A peek inside The Skeleton Cupboard

You’ll get more out of The Skeleton Cupboard, Tanyan Byron’s account of her training as a clinical psychologist, if you read the epilogue first.

It tells you that the patients described in the book are fictional, to preserve confidentiality, but indicates that the stories were representative of real situations.

This is a common device in clinical memoires, from Irvin Yalom’s existential tales of psychotherapy to Philippa Perry’s couch fiction, but I’m never quite sure what to make of these clinical quasi-biographies.

They are usually realistic, insightful and wonderful to read, Byron’s book is no exception, but the smudged line between truth and necessary fiction is sometimes hard to navigate.

In Byron’s case, her book is perhaps the most deliberately autobiographical in the genre, where she intends to reflect the role of the psychologist’s own psychology in working with distressed, impaired, and sometimes difficult individuals.

This is part of what clinical psychologists aim to do – understand how your own reactions are colouring your approach to the patient – but when the patients are literary collages of real people, it is perhaps the process rather than the content of those reflections that are the most informative.

From this perspective, The Skeleton Cupboard is best understood as an illustrated history of ‘how my thinking evolved as a clinician’ rather than a journal of patients past, although we assume the non-clinical parts are factual: the hard-boiled supervisor, the misjudged snogging of a psychiatrist, the friends through good times and bad.

Byron is Britain’s best ambassador for clinical psychology and a very good writer to boot and I’m sure The Skeleton Cupboard will prompt many to take up the profession or inspire them during their training. It’s also a good account of how thinking and practice evolves through first contact with patients.

It has some artistic license, maybe even melodrama in places, but it has some points of emotional truth that are hard to deny.
 

Link to more details of The Skeleton Cupboard.

Circumstances of the life and brain

Neurosurgeon Henry Marsh has written a philosophical, incisive and exasperated book about brain surgery called Do No Harm.

It’s a hugely entertaining read as Marsh takes us through the practical and emotional process of operating, or not operating, on patients with neurological disorders.

He does a lot of moaning – about hospital management, computerisation, administration – sometimes quite enjoyably it must be said, but in some ways he does reflect the stereotype of the bellowing “I’ve got lives to save!” surgeon that stalks hospital corridors.

Most strikingly though, Marsh is clearly aware of his faults and he is a tough critic of himself and his decisions, often to the point of guilt. But it is through the many battles won and lost where you can see the wisdom shine through.

It is a brilliant insight, more than anything, into the decision-making involved in neurosurgery and the emotional impact these professional choices have on patients and professionals alike.

It’s interesting to compare in tone to Katrina Firlik’s neurosurgical biography Another Day in the Frontal Lobe which is equally candid about the fog of surgery but relentlessly optimistic in conclusion.

In contrast, Marsh is a man trying his best in difficult circumstances. Some of those circumstances just happen to be several centimetres deep in the brain.

The book is also wonderfully written by the way. One not to miss.
 

Link to details of book Do No Harm.

A detangler for the net

I’ve just finished reading the new book Untangling the Web by social psychologist Aleks Krotoski. It turns out to be one of the best discussions I’ve yet read on how the fabric of society is meshing with the internet.

Regular readers know I’ve been a massive fan of the Digital Human, the BBC Radio 4 series that Krotoski writes and presents, that covers similar territory.

Untangling the Web takes a slightly more analytical angle, focusing more on scientific studies of online social interaction and theories of online psychology, but it is all the richer for it.

It covers almost the entire range psychological debates: friendships, how kids are using the net, debates over whether the net can ‘damage the brain’, online remembrance and mourning, propaganda and persuasion, sex, dating and politics. You get the idea. It’s impressively comprehensive.

It’s not an academic book but, unsurprisingly, given Krotoski’s background as both a social psychologist and a tech journalist, is very well informed.

I picked up a couple of minor errors. It suggests internet addiction was recognised as a diagnosis in the DSM-IV, when the nearest things to an internet addiction diagnosis was only discussed (and eventually relegated to the Appendix), in the DSM-5.

It also mentions me briefly, in the discussion of public anxieties that the internet could ‘rewire the brain,’ but suggests I’m based at University College London (apparently a college to the north of the River Thames) when really I’m from King’s College London.

But that was about the best I could do when trying to find fault with the book. It’s a hugely enjoyable, balanced treatment of an often inflammatory subject, that may well be one of the best guides to how we relate over the net that you’re likely to read for a long time.
 

Link to more details about Untangling the Web.

A concise, solid grounding in neuroscience

50IdeasHumanBrainI often get asked ‘how can I avoid common misunderstandings in neuroscience’ which I always think is a bit of an odd question because the answer is ‘learn a lot about neuroscience’.

This is easier than it sounds, of course, but if you want a solid introduction, a book by Mo Costandi called 50 Human Brain Ideas You Really Need to Know is an excellent starting point.

If you recognise the name Mo Costandi its because he has been writing the brilliant Neurophilosophy blog for the best part of the last decade as he’s moved from being a neurobiologist to a science journalist.

The book consists of 50 four page chapters each of which condenses a key area of neuroscience in a remarkably lucid way.

There is no pandering to the feint of heart in the selected topics (from free will to neural stem cells) but neither is there a glossing over of conflicting evidence or controversy.

You won’t get poorly researched hype here about ‘mirror neurons’ being ‘responsible for empathy’ or brain scans showing how the brain ‘lights up’ but you will get a concise, balanced and entertaining introduction to key concepts in neuroscience.

It’s worth noting that the book does not hand-hold you. It’s not a complete beginners guide. It’s aimed at a ‘smart high-school kid and up’ level but if that’s you, and you want to get to grips with the brain, this book is ideal.
 

Link to more details on 50 Human Brain Ideas You Really Need to Know.

A literary review of the DSM-5

Philosopher Ian Hacking, famous for analysing the effects of psychological and neuroscientific knowledge on how we understand ourselves, has reviewed the DSM-5 for the London Review of Books.

It’s both an excellent look at what the whole DSM project has been designed to do and a cutting take on the checklist approach to diagnosis.

It’s not often that a review gives you a feeling of both a wholesome read and a guilty pleasure, but Hacking does both with this piece.

The DSM is not a representation of the nature or reality of the varieties of mental illness, and this is a far more radical criticism of it than [NIMH Director Thomas] Insel’s claim that the book lacks ‘validity’.

I am saying it is founded on a wrong appreciation of the nature of things. It remains a very useful book for other purposes. It is essential to have something like this for the bureaucratic needs of paying for treatment and assessing prevalence.

But for those purposes the changes effected from DSM-IV to DSM-5 were not worth the prodigious labour, committee meetings, fierce and sometimes acrimonious debate involved. I have no idea how much the revision cost, but it is not that much help to clinicians, and the changes do not matter much to the bureaucracies.

And trying to get it right, in revision after revision, perpetuates the long-standing idea that, in our present state of knowledge, the recognised varieties of mental illness should neatly sort themselves into tidy blocks, in the way that plants and animals do.

The old joke about a dictionary review goes “the plot wasn’t up to much but at least it explained everything as it went along”.

For the DSM it might well be “the plot wasn’t up to much and neither did it explain everything as it went along”.
 

Link to ‘Lost in the Forest’ in The LRB (via @HuwTube)

Gotham psychologist

Andrea Letamendi is a clinical psychologist who specialises in the treatment and research of traumatic stress disorders but also has a passionate interest in how psychological issues are depicted in comics.

She puts her thoughts online in her blog Under the Mask which also discuss social issues in fandom and geek culture.

Recently, she was paid a wonderful compliment when she appeared in Batgirl #16 as Barbara Gordon’s psychologist.
 

I’ve always been of the opinion that comics are far more psychologically complex than they’re given credit for. In fact, one of my first non-academic articles was about the depiction of madness in Batman.

It’s also interesting that comics are now starting to explicitly address psychological issues. It’s not always done entirely successfully it has to be said.

Darwyn’s Cooke’s Ego storyline looked at Batman’s motivations through his traumatic past but shifts between subtle brilliance and clichés about mental illness in a slightly unsettling way.

Andrea Letamendi has a distinctly more nuanced take, however, and if you would like to know more about her work with superheroes do check the interview on Nerd Span.
 

Link to Letamendi’s Under the Mask (on Twitter as @ArkhamAsylumDoc)
Link to Nerd Span interview.

A treasure hunt for the mysteries of mind and brain

I’ve published a couple of free ebooks recently: Explore your blind spot shows you how to reveal the gap we all have in our visual experience of the world, and discusses what it means about consciousness that this gap is kept hidden from us most of the time. Control Your Dreams, co-written with Cathryn Bardsley and illustrated beautifully by Harriet Cameron, tells you how to have lucid dreams, those dreams where you realise you are dreaming and can take control over reality.

Both books are written as treasure hunts – travel guides, but for exploring inner space. When you start reading you will be told about the journey ahead, what you’ll need and how long it will take. Next we tell you about the treasure – some surprising or interesting feature of the mind and brain which is the core experience of the book. We tell you how to generate this experience for yourself, and the things to look out for, and what that experience might mean for our understanding of ourselves. We finish with “travellers’ tales”, which are reports from others who’ve experimented with the phenomenon and links to the scientific literature on the topic.

The core of psychology is experiences. Psychologists think about those experiences, turn them into theories, and try to settle arguments between themselves by generating new experiences – in the form of experiments. But the joy of psychological science is that everybody has access to the raw material. The books are a way of sharing that, an attempt to give away the raw material of psychological science, packaged as experiences for the reader.

The books are creative commons licensed, which means you download them, copy them, even modify them if you want to produced an improved version, and both are fully referenced so you can check up on any claims made in them. Science is naturally an open-source phenomenon, so it feels good to be doing some open source science writing.

Link: Explore Your Blindspot by Tom Stafford
Link: Control Your Dreams by Tom Stafford & Cathryn Bardsley, Illustrated by Harriet Cameron

Update 22 Jan: It looks like people are having problems downloading Control Your Dreams. This is something to do with the Smashwords site. Hopefully the issue will be fixed soon

Update 24 Jan: Fixed