Author: vaughanbell

NPR has a fascinating segment on psychotherapist Jim Cates, who works with Amish youth who are experiencing the turbulent time of ‘Rumspringa‘ – a period when they get to experience non-Amish life so they can decide whether they want to commit to their parents’ culture and traditions.

The Amish are a community based around Anabaptist Christianity who, to varying degrees, refuse modern technology and the common social practices of North America.

However, during the time of Rumspringa, the youth are free to wear modern clothes, use technology, and may experiment with drink, drugs and sex – on the basis that the Amish want their youth to freely enter their tradition having had the opportunity to experience the alternative.

For some young people, this causes some difficulties, not least with some who encounter difficulties with drink, drugs or emotional adjustment and Jim Cates is a psychotherapist who helps the young people work through the issues.

He describes how he needs to take a radically different approach when conducting psychotherapy with Amish youth, owing to the markedly different way of thinking, particularly about the role of the individual in society.

Cates notes that while traditional American culture is individualist, Amish culture is strongly collectivist, to the point where talking about yourself is seen as prideful and individual work without the involvement of the family is at best uncomfortable and at worst inconceivable.

In the NPR piece, Cates gives some fascinating insights into his take on Amish psychology and discusses the innovative approach he needs when working with the culture.

It’s one of the most interesting and surprising radio pieces I’ve heard in a while, and is by the excellent Alix Spiegel, who also produced the gripping 81 words.

Link to NPR ‘One Man Tackles Psychotherapy For The Amish’.

Scientific American has a knock-out article that questions whether the diagnosis of post-traumatic stress disorder is a coherent psychological concept or whether it is actually making the situation worse for soldiers with post-combat mental health problems.

As we’ve noted before, PTSD is a controversial diagnosis for two major reasons. The first is that it is not clear that the diagnosis describes anything different from other forms of anxiety and depression, except for that fact that it is related to a specific traumatic incident.

The second is that the diagnosis was largely introduced after pressure from veterans’ lobbying groups after the Vietnam war. In fact, PTSD was originally called ‘post-Vietnam syndrome’ and there are concerns that while it was politically expedient at the time, the concept doesn’t lead to good mental health care.

In fact, combat stress reactions have taken various forms through the years of which PTSD is the latest reincarnation.

The SciAm article tackles research in the US military suggesting that the syndrome is over-diagnosed and that the treatment plan is counter-productive and actually encourages people to remain disabled.

But one of the most interesting things about the article is that it tackles the one of the core features of the diagnosis – that the anxiety symptoms are directly tied to a specific traumatic event.

Many people who are diagnosed with PTSD turn out not to have been traumatised by the event they later attribute the trauma to, or may not have even been traumatised at all.

J. Alexander Bodkin, a psychiatrist at Harvard’s McLean Hospital, screened 90 clinically depressed patients separately for PTSD symptoms and for trauma, then compared the results. First he and a colleague used a standardized screening interview to assess symptoms. Then two other PTSD diagnosticians, ignorant of the symptom reports, used another standard interview to see which patients had ever experienced trauma fitting DSM-IV criteria.

If PTSD arose from trauma, the patients with PTSD symptoms should have histories of trauma, and those with trauma should show more PTSD. It was not so. Although the symptom screens rated 70 of the 90 patients positive for PTSD, the trauma screens found only 54 who had suffered trauma: the diagnosed PTSD “cases” outnumbered those who had experienced traumatic events. Things got worse when Bodkin compared the diagnoses one on one. If PTSD required trauma, then the 54 trauma-exposed patients should account for most of the 70 PTSD-positive patients. But the PTSD-symptomatic patients were equally distributed among the trauma-positive and the trauma-negative groups. The PTSD rate had zero relation to the trauma rate. It was, Bodkin observed, “a scientifically unacceptable situation.”

This does not necessarily mean the people are lying, but may simply be attributing true symptoms to an unlikely source.

It’s a wonderfully thought-provoking article that’s sure to ruffle a few feathers.

The writer, David Dobbs, has also put a load of background material and links to the relevant studies on his blog, so you can get a more in-depth perspective if it sparks your interest in the area.

Link to article ‘Soldiers’ Stress: What Doctors Get Wrong about PTSD’.
Link to David Dobb’s background material for the article.

The Economist has an excellent piece on crowd psychology and why group behaviour is essential in calming down street confrontations before they turn violent.

Crowds are often associated with senseless aggression, and perhaps the most widely quoted, and most colourful example, is from Gustave Le Bon’s 1895 book The Crowd.

He wrote that crowds showed several special characteristics such as “impulsiveness, irritability, incapacity to reason, the absence of judgment and of the critical spirit, the exaggeration of the sentiments, and others besides – which are almost always observed in beings belonging to inferior forms of evolution – in women, savages, and children, for instance”.

You can imagine how he went down at parties.

Nevertheless, this association between crowds and violence has remained a research focus for many years. Concepts such as deindividuation – a reduction in the feeling of personal identity and responsibility – are invoked to explain why ‘bad things’ supposedly happen when people congregate in groups. This also typically includes explaining why ‘bad things’ are allowed to happen without people intervening – the so-called bystander effect

The Economist article is interesting because it looks at research which seems to turn these assumptions on their head.

It discusses the work of psychologist Mark Levine, who studies crowd behaviour and has found that crowds actually act to reduce violence in many situations.

He has been analysing CCTV footage of incidents that control room operators thought might turn violent, not all of which did.

His first observation was that bystanders frequently intervene in incipient fights. The number of escalating gestures did not rise significantly as the size of the group increased, contrary to what the bystander effect would predict. Instead, it was the number of de-escalating gestures that grew. A bigger crowd, in other words, was more likely to suppress a fight.

Some incidents did end in violence, of course. To try to work out why, Dr Levine and his colleagues constructed probability trees to help them calculate the likelihood that a violent incident such as a punch being thrown would occur with each successive intervention by a bystander. Using these trees, they were generally able to identify a flashpoint at which the crowd determined which way the fight would go.

Judging the fight to begin with the aggressor’s first pointing gesture towards his target, the researchers found that the first intervention usually involved a bystander trying to calm the protagonist down. Next, another would advise the target not to respond. If a third intervention reinforced crowd solidarity, sending the same peaceful message, then a violent outcome became unlikely. But if it did not—if the third bystander vocally took sides, say—then violence was much more likely.

It’s a really eye-opening piece that’s well worth reading in full as it overturns both some common popular assumptions and some well-worn psychological clich√©s.

Link to Economist on ‘The kindness of crowds’.