True Detective…
… and the usual mix of books and other media reviews, including The Silence of Animals, trauma and creativity online guide, Psychology, Mental Health and Distress, and building a virtual brain.
18 April 2014
At peace with thoughts
The Silence of Animals: On Progress and Other Modern Myths
John Gray
In Britain, John Gray has become a well-known public intellectual, in no small part due to the massive success of his 2002 book Straw Dogs. This book saw him emphasise the similarities between humans and animals (he refers to 'human animals' rather than merely 'humans'), a theme he takes up again in The Silence of Animals. For psychological purposes, arguably the most relevant area of debate is that pertaining to the book's title, of exploring the kinds of silence pursued by human and non-human animals.
Whereas non-human animals run away from noise in their environment that they perceive as dangerous, human animals seek silence for 'an escape from inner commotion' (p.162). However, Gray thinks we human animals are not very good at doing this, for even the monastic flight into the desert or monastery will lead one into 'dialogue' with God, one's past, or projections of the future. Unlike other animals, humans construct narratives about their lives. Seeking meaning from these narratives, and the 'myths' that underpin them (such as of progress or redemption), humans cannot help but use language in this way. Gradually, human animals have come to realise the error of retreating into silence, preferring instead to keep oneself so unsustainably busy that there is no time for reflection. Instead of inward retreat or remaining busy, Gray thinks one should turn outwards to nature, to hear 'something beyond words' (p.165). To this end, Gray cites the example of J.A. Baker (1926–1987), author of The Peregrine. Baker spent a considerable amount of time following peregrine falcons, and whilst he neither aimed to, nor achieved, a release from language, he was nonetheless able to still his mind temporarily for the time he was out with the falcons.
To anyone familiar with the third wave of behavioural therapies, Gray's line of argument may be familiar. His assertion that 'to overcome language by means of language is obviously impossible' (p.165) is reminiscent of the shift from the second generation of behavioural psychotherapies to the third generation, or 'third wave', as it has been termed by Steven Hayes. Rather than aiming for direct cognitive restructuring, some third-wave therapies have introduced silence and contemplation, such as mindfulness-based stress reduction (MBSR). Gray would question whether MBSR would lead to inner chatter and conflict, rather than to peace. Other third-wave therapies, such as acceptance and commitment therapy, seem not to try to want to replace language through cognitive restructuring, but are arguably replacing one myth (progress) with another ('accepting one's fate', as Nietzsche would put it), for Gray would argue that we are always using myths to construct narratives. In other words, Gray's book functions as a thought-provoking challenge to third-wave therapies, making one question their aims and methods. Nevertheless, Gray's own solution, of an outward focus on peaceful nature, is romantic, but impractical; at some point the modern world demands we turn back from nature not only to society, but also to our own thoughts.
Allen Lane; 2013; Hb £18.99
Reviewed by Matthew Edward Harris who is a doctoral candidate in philosophy at Staffordshire University and Claire Harris who is an assistant psychologist at Green Lane Hospital, Devizes
For the course reading list
Psychology, Mental Health and Distress
John Cromby, David Harper & Paula Reavey
Yet another psychopathology textbook you may think, with reams of chapters about different therapies and disorders, but, oh no, this book's whole aim is the exact opposite, and in part achieves what it sets out
to do. In a bit of a two-finger salute to the medical establishment this book questions concepts in depth, such as diagnosis, the notion of normality and cultural identity, in a refreshing and certainly novel way.
At times the various authors appear to go a bit far, arguments appearing slightly unbalanced, instead coming across as a bit of an ideological and political rant. For example, as a way of deconstructing the labelling issue of diagnosis they instead use the term distress, however this appears to hold a number of negative connotations, a number of my patients certainly have some positive and life-enhancing experiences as a result of their illness, which they would probably not be too happy to have labelled as 'distress'.
Distinct chapters on culture and service-user experience are an inspirational change to the standard psychopathology literature, everything from politics to early childhood attachment being considered in relation to mental health, this certainly leaving me pondering on some of my current clients. As a clinician and an academic, I was left (in a good way) reflecting on elements of my practice in relation to diagnosis, formulation and treatment, all of which are detailed in their own chapters, but the anti-psychiatry message at times felt a bit strong and idealistic.
The easy read and engaging style, the vast range of references and up-to-date material mean this book would be a great addition to course reading lists. I still need convincing about its usefulness in clinical practice, but maybe the fact alone that I'm left reflecting on my view on related issues is exactly what the authors set out to achieve in the first place.
Palgrave Macmillan; 2013; Pb £38.99
Reviewed by Dr Claire Thompson who is a Chartered Psychologist and Senior Lecturer at Nottingham Trent University
Building a virtual brain
Exchanges at the Frontier
BBC World Service podcast
Professor Henry Markram has received the biggest personal grant in the history of science. But even with a billion euros from the European Union to play with, Markram has his work cut out. He has taken on the task of building a biologically accurate model of the human brain: 'almost certainly the most sophisticated thing in the known universe', according to podcast host A.C. Grayling.
Modelling a thinking, remembering, learning, decision-making, virtual version of the human brain requires a super computer which performs a million trillion calculations per second. Such a machine doesn't yet exist, but Markram's ambition is to have it built within the next decade. He shies away from the term 'modelling', preferring the concept of 'algorithmic or principle-based reconstruction' of the brain. 'We have to be able to get to the principles, to reconstruct the hypotheses of the brain, check it against the biology, and keep doing that until finally we've understood the principles and we have an accurate copy.' And Markram's end goal is an actual, visual representation: 'We have to get close up, we have to go inside, we have to travel inside to be able to image the virtual brain across all its levels.'
This idea of levels is where the whole thing gets a bit too vague for my liking. As Markram acknowledges, scientists get trained to study the brain at a particular level. 'The only way we can think of it is to build a digital model that contains all the levels.' But can this virtual representation in any way represent 'the genetic level, the protein level, the cellular level, the systems level, the whole-brain level, the behavioural level, the psychophysical level, the psychology level'? Markram wants his virtual brain, in a virtual body, to run around and make a decision... 'the moment it makes a decision – e.g. there is some cheese behind the door – we will be able to trace back the entire causal chain of events that led to that behaviour. This is just not possible with any technology or any approach available today.' I suspect that even in tomorrow's world, a billion euros could be a drop in the ocean in making it possible in any meaningful way.
But what do I know. By the end of the 50 minutes, Markram's soothing voice had reassured me that he was well aware of the vast, interdisciplinary nature of the challenge his scientists face. 'It's beautiful, the brain', he enthused. A neurone is 'like a galaxy', then later on Markram says it's like the universe itself. Either way, Markram plays the role of starsailor rather well, so much so that it seems small-minded to chide him for spending huge sums of money which could, in other ways, make a real difference to those suffering from the very disorders he seeks to explain. 'We need to put a spotlight on the human brain,' he says. 'This is not something where we should say "let's wait until we've understood the snail"… This is the one thing that guarantees society in the future.'
I suspect space agencies advance a similar argument, so why not properly fund an exploration of the universe within? Markram's own son has autism, and Markram sees people with such conditions as 'scouts of evolution'. Perhaps in 10, 20, 100 years time we will come to view this project in a similar way.
Podcast: www.bbc.co.uk/ podcasts/series/ideas
Reviewed by Jon Sutton, Managing Editor of The Psychologist
An easy guide to narrative therapy
Narrative CBT
John Rhodes
The popularity of narrative approaches both in psychology and medicine has hugely increased in recent years. Physicians are used to talking about narrative medicine, qualitative researchers about content analysis, and psychologists about narrative therapy. In the psychological field narrative approaches recur within very different frameworks: cognitivism, constructivism, psychoanalysis, and so on. Narrative CBT has already become part of the third wave of cognitive therapies, by recognising that problems and changes are embedded in the personal stories of one's own life. In this book, John Rhodes offers us the distinctive features of narrative therapy in the form of an accessible guide.
Narrative CBT exhibits the pros and cons of every easy guide. It creates an easy-to-understand overview of practical features and techniques, avoiding extensive theoretical and methodological backgrounds that can motivate the choice of one solution over another. The author himself explicitly recognises these limits and clarifies his aim to explore how narrative ideas and practices can be combined with CBT.
Narrative CBT is an introductory guide that may help CBT practitioners to embody the basic assumption of the third wave: perhaps it's better to change the meaning of an event, rather than the event itself.
Routledge; 2014; Pb £14.99
Reviewed by Simone Cheli who is in the Psycho-oncology Unit, Department of Oncology, Florence, Italy
A creative introduction
Did the trauma of World War One lead to great creativity?
BBC iWonder
Did the trauma of World War One lead to great creativity? That was the question addressed in an 'iWonder' online guide from the BBC, combining short video clips, slideshows and text presented by politician and academic Baroness Shirley Williams and Chartered Psychologist Dr Victoria Tischler (University of Nottingham).
Dr Tischler visited the Maudsley Hospital in London, built in 1915 to treat soliders suffering from shellshock. Patients were encouraged to take up creative pastimes to aid their recovery, and Dr Tischler described how this can help people to process traumatic experiences and deal with negative emotions. The result can be a positive identity shift, from patient to artist.
Baroness Williams spoke about her mother's book Testament of Youth, about her experience of serving as a nurse in World War One. 'Whilst acute trauma can hinder creativity,' she said, 'there is evidence that such experiences can increase the imaginative capacity. A 2012 study found that veterans with post-traumatic stress disorder were better able to develop imaginative and complex imagery compared to those veterans who has not suffered from it.'
As Baroness Williams concluded, the results of creative processes have a wider impact on society, challenging stigma, educating us all. This online guide is, in itself, a creative way to introduce a wide audience to concepts such as post-traumatic growth, and as such could be very suitable for teachers during this commemorative year.
www.bbc.co.uk/guides/zptgq6f
Reviewed by Jon Sutton, Managing Editor of The Psychologist
Nothing about us without us
CBT for Children and Adolescents with High-Functioning Autism Spectrum Disorders
Angela Scarpa, Susan Williams White & Tony Attwood (Eds.)
This book contains thought-provoking work by various authors on different CBT-based psychosocial approaches to treating young people with high-functioning autism (HFASD) – those diagnosed with ASD but with no intellectual impairment. Some chapters look at working with common problems, such as anxiety, that are comorbid with HFASD, whilst others look at working with difficulties, like social skills deficits, directly associated with HFASD. It is argued that CBT is an appropriate model for this work because young people with HFASD have a tendency to logical thinking that can be used to evaluate the biases and assumptions that affect their feelings and behaviours.
The thorough summaries of relevant research in each chapter show that evidence supporting the different approaches is very limited. In particular, the book contains many useful ideas about how to adapt therapy to the needs of young people with HFASD, which could be of relevance to all therapists working with this client group, but there has been little work done on which of these are effective. There could have been more emphasis on these adaptations, such as structuring sessions, offering multiple-choice answers, teaching about emotions, using special interests, and not relying on words but using textual and visual aids.
It would have been nice to know what the young people being treated thought of these approaches – the voice of the young person with HFASD is missing from the book. This reflects the underlying assumption that the therapist and the parents know what is best for the young person, which raises ethical issues that merit much greater consideration. It is only in Isabelle Hénault's excellent chapter on relationships and sexuality that the rights of the young person with HFASD are raised – the right, in this case, to experience sexual curiosity and interest. And that lack elsewhere is a pity.
Guilford Press; 2013; Hb £30.99
Reviewed by Chris Baines who is a schools counselling coordinator and trainee counselling psychologist
Do you need to go on a digital diet?
Menthal
Android app, free from Google Play
Menthal is an Android app designed to show users how much time they are spending on their smartphones. It was developed by Professor Alexander Markowetz and his team of computer programmers at the University of Bonn, with Markowetz commenting: 'If you would like to go on a digital diet, we will provide you with the scales.'
Menthal provides feedback on your mobile phone usage, with the developers claiming this allows the user to 'maintain a sustainable digital lifestyle'. Running in the background, it records every time you unlock your phone, start an app, receive a call, etc. The data is sent to the developers once a day (using just 100 kilobytes of data per day). There they extract the most interesting indicators, such as the total time you spent with your phone or the number of times you used a particular app. 'You can then browse this aggregated information', say the developers, 'and interpret it in the context of your lifestyle.'
Menthal has been applied to excessive smartphone use, but alternatively it could be conceptualised as a 'digital diary'. Perhaps it could benefit adults suffering with short-term memory loss or Alzheimer's disease, as the app allows users to recall personal time spent using technology. However, we would have liked to see more personalisation and social features: essential components for enhanced positive and engaged user experiences.
Reviewed by Derek Laffan, Niall Byrne and Seán Doyle who are at the Institute of Art, Design and Technology (IADT), Dun Laoghaire, Co. Dublin, Ireland
Beyond conscious horizons
The Power of the Placebo
How You Really Make Decisions
BBC Two
If a map of the human mind were to be drawn in the style of a 17th-century naval cartographer, there would have to be a sizeable region labelled 'Here be dragons'. The idea of unconscious influences on thought and behaviour was most famously developed into a theoretical framework by Freud. More recent investigations of the unconscious have ditched his largely unfalsifiable speculations about id, ego and superego, in favour of a focus on the physical and cognitive outcomes of unconscious processes.
In 'The power of the placebo' Horizon showed how positive medical outcomes often result from interventions that have no active ingredient, but that somehow fool the mind. In one instance, patients experienced pain relief when accidentally given the wrong treatment for their damaged backs. The 'right' treatment turned out to be a placebo. Likewise, fake acupuncture, where patients only think their skin is being punctured, is as effective as the real thing, and more so when the doctor behaves in a caring manner.
Placebo medicine can lead to measurable physical changes. Fake oxygen to treat altitude sickness reduces levels of the PGE2 neurotransmitter, even though blood oxygen levels do not change. Placebo treatment for Parkinson's disease leads to increased levels of dopamine, the neurotransmitter that regulates movement. Placebos can even work when patients know they are receiving placebo treatment.
Another Horizon programme, 'How you really make decisions', introduced the idea that conscious thought may, in large part, serve to rationalise decisions that have already been taken at an unconscious level. Intuitive thinking is often associated with irrationality and over 150 cognitive biases have been identified by
researchers.
The phenomenon of loss aversion appears to underlie irrational behaviour in cab drivers, city traders and rhesus monkeys. The animal research suggests that loss aversion may have evolved 35 million years ago, although no one addressed the question of why something so apparently irrational would have been favoured by natural selection.
We were also provided with a demonstration of inattentional blindness, in which focusing your attention on one thing can lead you to miss important information elsewhere. My own interest in the subject matter almost, but not quite, blinded me to one rather striking observation: both shows were heavily dominated by men. The placebo programme, narrated in an annoyingly breathless fashion by Steven Berkoff, featured some nine scientists, all male. In the decisions programme, also with a male narrator, I counted seven scientists, just one of whom was female and who (in the tradition of Diane Fossey and Jane Goodall) worked with animals. One wonders what unconscious influence this gender disparity might have on the potential scientists of tomorrow.
Reviewed by Dr David Hardman who is at London Metropolitan University
A pleasure to read
Political Psychology: Critical Perspectives
Cristian Tileaga
In a time when a wide variety of political actions are making headlines worldwide this well-written and informative book provides a new way of understanding the psychological factors involved in politics. The focus on European political psychology provides an interesting counterpoint to many of the other introductory texts, which tend to describe North American approaches to the subject.
The book presents a view of what it terms 'interpretive political psychology' that aims to go beyond simply describing modern culture to provide a deeper understanding of the way in which society functions over time. A wide variety of topics are looked at through this lens, including political communication, extremism and political identity.
The most striking thing about this book is the way in which complex topics are clearly and succinctly presented whilst still managing to emphasise the theoretical and methodological diversity of the field. Throughout all the chapters runs the author's vision of a political psychology that moves beyond the individualistic paradigms that are the norm in much of the current work on political values and behaviour. He effortlessly incorporates significant research in many areas of social psychology in a way that makes this book a pleasure to read. Of particular interest is the author's understanding of both individual and collective human action and the way in which these impact on politics and society.
Although this is an introductory textbook, there is a detailed bibliography that will enable those who are interested to further explore the ideas that are presented.
Cambridge University Press; 2013; £60.00
Reviewed by Evelyn Gibson who is with West London Mental Health Trust
Self-indulgent watching
True Detective
HBO
The new HBO series True Detective, showing in the UK on Sky Atlantic, is not a bundle of laughs. Anyone watching it for Woody Harrelson, expecting it to be like Cheers purely because he's in it (hello, my wife), is likely to be disappointed. The protagonists trudge through bleak backwood US settlements which look like they've been dropped out of the sky, solving grisly murders, all to a masterfully curated but gravelly soundtrack. But from an audience of psychologists, it may at least raise a knowing smile.
I have so far only caught up with episode one, but was struck by the psychological content in the script. 'We are things that labor under the illusion of having a self', says Rust Cohle. 'A secretion of sensory experience and feeling. Programmed with total assurance that we are each somebody, when, in fact, nobody is anybody.' Psychologist Professor Bruce Hood, and his latest book The Self Illusion, sprang to mind. Indeed, over on Discover Magazine blog (see tinyurl.com/obtb2xf), Kyle Hill was making the same connection, citing Hood's work and concluding: 'Matthew McConaughey's character in True Detective could go down in TV history as the world's biggest bummer – a pessimist walking into extinction. That doesn't mean he's wrong. Knowing that the mind is not separate from the brain, that our senses can be fooled, that our sense of self can break down if we simply pay attention to the here and now, Rust Cohle is right – we are a multitude of unconscious processes cobbled together in a locked room and labelled "You".'
The psychological analyses continued over on Psychology Today, with clinical psychiatrist Dale Archer writing on the identities and 'broken boundaries' of Cohle and his partner Martin Hart (heart and soul, anyone?).Cohle sees human consciousness as 'a tragic step in evolution… Nature created an aspect of nature separate from itself. We are creatures that should not exist by natural law.' He believes 'we became too self-aware', but for a series like this I'm not sure that's possible… I for one am looking forward to watching the rest of this series in an annoyingly self-aware fashion, unravelling its mysteries and pondering what it all means for our view of self.
Reviewed by Jon Sutton, Managing Editor of The Psychologist
A sturdy foothold
Psychopaths: An Introduction
Herschel Prins
Writing from over half a century of experience within the field, Prins offers a 'toe in the bath' introduction to psychopathy. Spanning five concise yet informative chapters, past literature, law and cultural examples are recruited to highlight the diversity of psychopathic research. Whilst this text is aimed at students in criminology, psychology and law, others with wider learning interests may welcome its accessible nature. Although earlier stages highlight the steep progression of psychopathic literature, it is the latter chapters, which will grasp the interest of the reader.
Questions are asked of how the British criminal justice systems are tasked with the difficulty of juggling containment, treatment and rehabilitation, whilst assessing wider complexities in understanding psychopathic disorder. This is staged in the context of a social climate whereby the public places higher importance on punitive, compared to rehabilitative measures for the 'mad or bad'.
Though interested readers may be left wanting to know more about some of the topics proposed, Prins provides further reading to key texts when appropriate and offers open discussion questions at the close of each chapter.
An informative read which is sure to offer a sturdy foothold to any student in the field.
Waterside Press; 2013; Pb £16.50
Reviewed by Dean Fido who is a PhD student at Nottingham Trent University