Category: Other People

Aaron Beck is the creator of one of the world’s most widely used and influential psychological treatments, cognitive behavioural therapy, and he’s profiled in an excellent article for The American Scholar.

While Beck is most associated with CBT, the article really nails why he is important in the development of psychological treatment, and its not just for the therapy he invented: from the very beginning he scientifically tested the effectiveness and principles his treatment meaning it has constantly changed and developed according to a solid research base.

If this seems obvious to you, you need to understand a little about the history of psychotherapy before Beck applied systematic testing to his own invention.

Previously, changes in psychotherapy were largely driven by the persuasiveness and personalities of the leading lights rather than systematic evidence for effectiveness.

In many forms of therapy, especially Freudian-inspired schools, the therapist’s own personality was considered to be intimately tied up with their methods, theories and techniques, meaning that rubbishing someone’s approach also meant you were rubbishing their skill as a therapist and, often, them personally.

In the early days of psychoanalysis, a common put-down used by Freud and his disciples was that a theory they didn’t like was bad because it was tainted by the unresolved conflicts of the author. The problem, in other words, was not with the idea, but with the author.

Beck approached psychological treatment with scientific tools and immediately distanced the practice from the personal. Ideas could be put forward, tested and it was expected that many of them would fail in the face of the data.

As a result, critical reviews of the evidence are considered the life blood of the treatment.

This research-led approach has not arrived without ruffling a few feathers. Recently, as health services have decided only to fund evidence-based treatments, CBT has become the treatment of choice and other therapies have been pushed out as they’ve traditionally not been interested in doing systematic studies.

As a result, critics have argued that CBT has been moulded to fit health economics rather than human nature. The debate continues and is likely to continue for some time.

The American Scholar article is an engaging piece looking at Beck himself, a famously reserved character in the flamboyant world of therapy, and the development of his treatment.

Incidentally, it’s written by Daniel Smith who wrote the wonderful book on hearing voices called Muses, Madmen and Prophets that I highly recommend.

Link to American Scholar article ‘The Doctor Is In’.

The LA Times has a reflective piece on the late teen movie director John Hughes‘ vision of adolescence in light of today’s fashion for medicating teenagers:

“If the brooding, solitary Andie played by Ringwald in “Pretty in Pink” were in high school in 2009, it’s hard to imagine she wouldn’t be a candidate for anti-depression therapy. Likewise, if “The Breakfast Club,” which is about five teens serving time in Saturday detention, took place in a post-Prozac, post-Columbine America, Ally Sheedy’s mostly mute, kleptomaniac misfit would have undoubtedly been medicated, and Anthony Michael Hall’s character would have received a lot more than detention for bringing a flare gun to school. As for Ferris Bueller, the kid obviously needed Ritalin.

“I’m not suggesting that any of us were better off when legitimate disorders went unrecognized and untreated. But in a culture in which diagnoses sometimes seem to get handed out like conservation-awareness fliers in front of the supermarket, it’s worth asking ourselves if old-fashioned eccentricity — of the teen or adult variety — can too easily be supplanted by the ease of assigning a code from the Diagnostic and Statistical Manual. Hughes, who left the movie business in the early 1990s because he feared the impact Hollywood would have on his children, should be remembered not just for the way he appreciated weirdness but for the way he normalized it — not with pills but with paisley.”

The monologue that bookmarks The Breakfast Club, with the line “You see us as you want to see us – in the simplest terms, in the most convenient definitions”, succinctly captures how society’s view of youth changes and yet always stays the same.

For the current younger generation, the simplest terms are mostly taken from psychiatry. This will eventually change and our recurrent anxieties about the young will largely be expressed in the next most convenient definition.

As a society, we are strangely blind to the complexities of youth.

Link to LA Times piece ‘He made weird normal’ (via Furious Seasons).

The New York Times has an interesting piece about the work of anthropologist Ann Dunham Soetoro, most famous for being the mother of President Barack Obama.

The article is by Yale anthropologist Michael Dove who knew and worked with Obama’s mother before she died in 1995.

Dr. Soetoro‚Äôs most sustained academic effort was her 1,043-page dissertation, ‚ÄúPeasant Blacksmithing in Indonesia: Surviving Against All Odds,‚Äù completed in 1992 and based on 14 years of research. This was a classic, in-depth, on-the-ground anthropological study of a 1,200-year-old industry. Her principal field site was a cluster of hamlets, containing several hundred households, on an arid limestone plateau on Java‚Äôs south coast. There, village metalworkers produced dozens of different iron blades and tools for use in farming, carpentry and daily life…

There is a final lesson from her work that is worth remembering: No nation — even if it is our bitterest enemy — is incomprehensible. Anthropology shows that people who seem very different from us behave according to systems of logic, and that these systems can be grasped if we approach them with the sort of patience and respect that Dr. Soetoro practiced in her work.

Link to NYT piece ‘Dreams From His Mother’.

The BPS Research Digest has the surprising news that a photo of Phineas Gage has been discovered. He became one of the most famous case studies in neuroscience when he had a large iron rod blown through his frontal lobes in in 1848.

He survived but his frontal lobe damage meant “Gage was no longer Gage”, at least according to his attending doctor, giving us some of the first clues that damage to specific brain areas could cause changes in personality.

The photo was apparently discovered by two photo collectors who went to great lengths to verify it was indeed Gage.

The photo may well show Gage in his later years as he toured the country with PT Barnum’s circus appeared at PT Barnum’s New York museum as one of the star attractions, always with the tamping iron on hand to amaze the crowds.

In the tradition of media circuses, the collectors have taken the long out-of-copyright photo, put a dirty great copyright sign across the front and are charging ‘usage fees’ for the undefaced version.

Phineas Gage may be dead, but the spirit of Barnum, it seems, lives on.

UPDATE: The LA Times has a short article and an undefaced version of the photo online.

Link to BPSRD on the photo.
Link to the ‘Meet Phineas Gage’ website with defaced photo.

The New York Times has a fantastic profile of ultramarathon runner Diane Van Deren who became a world class endurance athlete after having brain surgery to remove a large chunk of her right temporal lobe.

The surgery was to treat otherwise untreatable epilepsy and has left her with memory and organisation difficulties, neither of which stop her from running and winning races of several hundred miles.

Van Deren, 49, had a lobectomy in 1997. She has become one of the world‚Äôs great ultra-runners, competing in races of attrition measuring 100 miles or more. She won last year‚Äôs Yukon Arctic Ultra 300, a trek against frigid cold, deep snow and loneliness, and was the first woman to complete the 430-mile version this year…

[Neuropsychologist] Gerber, who works at Craig Hospital, a rehabilitation hospital in Englewood, Colo., for people with brain or spinal-cord injuries, said that Van Deren “can go hours and hours and have no idea how long it’s been.” Her mind carries little dread for how far she is from the finish. She does not track her pace, even in training. Her gauge is the sound of her feet on the trail.

“It’s a kinesthetic melody that she hits,” Gerber said. “And when she hits it, she knows she’s running well.”

Link to NYT on Van Deren.

I’ve just found this interesting 1988 article from the British Medical Journal on how surrealist artist Giorgio de Chirico took inspiration from visual distortions he experienced as part of his migraines.

According to the article, he clearly recorded experiencing the symptoms of migraine, including the marked visual disturbances, and these can be seen in some of his paintings.

One of the most common visual disturbances in migraine aura is scintillating zigzag edges, but it can also commonly induce sparkling, dazzling, dancing, or flickering lights, fire rings, stars, and moving lines.

There are three sets of de Chirico’s pictures that closely resemble patients’ illustrations of classical migraine attacks. In a set of prints illustrating Cocteau’s Mythologie the jagged effect of the water is very similar to the advancing edge of a scotoma and may be compared to a painting from the national migraine art competition.

The second example, a painting from the 1960, has as its central feature the silhouette of a man with a spiky edge, while figure 4, a lithograph from 1929, shows a black sun motifintruding into an interior scene. Both of these are reminiscent of drawings of negative scotomata by patients suffering from migraine. Other migrainous phenomena, such as the distortion of space, may be discernible in a series of paintings known as “Metaphysical interiors.” This association, however, is more tenuous.

The article is illustrated with some of de Chirico’s paintings and comparison pictures by people who were deliberately attempting to illustrate their migraine aura.

Link to article on PubMedCentral.

Edge has an excellent interview with science writer Jonah Lehrer who riffs on consciousness, the joy of discovery, the importance of the marshmallows in psychology and how he fell in love with science.

It’s interesting because rarely do science writers get the opportunity to give their own opinions on the big questions in neuroscience, despite the fact that, as Lehrer mentions, they have a distinct way of looking at the field as a whole.

Writers have a massive influence on politics, economics, business and the arts, to the point where they are actively courted and coerced by those wanting to control the agenda, but there is much less of a tradition of writers influencing science outside the political sphere.

In fact, it’d be interesting to directly ask science writers for their own theories one day, but in the mean time here’s a rare opportunity to see one ‘in action’ on the big issues.

The questions I’m asking myself right now are on a couple different levels. For a long time there’s been this necessary drive towards reductionism; towards looking at the brain, these three pounds of gelatinous flesh, as nothing but a loop of kinase enzymes. You’re a trillion synaptic connections. Of course, that‚Äôs a necessary foundation for trying to understand the mind and the brain, simply trying to decode the wet stuff.

And that’s essential, and we’ve made astonishing progress thanks to the work of people like Eric Kandel, who has helped outline the chemistry behind memory and all these other fundamental mental processes. Yet now we’re beginning to know enough about the wet stuff, about these three pounds, to see that that’s at best only a partial glance, a glimpse of human nature; that we’re not just these brains in a vat, but these brains that interact with other brains and we are starting to realize that the fundamental approach we’ve taken to the mind and the brain, looking at it as this system of ingredients, chemical ingredients, enzymatic pathways, is actually profoundly limited.

The question now is, how do you then extrapolate it upwards? How do you take this organ, this piece of meat that runs on 10 watts of electricity, and how do you study it in its actual context, which is that it’s not a brain in a vat. It’s a brain interacting with other brains. How do you study things like social networks and human interactions?

Link to Jonah Lehrer interview on Edge.

Frontier Psychiatrist has discovered an account of a curious incident where The Velvet Undergound played to the New York society for clinical psychiatry who had convened a high class dinner to discuss creativity.

But the 70s art rockers had the last laugh when they blasted the audience with distorted noise and bizarre questions, apparently as revenge for Lou Reed’s electric shock treatment he’d been given as a teen to ‘cure’ him of homosexuality.

The account is apparently give in an interview with John Cale, published in this week’s Guardian (although I’m damned if I can find it):

The second the main course was served, the Velvets started to blast and Nico started to wail. Gerard and Edie jumped up on the stage and started dancing, and the doors flew open and Jonas Mekas and Barbara Rubin with her crew of people with camera and bright lights came storming into the room and rushing over to all the psychiatrists asking them things like:

What does her vagina feel like?
Is his penis big enough? Do you eat her out?
Why are you getting embarrassed? You’re a psychiatrist; you’re not supposed to get embarrassed…

There’s plenty interesting material in Lou Reed’s songs for those interested in the mind and brain.

Of course, the heroin inspired lyrics of Perfect Day, but also the character sketches in Walk on the Wild Side:

Jackie is just speeding away
Thought she was James Dean for a day
Then I guess she had to crash
Valium would have helped that dash

She said, hey babe, take a walk on the wild side

‘Jackie’ refers to Jackie Curtis one of the gender-bending artists in Warhol’s The Factory. She was a enthusiastic drug user and became psychotic owing to her amphetamine use, apparently genuinely thinking she was James Dean at one point.

Valium, a long-acting anxiety-reducing and sleep-inducing benzodiazepine could have helped, but cutting out the speed probably would have been a better option. Curtis eventually died of a drug overdose in 1985.

There’s a fantastic documentary on Curtis’ life and art called Superstar in a Housedress.

And if you’re interested in the history of rock n’ roll psychiatry fusions, see one of our previous posts on The Cramps playing Napa State Mental Hospital.

Link to Frontier Psychiatrist on New York psychiatry rock chaos incident.

I’ve just noticed an excellent article in the Times about Rita Levi-Montalcini, the Nobel prizewinning neurologist who’s still working at 100.

Levi-Montalcini won the Nobel in 1986 for her discovery of brain-derived neurotrophic factor (BDNF), a protein that helps control when and where brain cells grow.

Fiercely independent, she’s escaped fascist regimes, anti-semitism and the bombing of Turin, where she continued her work by setting up a laboratory in a country cottage.

Do the workings of the brain still hold mysteries? “No, it is much less mysterious. We have the most amazing scientific and technological advances. We have been able to see how the brain does work. And now discoveries are being made by by anatomists and physiologists or experts in behavioural science, physicists and mathematicians, computer experts, biochemists, and molecular scientists. The barriers are breaking down between disciplines. At 100 years of age I am still making discoveries about the factor that I myself discovered more than half a century ago.”

Despite her neurobiological nous, cognitive neuroscience is obviously not her strong point as she does spout some nonsense about brain hemispheres in a few places though, like “The important thing is to have lived with serenity using the rational left-hand side of one’s brain, and not the right side, the instinctive side, which leads to misery and tragedy.”

Or the backside, which leads to… oh forget it.

Link to the Times on Rita Levi-Montalcini.

Counter-culture psychiatrist R.D. Laing is the patron saint of lovable rogues, although, according to an article in The Sunday Times, he was a hard man to love. “Being the son of RD Laing was neither amazing nor enlightening,” wrote his son in a biography of his father, “for most of the time it was a crock of shit.”

Inspired by existential philosophers, Laing produced a series of humane and revolutionary books during the sixties that argued that we undervalue both the experience of mental illness and those who are mentally ill.

Madness, he argued, was a transformative experience, rich with personal meaning, that functions like an existential rite of passage. Delusions and hallucinations were the expression of the unmentionable, illustrating the emotional double-booking keeping of the family with an unignorable tear in the fabric between the conscious and unconscious mind.

When you talk to psychiatrists from Laing’s generation, they are rarely complementary. The fact he fuelled the ‘anti-psychiatry’ movement (unwittingly, he claimed) is secondary to the fact that they chiefly remember his decline from a brilliant thinker to a tacky drunk.

While his public persona was just saddening, his family life was frequently shattered by his emotional instability. Fathering 10 children by four different women, the Times article recounts how his children remember his emotional neglect, sometimes punctuated with violence.

Yet Laing remains fascinating. Partly we revel in the irony as he highlighted the naivety of his own theories – his depression and alcoholism were hardly a rite of passage, and he embodied the dark force of ambivalent family turmoil that he railed against in his writing.

But partly it’s because he reflects those times when our inadequacies get the better of how we want the world to be. To borrow from Jung, he is the archetypal wounded healer, a modern day Fisher King whose wounds destroyed his kingdom.

 

Link to Sunday Times article ‘RD Laing: The abominable family man’.

Psychiatrist and iconoclast Thomas Szasz takes part in a hard-hitting interview on ABC Radio National’s All in the Mind where he shows that at the age of 89 he’s lost none of his fire which has raged through psychiatry for almost 50 years.

It’s a two part interview with the second appearing next week and it’s classic Szasz.

He’s an important thinker because he relentlessly attacks the conceptual foundations of psychiatry, the definitions which usually can’t be empirically tested because they’re philosophical issues – in other words, the assumptions we need to make about the world before we can start measuring anything.

Szasz comes from a classical liberal perspective, citing the rights and responsibilities of the individual as primary in any social decision-making.

As psychiatry is involved in changing behaviour, detaining individuals against their will, and discharging responsibility for serious crimes through the insanity defence – all based on what Szasz argues is a flawed concept of ‘mental illness’ – he fundamentally opposes much of the psychiatric system.

He’s always fascinating to read or listen to as there are always ‘that man is a genius’ and ‘how can he be so stupid?’ moments following closely together. Of course, not everyone agrees on which are which.

The presenter, Natasha Mitchell, does a fantastic job of pressing hard questions and doesn’t shy away from tackling accusations of anti-psychiatry, medical irresponsibility and collusion with scientology (next week).

Great stuff.

Link to AITM ‘Thomas Szasz speaks’ Part 1.
Link to more background on the AITM blog.

Classic British TV comedy Yes Prime Minister has important lessons for those who want to interpret questionnaire data. This clip shows two civil servants discussing a policy suggestion. Bernard Woolley, who we see first, thinks the public are in favour of the policy – the minister has had an opinion poll done. Luckily senior civil servant, Sir Humphrey Appleby is there to set him straight:

Fans of cognitive biases, note that Sir Humphrey uses at least three in his illustration of a biased questionnaire: framing, priming, and acquiescence bias.

This example exaggerated, but the moral still holds : questionnaires can be designed to encourage the answers you want. People’s opinions are not objective facts like their height and weight, they change depending on the context and on how they are asked.

New Scientist has an interesting interview with Daniel Tammet, a young man with with Asperger’s syndrome, synaesthesia and amazing savant memory skills.

Tammet has also been the subject of scientific investigation, with a 2007 study published in the journal Neurocase examining how activity in his brain is related to his exceptional recall.

Tammet is interesting because savantism is usually associated with people with quite profound autism who are not easily able to communicate their experiences. Owing to the fact that Tammet is highly articulate, he describes how his experiences his mind in wonderful detail.

You also excel at learning languages. How do you pick them up so quickly?

I have synaesthesia, which helps. When there is an overlap between how I visualise a word and its meaning, that helps me remember it. For example, if a word that means “fire” in a new language happens to appear orange to me, that will help me remember it. But more significant is my memory and ability to spot patterns and find relationships between words. Fundamentally, languages are clusters of meaning – that is what grammar is about. This is also why languages interest me so much. My mind is interested in breaking things down and understanding complex relationships.

A documentary about Tammet, called The Boy with the Incredible Brain is available on Google Video and shows him at work as well as talking to neuropsychologists about savant skills.

Link to interview with Tammet at NewSci.
Link to documentary The Boy with the Incredible Brain.

ABC Radio National’s excellent The Philosopher’s Zone recently broadcast a great programme on one of the most influential philosophers in cognitive science – the French phenomenologist Maurice Merleau-Ponty.

The first part of the programme deals with a broad overview of his life and ideas while the second section discusses his most famous work where analysed concepts behind the psychology of perception.

Merleau-Ponty was a phenomenologist, a philosophical tradition that aims to understand the structure of the mind through the analysis of conscious experience.

Introspection and subjective judgements about the mind get a bad rap in modern psychology but actually form the basis upon which much cognitive science rests.

To study something scientifically, it needs to be distinguished from other things – so we need to decide what sorts of things there are before we can apply science. As philosophy is essentially ‘conceptual engineering’, one of its most important roles is to make sure that these distinctions are based on sound concepts.

Many of the phenomenologists were interested in how we generate these concepts and looked to the structure of the human mind for clues. They came to the conclusion that there may be certain aspects of the mind that lead us to understand the world in specific ways.

Merleau-Ponty strongly argued that perception, including the whole experience of the body, was one of the most important influences and that if we rely solely on an objective and abstract science we will never understand lived-experience itself.

Link to the Philosopher’s Zone on Merleau-Ponty.

The New York Times has an obituary to psychologist Robert Zajonc, who made some of the most significant discoveries in cognitive science. What I didn’t know is that he’d also been bombed, captured by the Nazi’s, made his escape, joined the French resistance and acted as a translator for the Allied forces during the War.

Zajonc was one of those unsung heroes of psychology who you probably know through his discoveries, even if you don’t recognise the name.

He discovered the ‘mere exposure effect‘, the effect of birth order on IQ, the interaction between audience and expertise, and that smiles can lift the mood as well as be triggered by happiness.

Professor Zajonc was perhaps best known for discovering what he called the “mere exposure” effect. In a seminal experiment, published in The Journal of Personality and Social Psychology in 1968, he showed subjects a series of random shapes in rapid succession. The shapes appeared and disappeared so quickly that it was impossible to discern that some of them were actually repeated. Nevertheless, when subjects were later asked which shapes they found most pleasing, they reliably chose the ones to which they had been exposed the most often, though they had no conscious awareness of the fact.

I had the experience of reading through the piece thinking, ‘wow, I didn’t realise all these discoveries were from the same guy’.

Link to NYT obituary for psychologist Robert Zajonc (via AHP).

The New York Times has an excellent profile of free-thinking neuroscientist Rudolfo Llin√°s who is renowned for his theories on the importance of brain oscillations and his unique take on consciousness.

Now based in New York, Llin√°s is a native of Colombia and is considered one of the most important living neuroscientists.

He views the brain as a neurophysiologist but applies his knowledge of neurobiology to understanding some of the bigger questions, such as conscious experience and mental illness.

When the brain is awake, neurons in the cortex and thalamus oscillate at the same high frequency, called gamma. “It’s like a Riverdance performance,” Dr. Llinás continued. “Some cells are tapping in harmony and some are silent, creating myriads of patterns that represent the properties of the external world. Cells with the same rhythm form circuits to bind information in time. Such coherent activity allows you to see and hear, to be alert and able to think.”

But at day’s end, cells in the thalamus naturally enter a low-frequency oscillation. They burst slowly instead of firing rapidly. With the thalamus thrumming at a slower rhythm, the cortex follows along. You fall asleep. Your brain is still tapping out slow rhythms, but consciousness is suspended.

So if a small part of the thalamus gets permanently stuck at a low frequency, or part of the cortex fails to respond to the wake-up call, Dr. Llin√°s said, an abnormal rhythm is generated, a so-called thalamocortical dysrhythmia.

And Llin√°s claims that specific dysrhythmias can be seen in various brain problems each of which might represent a specific breakdown in the normal oscillations of the brain.

Link to NYT ‘In a Host of Ailments, Seeing a Brain Out of Rhythm’.