Hallucinating in the deep waters of consciousness…

A handbook at its best 

Handbook of Emotional Regulation
James J. Gross

What is meant by emotional regulation? How do we learn (or not learn) to manage our emotions? Why are some people so much better at delayed gratification than others? Why can we 'lose it' with our intimate partners but remain composed in our professional lives? These questions, and many more, are discussed in this book. This is a handbook at its best, offering 35 chapters covering almost every conceivable angle on the topic, each written by leading figures in their fields worldwide (although admittedly contributors are predominantly from North America).

There should be something for almost everyone including sections on biological, developmental and social perspectives on emotional regulation as well as consideration of the influence of personality and psychopathology. New entries in this edition include a greater coverage of clinical issues and the impact of emotional regulation on health. The chapters link together well and there is a sense of progression from developmental perspectives on neural pathways right through to the impact on health, even society, of emotional dysregulation.

While I found many of the topics engaging; at times, I would have liked some of the material brought a little more to life: for example, by including more accounts from 'experts by experience' (particularly in the section on psychopathology) and offering more real-life scenarios. The book is almost encyclopedic in its scope, which means it can be on the technical and detailed side. This would suit those in academia and research looking for a thorough grounding in the topic. For clinicians, the book makes excellent background reading and has certainly enhanced my practice. It is not, however,  a 'how-to' therapy guide and would probably be hard-going for those with a more passing interest or seeking to gain further insight into emotional regulation from a more lay perspective.

Guilford Press; 2014; Hb £63.00
Reviewed by Dr Laura Pipon-Young who is a clinical psychologist, Forensic Services, Sussex Partnership NHS Foundation Trust

Hallucinating in the deep waters of consciousness
Narcose

Julie Gautier (Director)

Narcose is a French short film about a dive by world champion free diver Guillaume Néry. It documents a five-minute dive from a single breath and the hallucinations he experiences due to carbon dioxide narcosis.

The film is visually stunning. A masterpiece of composition, light and framing. It's also technically brilliant. The director presumably thought 'what can we do when we have access to a community of free divers, who can hold their breath under water for minutes at a time?'
It turns out, you can create stunning underwater scenes with a cast of apparently water-dwelling humans.

But most importantly it is a sublime depiction of Néry's enchanted world where the boundaries between inner and outer perception become entirely porous. It is perhaps the greatest depiction of hallucinations I've seen on film.

Darken the room, watch it on as big a screen as possible and immerse yourself.

To watch, see http://vimeo.com/95182734
Reviewed by Vaughan Bell, who is a clinical psychologist and visiting researcher at the Institute of Psychiatry, King's College London. Vaughan blogs at www.mindhacks.com, where this review originally appeared.

Paving the way
The Behaviour Change Wheel: A Guide to Designing Interventions

Susan Michie, Lou Atkins & Robert West

This new book release comes as the result of years of developing behaviour change research from health psychology experts at University College London. What has been produced is a concise, accessible introduction to behaviour change, suitable for a wide range of interested parties. The book begins with a quote from psychologist Kurt Lewin: 'There's nothing as practical as a good theory.' Indeed, the practical application of this body of work is emphasised throughout. It is very much written as a book for both fieldwork and study: providing handy tables of concepts as well as exercises to test your understanding.

Core to the book is description of the processes and applications behind the Behaviour Change Wheel. This is a synthesis of 19 frameworks divided into three operational layers that encourage the user to consider the source of target behaviour, the function of their intervention and related policy. The complementary Behaviour Change Taxonomy is also presented: providing readers with a range of ideas on how to apply concepts in their work. Helpful abstracts of international research examples are provided throughout to illustrate concepts.

An accompanying online training programme (www.bct-taxonomy.com) and BCT Taxonomy app (Available in Apple and Google Play app stores) provide great supplementary support.  This book really paves the way as the 'go-to' book in behaviour change techniques and development. It is not simply a presentation of work in the field, but a guide to develop skills in identifying and using behaviour change techniques. It is recommendable to students, academics and practitioners alike across a range of fields. With these helpful resources, we are undoubtedly progressing further towards working on the same page in intervention design.

Silverback Publishing; 2014; Pb £18.99
Reviewed by Emma Norris who is a PhD Student, University College London, and Associate Editor for 'Reviews'

Deferred gratification
Boyhood
Richard Linklater (Director)

Boyhood is very long, nothing out of the ordinary happens, and the lead (Ellar Coltrane) is completely unknown. It is also a unique work of art that uses the medium of film in a genuinely novel way, with astonishing results.

The director Richard Linklater has been best known to date for his 'Before…'trilogy, starring Ethan Hawke and Julie Delpy. First in 1995 and then at nine-year intervals, Linklater crafted the story of a couple who meet on the train to Vienna. It was compelling to watch Hawke and Delpy age with us over the 18 years between the first and last film, as we too gained wrinkles and became weighed down by our responsibilities.

Boyhood takes the idea of actors ageing in real time much further. Linklater cast six-year-old Coltrane as Mason at the turn of the century, and then filmed for a short period once each year over 12 years. The film seamlessly cuts from each year's shooting to the next. There is no text on screen to tell us it's now 2004, or 2008. We can only intuit this from close examination of Mason and his older sister Samantha (Lorelei Linklater), or occasionally from the intrusion of public events (such as Obama's first election). The ageing is less obvious as Mason goes from 8 to 9 to 10, but suddenly the teenage years are upon us and he's stooping down to his mother, with a huge fringe hiding his increasingly hairy face.

As a method of film-making, there are no real comparisons. Michael Apted's 7-Up has been mentioned, but Boyhood is no documentary. Nor is it great makeup or CGI: we are in a time machine, watching
the actors actually age, in front of our eyes.  As we watch the film, we get to know Mason, but as each year passes, he changes and matures, just like children do. Although we might notice and sympathise with the sags and wrinkles of the adult actors, watching the children develop is breathtaking. It's a cinematic experience, but at times it feels uncannily like real life.

The film is brilliant at showing us childhood from the child's point of view. Mason and his sister go to a midnight launch party for Harry Potter and the Half Blood Prince. We see the magic and excitement of the event through their eyes, without cynicism. But a wedding which obviously occurred at about the same time, and has a huge impact on Mason's life, is not shown. This emphasis seems truer to the 11-year old boy. In another scene, Mason is threatened by two boys in the toilets at school. No adult conveniently intervenes, and as far as we can tell, Mason tells no one. He suffers the event and we suffer with him, impotent. This storyline goes nowhere – has Mason forgotten other incidents, or were there none? This uncertainty makes it seem as if we're watching Mason's actual memory of his childhood.

As Mason matures, so does his understanding, and the adult characters imperceptibly become more rounded. Patricia Arquette as his mother evolves from taxi driver-cook-disciplinarian (wry parental smiles) to someone who has a life of her own outside the family. Mason starts to gain a perspective on his fun-loving but absent father (Ethan Hawke again), and some of the other father figures in his life.

Pavlov, Skinner and Bowlby get name-checked in the film as sly signposts to particular characters. Mention of Bowlby perhaps offers the strongest hint at Linklater's view: without attachment to others and a safe base from which to explore, the boy will never become the man.

Each viewer is likely to have a different experience when watching Boyhood, as they are touched by different aspects. As a step-parent, I found the scenes with the step-siblings especially affecting. Those whose are about to become empty-nesters may get through several hankies as (spoiler alert) Mason heads off to college, ready to take those exploratory steps into manhood. There is so much to enjoy and marvel at in this complex yet simple-looking film, and it's hard to imagine that any other this year will match it.
I    Reviewed by Kate Johnstone who is a postgraduate student at UCL

Compelling honesty
What's Normal Anyway? Celebrities' Own Stories of Mental Illness
Anna Gekoski & Steve Broome

To highlight the uniqueness of each individual's experience of living with a mental health disorder, 10 celebrities with disorders from bipolar (Bill Oddie) and body dysmorphia (Alicia Douvall) through to depression (Alistair Campbell and Tasha Danvers) were interviewed.

There is a compelling honesty throughout the book, with each participant telling their own story in their own words. This does mean each chapter suffers from disjointed changes in tone and style, but cleverly highlights that even those suffering from the same disorders can experience them very differently. When their celebrity status is stripped away it is clear they are simply individuals suffering from an individual illness and dealing with it in their own unique way. What unites them however is the message that finding your own perspective and the right support and coping strategies at the right time will make all the difference.

What's Normal Anyway? may offer support to those recently diagnosed with a mental health disorder by showing that anyone in society can be afflicted. There is much here also for those who wish to learn more about mental health disorders and to understand a diversity of current and relevant issues, such as the rising influence of medication and talking therapies, and the pervasiveness of discrimination and stigma.

Constable; 2014; Pb £9.99
Reviewed by Josephine Perry who is an MSc psychology student, Kingston University

Inadvertent research
Reverse Engineering Chinese Censorship
Professor Gary King (podcast)

I was introduced to the fascinating government research work of Harvard Professor Gary King at the ESRC Research Methods Festival at Cambridge in July; this podcast is a concise introduction to his work.

The current state of Chinese social media censorship is first outlined. 200,000 human censors across the 50,000 towns and cities of China read the posts of over 1000 Chinese social media sites within hours of their publication. If posts violate censoring rules, they are taken offline for investigation or removal. Although this procedure is public knowledge in China, what remained unclear was how the investigation or removal of posts was determined.

It was previously assumed that posts criticising government figures were censored. However, the detailed work of Professor King and colleagues has surprisingly found that this is not the case. Posts identified as being censored were in fact those with 'collective action potential' (i.e. seeking to form a crowd). Censoring occurred whether these crowds aimed to protest against negative events, such as political corruption, or positive events, such as environmental funding.

So, what is the purpose of this censoring? Is there a set policy for censor enforcers or is it an emergent process they have developed? The true reason is not yet known. However, Professor King describes how this format of censorship makes sense. If they were to censor all negative comments pertaining to the Chinese government, this would be very obvious and uncomfortable for the public. However, censoring collective action posts can help identify potential riots and crowds and reduce associated costs.

Especially interesting in this podcast is Professor King's openness about his changing aims during this research. The initial goal was not to understand censorship processes. Instead his team planned to stress-test their automated text analysis systems on Chinese language social media. However, they instead found that by extracting millions of posts as they were written, they had inadvertently archived un-censored posts. When they tried to re-access posts via URLs, they found many had since been censored. This reflection of changing research aims and contexts is reassuring for researchers across the social sciences and beyond.

I heartily recommend this as well as the other National Centre for Research Methods podcasts (tinyurl.com/mvqmv5y) for providing concise introductions to novel social science methods and projects.

Reviewed by Emma Norris who is a PhD student at University College London and Associate Editor (Reviews)

What is to be done?
Inside the Ethics Committee: Treating Patients with Dementia
BBC Radio 4 Thursday 31 July 

Using the framing device of real-life cases, medical ethical dilemmas are discussed with an expert panel. This episode in series 10 comprised a cardiologist, a psychiatrist and an expert in medical law and ethics, led by presenter Joan Bakewell.

Discussion centred around the case of Jean, aged 92, and whether the battery should be changed in her pacemaker. Since it was fitted in her 80s, Jean developed dementia, making it impossible to ask Jean her wishes and making the routine procedure distressing for Jean and more complex.

One of the two key questions raised was regarding quality of life. James Beattie, cardiologist, stated that heart-failure patients often rate their quality of life higher than their relatives would. This was echoed by panel member and psychiatrist Liz Sampson with regard to patients in the early stages of dementia. Psychological interventions were mentioned as being able to connect even with late-stage dementia patients.

The other key question, and the main focus of the programme, was capacity. Life-prolonging treatments are provided based on government guidelines, and care homes often provide flu jabs, but the issue was raised that flu may lead to pneumonia and a natural death. So who should make treatment decisions? Beattie commented that medical advances have made us less familiar with death, preventing necessary discussions and making healthcare decisions more problematic as patients' wishes are often not known.

With life expectancies and degenerative diseases increasing, this programme highlighted areas that need to change. Beattie felt that medical specialties were working in 'silos', and the panel suggested that more cross-department communication would help with treating patients, especially when hospital treatment is required. But patients themselves, in conjunction with healthcare providers, and potentially relatives, need to consider more forward planning as to when treatment should be provided and, crucially, when they would prefer it wasn't.

This is clearly not an area of easy answers, but programmes like this are at least getting us to think about the questions.

Reviewed by Louise Beaton who is an Open University psychology graduate

Is Utopia out of reach?
Utopia
Channel 4
It is easy to distract ourselves from the increasing pressure each individual places upon the earth – we are all far too busy preparing manuscripts or working with clients to save the world too! Utopia brings this into sharp focus, throwing a group of 'everyday' individuals in between an almost mythical comic-book that predicts negative future events, and a dangerous group trying to 'save' the earth by massively reducing the population. Intense in both storyline and visual presentation, Utopia is a masterclass in manipulation and motivation, exploring the consequences of our growing and consuming society.
A quirky and piercing soundtrack and over-saturated visual style help the transition between seemingly mundane events, cheeky humour and bold violence. Utopia is intensely atmospheric and will continually surprise with twists in plots, characters and tone.

As psychologists, we often like to statistically predict future events, but we have to question, are we doing enough to tackle some of the biggest questions threatening the continued existence of the human race? Start watching the first series, with its labyrinth of entwining plots, and you will feel uncomfortable, repulsed, but also amused and addicted, and end up asking: what lengths do we really need to (and can we) go to, to save the human race from ourselves?

Reviewed by Thomas Rhys Evans who is a PhD student and lecturer, Coventry University

A book you do
The Writer's Key: Introducing Creative Solutions for Life
Gillie Bolton

The first thing to say about this book is that it is not a book you read but a book you do. Gillie Bolton has written an inspiring book to get people out of their heads by writing things down. Key writing is something that takes practice and there is not a one-size-fits-all method for everybody. However The Writer's Key gives almost unlimited suggestions for how to get writing from the six-minute write to journaling, poetry, letters and even dreams.

There are many and varied real-life examples of how writing has helped people to tackle many of life's problems as well to use it to develop their own wisdom. The books premise fits nicely with my own preferred approaches of working with clients using both narrative therapy and mindfulness approaches. The Writer's Key combines the ideas that the stories we choose to focus on and tell about ourselves and the process of developing our awareness of the everyday can have significant therapeutic benefit.

This book asks you to take a leap of faith that writing, something we do every day without much thought, can actually change your life. The first time I tried a six-minute write I was amazed at what came out and what didn't! This is a book you could use for your own personal benefit but also for some inspiring exercises to do with clients of any age. The Writer's Key is the latest in Gillie's Writing for Therapy or Personal Development series.

Jessica Kingsley; 2014; Pb £14.99

Reviewed by Jo Medway who is a clinical psychologist working with looked after children for Reading Borough Council and Berkshire Healthcare Foundation Trust

Mixed perceptions
The Valley of Astonishment
Young Vic, London

A play that cites the work of Oliver Sacks as its inspiration, and thanks Simon Baron-Cohen in the programme, promises to be of interest to psychologists. Performed in English by the Théâtre des Bouffes du Nord from Paris, The Valley of Astonishment is written and directed by the theatre's founder, Peter Brooks, and Marie-Helene Estienne. Brooks has long been fascinated by neurology: he first put Sacks's work on stage in the early 90s in The Man Who (…mistook his wife for a hat). This puts him ahead of a recent trend of plays with psychological themes, such as Incognito (reviewed in July's issue) and The Effect.

The play opens with Sammy, a journalist with a phenomenal memory, who is regarded with suspicion by her new boss. He sends her off for testing. She explains to the doctors how she perceives spoken language as text, making what seems to be feats of memory no more challenging to her than reading aloud. They diagnose synaesthesia. In the blink of an eye Sammy loses her job and becomes a stage act, spouting phone numbers and feeling like a freak. Her story is interwoven with another's, a musician whose perception mixes colours and sounds. Two actual musicians accompany the actors, as if they were another character.

The intention is no doubt to give the audience the experience of synaesthesia, by using music in place of words, or colours and music together.  But this is disappointing in its realisation. In addition, the tone of the play is uneven and the plot slightly incoherent. One scene involves audience members on stage participating in a card trick for reasons that remained a mystery, and why a photographic memory should be a handicap for a journalist is baffling.

Kathryn Hunter as Sammy is a commanding presence (despite her diminutive size), but she is better than the material given to her. Yet the play has had rave reviews elsewhere, and many gave it a standing ovation this night. So perhaps it is all down to perception, after all.

Reviewed by Kate Johnstone who is a postgraduate student at UCL. The Valley of Astonishment is on tour internationally until December 2014.