A social vanishing

CC Licensed Photo by Flickr user Jonathan Jordan. Click for source,A fantastic eight-part podcast series called Missing has just concluded and it’s a brilliant look at the psychology and forensic science of missing people.

It’s been put together by the novelist Tim Weaver who is renowned for his crime thrillers that feature missing persons investigator David Raker.

He uses the series to investigate the phenomenon of missing people and the result is a wonderfully engrossing, diverse documentary series that talks to everyone from forensic psychiatrists, to homicide investigators, to commercial companies that help you disappear without trace.

Missing people, by their absence, turn out to reveal a lot about the tension between social structures and individual behaviour in modern society. Highly recommended.
 

Link to Missing podcast series with iTunes / direct download links.

From school shootings to everyday counter-terrorism

CC Licensed Image from Secretive Ireland. Click for source.Mother Jones has a fascinating article on how America is attempting to stop school shootings by using community detection and behavioural intervention programmes for people identified as potential killers – before a crime has ever been committed.

It is a gripping read in itself but it is also interesting because it describes an approach that is now been rolled out to millions as part of community counter-terrorism strategies across the world, which puts a psychological model of mass-violence perpetration at its core.

The Mother Jones article describes a threat assessment model for school shootings that sits at an evolutionary mid-point: first developed to protect the US President, then to preventing school shootings, and now as mass deployment domestic counter-terrorism programmes.

You can see exactly this in the UK Government’s Prevent programme (part of the wider CONTEST counter-terrorism strategy). Many people will recognise this in the UK because if you work for a public body, like a school or the health service, you will have been trained in it.

The idea behind Prevent is that workers are trained to be alert to signs of radicalisation and extremism and can pass on potential cases to a multi-disciplinary panel, made up of social workers, mental health specialists, staff members and the police, who analyse the case in more detail and get more information as it’s needed.

If they decide the person is vulnerable to becoming dangerously radicalised or violent, they refer the case on the Channel programme, which aims to manage the risk by a combination of support from social services and heightened monitoring by security services.

A central concept is that the person may be made vulnerable to extremism due to unmet needs (poor mental health, housing, lack of opportunity, poor social support, spiritual emptiness, social conflict) which may convert into real world violence when mixed with certain ideologies or beliefs about the world that they are recruited into, or persuaded by, and so violence prevention includes both a needs-based and a threat-based approach.

This approach came from work by the US Secret Service in the 1990s, who were mainly concerned with protecting key government officials, and it was a radical departure from the idea that threat management was about physical security.

They began to try and understand why people might want to attempt to kill important officials and worked on figuring out how to identify risks and intervene before violence was ever used.

The Mother Jones article also mentions the LAPD Threat Management Unit (LAPDTMU) which was formed to deal with cases of violent stalking of celebrities, and the FBI had been developing a data-driven approach since the National Center for the Analysis of Violent Crime (NCAVC) launched in 1985.

By the time the Secret Service founded the National Threat Assessment Center in 1998, the approach was well established. When the Columbine massacre occurred the following year, the same thinking was applied to school shootings.

After Columbine, reports were produced by both the FBI (pdf) and the Secret Service (pdf) which outline some of the evolution of this approach and how it applies to preventing school shootings. The Mother Jones article illustrates what this looks like, more than 15 years later, as shootings are now more common and often directly inspired by Columbine or other more recent attacks.

It’s harder to find anything written on the formal design of the UK Goverment’s Prevent and Channel programmes but the approach is clearly taken from the work in the United States.

The difference is that it has been deployed on a mass scale. Literally, millions of public workers have been trained in Prevent, and Channel programmes exist all over the country to receive and evaluate referrals.

It may be one of the largest psychological interventions ever deployed.
 

Link to Mother Jones article on preventing the next mass shooting.

The Quiet Room

This month’s British Journal of Psychiatry has a brief but fascinating article about a 1979 Marvel comic featuring and written by rock legend Alice Cooper which depicts his real-life admission to a psychiatric ward.

The comic was timed to coincide with the release of his concept album From The Inside which describes his experiences as a psychiatric patient being treated for severe alcoholism and depression.

He was there for 3 months and in the comic he depicts the patients, doctors and nurses he met during his admission. Alice has often commented in interviews that treatment in hospital and recovering from his substance misuse saved his life, when many similar artists at that time, such as Jim Morrison and Janis Joplin, were not as fortunate, succumbing to their addictions. The lead single from the album was ‘How You Gonna See Me Now’, a song describing the anxiety the singer felt coming back home to his wife after his stay in hospital and facing the stigma of being treated for his mental illness. It went on to become a well-known successful ballad. The comic can still be found in comic shops or through online auction sites.

 

Link to brief British Journal of Psychiatry article.

Hold infinity in the palms of your hand

CC Licensed image from Wikipedia. Click for imageA rare documentary about three people who have had hallucinatory and profound revelatory experiences is now available online.

Those Who Are Jesus examines the borders between revelation and psychosis and hears people recount their intense experiences while looking at how they can be understood in terms of sociology, neuropsychiatry, religion and radical mental health.

Julian believes he has been shown Jacob’s Ladder, how a universe is created and told his soul is Time itself.

Sadat says a vision of an angel said to him: “You were Jesus Christ before and you were raised to life again and you are Jesus Christ”

It’s a great non-judgemental documentary that looks at what happens when intense and idiosyncratic experience intrude on everyday life.
 

Link to Those Who Are Jesus on Vimeo.
Link to info about the documentary.

Wanted: political diversity in social psychology

A fascinating article on why social psychology needs more political diversity is due to be published in Behavioral and Brain Sciences. Sadly the full article is locked behind a paywall but the abstract gives an excellent summary of the article and the wider problem itself.

Political Diversity Will Improve Social Psychological Science.

Duarte JL, Crawford JT, Stern C, Haidt J, Jussim L, Tetlock PE.
Behav Brain Sci. 2014 Jul 18:1-54. [Epub ahead of print]

Psychologists have demonstrated the value of diversity-particularly diversity of viewpoints-for enhancing creativity, discovery, and problem solving. But one key type of viewpoint diversity is lacking in academic psychology in general and social psychology in particular: political diversity. This article reviews the available evidence and finds support for four claims:

1) Academic psychology once had considerable political diversity, but has lost nearly all of it in the last 50 years;

2) This lack of political diversity can undermine the validity of social psychological science via mechanisms such as the embedding of liberal values into research questions and methods, steering researchers away from important but politically unpalatable research topics, and producing conclusions that mischaracterize liberals and conservatives alike;

3) Increased political diversity would improve social psychological science by reducing the impact of bias mechanisms such as confirmation bias, and by empowering dissenting minorities to improve the quality of the majority’s thinking; and

4) The underrepresentation of non-liberals in social psychology is most likely due to a combination of self-selection, hostile climate, and discrimination.

We close with recommendations for increasing political diversity in social psychology.

As the article notes there is considerable evidence that social diversity is beneficial on many levels for numerous types of social groups.

This is widely believed in social science and community work except when it comes to political opinion where many believe that non-liberal views are incompatible with this type of work, when clearly they are not. This affects the field to the point where people are seemingly prepared to actively discriminate against non-liberals.

The defence of diversity matters most when you are defending the inclusion of people with whom you disagree or who make you uncomfortable. And we will all be better off as a result.
 

Link to PubMed entry for article.

Context Is the New Black

The New Yorker has one of the best articles I’ve ever read on the Stanford prison experiment – the notorious and mythologised study that probably doesn’t tell us that we ‘all have the potential to be monsters’.

It’s a study that’s often taught as one of the cornerstones of psychology and like many foundational stories, it has come to serve a purpose beyond what we can confidently conclude from it.

Was the study about our individual fallibility, or about broken institutions? Were its findings about prisons, specifically, or about life in general? What did the Stanford Prison Experiment really show?

The appeal of the experiment has a lot to do with its apparently simple setup: prisoners, guards, a fake jail, and some ground rules. But, in reality, the Stanford County Prison was a heavily manipulated environment, and the guards and prisoners acted in ways that were largely predetermined by how their roles were presented. To understand the meaning of the experiment, you have to understand that it wasn’t a blank slate; from the start, its goal was to evoke the experience of working and living in a brutal jail.

It’s a great piece that I can probably do little to add to here, so you’re best off reading it in full.
 

Link to The Real Lesson of the Stanford Prison Experiment.

Hallucinating children

CC Licensed Photo by Flickr user Tali Le Bamba. Click for source.I’ve got an article in The Observer about childhood hallucinations which are much more common than we previously imagined.

You tend to get one of two reactions when you discuss children hallucination: that’s obvious – children live in a fantasy world, or that’s horrendous – there must be something very wrong with them.

The answer is that neither response is particularly accurate. Children’s fantasies are not the same as hallucinations but neither are they normally a sign of something ‘going wrong’ – although certain forms of hallucinations can suggest a more serious problem.

Hallucinations often reflect a bizarre, blurry version of our realities and because play is an everyday reality for children, the content can seem similar. Both can contain quirky characters, strange scenarios and inspire curious behaviour. One child described how he saw a wolf in the house, another that he had “Yahoos” living inside him that ate all his medicine. On the surface, these could just as easily be a child’s whimsy, but genuine hallucinations have a very different flavour. “In play and make-believe, children are imagining,” says Elena Garralda, a professor of child and adolescent psychiatry at Imperial College London. “They do not have the actual perceptual experience of seeing and hearing.” Another key difference, notes Garralda, is that “hallucinations feel imposed and children cannot exercise a direct control over them”.

There’s more on these fascinating experiences in the full article linked below.
 

Link to ‘Childhood hallucinations are surprisingly common – but why?’

A less hysterical reaction

CC Licensed photo by Flickr user Les Black. Click for source.There’s a fascinating article in The Guardian about one of the least understood aspects of human nature: experiences like blindness, paralysis and seizures that seem to mimic gross damage to the nervous system but aren’t explained by it. People can experience profound blindness, for example, but have no detectable damage to their visual system.

These difficulties have various names: conversion disorder, hysteria, dissociative disorder, medically unexplained symptoms, functional neurological symptoms, somatoform disorder, or are denoted by adding the word ‘functional’ or ‘psychogenic’ to the disability.

The original concept, usually falsely attributed to Freud but actually first suggested by French psychologist Pierre Janet, was that emotional disturbance was being expressed as a physical problem, potentially as a form of psychological defence mechanism.

This is the origin of one of the modern names – ‘conversion disorder’ – but it’s not clear that ’emotion being converted into a physical symptom’ is a good explanation. We do know, however, that these experiences are more likely in people with a history of trauma, stress or emotional difficulties.

Crucially, people affected by these conditions feel no voluntary control over their symptoms – they’re not faking – but if you understand the nervous system you can often see how the symptoms aren’t consistent with the disabilities they appear to mimic.

For example, in the article, the neurologist tests a patient’s blindness like so:

He took from his bag a small rotating drum painted in black and white stripes. He held it in front of Yvonne and spun it quickly. Her eyes flickered from side to side in response to it, involuntarily drawn to the spinning stripes.

If the patient was blind due to damage to the eye, retina or optic nerve, visual material wouldn’t cause an involuntary eye tracking response, because the visual information would never make it to the brain.

So strikingly, the visual information is clearly being perceived at one level but is not accessible to the conscious mind – and it is this dramatic dissociation between the conscious and unconscious which is at the core of the problem, and is so poorly understood.

Unfortunately, these problems have also been traditionally stigmatised within medicine with people affected by them sometimes treated as fakers or time-wasters.

Similarly, to patients, the problems often feel as if “something has gone wrong with their bodies” meaning it can be difficult to hear that the origin may be psychological – partly of course, due to the common misconception that ‘psychological’ means ‘under your control’.

So this is why The Guardian article is so interesting because it is a little discussed area that needs a wider understanding both clinically and scientifically.

It describes several people with exactly these difficulties and how they are experienced.

Apparently, it’s taken from a new book by the same neurologist which is entirely about ‘functional neurological symptoms’ which could be equally as interesting.
 

Link to ‘You think I’m mad?’ – the truth about psychosomatic illness.

A brief and unlikely scenario

The Independent have been running a series called ‘If I were Prime Minister’ where they’ve asked a diverse range of people what they would do if they were PM. I written a brief piece for them where I talk about why we need to make hospital care for people with psychosis much less distressing.

It’s worth saying that I’d make a rubbish Prime Minister (“Exchange rate, yep, are there any snacks in here?”) but before I’d get the Queen to let me off the hook, I’d certainly make transition to psychiatric hospital care a much more positive experience,

Being treated in hospital under section is one of the most serious psychiatric interventions but you may be surprised to hear that it is one of the most poorly researched. We have so little evidence about what works and how to help people in a way that is safest for both their physical and their mental health. So if I were prime minister, I would ensure that the transition to inpatient care, for the most seriously unwell, was also a priority for research, funding and improvement.

It’s not fashionable to talk about gentleness in healthcare but it is exactly what is needed for people in crisis. Through neglect and under-funding, we have created a system that makes the time, consistency and environment needed for gentleness almost impossible to achieve – both for the staff who want to provide it and for the people who need it most. We are using our sanctuaries as warehouses and they need reclaiming.

Link to piece on crisis care in mental health.

Vice on mental health

Somewhat unexpectedly, Vice magazine has just launched a series of articles, videos and interviews on mental health, and it’s really very good.

The VICE Guide to Mental Health covers the science of mental illness, what it’s like being sectioned, recovering from suicide or being severely anxious, and the social issues in getting mental health care, to name just a few of the many articles.

It also covers sex and drugs (it is Vice magazine after all) but even those are pretty good.

The series has been done in collaboration with the mighty mental health charity Mind and is well worth your time.
 

Link to The VICE Guide to Mental Health.

She’s giving me hallucinations

Last year I did a talk in London on auditory hallucinations, The Beach Boys and the psychology and neuroscience of hallucinated voices, and I’ve just discovered the audio is available online.

It was part of the Pint of Science festival where they got scientists to talk about their area of research in the pub, which is exactly what I did.

The audio is hosted on SoundCloud which gives you an online stream but there’s no mp3 download facility. However, if you type the page URL into the AnythingToMP3 service it’ll present you with you an mp3 to download.

It was a fun talk, so do enjoy listening.

UPDATE: The nice folks at Pint of Science have made the mp3 downloadable directly from the SoundCloud page so no second website trickery needed.

Link to audio of Vaughan’s talk on hallucinated voices.

How is the brain relevant in mental disorder?

The Psychologist has a fascinating article on how neuroscience fits in to our understanding of mental illness and what practical benefit brain science has – in lieu of the fact that it currently doesn’t really help us a great deal in the clinic.

It is full of useful ways of thinking about how neuroscience fits into our view of mental distress.

The following is a really crucial section, that talks about the difference between proximal (closer) and distal (more distant) causes.

In essence, rather than talking about causes we’re probably better off talking about causal pathways – chains of events that can lead to a problem – which can include common elements but different people can arrive at the same difficulty in different ways.

A useful notion is to consider different types of causes of symptoms lying on a spectrum, the extremes of which I will term ‘proximal’ and ‘distal’. Proximal causes are directly related to the mechanisms driving symptoms, and are useful targets for treatment; they are often identified through basic science research. For example, lung cancer is (proximally) caused by malfunction in the machinery that regulates cell division. Traditional lung cancer treatments tackle this cause by removing the malfunctioning cells (surgery) or killing them (standard chemotherapy and radiotherapy)…

By contrast, distal causes are indirectly related to the mechanisms driving symptoms, and are useful targets for prevention; they are often identified through epidemiology research. Again, take the example of lung cancer, which is (distally) caused by cigarette smoking in the majority of cases, though it must be caused by other factors in people who have never smoked. These could be genetic (lung cancer is heritable), other types of environmental trigger (e.g. radon gas exposure) or some interaction between the two. Given the overwhelming evidence that lung cancer is (distally) caused by smoking, efforts at prevention rightly focus on reducing its incidence. However, after a tumour has developed an oncologist must focus on the proximal cause when proposing a course of treatment…

The majority of studies of depression have focused on distal causes (which psychologists might consider ‘underlying’). These include: heritability and genetics; hormonal and immune factors; upbringing and early life experience; and personality. More proximal causes include: various forms of stress, particularly social; high-level psychological constructs derived from cognitive theories (e.g. dysfunctional negative schemata); low-level constructs such as negative information processing biases (also important in anxiety); and disrupted transmission in neurotransmitter systems such as serotonin.

It’s not a light read, but it is well worth diving into it for a more in-depth treatment of the brain and mental illness.
 

Link to Psychologist article neuroscience and mental health.

Trauma is more complex than we think

I’ve got an article in The Observer about how the official definition of trauma keeps changing and how the concept is discussed as if it were entirely intuitive and clear-cut, when it’s actually much more complex.

I’ve become fascinated by how the concept of ‘trauma’ is used in public debate about mental health and the tension that arises between the clinical and rhetorical meanings of trauma.

One unresolved issue, which tests mental health professionals to this day, is whether ‘traumatic’ should be defined in terms of events or reactions.

Some of the confusion arises when we talk about “being traumatised”. Let’s take a typically horrifying experience – being caught in a war zone as a civilian. This is often described as a traumatic experience, but we know that most people who experience the horrors of war won’t develop post-traumatic stress disorder or PTSD – the diagnosis designed to capture the modern meaning of trauma. Despite the fact that these sorts of awful experiences increase the chances of acquiring a range of mental health problems – depression is actually a more common outcome than PTSD – it is still the case that most people won’t develop them. Have you experienced trauma if you have no recognisable “scar in the psyche”? This is where the concept starts to become fuzzy.

We have the official diagnosis of posttraumatic stress disorder or PTSD but actually lots of mental health problems can appear after awful events, and yet there is no ‘posttraumatic depression’ or ‘posttraumatic social phobia’ diagnoses.

To be clear, it’s not that trauma doesn’t exist but that it’s less fully developed as a concept than people think and, as a result, often over-simplified during debates.

Full article at the link below.
 

Link to Observer article on the shifting sands of trauma.

A love beyond illusions

Articles on people’s experience of the altered states of madness often fall into similar types: tragedy, revelation or redemption. Very few do what a wonderful article in Pacific Standard manage: give an account of how a young couple learn to live with psychosis.

It’s an interesting piece because it’s not an account of how someone finds the answer to loving someone who has episodes of psychosis, it’s how a couple find an answer.

It discusses psychiatry, antipsychotics and R.D. Laing but not in terms of what we should or could think of psychosis and society, but what one couple takes from them – finding value where it helps.

Touching, genuine, unpretentious and uncensored.

It is romantic in the truest sense.
 

Link to ‘My Lovely Wife in the Psych Ward’.

Economics against sexual violence

PBS has an article on ‘How economic theory can help stop sexual assault’ which despite its unappealing title is actually a genuinely thought-provoking piece on how game theory and social norms marketing could help prosecute and prevent sexual violence.

Both approaches look at how people’s behaviour is shaped by their perception of other people’s beliefs and behaviour.

People are less likely to report rape when they think they’re going to have to do it alone and people are more likely to intervene to prevent violence if they believe other people will also intervene.

The article discusses two existing interventions to tackle sexual violence based on game theory and social norms marketing and the article is also a great guide to the theories themselves.
 

Link to PBS article on approaches to preventing sexual assault.

You won’t find the data in my pants

The journal contexts has an excellent article on the long history of exploring the sex lives of sex researchers as a veiled attempt to discredit their work.

…these stories suggest a troubling pattern: they tend to focus on researchers’ alleged sexual proclivities, spinning them as deviant motivations which compromise the research.

For example, James Miller’s biography of Michel Foucault links Foucault’s work to unconventional sexual activities like sadomasochism. Thomas Maier begins his biography with Virginia Johnson losing her virginity, portrays her as a sexually conniving secretary, and delights in exposing complicated aspects of the researchers’ sex life together. And historian James Jones depicts Kinsey as deeply twisted.

The problem is not simply that sexuality research remains stigmatized. It is that, in many circumstances, sex itself remains stubbornly discrediting. Sexuality’s cultural meanings are paradoxical—it is simultaneously repulsive and attractive, taboo yet vital to our happiness. It is difficult to write sexual stories without reproducing what Michael Warner calls “the ordinary power of sexual shame.” Moreover, stories that examine sex research through the prism of the researcher’s sex life rely on the simplistic notion that there is a specific connection between one’s sexual experiences and research.

A fascinating piece which covers the sort of leering interest sex research continually attracts despite it being one of the most important and under-investigated aspects of human health and behaviour.
 

Link to ‘The Sex Lives of Sex Researchers’ in contexts.