Might I Just Add...

You would not believe the trouble I went through AGAIN trying to actually post my response. Error messages like you wouldn't believe. You would think I would get the hang of it...

My Soccer Coach, My New Wisdom and My Best Friend

In last week’s discussion of the assigned readings, my reckless use of puns blatantly violated perhaps the most cautionary principle of writing ever conveyed to me by my high school English teacher (and soccer coach and friend): “clichés are lame.” Further, my frequent reference to Guns n’ Roses lyrics harshly disproved another of his most prominent assertions: “the musical genius that is Jimmy Buffett will never be surpassed (cue Steven Adler: ba dum bum).” This week, I hope to actually embrace Mr. Desautels' most profound literary suggestion to: “write what you know.” And what is it that I know, you ask? Well, after reading this week’s articles, I think I know a little bit about: 1) the prescription privileges debate, 2) the community’s response/reaction to “unpopular”/controversial finding, 3) Hippocratic vs. “hypocritical” science, research and practice, 4) decision-making, and 5) Rorschach inkblot tests. But what is it that I know better than anything else that might help me portray my new found knowledge? Dream chickens? No, been there. Bud Light? Nah, done that. Christian Louboutin shoes? I wish. I've got it...TV. TV became my friend for some time following an accident that kept me out of work...actually, [watching] TV was my best friend for a week or two since the accident made it difficult to do much else. Long story short, we got to know each other well. So well that I feel only too comfortable describing and discussing the nature, content and/or implications of each above-mentioned article as it relates to TV. News programs, sitcoms, reality shows, talk shows, and/or infomercials, daytime, primetime, late night, whatever. I know I know them all. Here we go.

1) Sechrest and Coan: “So You Think You Can Dance?” and “Dancing With The Stars”

In their report entitled “Preparing Psychologists to Prescribe,” Sechrest and Coan describe the curricula and training requirements implemented by current “prescribing-privileged” professions/fields, and explores not only the feasibility of implementing similar programs in the field of psychology, but evaluates the potential implications associated with granting such authorization. The first parallel is drawn between this article and the reality show “So You Think You Can Dance.” As the American Idol of dance, this show follows thousands of young hopefuls as they pursue their goals of becoming professional dancers. In this case, if dancing = prescribing, the winners of the competition = prescribing professionals. Further application of this analogy as it applies specifically to psychologists and prescribing privileges may be seen in the celebrity version of this show—“Dancing With The Stars”—in which celebrities are paired with professional dancers, and for any/all of the following reasons, learn to (try to) compete in dance: 1) they are hoping for their 16^th minute of fame (knowing, however, that it may be found in success or failure); 2) they want to shed that unwanted post-pregnancy baby weight; 3) they are looking for love (…and may ultimately find it and/or heartbreak); 4) they are preparing for a role in a show about a show about a show about dancing; 5) they feel the need to prove once and for all that AC Slater is, and will always be way cooler than Zack Morris; 6) they want to make the world a better place.

Some things to consider: 1) contestants on both shows are evaluated on their: dedication, interest, basic dance foundation, advanced skills, potential to rehearse/ability to perform various styles of dance, etc.; 2) contestants on both shows are judged by a panel; 3) celebrity contestants on “Dancing With The Stars” are paired with professional dancers; 4) what is the motivation? And 5) what are the potential outcomes, opportunities, implications, (ie. immediate vs. long-term, benefits vs. risks, individual/personal vs. professional, etc.)?

With respect to the abovementioned TV programs, the number (and prestige) of the contestants speaks to the fact that there are people out there who want to dance, and the nature of the competition suggests that there are even some (celebrities and otherwise) who can dance. However, determining if, how, when, where, whom and with whom celebrities should dance is quite a bit more complicated. Further, how, when, and by whom are these decisions reached? By the panel of judges or by audience member votes? By the subsequent success of the contestants or by the success of the show? Further, how is “success” of the show and/or the contestant measured/quantified? According to Sechrest and Coan, it will be crucial to consider similar questions and several additional concerns when evaluating the prescribing privileges for psychologists.

For the sake of space, each of the other articles and its respective TV show correlate will be discussed in subsequent posts.

November Rain

If any pair of readings (Moffitt and Linehan) was to inspire a response consisting purely of puns, clichés, proverbs, and/or Guns N Roses lyrics, I would have to say, this is it.

To add insult to injury: In the words of GNR, “welcome to the jungle, it gets worse here every day.” Such righteous lyrics relate to both authors’ contentions that biological, genetic, environmental, interpersonal, emotional, cognitive etc. vulnerabilities intensify the effects of each other, thus contributing to a vicious cycle or individual/environmental interactions that only exacerbate and reinforce the emotions and behaviors associated with borderline personality disorder (BPD) and antisocial behvior (AB).

To expand a bit (in a slightly different direction), certain characteristics of both BPD and AB reveal this sort of “snowball” effect, action/reaction/action thing. The interesting thing in both BPD and AD is that the traits (personality and otherwise) are implicated not only in shaping the action, but in shaping the reaction, as well as influencing the way certain action/reaction combos are perceived, maintained and reinforced. For the individual with BPD, she tends to be highly sensitive to the point that it may seem self-centered. Such traits can influence the way she interacts with others, which can then contribute to increased self-focus, misery, etc. In BA, “difficult temperament” is often accompanied by several, profound disadvantages that limit opportunities and exposure, ultimately influencing the capacity to change. In both cases, the traits that are commonly identified as problematic, are those that complicate interpersonal interactions, and ultimately outcomes.

The squeaky wheel gets the oil: But is it enough to prevent the rust? Perhaps one of the most interesting parallels that emerged through these readings was the notion that individuals with BPD and BA demonstrate qualities/traits/behaviors that are not so subtle that they are unproblematic and/or go unnoticed, nor are they so severe that they are easily and immediately recognized, demanding dramatic intervention and/or accommodations early on so as to minimize the negative consequences. However, they are both recognized as pathologies, the causes and manifestations of which cannot easily be explained or treated, respectively. Awareness and access to resources also deserve discussion.

The apple doesn’t fall from the tree: Much attention is devoted to the potential influence of parent behaviors, traits, states on life-course—biological/genetic, environmental, learning, etc.—but not in the adolescence-limited group, where the emphasis seems to be more conscious, socially motivated, individually motivated, adaptive. Such findings provide some insight regarding the tendency to attribute certain characteristics, but not others to biological, environmental, individual, group effects. Is this a simple case of nature vs. nurture? I think not.

Birds of a feather flock together: This little saying supports Moffitt’s theory that mimicry and interaction with delinquent peers plays a role in adolescence-limited AB. It may also provide insight regarding the dispute over whether AB abstinence or AB conduct constitute pathology. Further, it may also apply to the finding that individuals with BPD find themselves in stressful, difficult relationships with individuals who may exhibit similar destructive behaviors.

Back in the good old days. Times have changed, societal values have changed, laws have changed. Moffitt reports on the relationship between age and the prevalence of crime in English men at different times (ie. 1938, 1961, and 1983) and attributes such trends to modernization as it relates to the widening maturity gap, motivation to demonstrate independence, etc. However, little attention is given to the underlying social and evolutionary mechanisms linking law (ie. what constitutes a crime), technology and success. According to some, rules and laws are implemented to protect us from imminent and/or anticipated harm. For a human in the olden days, the laws that governed us we those that ensured our survival. That meant a couple of things: 1) if you see a bear, run; 2) if you see a stick, use it to fight off the bear…or to fish some bugs out of a hole for a little snack; 3) if you see another human, whom you find a) attractive, share your bugs with him/her and protect him/her from the bear so that you may mate; or b) unattractive, use your stick to point him/her out to the bear, increasing your chances for survival, among other things. You see, the bear=harm or threat; the stick=technology; and success=dinner and a date. The evolution of certain technologies and social norms, however, has dramatically changed our definitions/perceptions of danger, ability and success. Ok, maybe not the best example, but hopefully it communicates the notion that specific outcomes are (or are perceived to be) unfavorable and perhaps detrimental to our physical, social, emotional selves…

And, while several of these rules and norms are implemented to protect our children…one might ask, from whom? Themselves? It can be suggested, however, that imposing such restrictions interferes and interacts with the processes of development such that these rules and laws may in fact be harming them, restricting them, preventing them from spreading their wings, learning to fly. The implications/consequences of such restriction can be explained from biological, social, learning, developmental, environmental, standpoints.

People in glass houses shouldn’t pick their noses. Just kidding. But while this “rule” may seem applicable to adults, there is some flexibility in the stringent application of some rules (but certainly not others) as they relate to children. Why is it that we cut kids a lot of slack in some respects? Because they are cute? Because they don’t know any better? Because they are a reflection of us? Because they are our future? Because they can (cannot) be helped? Because we feel sorry for them? Because it isn’t their fault? While these questions may seem horribly insensitive, or entirely too sensitive, or something, I pose them because I think they reveal something about the stigma and difficulty (assessing, predicting, preventing, treating, etc.) associated with these and other pathologies.

Age before beauty or over the hill? It can be suggested that the processes of aging may partially explain the observation that following the “peak” of AB in adolescence, the frequency (and perhaps, the extremity) of such behavior declines with age. In addition to the developmental, psychological and social changes associated with puberty, it can be suggested that physical fitness, physiological motivation and dispensable time/energy also peak. Thus, from a purely physical standpoint, adolescence represents the time in a man’s life in which his capacity to engage in physically demanding tasks/activities is greatest. Conversely, physical, cognitive and self-sufficiency/responsibility-related limitations in early childhood and older age may obstruct the expression of SA tendencies. For example, whereas during childhood, individuals may be lacking physical strength, among other strategic and material resources required to say, steal a car, a middle-aged man may simply be lacking the physical and cognitive energy to execute such a task.

Guitar solo, whistle, whistle; [thank you so much for your] patience, yaaaaaay, patience.

Glo, By J-Lo; Stuff, By Duff; Living Lohan, With Dina?

I cannot believe it is already almost 10 o’clock on Tuesday night. Though my post is late (once again), I am not yet ready to surrender my coveted position as a JAM JR member. In fact, I think it would just be plain irresponsible to even consider pulling out the only vowel and replacing it with say a B, or an M. Now, if anyone has a friend named, say, Irene or Isaac, by all means. Then, it could be JIM JR…

Anyway, I think that both Barlow and Mineka would be thrilled to know that JAM JR, or JBM JR, or JIM JR is on the case…the case of the elusive origin, etiology, nature of anxiety and related disorders, that is. And what a tricky case it is. Both Barlow and Mineka provide interesting theoretical perspectives regarding anxiety, a common and costly phenomenon. While Mineka’s contemporary learning stance is fascinating and consistent with previous JAM JR readings and discussions, I cannot help but embrace Barlow’s “triple threat” approach. As you all know, the opportunity to discuss psychological theories in the context of anything media or celebrity-related is just one on which I cannot pass. While the Crime Scene Investigation (CSI) approach may be the predictable one, the Lindsay Lohan, Hillary Duff, J-Lo parallel just seem so much more fitting. So, what do these three ladies have in common? Yes, they all wear velour Juicy sweat suits; they all have chauffeurs (or at least, they should); and they all like soup. But what is the key? They are all triple threats—“singers,” “dancers” and “actors.”

Interestingly, as mentioned above, this “triple threat” concept is one that Barlow applies when addressing the causes of anxiety. He identifies biological, general psychological and specific psychological vulnerabilities as key factors influencing the development, persistence and perhaps evolution of anxiety and related disorders. While Barlow emphasizes this threesome of vulnerabilities, he makes clear that the model of anxiety is much more complex. Specifically, just as singing, acting and dancing do not a Hollywood star make (or else, I would surely be one), there is much more to the mystery of anxiety—the etiology, observed individual differences, etc. Barlow’s consideration and discussion of emotion theory, affective states, perceived control, personality, etc. demonstrate that he is well on his way toward designing a clothing line, releasing a perfume and/or airing a reality television show based on his parents.

Child Star Turned A-Lister

I believe it was Britney Spears who said: “It is better to burn out than to fade away.” Or was it Scott Baio? Regardless of the source, surely I am not the first to recognize that such a profound statement applies not only to pop and/or childhood stars, but to graduate students destined for at least 15 minute of fame…or notoriety. If James C. Coyne were a child actor starring in a hit sitcom, who would he be? Dustin Diamond as “Samuel ‘Screech’ Powers” on Saved By the Bell? Andrea Barber as “Kimmie Gibler” on Full House? Or perhaps Jaleel White as “Steven Q. Urkel” on Family Matters? Who is to say? All we know is that when it comes time to produce the “Where Are They Now?” show, James Coyne could be proud.

Coyne’s character makes a bold entrance from stage left with the title of his chapter: “Thinking Interactionally About Depression: A Radical Restatement.” The audience is immediately captivated by the promise of something “radical.” However, in his first monologue, Coyne’s character shows some vulnerability, acknowledging that the breakout performance that elevated him to at least the D-list (as far as the red carpet goes), was in fact a naïve statement, made by an inexperienced graduate student.

Coyne continues with, shall we say, a defense of his previous work by denying it as an attempt to establish a formal model of depression, but rather as a suggestion that a set of processes associated with depression could be related to interpersonal issues. More than anything, it appears as though Coyne’s intention was to propose a theoretical approach with respect to depression and to call to action his colleagues for their insight and contribution.

Sweet Dreams

The objective of the present blog is to provide insight regarding a case study of insomnia. For the sake of protecting the participant’s identity, I will refer to her as…myself. Stimulus control, sleep hygiene…work your magic.

Here “I” am, unable to sleep. And so “I” get out of bed and go into the living room to find something to do to that is not associated with the bedroom in the hopes of re-inducing sweet slumber…although, “I” cannot necessarily say that tonight’s slumber has been all that sweet, as “I” believe it was a dream (or nightmare?) about statistical codes and power functions in r that awakened “me” in the first place. So, let’s see…It might be inappropriate to vacuum right now, (at 5:03am) although “I” don’t think the girl who lives below “me” will notice. You see, her boyfriend snores like a…like a…like a…”I” don’t know what. Anyway, vacuuming will have to wait…the dusting is done, the dishes are done, the laundry is done. “I” suppose “I” could go to the dresser and rearrange “my” sock drawer, but that’s located in the bedroom. Strike 2. Ok, so “I” go to the fridge (which thanks to Jess has in it something more than just “Bud Light”), but there isn’t really anything in there that appeals at the moment. Strike 3. What now? Work. There is so much of it. Where to begin? Where will it end? Ok, “my” eyes are glazing over….is it an anxiety driven avoidant technique? Or perhaps a cue that “I” am ready to hit the hay for round 2. “I” am just hoping that “I” don’t have any more dreams about linear regressions…

The BT Show

According to Darwin’s theory of natural selection, we as humans strive to survive, progress for success, solve (problems) to evolve, move to groove, etc. Much like the turtle and his shell, the porcupine and her spines, and the possum who plays dead, certain defense mechanisms—both inherent and acquired—serve to protect us, ultimately, to promote survival. Much attention has been devoted to exploring evolution in human beings and it can be suggested that given the increased insight regarding our own adaptive “progress,” one might easily get carried away, expecting all protective measures to be infallible, reliably and dependably keeping us from harm and ensuring that we thrive.

However, one must consider the case of Barry the Bee. I think it is safe to say that Muhammad Ali’s famed taunt, boasting that his ability to “float like a butterfly and sting like a bee,” permitted him to defeat his opponent is actually quite misleading. Unlike the world champion boxer, there will be no gold medal for Barry the Bee…no Rumble in the Jungle…no Thrilla in Manilla…no major motion picture about his life (actually, that last one is not true), because in Barry’s case, with his sting, he gives his life.

And what about Pepe le Pew? While the ability to deter and disgust most any predator with just a little wiggle of his hindquarters is enough to inflate his ego (according to Darwin, the skunk appears “conscious of his power”), even he cannot deny the fact that he cannot find a date. With all due respect, the cat he is always chasing in the cartoons is not being coy…she just doesn’t like him because he stinks.
Loose contemplation regarding the physical and social consequences both Barry and Pepe likely endure as a result of their respective defense mechanisms provides insight regarding the behavioral activation (BA) model. All references to cartoon characters aside, Jacobson et al. thoroughly review the origin and history, as well as the underlying principles of the BA model. While widely recognized as a major component of cognitive therapy, BA seemed to be overlooked when it came time to interpret and explain the efficacy of CT. Specifically, much of the success associated with CT was attributed to the cognitive aspect. Jacobson et al. challenge these assumptions and provide empirical data that supports the contrary: BA, applied independently, represents a potentially promising intervention strategy for individuals with depression.

Evidence supporting this behavioral approach can be extracted from real life, every day life—not just the cartoons. As we have discussed, one may experience negative cognitions in response to a negative experience (ie. a perceived threat to one’s social self). Such negative reinforcement (real or perceived) is likely to influence future thoughts and behaviors, as well as the way they are interpreted. Thus, the withdrawal from social situations, low self-esteem, and other symptoms that we associate with depression may initially have been defense mechanisms…and such behaviors may result in social isolation, decreased sense of social support, poor social skills, etc. While avoidant behavior may be useful in some instances, it can also contribute to a vicious cycle…

Some concluding questions/thoughts:

What comes first, the Dream chicken or the egg?

If you are a hammer, is everything/everyone a nail?

Are we really what we eat…and if so, does that make me bowl of quinoa and a bottle of Bud Light?

Wouldn't each of the behavior therapy technologies make great sitcoms? Or at least sitcom episodes? For example, imagine if Zack used a DBT approach when he went to pick up Kelly for a date and she asked him if she looked "fat" in her neon blue spandex dress.

Big Al

Schmegaloooooo, I love the picture you posted of Big Al Ellis.
It makes me think of his work in an entirely different way...
Specifically, I wondered about the role that certain "client characteristics" might play in explaining the efficacy/effectiveness of CBT in some patients, compared to others...
For example, in order for a client to benefit from CBT, it is implied that he/she must assume a certain level of responsibility for his/her beliefs, attitudes, behaviors, etc. What about those who may be content blaming others, dwelling on the past, etc.?

More to come.

White Fronted Bee Eaters

To suggest that the client-therapist relationship has no impact on treatment outcome would just be silly given consideration of the past few weeks’ readings and discussions. It also seems sort of silly to say that any strategy implemented to facilitate psychological treatment is anything but “person-centered.” While the role of the therapist may vary depending on theoretical orientation, it can be argued that the “person,” or “client” (a term popularized by Rogers), represents the key variable in the therapeutic equation. Specifically, regardless of the approach (ie. CBT, interpersonal, even electro-shock therapy), assessment, evaluation and monitoring of a treatment’s success or failure is ultimately communicated (directly via patient self-report, indirectly via behavioral observations, etc.) by the person/client. Thus, while Castonguay and Kirschenbaum address a crucial issue, the novelty is…well…the opposite of found.

On a different note, I would like to briefly address one of the “core” conditions Rogers identified as a crucial component of effective psychotherapy. Rogers and his followers report that “therapists or counselors who are accurately empathic, nonpossessively warm in attitude, and genuine, are indeed effective.” That said, I know of at least 4 lovely human beings who will make fabulous, effective therapists. However, if one defines empathy strictly and literally as “the capability to share and understand another's emotions and feelings,” it can be suggested that, taken to the extreme, empathizing with others (all others) may stress/strain one’s own capacity to cope. Thus, as therapists, actively excessive empathy may just give us that little extra boost allowing us to surpass the African white-fronted bee eater and claim the title of the most altruistic species ever.

Screech was on Celebrity Fit Club

I might liken my initial response to the pseudo-question posed by David A. Smith in his paper entitled: “The end of theoretical orientations?” to that which I experienced when rumors of Zack and Kelly’s “real life break-up” triggered heated discussion between network reps as to whether or not this was “The end of Saved By The Bell.”

As you can imagine, this news caused quite the frenzy among Saved By The Bell (SBTB) fans. This is not to say that the mounting tension among the cast members went unnoticed following the dissolution of the hit musical sensation, Zack Attack. While it appeared on the surface that Zack was happy to assume the role of talent manager for the all girl group, Hot Sundae, I would contend that things were never quite the same with “the crew.” It seemed as though they were on the divide…Zack (ie. integration), Slater (standardized practice), Lisa (managed care) and Screech (eclecticism) on one side, Jessie (structure) and Kelly (voted most popular), and perhaps, Milo (the middle school hall monitor who represents historical precedence) on the other.

What can be done? Do the network execs really think that they can "send Jessie to rehab” and Kelly to “Paris on a modeling scholarship" and things will all be ok? Do they really think that Tory, the motorcycle-riding, leather jacket-wearing “hot girl” who keeps Zack and Slater in line, can cut it? As I recall, Tory wasn't even a very good dancer. And where, might I ask, has Mr. Belding been this whole time? We haven’t so much as heard him say: “Hey, hey, hey, hey…”

Alas, if the analogy between SBTB and theoretical orientation stands, what can we expect? Well, the “New Class” may not be so great...and “The College Years” may introduce us to some pretty wacky characters, and while SBTB may ultimately be canceled, we will always have the reruns. Every morning from 7:00 to 9:00 on TBS...and don't you forget it.

Hmmm...

In reviewing the literature and assigned readings (not just for this class), I often find myself overwhelmed by this sort of disconnect or divide between the theoretical and practical approaches to cultural issues, particularly as they relate to psychology.
Below I will briefly address but one of these contradictions:
Often times it seems as though we refer to our culture as something that makes us unique…an individual. However, it can be suggested that we created culture and that by identifying with it, we imply that we share common beliefs, goals, etc. Along these lines, it can be suggested that identifying with a certain culture is efficient and essential for survival/success because we can base our behaviors and actions on the beliefs, attitudes, and experiences of others “like us,” thus providing an unconditional sense of community, belonging, support. Further, by identifying with a certain culture we may embrace and implement the positive attributes associated with our culture and be better equipped to deal with our experiences, attain our goals etc. Conversely, when it comes to negative attributes associated with our cultures, we might be expected to surrender such cultural collectiveness or unification and consider ourselves culturally unique.
In addition to the “culturally unique vs. culturally unified” contradiction, other dichotomies pertaining to culture and psychology come to mind: culture as a product of psychology vs. psychology as a product of culture; culture is created vs. inherent/inherited; past, present, future cultural values; implementation/active participation vs. rejection of cultural values/norms; majority vs. minority; awareness vs. ignorance; acknowledgement vs. bias; individual experience vs. experience of a group; and the list could go on.
From an evolutionary perspective, “culture” seems to have replaced food, water and shelter as the most critical resource for human survival. Specifically, it can be argued that certain aspects of our culture influence what we eat, how and where we live, how we define, measure and attain success, etc. However, unlike some natural mechanisms, culture can be changed. And apparently, psychology can be changed. It is very nice to know that so much attention and discussion have been devoted to this issue. I guess for the sake of continuity, I will conclude with another kind of paradox (?): with respect to psychology and culture as interdependent entities, I have great hope for and major concern about what the future will hold. But…mostly hope.

Kind of off topic...

Based on previous discussions regarding the evolution of psychology “as a science,” it is not surprising that much attention has been devoted to defining and comparing therapeutic interventions using an empirical approach. As in any field, developing, evaluating and optimizing therapeutic interventions is crucial not only in improving patient/client care, but in providing valuable insight regarding the causes, underlying mechanisms, pathological features, etc. of the condition in question. Given that the objective is to provide the highest quality of care, it seems valid to employ treatment strategies that are supported by evidence. According to Hunsley, evidence based practice as it relates to psychotherapy has received quite a bit of attention over the past couple of decades. While it can certainly be argued that evidence based practice is highly desirable in this context, it may be difficult to implement routinely, especially for persons with psychological conditions, where symptoms, responses to treatment, and definitions of improvement can be so variable and unpredictable.
Thus, it can be suggested that developing and evaluating outcome measures to determine clinical efficacy of new treatments in clinical trials, to monitor progress in clinical practice, and to modify treatment strategies could be the egg to the therapy’s [dream] chicken, or vice versa, if that makes any sense. Further, how can we decide which treatment is better if we do not know how to define “better?” How do we know if the treatment treats the problem, if more than one problem exist?

PSYC 7470

Experimental Psychopathology
Wednesday: 9:00am to 11:30am
Gilmer 081