bombshell. They claimed to have identified the schizophrenia specific scent and got their results published in glittery headline journal Science.

Using gas chromotography they identified the ‘odorous substance’ as trans-3-methyl-2-hexenoic acid, now known as TMHA.

At this point, you may be staring blankly at the screen, batting your eyelids in disinterest at the mention of a seemingly minor chemical associated with the mental illness, but to understand why it got splashed across the scientific equivalent of Vogue magazine you need to understand something about the history, hopes and dreams of psychiatry research.

For a great part of the early 20th century, psychiatry was on the hunt for what was called an ‘endogenous schizotoxin’ – a theorised internal toxin that supposedly triggered the disorder.

A great part of the early scientific interest in psychedelics drew on the same idea as psychiatrists wondered whether reality-bending drugs like LSD and mescaline were affecting the same chemicals, or, in some cases, might actually be the ‘schizotoxins’ themselves.

So a chemical uniquely identified in the sweat of people with schizophrenia was big news. Dreams of Nobel Prizes undoubtedly flashed through the minds of the investigators as they briefly allowed themselves to think about the possibility of finally cracking the ‘mystery of madness’.

As the wave of excitement hit, other scientists quickly hit the labs but just couldn’t confirm the link – the results kept coming in negative. In 1973 the original research team added their own study to the disappointment and concluded that the ‘schizophrenic odour’ was dead.

Looking back, we now know that TMHA is genuinely an important component in sweat odour. Curiously, it turns out it is largely restricted to Caucasian populations but no link to mental illness or psychiatric disorder has ever been confirmed.

The theory seems like an curious anomaly in the history of psychiatry but it occasionally makes a reappearance. In 2005 a study claimed that the odour exists but is “complex and cannot be limited to a single compound, but rather to a global variation of the body odor” but no replications or further investigations followed.

I, on the other hand, am still convinced it was the staff that were the source of the ‘strange odour’, but have yet to get research funding to confirm my pioneering theories.

Now available in Italian L’odore della schizofrenia
(thanks Giuliana!)

Escaping from the past of disaster psychology

Scientific American has a useful piece on how the immediate treatment of psychological trauma has changed since 9/11. The issue is interesting because recent progress has turned lots of psychological concepts on their head to the point where many still can’t grasp the concepts.

The article notes that at the time of the Twin Towers disaster, the standard form of treatment was Critical Incident Stress Debriefing – also known as CISD or just ‘debriefing’ – a technique where psychologists would ask survivors, usually in groups, to describe what happened and ‘process’ all the associated emotions by talking about them.

This technique is now not recommended because we know it is at best useless and probably harmful – owing to the fact that it seems to increase trauma in the long-term.

Instead, we use an approach called psychological first aid, which, instead of encouraging people to talk about all their emotions, really just focuses on making sure people feel secure and connected.

Although the article implies that 9/11 was a major turning point for our knowledge of immediate post-trauma treatment, the story is actually far more complex.

Studies had been accumulating throughout the 90s showing that ‘debriefing’ caused harm in some, although it wasn’t until around the turn of the century that two meta-analyses sealed the deal.

Unfortunately, the practice of ‘debriefing’ by aid agencies and emergency psychologists was very hard to change for a number of interesting reasons.

A lot of aid agencies don’t deal directly with the scientific literature. Sometimes, they just don’t have the expertise but often it’s because they simply have no access to it – as most of it is locked behind paywalls.

However, probably most important was that even the possibility of ‘debriefing’ having the potential to do damage was very counter-intuitive.

The treatment was based on the then-accepted foundations of psychological theory that said that emotions always need to be expressed and can do damage if not ‘processed’.

On top of this, for the first time, many clinicians had to deal with the concept that a treatment could do damage even though the patients said it was helpful and were actually and genuinely getting better.

This is so difficult to grasp that many still continue with the old and potentially damaging practices, so here’s a quick run down of why this makes sense.

The theoretical part is a hang-over from Freudian psychology. Freud believed that neuronal energy was directly related to ‘mental energy’ and so psychology could be understood in thermodynamic terms.

Particularly important in this approach is the first law of thermodynamics that says that energy cannot be created or destroyed just turned into another form. Hence Freud’s idea that emotions need to be ‘expressed’ or ‘processed’ to transform them from a pathological form to something less harmful.

We now know this isn’t a particularly reliable guide to human psychology but it still remains hugely popular so it seemed natural that after trauma, people would need to ‘release’ their ‘pent up emotions’ by talking about them lest the ‘internal pressure’ led to damage further down the line.

And from the therapists’ point of view, the patients said the intervention was helpful and were genuinely getting better, so how could it be doing harm?

In reality, the psychologists would meet with heavily traumatised people, ‘debrief’ them, and in the following weeks and months, the survivors would improve.

But this will happen if you do absolutely nothing. Directly after a disaster or similarly horrible event people will perhaps be the most traumatised they will ever be in their life, and so will naturally move towards a less intense state.

Statistically this is known as regression to the mean and it will occur even if natural recovery is slowed by a damaging treatment that extends the risk period, which is exactly what happens with ‘debriefing’.

So while the treatment was actually impeding natural recovery you would only be able to see the effect if you compare two groups. From the perspective of the psychologists who only saw the post-trauma survivors it can look as if the treatment is ‘working’ when improvement, in reality, was being interfered with.

This effect was compounded by the fact that debriefing was single session. The psychologists didn’t even get to see the evolution of the patients afterwards to help compare with other cases from their own experience.

On top of all this, after the ‘debriefing’ sessions, patients actually reported the sessions were useful even when long-term damage was confirmed, because, to put it bluntly, patients are no better than seeing the future than professionals.

In one study, 80% of patients said the intervention was “useful” despite having more symptoms of mental illness in the long-term compared to disaster victims who had no treatment. In another, more than half said ‘debriefing’ was “definitely useful” despite having twice the rate of postraumatic stress disorder (PTSD) after a year.

Debriefing involves lots of psychological ‘techniques’, so the psychologists felt they were using their best tools, while the lack of outside perspective meant it was easy to mistake instant feedback and regression to the mean for actual benefit.

It’s worth saying that the same techniques that do damage directly after trauma are the single best psychological treatment when a powerful experience leads to chronic mental health problems. Revisiting and ‘working through’ the traumatic memories is an essential part of the treatment when PTSD has developed.

So it seemed to make sense to apply similar ideas to those in the acute stage of trauma, but probably because the chance of developing PTSD is related to the duration of arousal at the time of the event, ‘going over’ the events shortly after they’ve passed probably extends the emotional impact and the long-term risks.

But while the comparative studies should have put an end to the practice, it wasn’t until the World Health Organisation specifically recommended that ‘debriefing’ not be used in response to the 2004 tsunami [pdf] that many agencies actually changed how they went about managing disaster victims.

As well as turning disaster psychology on its head, this experience has dispelled the stereotype that ‘everyone needs to talk’ after difficult events and, in response, the new approach of psychological first aid was created.

Psychological first aid is actually remarkable for the fact that it contains so little psychology, as you can see from the just released psychological first aid manual from the World Health Organisation.

You don’t need to be a mental health professional to use the techniques and they largely consist of looking after the practical needs of the person plus working toward making them feel safe and comfortable.

No processing of emotions, no ‘disaster narratives’, no fancy psychology – really just being practical, gentle and kind.

We don’t actually know if psychological first aid makes people less likely to experience trauma, as it hasn’t been directly tested, although it is based on the best available evidence to avoid harm and stabilise extreme stress.

So while 9/11 certainly focussed people’s minds on psychological trauma and its treatment (especially in the USA which is a world leader in the field) it was really just another bitter waymarker in a series of world tragedies that has shaped disaster response psychology.

So unusually for a psychologist, I’ll be hoping we’ll have the chance to do less research in this particular area and have a more peaceful coming decade.

Link to SciAm piece on psychology and the aftermath of 9/11.

The spark of the cognitive revolution

Monitor on Psychology has a fascinating article on Otto Selz, a little known pioneer of the cognitive revolution who was decades ahead of the rest of psychology, before being captured and killed by the Nazis.

He was so little known, in fact, that the majority of people have never heard of him. In fact, this is the first time I’ve ever seen anything written about him, despite the fact he was a major influence on the key players who launched the concept of ‘mind as information processing metaphor’ in the 1950s.

Selz began to lay the foundation for cognitive research in a series of experiments he and his colleagues conducted from 1910 to 1915. They asked participants to explain their problem-solving thought processes out loud as they tried to complete a task, such as finding a word related to but more generic than “newspaper” or “farmer,” such as “publication” or “worker,” respectively. The participants would explain how they identified the features of those words, how the features fit into larger categories and how the categories led them to new words.

Based on these statements, Selz concluded that their minds were doing more than simply associating words and images they’d heard in conjunction before. To Selz, the participants were operating under what he called a “schema,” or an organizing mental principle, that guided their thoughts. Under this schema, the mind automatically orders relationships between ideas and can anticipate the connections among novel stimuli, serving as a basis for problem-solving. The existence of such an organized mental life would later become a cornerstone of the cognitive revolution.

Selz was actually captured twice by the Nazis. He was first sent to the Dachau concentration camp but was released after five weeks on the condition that he leave the country.

He went to Holland and continued working for two years but was captured again when the Nazi’s invaded. He died while been transported to Auschwitz.

The article has an incredibly poignant moment where it mentions “His last recorded correspondence was a postcard to his colleagues, telling them he planned to begin a lecture series for his fellow inmates.”

Link to APA Monitor article on Otto Selz.