everyday psychology

3/12/2008

What we have here is a failure to communicate

Of all the reasons that a couple might give to explain how or why their relationship is troubled, the one that is probably offered most frequently is "communication problems." Could it be that marriage or involvement somehow renders people incapable of expressing themselves and understanding others? Not likely. In reality, the problem is usually not that people cannot communicate. Instead, the problem is that they are in conflict.

A wife complains that her husband spends too much time in front of the television, that he doesn't help with the housework, doesn't compliment her or pay attention to her, and doesn't appreciate the work she does. He says that she doesn't respect him or understand him, that she spends too much time with friends, and that she demands too much of his time. They both complain about the spending habits of the other and about the frequency of their love-making. They say they have a communication problem.

Communication problem? Is it possible that they can't figure out what the other is complaining about? It is clear that their needs, priorities and expectations are different. It is a conflict, not a misunderstanding. The problem is that they disagree and cannot resolve their disagreements. They both want something from the other and can't seem to get it.

I tend to believe that the focus on communication problems is a direct result of the 1968 film, Cool Hand Luke. In the role of a chain-gang prison camp warden, actor Strother Martin uttered what would become a famous movie line: "What we have here is a failure to communicate." Years later, he would repeat the line on Saturday Night Live, that being how famous the phrase had become. Perhaps the line resonated because it seemed such a simple or obvious explanation for almost any complexity. Or perhaps it was because it was absurdly ironic.

In the movie, Martin was speaking to Paul Newman, who in the role of Cool Hand Luke was a rebellious, recalcitrant and non-conforming inmate. Their characters were locked in an irresolvable struggle for control and domination. The line came after Newman escaped from the camp and was then hunted down and brought to his knees. What Strother Martin was actually saying was that he had won and that he was in charge. The twinkle in Paul Newman's eye said that their battle was far from over.

In relationships, communications are in fact frequently muddled, and for good reason. The wife does not express herself clearly because she does not wish to anger her husband. She does not want to seem unreasonable or appear to be nagging. The husband does not understand her because he is too busy offering excuses or denying that her complaints are valid. Their communications are muddled because neither wishes to appear to be at fault or to blame. They are not actually attempting to communicate. Instead, they are both struggling for control, while trying to appear righteous and innocent.

Ultimately, every argument they have is about the same thing: who is right and who is wrong. Rather than discussing the specifics of what they actually want, the argument comes to be framed in abstract terms such as appreciation, understanding, respect, cooperation and commitment. They might both try to appear accommodating, while giving not an inch of ground. Rather than working towards resolution, they are both attempting to defend their positions. Often times, couples will continue to struggle over who was right and who is to blame, even when they are basically in agreement.

And to explain this complex struggle and conflict, there is always the easy explanation: it's a communication problem.

It is, however, a tragic explanation. It is tragic because when the pointless and irrelevant discussion about who is right and who is at fault is set aside, and when their needs, desires and goals are communicated in simple, concrete terms, couples often find that compromise and accommodation would have been a simple matter. When guilt and blame are set aside, untenable demands become reasonable requests. Sorrow and forgiveness can emerge. Conflicting interests can yield to an awareness of common purpose.

When the focus turns from "a failure to communicate" and is directed towards the actual conflict, then a couple has something to work on: a problem that can actually be solved.

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3/11/2008

Helicopter Parents: disturbing trend or urban myth?

As children head towards college, should we worry about parents being overly involved, overprotective and excessively supportive? Or should we instead be concerned about kids who are on their own without a parachute?

It's Spring, so the college application, admission and selection process is coming to an end. Parents of high school seniors are both exhilarated and fatigued from that long, last sprint to the finish. The enormous hurdles presented by parenting a child and then parenting a teenager have been cleared. It's time to celebrate graduation. Soon, the kid will be off to college, and finally, there will be some peace and quiet in the empty nest. But then you realize, it's still a marathon, and you are not done. And then, someone tells you that rather than being a help, you are actually a hindrance. After years of functioning as a member of your child's support staff, now they are telling you that you are actually just a "helicopter parent," preventing your child from flying on their own.

This story has been written many times. The evidence is always anecdotal. College advisers and administrators obviously have stories to tell. They have seen the extreme examples of parental over-involvement. Their time with parents is often spent with the parents who have complaints. Many have been to workshops teaching them how to "manage" today's parents.

In a November 2006 MSNBC article, a college counselor was willing to be quoted as saying that the "problem" of hovering parents "has now reached epidemic proportions." In a March 2008 Sacramento Bee article, a college counselor estimated that the rate of parental hovering stands at 30 percent and is increasing 2 to 3 percent a year. In the online magazine Key, a guide to college life, we are offered a list of "signs and symptoms," as if you should check to see if you suffer from this disorder. If you help your kid write a paper, or provide extra money, you may be afflicted. On the Today Show in October 2007, "national mom expert" StacyDeBroff pegged the rate for this problem at 60 to 70 percent of "all" college parents. She provided a sort of diagnostic system to describe the different types of hovering parents, and she advised that some may need to "get help."

A USA Today story from Februray 2007 described "what's believed to be the first scholarly research on parents who hover too closely over offspring." This "scholarly research" appears to have been published only in USA Today, and it is likely the original source for the 60 to 70 percent epidemic figure cited by the "mom expert." But this study is based entirely on interviews with 50 "college officials." In other words, it is nothing more than a collection of anecdotes.

On this topic, I was able to find three sources of reliable data. I searched both the web and the professional literature.

In March 2007, the College Board reported on a survey of some 1700 students randomly drawn from the pool of SAT applicants. The College Board was looking at "hovering" occurring during the application process. What they found is that there is "little evidence of extreme or intrusive parental involvement." From a list of tasks on which parents could either help or take control, "only a small number of students reported what could be considered extreme behavior on the part of their parents." The behavior in which parents were most likely to be "very involved" (32%) was "encouraging" students to apply to certain schools. The two tasks on which the parents were most likely to take control were filling out financial aid forms (12%) and "deciding what colleges the students could afford" (16%). The latter finding begs the question: whose money is it?

The number of students reporting that their parents actually took control and did things for them (like writing essays, filling out applications or meeting with college counselors) was on the order of only one to three percent.

Based on their judgment about tasks that parents really should help with, the College Board concluded that "much of the reported parental involvement is actually very positive and supportive."

In January 2008, the Higher Education Research Institute (HERI) released a note on this topic based on their long-running "CIRP Freshman Survey." With 700 participating schools, they gather data from some 400,000 students each year. In contrast to the College Board, HERI looked at the perceptions of students, rather than actual behaviors. On five out of six measures of parental involvement, more students said that they received "too little" help from parents, rather than "too much. " On all of the measures, sizable majorities said that they received the "right amount" of help. The only item for which the number of students complaining about too much help exceeded the number receiving too little was the actual decision to go to college ("get up off that couch").

The three questions most relevant to the so-called "hovering" phenomenon had to do with whether parents were involved in choosing college activities, choosing courses, and dealing with college officials. Less than 4% said that their parents were over-involved in choosing their activities and courses. Less than 6% said that their parents were too involved in dealing with campus officials. In contrast, 24% said they wanted more help with choosing courses. 22% wanted more help with choosing activities. And 17% wanted more help dealing with problems on campus.

From the students' point of view, there is not that much hovering going on (at most, only 6% say their parents are too involved), and there are a lot of students wishing that their parents would hover more.

Finally, there are the findings in the 2007 Annual Report from the National Survey of Student Engagement (NSSE). This ongoing project focuses on the development of strategies to enhance educational programs, the learning process and overall student success. As part of a much larger yearly survey, 4500 freshmen from 24 institutions were asked about family support: how often their parents had intervened on their behalf to help them solve problems at school and how often they were in contact with their parents.

The NSSE found that 13 percent of first year students reported that their parents frequently intervened on campus. That 13 percent figure does not actually define the scope of the "hovering problem." As we saw above, more often than not (like 94% of the time), the students want their parents to be involved.

More importantly, this report goes on to note that the "students who have the most frequent contact with their parents are at least as engaged and often more engaged" in the academic process and in learning activities that lead to success. Those with parents who stay in contact and help them deal with problems on campus are also more satisfied with their college experience and report having gained more from college.

So what do we learn?

First, there is no disturbing trend or epidemic to be observed. "Helicopter parenting" is simply a pejorative term, and the frequency is not 60 percent or 30 percent or even 13 percent. The figure might be 6 percent, the number of students who say that their parents are overly involved. Or it might just be the one to three percent number reported by the College Board.

Obviously, there will be cases in which parents go overboard and in which they are overly-assertive and over-involved. But from what you can read on this topic, it seems to be more of a problem for educators than for students.

The available data suggest that parental involvement is a good thing, just as common sense would tell us. Yes, kids need to grow up, separate from their parents, become independent and, as psychologists say, "individuate." But that is not something that can be accomplished just by moving into a dorm. College involves many challenges, and it makes no sense to insist that young adults do this on their own, without help, and by trial and error. Freshmen enter college with different skill sets, different adaptive abilities and different levels of maturity. For some, the transition from home is a smooth ride with no bumps. Others encounter nightmare scenarios and need help.

What colleges and universities should be concerned about are all of those students who enter and then fail. The average retention rate for entering freshmen is less than 75 percent. That's just in the first year. Rather than spreading stories about parents-from-hell, what colleges should be doing is focusing on their students' need for support of all different types. Indeed, it should raise a red flag in a parent's mind when they hear a college official saying that helicopter parents are a problem. It actually says more about the administrator's attitudes than it does about parental behaviors, and it calls their judgment into question.

Here's the correct response a college adviser should give when asked to comment on this urban myth: "We sometimes encounter what you might call a helicopter parent, but we are actually more concerned about getting parents involved. That's what most students want and what they actually need. We're less concerned about the helicopters and more concerned about students who come to us without a parachute."

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2/08/2008

The psychology in art. What can we learn?

Art is frequently used as a tool by psychologists. The psychology of art is actually a field of study in itself. I want to focus here on just one particular function of art: it's ability to illustrate themes and to serve as a metaphor for complex ideas. Sometimes in therapy, a clinician might refer to a work of art in order to express or capture an idea, and along with it a mood and a set of feelings. A painting, for example, can be used to exemplify, summarize and dramatize a theme, and to impress it on the mind of an individual in a way that cannot be done with words alone. The same principal applies with movies and songs, and with stories and myths. What brought this issue to mind is an old postcard that fell out of a book I pulled from the shelf the other day. The card shows painter Winslow Homer's work The Gulf Stream.

Winslow Homer is one of my favorite artists. I have a framed copy of Fog Warning in my office, and during the years I saw patients in therapy, I would often refer to it and discuss it with my clients. Before I talk about Fog Warning, I want to discuss two other works by Homer.

The Gulf Stream

The Gulf Stream is a troubling work of art. A man is on a sailboat, adrift in a turbulent sea. Far off in the distance, a schooner has passed him by and a tornado menaces. His mast has been sheered off and his tiller is gone. There is blood in the water and sharks surround him. The ropes on his deck are a symbol of his having somehow been freed (the man is Black and the era is post Civil War), but whether he was on a journey to freedom or not, he is shown in absolutely dire straits, with no chance for survival.

What is remarkable in this work is that the man seems peculiarly unconcerned. He is not shown in despair or distress, or in panic or fear. He looks back towards where he has been, and not towards the ship that could have rescued him or towards the sharks or the storm that threatens. He is not resigned to his fate, but instead, he appears to accept it. In a sense, this painting is a metaphor for the human condition. The man's attitude might be said to represent a strength of faith or simply a strength of character. Emotionally, he is not overwhelmed by his circumstance. In real life, with similar challenges, few people can ever achieve such peace.

Breezing Up

Breezing Up is probably Winslow Homer's best known work. What we seem to see in this painting are four young men enjoying the vitality of life on a pleasant afternoon. Their youth and their carefree manner speaks to the fact that all of the options and possibilities of life are before them. They lounge on the boat in a relaxed and comfortable manner. That is what we seem to see in this work, and even the title suggests optimism and good fortune.

A closer look, however, shows that they are in deep trouble and that they don't really know what they're doing. Perhaps to see that you need to have been in a small sailboat, far from shore on a windy day. With an experienced eye, what you see is that their boat is "heeled far to port with the gunwales in the water," and that the sea below them is churning. The ship in the background illustrates the strength of the wind and highlights the peril and the vulnerability of these youth. The sky is darkening, and they do not seem to appreciate the risks ahead. The available metaphor in this work involves the themes of maturity, judgment and experience.

Fog Warning

Fog Warning is a different metaphor. Again, we see a man alone in troubled waters. Here is how this painting was described by William Howe Downes in American Paintings in the Boston Art Museum: "Men who are accustomed to danger occupy a mental attitude towards it that has no room for melodramatic pose. Simple and sober, the unconscious hero of the picture turns to get the bearings of his schooner as he bends to his oars with all the steadiness of a man who has a long way to row and who must neither waste his strength in spurts nor lose his head. Small amidst the waves of the Atlantic looks his dory, far away seems the vessel, hard and cruel is the complexion of the sea."

It is a metaphor for a particularly complex form of human strength and character. For an individual whose life is troubled and who sees no hope, this work is an inspiration. He is referred to as an "unconscious hero" because emotionally, he is immune to the enormity of his struggle. Instead, he is confident and determined.

ooo0ooo

Art is a topic of study in psychology because it can speak to our deepest thoughts and most complex emotions. Enduring truths and essential wisdom can often be gleaned from our reaction to and involvement with art. It can educate and it can inspire. And sometimes, it can help us heal.

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2/06/2008

Is clinical psychology an overrated career?

That's what you can read in US News and World Report (February 2008). The writer who expressed that opinion is Marty Nemko, a self-described career coach. He says that a career as a "personal coach" is a more rewarding alternative. Is his analysis of any import? No. Quite frankly his opinion is misinformed, uninformed and nonsense. Clinical psychology may be overrated if one assumes that it provides a hassle-free path to easy money and immediate gratification. Otherwise, career seekers will recognize that psychology is about challenge and satisfaction.

Nemko says that the appeal of clinical psychology is that "you'll work one-on-one with clients in a private, peaceful setting, helping them conquer their inner demons." That statement is not even remotely adequate to describe the range of career activities and options within the field. Some people enter this profession because they think we are about "helping people." Most enter because they are deeply fascinated by the roots and dynamics of the human condition.

Psychologists set forth on the career path only after completing college studies. By this point, they have been exposed to mentors and educators, as well as professionals, who have inspired them to be curious about how people think, feel and behave. At no point in the education of a psychologist will any senior member of the profession suggest that we are simply about "helping" people.

We have a rich intellectual history, and no career candidate can escape immersing themselves in our scientific methods and traditions. We are a doctoral level profession. Most of us hold the Doctor of Philosophy degree, indicating that even if we are in professional practice, we are trained first as scholars. Only those who are intensely fascinated by our subject matter and our body of knowledge will endure the rigorous training and the years of effort.

For those who are motivated to "work one-on-one with clients in a private, peaceful setting," there are many career paths. One can become a "counselor" or therapist with much less effort. And with no effort or knowledge at all, one can hang out a shingle as a "personal coach." If clinical psychology was simply about sitting in an office with patients, it is hard to imagine that it would appeal to anyone.

Nemko says that the profession of clinical psychology is being overshadowed or diminished because "research is revealing that many psychological problems have physiological roots, taking some of the luster off traditional psychotherapy." This is like saying that auto mechanics are in danger because the airline industry has an increasing number of passengers.

The fact is that the U.S. Department of Labor describes the expected growth in clinical psychology jobs as "faster than average." 24,000 positions will be added in the next ten years, a 16% increase. Right now in Great Britain, there is a major government funded initiative underway to increase the number of psychology-trained clinicians. The British government recognizes that more psychologists are needed if their system is going to provide comprehensive and effective health care.

Nemko also says that people are rejecting psychologists in favor of therapists and coaches who can provide practical solutions to the problems of living. He would like you to believe that those who are trained to understand the complexities of those problems are incapable of helping you to solve them. It's like saying that if your gardener understands how and why the grass grows, she won't know how to cut the lawn.

Is psychology an overrated career? If you think that it's an easy path to easy money, then it is overrated. Psychologists pursue this field of work because they are deeply fascinated with our profession's rich knowledge base. Psychologists are motivated by scholarly inquiry. If you pursue this career because you think it is glamorous or will provide prestige, you are bound to be disappointed. It is a difficult path from college graduation through graduate study and training. And when you arrive in the profession, you are left with nothing more than a challenging, satisfying and rewarding career.

Was the analysis and ranking from the US News and World report really worth anything at all? One only has to look at the online video that accompanied their list of overrated careers. In the videos, an architect describes the hassles and frustrations of his business. He also comments on what is "wonderful" about his career and "where the joy comes from." He ends by saying, "if you don't have the passion I have, forget it."

In the end, that is not the definition of an overrated career. A career that can be described as wonderful, and as a joy, and as a source of passion is not something that should ever be described as overrated. It is not true about the architect who was featured, and it is not true about clinical psychologists.

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1/29/2008

Is Dr. Phil actually a psychologist?

No, actually he is not. But he does play one on TV. Had he not recently "stepped in it," most professionals would probably just think of him as an entertainer who happens to have a professional degree. Despite the uproar, he probably didn't cause himself any legal problems by visiting that hospital or by making a public statement. But he may have crossed over a line when he went on the air and explained himself.

Dr. Phil never refers to himself as a psychologist. He certainly knows that to do so would bring him into conflict with California law. Unless you are working for the government or working in academia, you can't represent yourself as being a psychologist unless you hold a valid license. It's the same as with an attorney or a physician. You can't act like you are a physician unless you have a medical license. If you didn't pass the bar or you lost your license, you can't say that you are an attorney.

It's not just that you can't practice as a physician or as a lawyer, or that you are not supposed to use those titles. The law says that you are not supposed to tell people that you are trained or experienced in those fields, or that you are an expert. The same rule applies for professional psychologists.

Before he went on air and apologized (or didn't) for his involvement with Britney Spears, members of the professional community accepted Dr. Phil as an entertainer who toils in the field of pop-psychology. Indeed, the American Psychological Association invited him to speak at one of its annual conventions. No one minded what he does. Some admire his success. Some envy it.

But in the statement that he made explaining himself, Dr. Phil made some errors in judgment. After being criticized for his involvement with Britney and for publicizing his involvement, the spotlight was turned on Dr. Phil, and he didn't handle it well.

Dr. Phil's statement implied that he was actually qualified to provide Britney with treatment. In his words, "I made it clear that I, of course, would not be directly involved in any treatment should that come to pass, because it’s well known that I don’t practice psychology privately anymore ..." Before saying this, and referring to his work, he said "this is serious business." He basically said that the only reason he would not provide treatment is because he only practices on TV.

Dr. Phil followed this by saying, "I listen and then suggest or refer them to the right professionals in whom I have confidence — the people who have the time and the focus to really get involved across time and work with them." In other words, he said that he does in fact practice by evaluating people and making referrals, indicating that he doesn't provide treatment himself only because he doesn't have the time. He was suggesting that he is trained and experienced to provide treatment, if he wanted to.

Following from the above comments, Dr. Phil went on to "explain" why he didn't need a license. He said that he didn't need a license because the only reason you need one is to "hang out a shingle" for private practice and to accept fees from the public. That's just not correct, and it's also misleading. The licensing law also says that you you can't act like you're a psychologist.

And then, in a comment that stunned me, Dr. Phil said: "I do, however, still have 30 years of experience, (and) a hard-earned Ph.D in clinical psychology ... I am certainly eligible to be licensed in California so far as education, training and experience." Emphasizing his point, he included the imperative: "So you still have to call me Dr. Phil."

This statement is the very essence of what California law says that someone is not supposed to do unless they are actually a psychologist. It doesn't matter in the least bit if you don't take any fees and if you aren't in "private practice." You still can't go around acting like you have the credential. His statement about the law was entirely inaccurate. The fact that he does not accept any fees for his services gets him out from underneath any complaint that he practices psychology (on TV), but it does not absolve him for misrepresenting his professional status, or lack thereof.

So what's the big deal about whether he's licensed or not?

Two things.

First, getting a license is a way of proving that you know the laws and the regulations relating to the profession. It's like getting a driver's license. You have to prove that you know the rules of the road. Dr. Phil was real careful not to say that he actually was a psychologist, but if he knew the laws, he would have been a whole lot more careful. He would have been more careful about giving people the impression that he is a psychologist, saying that he has the training, experience and expertise.

Second, when you get a license, you are binding yourself to a specific set of ethical guidelines and standards of behavior. If you are not actually a member of the profession, you don't have to answer to anyone other than yourself. You don't have to consider anyone else's judgment. Had Dr. Phil been more cognizant of professional standards, he probably wouldn't have gotten himself into that mess down in Los Angeles in the first place. And I wouldn't have had to read that Oprah is angry with Phil while I stood in line at the grocery store.

So is Dr. Phil going to be disciplined?

You probably heard that someone filed a complaint with the California Board of Psychology (the BOP). We don't actually know that. What we know is that someone filled out a complaint form and leaked it to the media. The BOP would never actually release any information about whether or not they received a complaint, or were investigating one, before taking formal action. If someone actually did file a complaint, and if the investigation of the complaint warranted action, the Board could refer it to the Attorney General, or it could simply issue a warning letter. If the AG were to get the complaint, there could be a citation, and possibly a fine.

What's probably going to happen?

Here's my guess, and it's only a guess.

I don't think anything is going to come of his having visited Britney. There is too much confusion and ambiguity about the relationships that existed, and about the role that he played. I think it ends with his having said that if he had it to do over, he wouldn't do it again.

About his apparent violation of California's psychology licensing law - the fact that he represented himself as being trained, educated and qualified as a psychologist? My guess is that at best, the BOP might issue a warning letter. Psychologists and the BOP are in fact concerned on a daily basis with serious business. Dr. Phil is in the entertainment business and the field of pop-psychology.

The BOP's job is to protect the public and to protect consumers. If Dr. Phil gets out of line, the media and the market will take care of him. If need be, Oprah will slap him down. In misleading the public, Dr. Phil offended the profession. The BOP protects consumers, not the profession.

Did Dr. Phil really and intentionally mislead the public?

He did mislead the public by suggesting that he is a psychologist.

He also misled the public about why he doesn't have a license. His statement was: "I retired my license ... I don't need a license ... I’ve chosen instead to pursue another course and use of my education." It's true that for what he does on TV, he doesn't need to actually be a psychologist. But there is more to the story about his having "retired" his license. He was in fact disciplined by the Texas Board of Psychology in 1989, and it appears that he may have "retired" his license, rather than responding to their disciplinary requirements. We don't know for sure, but it may have been a little bit different than an ordinary retirement.

But rather than saying that he was dishonest, I think it is more accurate to suggest that he was trying to cleverly walk a fine line. If he were actually familiar with the law, I think he would have done a better job of walking that line.

Shouldn't he just do the right thing and get a license?

That's hard to say. We don't really know why he decided to leave the profession, and we don't know what hurdles he would face if he were to try to return. He has been in the public eye, and so there are controversies that surround him. To practice psychology on TV as he does, he doesn't actually need to be a psychologist, and as I said, the media and the public are available to hold him accountable. His style and his methods are a bit out of the mainstream, but I have never heard it said that he has done anyone harm (and we would quite certainly hear about that). He practices pop-psychology and entertainment, and people get to choose whether or not to watch.

Dr. Phil is not actually a psychologist, but he does play one on TV. That was never a problem. But then one day, he decided to walk off the stage and into someone's very real life. And that was a mistake.

As to how he should conduct himself, he summed it up by saying: "I have to own my own choices."

Update: Dr. Phil has gone on the Today show to explain again. Matt Laurer referred to him a number of times as a "psychologist." Dr. Phil didn't correct him.

My guess is that if I started a broadcast on the internet, and I called it "The Today Show," I would hear from some attorneys real quick.

California's own Dr. Marty Greenberg, former President of the BOP also appeared. His opinion: the hospital visit and the public statement about it isn't a matter that the law covers or will be concerned about. As I suggested, nothing will come of any complaint.

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1/23/2008

Why so long since I've written?

For the past year, I have been spending my time developing psyris.com, the Psychology Resource Information System. It's now online, and definitely worth a visit, especially if you are trying to find a therapist or you are a professional in the mental health community.

On the public side, psyris provides links to relevant information, and a custom search engine where you can find a therapist.

On the professional side, there are two primary services available, free.

Professionals can create their own personalized webpage at psyris ... it's as simple as filling out a form online. Your profile becomes part of the the psyris referral directory and is searchable on the web. You can change your profile at any time, and you can include your picture or logo.

The system also provides a free classified ad system. Posting an ad is as easy as sending an email:

psyris-jobs ... position openings

psyris-ce ... continuing education

psyris-ads ... books, groups, services, offices and everything else.

So visit today. And if you are a licensed professional, create your psyris page now.

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4/18/2007

Is existence too painful to endure?

The common understanding is that individuals who perpetrate explosive acts of violence are possessed by "over controlled hostility." It is in fact a useful and relevant explanation for many cases of unpredictable violence. But it is not a paradigm that is in any way adequate to understand the carnage at Virginia Tech on April 16th, 2007.

In a classic study of incarcerated murderers, psychologist Edwin Megargee showed that those who had killed multiple victims were more likely to have been less violent and aggressive in the past, when compared to murderers who had killed only once. The reasoning was simple: chronically aggressive individuals were in the habit of expressing their feelings and "letting off steam." Those who "bottled up" their feelings of anger and resentment were more likely to "explode."

It is not the characteristically aggressive individual who is most likely to commit catastrophic acts of rage. Instead, it is those who are emotionally rigid and inflexible, self-righteous and judgmental, and passive in a way that causes others to ignore or take advantage of them. Characteristically non-assertive, the over controlled hostility types often develop deep seated grudges and overwhelming resentments.

But is our knowledge of the over controlled hostility personality style of any use in understanding the traumatic events at Virginia Tech? Having interviewed hundreds of killers of all stripes, I would suggest that there is another, more primary dynamic underlying dramatic acts of violence.

For everyone, there are times when life is difficult or painful. For some, it can become unbearable. It is not uncommon for people to fantasize about changing everything and making everything in life different.

For some, this fantasy emerges in the form of an impulse to put a stop to everything that his happening in their life. The impulse is to destroy reality or to tear reality apart.

For someone who is sad and suffering, the impulse might simply involve a self-destructive act, like a suicide attempt or a suicide gesture. Another frequent method is to set one's house on fire. Even if the fire is quickly extinguished, the underlying motivation will have been satisfied. You are no longer in the house, you're now in jail.

There are others, however, who are not just depressed or distressed. They are deeply disturbed, and tormented by anger, hostility, rage and resentment. For these individuals, it is not enough to bring an end to their existence or the reality they face. Instead, they seek satisfaction by lashing out, destroying others, wreaking havoc and fulfilling their desire for revenge.

At times, most of us have thought something like "I wish I had told him off" or "I wish I could punch that guy." The thought is motivated by a desire to relieve frustration or achieve satisfaction. An explosive act of violence is, in a similar sense, a desire for fulfillment and satisfaction. But it is also an act that is hateful and selfish, and the ultimate expression of narcissistic self-indulgence. It is the ultimate act of significance in an otherwise insignificant life. In a sick and a perverse way, the unbearable pain of existence is relieved.

There are some who are troubled and in pain for whom we have sympathy. There are others for whom no sympathy is due and no empathy is available. Anger is an emotion that can relieve frustration. We understand anger when provocation is involved. A momentary lapse is typically excused.

At other times, we see that an individual has harbored their anger and nurtured their rage, using it as an excuse to offend and frighten others and to satisfy themselves through repeated acts of aggression. Rather than being troubled by violent fantasies, they indulge themselves with such reverie. In the end, we wonder if perhaps they have also nurtured their emotional pain, using it as something that will make them feel alive. Sometimes, this is why people cut themselves: to experience the rush of intense feelings.

Putting an end to the torment of a troubled and disturbed existence was quite probably a factor in the killer's motivation. But it was not likely the only motivation.

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Stressed out on campus?

As details about the Virginia Tech shooter emerge, we are learning that this was not a case in which someone was "stressed out," upset or having a bad day. It is not a case of someone who was "pushed" over the edge and "couldn't take it" anymore. Instead, what we are learning is that the killer was a deeply disturbed and chronically troubled individual whose emotional life was punctuated by morbid rage and twisted anger.

A disturbance of this intensity is absolutely not something that could just happen to any of us. But it does give us reason to pause and to think about the stress in our lives. It is a moment in time when we should all reflect on the pressures we face and how well we are doing in maintaining a sense of well-being.

Psychological stress is not one thing. It involves four factors.

First, it involves the way our bodies react to events and prepare to respond or take action. When your body is in a constant state of activation, without adequate time for rest and recovery, physical and psychological harm can result.

Stress is also defined in terms of the events we are reacting to. Sometimes it is a big life change event (like losing a job or failing a class). Stress can also develop from life's "daily hassles" - like finding a parking space or dropping your cell phone and finding it broken.

Although events matter, our perception of events is also critical. Maybe it was a good thing you lost that job you actually hated. Rather than a setback, it might be an opportunity. The failed class? Perhaps the failure taught you something you might never have otherwise realized. Stuck in the grocery line? A great chance to relax and read the tabloids. Can't find parking? Maybe that spared you from the first ten minutes of a dreadful lecture. What you view as a hardship might be perceived by another as a challenge to be faced. We thrive on challenges and we find events to be stressful depending on how we interpret them.

Finally, stress is mediated by the adaptive skills and the coping resources we bring to bear in any situation. One such skill is the ability to recognize when we need the help of others.

Given this formulation, there are four things you can do to combat stress:

1. Change the way your body is reacting. Get some exercise, eat right, get more sleep, and learn some relaxation techniques.

2. Change the events in your life. Do that assignment early, rather than at the last minute. Quit the job that is killing you. Take the parking space at the edge of campus, and then enjoy the walk.

3. Change your perceptions. Think about it again: was it a setback or an opportunity, a burden or a challenge, a loss or a relief? The bad thing is that your computer died. The good part is that you can now justify getting that new one.

4. Enhance your coping skills. In essence, that is what you are doing in school, learning how to perform new tasks and expanding your skill and knowledge base. You might also need to improve your social skills or your time management abilities, or perhaps your language or your writing skills. And you may need to learn when to ask for help. Talk to the professor if you are failing a class. If your work life is miserable, talk to the campus career counselor. And if you are feeling stressed or depressed or upset, go to the Campus Health Center and speak to a counselor. Therapy is a relief. You don't need to be ill or disturbed. Most therapy is short-term and for help with the ordinary problems of life and the ordinary difficulties of adjustment. Talking helps.

Is stress about to do you in? The answer to that question depends on your Sense of Coherence.

(This article was written for an electronic newsletter at Sacramento State University, at the request of the editor.)

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The Sense of Coherence

Optimal human performance - at home, in school, in the community or at work - requires that a person experience themselves as having a sense of coherence. This experience also determines how you will respond and whether you can cope with stress.

Beyond the specific stress factors that one might encounter in life, and beyond your perception and response to those events, what determines whether stress will cause you harm is whether or not the stress violates your sense of coherence.

The sense of coherence is comprised of three factors:

• a sense of comprehensibility:

Do you feel that you can understand things, that things make sense and are not confusing?

Do you feel that things are predictable or can be expected? In other words, do you feel like you know what’s going to happen next, or that you know what’s coming?

• a sense of manageability:

Do you feel that things are manageable or within your control, that things can be handled or taken care of?

Do you feel you have the skills or ability, the support, the help, or the resources necessary to take care of things?

• a sense of meaningfulness:

Do you feel that things are interesting or fascinating, a source of pleasure or satisfaction?

Do you feel that things are really worth it, that there is good reason or purpose to care about what happens?

The third factor is the most important. If you don’t understand what’s going on, but you know you can handle it, that’s not such a problem. If you understand things but can’t deal with them, at least you know where you stand and you’ll probably be able to get through it. If you don’t understand stuff and you don’t know what to do, you can still hold out hope that things will get better, as long as it is really worth it to hold on.

But when there is no pleasure or satisfaction to be found, when it doesn’t really seem worth it, and there is no good reason to care about what happens, that is when people are genuinely in trouble. That is when stress will do you in or do you harm.

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2/07/2007

Why did the astronaut crash to earth?

It is truly an astounding story. Astronaut Lisa Nowak stands accused of having traveled from Houston to Orlando to confront her rival, or perhaps to do more serious harm. Selected for having The Right Stuff, how could someone who had flown so high fall so far?

It is well known that astronauts are a select few. They are screened, evaluated and tested in every way, before they even begin to be trained and tested again. I happen to be connected to this process by less than six degrees. My clinical mentor was mentored by a UC Berkeley psychologist who was involved in selecting the original Mercury Seven.

Whether those screening processes are of value or not, it still seems inconceivable that someone with a record of such accomplishment could betray such human fallibility. It is of course made worse by the fact that the fall seems to have involved so much thought, planning and determination. This was no accident.

It will take time before we know the whole story. But this much is certain already: there will be no end to the speculation about how this could have happened. On one news show, an expert commentator said that perhaps it was the result of a "core psychosis" or an emergent "bipolar" disorder. Another commentator offered the opinion that she must have had a massive, underlying sense of insecurity. I also read that this behavior might have been the result of a "narcissistic" personality disorder, a condition that includes a heightened sensitivity to rejection or abandonment. Without specifically seeking to explain Ms. Nowak's behavior, a well-known psychiatrist from Los Angeles said that similar behavior is often the result of a delusional disorder (a form of psychosis) or the result of schizophrenia.

As a clinician, I find most of this speculation to be silly. Each explanation requires us to believe that despite her history of performance and achievement, there must have been something fundamentally wrong with her. The assumption is that her adaptive strengths and capabilities were more apparent than real, or that they were just an illusion. They assume that she was disturbed in some way that no one ever noticed.

What I would suggest instead is that the words of famed psychoanalyst Harry Stack Sullivan apply: in the end, she was "more uniquely human than otherwise." My guess is that in the end, we will learn that she was an ordinary and healthy individual.

However naturally skilled or talented one might be (and no matter how well-adjusted), to face the type of challenges necessary to be chosen for a mission as demanding as space flight, one would have to have a finely tuned sense of self-esteem. In a 2004 Psychological Bulletin article titled "The Costly Pursuit of Self-Esteem," University of Michigan professors Jennifer Crocker and Lora E. Park wrote:

"Success at this pursuit leads to positive emotions, reduced anxiety, and a sense of safety and control over events and can be highly motivating. On the other hand, failure at the pursuit of self-esteem can lead to feelings of worthlessness, shame, sadness, and anger, leaving people feeling vulnerable to mortality or social rejection or feeling unable to cope with life events."

But how could this lead to such seemingly irrational behavior? In October 2006, the Journal of Personality and Social Psychology published an article by Northeastern University professors David DeSteno et al: "Jealousy and the Threatened Self: Getting to the Heart of the Green-Eyed Monster." In a series of actual experiments, they:

" demonstrated that threatened self-esteem functions as the principal mediator of jealousy ... and provided direct evidence for jealousy as a cause of aggression."

This recent work fits well with established theory and common observation. Unique about their work is that they actually created a situation involving rivalry and threatened self-esteem, and they provided an opportunity for aggression to be displayed. Their finding was that

"jealousy represents a specific emotional response to a specific form of social rejection: the actual or looming rejection by a partner in favor of a rival ... (and it) mediates actual aggression aimed at partners and rivals."

In the end, I expect that rather than learning that she was disturbed or disordered, we will learn that she was quite simply human, and that the loss of love - or the failure at love - was a blow to her self-esteem that left her vulnerable and unable to cope with life events.

I expect that we will also be hearing more about stressful events in Ms. Nowak's life. Buzz Aldrin is known to have had difficulties adjusting to ordinary living after having walked on the moon. Ms. Nowak trained with those who died in the 2003 space shuttle Columbia explosion. There will be discussion about the time she had to spend isolated from her family and about how one adjusts after returning from a pinnacle.

It could very well be the case that NASA did not miss anything at all in its decision to send Ms. Nowak into space. Although generally not newsworthy, incidents involving similar dynamics happen all the time, and are in fact an everyday occurrence. Until we hear otherwise, there is no need to search the diagnostic manuals to find an explanation.

In my view, what this incident shows is that no one is immune to either the foibles or failings of human nature. What it shows is the power of human emotion and the capacity for passion to overwhelm reason.

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1/18/2007

Why do kidnap victims sometimes fail to escape, even when they have the chance to run?

With the news from Missouri about the rescue of kidnap victim Shawn Hornbeck, the Steven Staynor, Patty Hearst, and Elizabeth Smart cases immediately come to mind. Why didn’t they run or cry out for help? It seems beyond reason. They all had ample opportunity.

A former FBI profiler appearing on the Today show said that Hornbeck was probably threatened and that he was afraid for both himself and his family. Could it possibly be that simple?

In 1973, a Swedish gunman held four bank employees hostage for almost six days. When released, the hostages expressed sympathy for their captor and defended his actions. It was certainly not the first time that this strange phenomenon was observed, but it did give rise to the term “Stockholm Syndrome,” an adaptive response that has been described in FBI bulletins and in the psychological literature. The victims bonded with their captor, identifying with him and attaching themselves emotionally.

The process involves a psychological defense mechanism that was first identified by Anna Freud, Sigmund’s daughter and a scholar in her own right. In a 1936 publication, Freud coined the term “identification with the aggressor.” Ordinarily, it is a normal and healthy process for people to identify with others, such as parents, and to establish loyalty and to take on their traits and their values. But at times, it becomes a perverted form of learning that is necessary for self protection. The need to defend oneself can involve a response to both psychic and physical threats.

This psychological response has been described in various ways, but it is perhaps easiest to understand in terms of our need for cognitive consistency and our drive to avoid anxiety and distress. A kidnap victim will obviously be terrified. But their life depends on the good will of their captor and their ability meet that person’s demands. A conflict will exist between the need to please and the loathing that is experienced. Psychologically, it is enormously difficult to entertain both thoughts or both motivations.

In the same way that a river will naturally change course when there is a break in a levee, the mind will resolve the conflict in the only way possible: changing one’s feelings about the aggressor. Adopting a positive attitude towards the one on whom your life now depends will serve to relieve the fear and distress, as well as insuring survival. The perpetrator becomes an ally, rather than an enemy. The relief from fear serves as a powerful reinforcement for the change in attitude, making that cognitive adjustment a real personal transformation, rather than just a contrived presentation.

This basic mechanism serves partly as an explanation for the fact that abused children often identify with their tormentors and grow up to be violent spouses and parents. It is also a component in the tendency of battered spouses to remain in abusive relationships, sometimes even defending the “partner” who tortures them.

After Patty Hearst was rescued, some commentators dismissed the possibility that she had been “brainwashed,” arguing that the clumsy band of criminals who seized her could not have possessed any of the sophistication necessary to accomplish such a feat. Correctly understood, the process requires no talent, training or intellect at all. All that is really required is a twisted mind, violent behavior and a threatening disposition, and the ability to isolate the victim from reality.

In these cases, the destruction of the victim’s will is facilitated by the nature of the threats. In addition to being told that they or their families will be killed, what they hear is that the authorities seeking their release are a threat because a rescue will involve violence. They also hear that they have been abandoned by those they love. Both threats become plausible to the victim. The victim will notice that in fact they have not been rescued by their loved ones, and they know that if the police come, they will come with guns drawn.

Over time, when the initial fears have subsided, the surreal essence of their captivity will come to seem normal. The cage will become familiar. It will feel safe and even ordinary, a space that needs to be protected. The point is that over time, one cannot survive emotionally without adjusting and adapting to the reality of captivity, or without accepting the reality imposed by the psychopath in control.

Is this a conscious process of accommodation? Quite certainly not. Could you or any other ordinary person fall victim in the same way? That is hard to know. It would depend on the circumstances, but the answer is most probably yes. What is certain is that it is hard to for us to comprehend how this can happen, because we all believe it could not happen to us, that we would not react in a similar manner.

The latter issue - our difficulty in understanding or accepting how this might happen - is a topic that is itself of psychological interest. It is related to the frequent observation that in the face of tragedy or disaster, observers often tend to “blame the victim” or to focus on how the victim might have contributed to their own suffering. Again, the motivation involves the drive for cognitive consistency. Albert Camus made this point in his novel The Plague. What his characters reveal is that people have a hard time accepting the fact that bad things can happen to good people, and therefore, people will often alter their perceptions of a victim, assuming that they must somehow be at fault. This cognitive distortion provides a sense of relief or relief from fear: “I’m a good person, so it couldn’t happen to me ... I am safe from such harm because I would never have put myself in that position ... if faced with similar circumstances, I would have acted differently.”

In fact, we don’t really know if we might have behaved differently, but we find relief in the belief. That is what makes it so difficult to understand why Patty Hearst, Steven Staynor, Elizabeth Smart and now Shawn Hornbeck didn’t run. It is similarly difficult to understand why some people remain in abusive relationships. From a psychological perspective, it is actually quite easy to understand how they were controlled, even when they were not under direct control. They were each in a cage with bars that were stronger than steel.

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11/30/2006

Does Therapy Work?

Yes. Countless studies have shown that psychotherapeutic treatment works. The effects have been measured in terms of improved social functioning, relief from anxiety, reductions in depression, and in just about every other way that improvement and effectiveness can be defined.

According to the U.S. Surgeon General: "Mental disorders are treatable ... the evidence for treatment being effective is overwhelming ... the inescapable point is that studies demonstrate conclusively that treatment is effective."

Consumer Reports magazine concluded similarly. In their extensive study, which relied largely on self-reports from patients, 9 out of 10 Americans reported positive benefits. Consumer Reports gave psychological health care a solid endorsement, and noted that treatment by more highly qualified therapists - such as psychologists - was more likely to produce benefits.

But perhaps the best way to measure the outcome is to look at the cost. Dating back some thirty years to a study of 10,000 Kaiser patients, it has been repeatedly demonstrated that psychotherapy is cost effective. Patients who receive treatment reduce their health care utilization to a degree sufficient to entirely "offset" the cost of therapy. Treated patients tend to be healthier and they use less medical care of all types. They spend less days in the hospital when they need care and they visit their physicians less frequently. The reason is that a substantial number of physician visits are essentially motivated by emotional or stress-related problems.

In a series of studies on health insurance, the Rand Corporation found that in any given year, about 10% of the population will suffer from a diagnosable psychological difficulty. One fifth of those people will seek psychotherapeutic care. One fifth will not receive any treatment. And the remaining 60% will visit a physician. But rather than complaining about stress, anxiety or depression, they will complain about pain, sleep problems, stomach distress, problems eating, fatigue, headaches, and so on. They will complain about problems that are known to be directly related to stress.

Business and industry is well-aware of this phenomenon, and that is why Employee Assistance Plans have become standard features in employee benefit packages. Employers know that stress contributes significantly to accidents at work, reduced productivity, over-use of sick time, absenteeism, and increased medical costs. Employers know that therapeutic services are good for the bottom line. OSHA - the occupational safety and health care administration - has identified stress as one of the top ten workplace safety threats, and one of the most costly if left untreated.

Psychologists have demonstrated that providing access to mental health treatment is one of the very best ways that America can reduce health care costs. This has been known for thirty years in the research literature. Unfortunately, it too often remains unknown to the managed care industry.

Yes. Therapy works.

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11/26/2006

Why do kids commit murder?

This article appeared in the print edition of the Sacramento Bee on 11-26-2006 as part of a series of articles on this topic.

For all of the theory and speculation about why kids commit murder, the answers do not differ greatly from what we have learned about adults who kill. With few exceptions, adolescents are just as capable of knowing that what they did was wrong.

As with adults, some adolescents kill because they are chronically aggressive, cold and unfeeling. Some will kill because they "explode" in response to a history of "over-controlled hostility." Some will lash out after wallowing in feelings of victimization and after nurturing longstanding resentments. Others kill because they have been traumatized and are unable to tolerate their existence. Some who are immature and narcissistic become “obsessed.” Deprived of love or gratification, they feel justified while escalating to violence. Less common, but often more dramatic are the killings committed by the psychotic, those with disturbed and disordered thoughts and only a tenuous grasp on reality.

During the course of my career as a forensic psychologist, including the time that I worked at the California Youth Authority, I have conducted several hundred evaluations of adolescents who have committed homicide or attempted homicide. Today, the district attorney can take most juveniles charged with homicide directly to adult court. Before the law changed about five years ago, adolescents routinely underwent extensive psychological examination before a judge would decide whether to try them as an adult or as a juvenile. An additional evaluation was required before an adolescent convicted as an adult could be sentenced to an adult prison.

A psychological interview provides unique insights into the mental, emotional and motivational dynamics of the offender. Typically, it is the only time that the full story is told in rich detail, from the offender’s perspective, and with their feelings, beliefs and perceptions exposed. At no other point in the criminal justice system will the offender ever describe what they were thinking and how they viewed reality when they pulled the trigger or struck the fatal blow. Their story is rarely shared with the prosecution or the court, and may not be revealed to their own attorney. Often times, in a psychological interview, what the offender says is not sufficient to explain the motivation for their actions. In other cases, offenders will say enough for us to know whether the case should be described as an example of tragedy or an example of evil.

Although similar in these ways to adult offenders, there remain unique features of adolescent violence.

We know that the young tend to engage in more high-risk behaviors of all types. The research suggests that a familiar stereotype about kids is probably not true. Studies show that teenagers do not actually tend to view themselves as invulnerable or invincible, any more so than adults. Instead, kids are more likely to behave as if they are invincible because of immaturity, impulsivity and bad judgment. Lacking experience and being less mindful of obligations, responsibilities and consequences, they can display an indifference to risk and a sense of fearlessness that facilitates dangerous behavior.

Values, attitudes and beliefs also contribute to violence. Many juveniles have learned or come to believe that aggression is a legitimate method for resolving various interpersonal problems and conflicts encountered in life. When provoked, they fight back or attack, never thinking that a simple act of battery might have a deadly outcome.

Over the years, I have watched as the concept of “respect” has evolved in the youth culture. It is heard in the words of kids who say, “I respect them if they respect me” and those who explain their outbursts by saying, “He didn’t give me my respect.” I have come to view this as a particularly virulent and dangerous attitude, the idea that “respect” is a possession, an entitlement or a conditional offering. Sometimes teenagers kill while defending a sense of honor that they never earned or deserved.

The defense of honor frequently interacts with group dynamics. For a variety of reasons, adolescents tend to roam in groups, often displaying the attitudes and trappings of gang culture, even if they are not actually organized, sophisticated and with criminal purpose. In a group, even loosely formed, individuals may engage in extreme behaviors that they might never have undertaken on their own. The phenomenon results from a “diffusion of responsibility.” In a crowd, individuals often abandon restraint and give vent to impulses because no one feels individually responsible. Violence in defense of the honor of the group is a common theme.

There is a final element that can turn a simple confrontation into a deadly encounter. That is the possession of a weapon. I have heard it said time and again: The knife or gun was just for protection. It is rare that I have heard a juvenile admit that the gun made them feel powerful, but it is often clear that the weapon was carried for its emotional value, rather than for its use as a tool. And then, in response to some situation, the impulse and bad judgment come into play and the weapon is used.

Patterns notwithstanding, what I have found is that every case is different. A psychologist’s purpose is to explain, not to judge. In responding to the threat of violence, the worst thing that we can do as a society is to fail to understand exactly what happened in any particular case. Sometimes we ignore facts out of fear that an explanation will be offered as an excuse. If we rely upon our preconceived notions about the causes of violence, rather than listening to what a particular individual was thinking and feeling at that particular moment, we will fail to learn what is most important: How do we as a society protect ourselves from violence?

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11/16/2006

Can loneliness affect your health?

The answer is quite certainly yes. And the research causes us think about what it really means to be lonely.

In a 2005 article in the journal Health Psychology (Vol. 24, No.3), Carnegie Mellon Univserity professor Sarah D. Pressman (and colleagues) described the effects of both "loneliness" and "social network size" on immune responses to influenza vaccinations, focusing on the reactions of a group of college freshmen. The "competence" of your body's immune system can be measured in terms of how well it reacts to a vaccination. The quality of that reaction can then be compared to other social and psychological factors.

What Pressman et al found is that social, emotional and psychological factors do in fact make a difference in how well an individual's body reacts to viral threats. While that is of interest by itself, it is not an entirely new finding. What is more generally of interest in this article is the general discussion of loneliness, social isolation and health.

Reviewing the literature, Pressman's research team noted that loneliness and social isolation have both been found to be associated with a variety of negative health effects. They went on to note that loneliness and social isolation are not at all the same thing. Loneliness is a feeling or a perception. Sometimes, people will "feel" lonely, even though they have a lot of friends and enjoy a lot of social interaction. Sometimes people who tend to isolate themselves will not feel lonely at all.

In this type of research, the real question is "how does this happen?" How could feeling lonely or being isolated actually affect your body's immune response or other health related measures?

What Pressman's team found is that feeling lonely is more significant than actually being isolated. The feeling of loneliness is a more consistent predictor of disturbed sleep, depression and psychological distress. The general measure of psychological "stress" or distress was the factor most highly related to compromised immune function. Loneliness and isolation were both related to negative health effects, but it seems that feeling lonely is worse than being isolated. For those who felt lonely, it could be seen that stress factors affected their health and that the effects were more serious. The negative health effects associated with actually being alone were not as significant, but it was not actually clear as to why isolation makes a difference. It wasn't because those who were alone were distressed or upset.

In other words, those who felt lonely were more distressed, and their stress or distress could be linked to the negative health effects. That's how it happens. The negative health effects of being alone were not caused by or related to stress. Maybe those in isolation don't take care of themselves as well, or maybe they have more bad health habits. That is not clear from this study.

What we learn from this study is that emotional, psychological and social factors can indeed affect one's health. This is well known. We also learn that how this happens is not a simple equation. The study confirms that "stress," generally defined, is an important factor in wellness and well-being. The study also supports the idea that how you feel about things, and how you perceive and interpret events is probably more important than the events and experiences themselves.

You don't have any friends? Well, that's not good, but it's not as bad as feeling like you don't have any friends, and it's not as bad a being upset because you feel like you have no friends.

The underlying message here is that emotional and psychological well-being are critical and essential health factors. Everyday, you need to make certain that you get enough fiber in your diet. In the same way, it is critically important that you obtain enough joy and that you derive enough pleasure, meaning and satisfaction from life.

Loneliness causes stress. Stress will kill you. Social isolation is not good. Isolation is not as harmful as feeling lonely, but it is still not a place you want to go.

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11/09/2006

Does the handshake matter?

It's not just just common sense. The research shows that the handshake matters. It does in fact contribute to "first impressions." It is not an entirely bogus way for people to judge you: your handshake actually reflects certain personality characteristics. And the research shows that when it comes to self-promotion, handshake etiquette may be more important for women than for men.

Everyone knows, from personal experience, that we make judgments about people based on how they shake hands. It's one thing to say "Hi" or "good morning" to someone you pass on the street. It is something entirely different to engage someone at the level of touching hands and making physical contact. Sometimes it might mean nothing at all, like at a gathering where you are introduced to one person after the next. If you are a politician, you might shake hundreds of hands in the course of just a few minutes, simply because people want to connect to you. But there are other times when this ritual of personal engagement is a prelude to more important business that will follow. It could be at the start of a contest or negotiation, or in advance of an important interview, or upon meeting the parents or the family. Handshakes are an important introductory ritual in all manner of social contacts, and the research shows that the quality of the handshake makes a real difference.

There have been a number of studies that explore the dynamics of handshaking, but the one that stands out is an article by University of Alabama psychologists William F. Chaplin et al published in 2000 in the Journal of Personality and Social Psychology. What is unique about their study is that rather than gathering subjective data, they made an effort to provide objective measurements of the variables of interest. Their method itself is of interest.

The subjects in the study were introduced to four different "handshake judges" in a way that made it seem natural that they would be greeted with a handshake. Following the introduction, the subjects completed a set of personality tests, providing an independent measure of whether or not their handshakes reflected any actual personality differences.

Before being sent out to evaluate handshakes, the judges trained and practiced for a month, until they could reliably distinguish eight different handshake characteristics: completeness of grip, temperature, dryness, strength, duration, vigor, texture, and eye contact. In normal situations, it may not be the case that anyone actually judges you on all of these factors, but it is worth noting that these variables might all be in play when you do shake someone's hand. In addition to evaluating the characteristics of each handshake, the judges were asked their impressions about the personality characteristics dispslayed by each participant.

Although the judges rated the subjects on a full set of personality traits, it turned out that the handshake did not actually allow them to draw clear distinctions on particular traits. The judges did form consistent opinions of those whose hands they shook, but the judgments were global, rather than specific. They could reliably agree only on whether the handshake conveyed a "good impression" or a "poor impression."

It also turned out that the individual handshake characterstics (i.e., vigor, duration, eye-contact, etc.) were all highly correlated. In other words, people are not usually judged on these factors individually, and instead, the differences tend to collapse into one global factor which is best described as a "firm handshake."

After a month of training in how to judge a handshake, the judges were able to reliably identify those who had a firm handshake and to reliably distinguish those whose handshake provided for either a "good" or a "poor" impression.

As to how "firm handshake" corresponded to the measured personality factors, what they found is that it does correlate with factors such as "openness to new experience" and extraversion. Those who did not have a "firm handshake" were found to score higher on measures of "neuroticism" (which means that they tend to be more prone to anxiety) and to display more "shyness." In other words, from your handshake, people can learn whether or not you are shy and anxious, and whether you are "open" and outgoing.

The key points here may seem obvious, but it is worth repeating: people do in fact form impressions based on the quality of your handshake, and those impressions do reflect certain elements of your personality.

As to how this relates to "first impressions," the authors' next finding is particularly interesting. Women with a firm handshake were viewed as more "open," and made a more favorable impression. It is sometimes thought that when women present themselves as outgoing and confident, others will judge them negatively, believing that they are "pushy" or aggressive. What this research shows is that at least when it comes to the handshake, women benefit from appearing strong and are not penalized for appearing confident. For men, the effect was not as strong. In other words, a woman benefits more from having a firm handshake than does a man. For both genders, a weak handshake tends to generate less favorable impressions.

What this means is that everyone, both men and women, should pay attention to how they go about shaking hands. People are judging you and assessing your personality and character based on this moment of touch. For women, having a firm handshake is probably more important than for men.

The other point to be drawn from this study is that while your handshake is to some extent a genuine reflection of your actual personality, it can still be a practiced and developed skill. Think of the judges who spent a month learning how to receive a handshake and then realize that you can perfect and improve your own method before that important meeting.

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11/03/2006

Compulsive shopping: If the psychiatrists put it in the diagnostic manual, does that make it an illness?

A recent article in the American Journal of Psychiatry (October 2006) describes "compulsive buying" as a relatively common affliction. An editorial in the same journal argues that the condition should be recognized as a "mental disorder" and included in the next edition of the official diagnostic manual. Is this another example of psychiatry's quest to describe every human failing and foible as an illness?

The study, conducted by Stanford University medical professor Lorrin M. Koran (et al), was an effort to estimate the prevalence of this problem. They conducted a telephone survey, asking people about a series of behaviors that are associated with compulsive buying.

What they found is interesting: 5 or 6 percent of the people in the population fit the profile of compulsive buyers. They spend beyond their means for things they don't need, can't afford or really won't use, and they abuse credit and create financial difficulties for themselves. And it is a behavior these people find to be troubling. The prevalence is 1 out of 20 people, and that can be considered a very large number.

The other important thing they found is that it is not just women. Previous estimates have focused on the fact that women are more likely to admit that shopping is a problem. In other words, women are more likely to seek help. The previous estimate was that 80 or 90 percent of compulsive shoppers were women, and that estimate turned out to be completely wrong. What Dr. Koran and his colleagues found is that the numbers are equal. Whether or not the stereotype is true, it can be said that in the electronics department or at the hardware store, men are behaving exactly the same way as women in the shoe department or at the department store. (And there we have another stereotype.)

So is it an illness just because it has a high prevalence and is equally distributed, irrespective of gender?

Actually, there is another factor involved. It is a behavior that causes distress and is associated with both anxiety and depression. It can either result from or result in emotional disturbance.

But still, does that make it an illness or a "diagnosable mental disorder?"

For now, I am not going to try to explain the dynamics of compulsions or the complex nature of addictions. What I want to focus on is what it means when a condition is described as a disorder in psychiatry's official diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders: the "DSM" or "bible" of disorders.

To be included in the DSM, a pattern or a syndrome, a condition or an ailment, a disorder or a disease does not have to actually be something that we would all generally recognize as a "mental illness."

To be included in the DSM, what is required is that a typical pattern of feeling, thinking and behaving is common enough for us to recognize it when we see it. Conditions can be recognized as something to which attention should be paid or towards which treatment should be directed. Conditions are listed in the DSM so that clinicians can say: "this is what I saw, what I saw is an example of ..." What the DSM provides is a systematic way for clinicians to describe their observations.

In my yard, there are trees that look like bushes and bushes that look like trees. For individuals who are suffering, the DSM tells us how to distinguish between the two.

If "compulsive buying" should in fact become a formal diagnostic label, it doesn't mean that anyone has concluded that it is the result of an illness or a disease process. It doesn't mean that anyone will be less responsible before the law. It does not mean that this is an excuse, even though it might perhaps help to provide an explanation.

The fact that psychiatrists have said that this is a pattern of behavior that we should pay attention to does not mean anything more than that this is a pattern of behavior towards which we should direct attention.

If the pattern proves to be stable and consistent enough to make it into the diagnostic manual, it doesn't mean it's an "illness."

All it means is that it is common, that it's a problem, that we can recognize it, that there are typical features, that we should study it, that it disrupts people's lives, that we should help them, and that there is common agreement about what we are looking at.

With that having been said, I'm off to the mall to buy that 42 inch HDTV monitor I've had my eye on ... I know I can't afford it, but I can put it on my visa card.

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