Thursday, October 31, 2013

Psychological Treats for Halloween Tricks

Jessica Kendorski, Ph.D  & Stephen R. Poteau, Ph.D.

If someone breaks out the Ouija board at the Halloween party you’re attending in attempts to contact and converse with their late Uncle Bernie, do them a favor, and tell them any movements they make on the board can be explained by the theory of ideomotor action (I’m sure it’ll make you the life of the party). The gist of ideomotor action is that people are prepared to initiate movements they think about performing even if they are not going to actually enact the movement, and most importantly, that there is a tendency to enact the movement the more vividly it is imagined. [1]

Ideomotor action has been used as far back as the 1800s to explain various psychic phenomena such as water witching (using a diving rod to find water underground, a debunked practice which is still very much in practice today), magic pendulums (used to ascertain the sex of an unborn baby; also debunked), and yes, those seemingly involuntary movements made on Ouija boards.[2] There is support for a particular type of ideomotor action that is called intentional induction, which entails the greater likelihood of instigating a movement if it results in something we would like to see happen.[3] One could liken intentional induction to a confirmation bias or self-fulfilling prophecy. Applied to the Ouija board, if your friend expects Uncle Bernie’s psychic powers to move their hands, the intentional induction facet of ideomotor action theory suggests their hands will be more likely to move across the board and spell out what they think is Bernie’s message. It turns out Bernie’s message is merely what you would like to hear from Bernie. 

Interestingly, there is some knowledge to be gleaned from Ouija boards. In a study involving a memory task that specifically examined implicit sematic memory, which is not accessible to conscious recall, participants providing volitional responses to questions they had to guess the answers to were accurate at chance levels (about 50%).[4]  However, participants who used a Ouija board to respond to questions they were guessing the answers to were accurate 65% of the time, a significant difference from the volitional response group. It turns out ideomotor actions can tap into knowledge we have but don’t know we have. Ouija boards can be a useful tool to communicate information about ourselves to ourselves, but falls short of tapping the communication lines of ancestral ghosts. In short, belief in the traditional powers of Ouija boards is plain, old superstitious.
Superstitions. What are they? Why do so many of us believe in them? And how is it that people will do seemingly irrational things in order to continue their good fortune and not invite misfortune? Superstition is defined as an irrational belief that an object, action, or circumstance not logically related to a course of event influences its outcome. It’s October, and it seems the month of October is bombarded with superstitions like “playoff beards” in baseball and the ominous sign of black cats on Halloween night. What these things have in common are people engaging in behaviors to support the belief that they are somehow in control of the outcome.

Fifty years ago, one of the greats in Experimental Psychology, B.F. Skinner shaped superstitious behavior in pigeons. In his paper published in 1948, titled "Superstition in the Pigeon," Skinner explained how reinforcing pigeons on an interval schedule (delivering a treat after a certain amount of time has passed) produced superstitious behavior in the pigeon. For example, Skinner would deliver a food pellet to the pigeon after a certain amount of time. He found that the pigeon would then continue to perform any behavior that occurred immediately before the food pellet was delivered. The pigeon's behavior did not control the delivery of the food pellet, but the pigeons began to walk in counter-clockwise circles, bob their heads, or toss their heads as if the pigeon was lifting an "imaginary lever."[5] Although the pigeon's behavior had no control over the outcome, the pigeons continued to engage in the behavior that may have resulted in their fortune. The pigeon’s behaviors sound a lot like lucky socks before a game, a lucky tie before a job interview, never again wearing the shoes that resulted in a particularly bad day. Want to make someone engage in irrational behaviors in their attempt to control the outcome of an event they actually have no control over? Just deliver treats on a time schedule and see what types of behaviors you begin to see. 

And if you want to get a gruesome image stuck in someone’s head while they are performing these irrational behaviors, just tell them not to think of flesh-eating zombies of The Walking Dead ilk. In a study of thought suppression,[6] where participants were instructed not to think of a white bear, what do you think happened?  You guessed it, they reporting having intrusive thoughts of a white polar bear. This is explained by ironic process theory, which states that there is a dual process of cognition: one is automatic and effortless and is responsible for looking for a failure of control, while the other is the conscious operating process.[7] In the polar bear experiment, participants tried to consciously think of something else, but the automatic, effortless process of looking for a failure of control (thinking of a white bear) often kicked in and this restarted the cycle of consciously attempting not to think of the bear yet again…until the automatic, effortless process looking for failure of control forced the white bear back into consciousness (hence the name ironic effects of mental control). It is important to note that these effects are most pronounced under high cognitive load where resources are taxed thereby making those automatic, effortless processes much more influential. This doesn’t take away from the effects of ironic processing theory because in everyday life, we are typically cognitively taxed with the billions of bits of information flooding our senses. In point of fact, the ironic effect of mental control has been demonstrated in several facets of life such as depression, sleep disorders, and even sexual deviancy,[8] which makes this theory one of clinical relevance.

So there you have it, the psychology behind Halloween-related phenomena. Hopefully, a black cat will not cross your path this Halloween night as you are stepping on a crack on the sidewalk, fingers crossed! -just in case. Boo!

[2] Pfister, R., Janczyk, M., Kunde, W. (2013), Action Effects in Perception and Action: The Ideomotor Approach. Frontiers in Cognition.
[3] Knuf, L., Aschersleben, G., Prinz, W. (2001), An Analysis of Ideomotor Action. Journal of Experimental Psychology General, 130(4): 779-98 
[4] Gauchou, H.L., Rensink, R.A., Fels, S. Expression of Non-conscious Knowledge via Ideomotor Actions,Consciousness and Cognition: An International Journal, Vol 21(2), Jun, 2012. pp. 976-982
[6]   Wegner, D. M. (1989), White bears and other unwanted thoughts: Suppression, obsession, and the psychology of mental control, New York: Viking/Penguin
[7]  Wegner, D. M. (1994), Ironic Processes of Mental Control, Psychological Review 101 (1): 34–52
[8] Johnston, L., Ward, T., Hudson, S. (1997). Deviant Sexual Thoughts: Mental Control and the Treatment of Sexual Offenders, 34(2).

Friday, October 11, 2013

The Stigmatization of Mental Illness

Petra Kottsieper Ph.D

This week, October 6-13 is mental health awareness week.  The first full week of October was designated for this purpose by Congress to further the National Alliance on Mental Illness’ (NAMI) efforts to educate the public about mental illnesses. 1

Over the past several decades NAMI’s agenda included raising awareness that mental illnesses are biological brain disorders due to chemical imbalances, in an attempt to get these problems classified alongside medical disorders such as diabetes. This in turn, would hopefully achieve their second goal to reduce the stigmatization of mental health problems.  This largely overlapped with the declaration by H. W. Bush that 1990-1999 was to be the  “Decade of the Brain."  Consequently, mental health disorders became increasingly labeled as disorders of the “brain” with research focused on neurobiological etiologies, and the development of a large cadre of psychiatric medications to treat these disorders.
In 2010, Bernice A. Pescosolido, Ph.D. and her colleagues published a study on Americans’ attitudes on the attributions/causation of mental illnesses and alcohol dependence. They also looked at attitudes towards psychiatric treatment  and what stigma beliefs respondents held.   The surveys conducted compared the years 1996 and 2006.  It was found that in the 2006, following the "decade of the brain," significantly more respondents stated that they believed the causes of mental illnesses to be rooted in neurobiological problems, and that these problems should be treated by a psychiatrist.  This was good news for those who working towards demystifying  and/or developing a reductionist etiology of  mental illnesses.  According to the beliefs of NAMI and many other advocates, these changes in attitudes should have also translated in a reduction in stigma and negative beliefs often held with regard to this population, but this was not found. 

In a survey conducted in 2006, there was a slight increase in respondents stating that they would not want to work or live next to an individual with schizophrenia or alcohol dependence.   It is obvious that these beliefs have real and significant consequences for individuals with mental illnesses.   Following the de-institutionalization movement , most people with mental illnesses reside in the community , and the main goal for mental health policy makers, providers, advocates and individuals with psychiatric disabilities has been to have people reside in the community and utilize acute care hospital on an as needed basis.  However, as the Pescosolido and other studies have shown , living in the community has not necessary translated into being part of the community.

At this point it might be helpful to talk about what mental illnesses really are and what I mean when I talk about serious mental illnesses (SMI).  First of all they are NOT intellectual disabilities (formerly called mental retardation). Intellectual disabilities, communication disorders, Autism Disorders (including the formerly known Asperger’s disorder) , Attention-Deficit/Hyperactivity Disorders, and some other disorders make up what is called the neurodevelopmental disorders.     Second, mental illnesses and substance use disorders are incredibly heterogeneous.  There are people with what are called personality disorders, where symptoms are thought to be more stable and consistent (which does not mean they cannot be very serious and impairing someone’s functioning), and then there are individuals with what are usually thought to be more “acute” or waxing and waning mental health problems such as depression, anxiety, bipoloar disorder, eating disorders, delusional disorders, somatic disorders and so on.  There is a federal definition for SMI, which does not list specific diagnosis, but addressed that the problems must result in significant functional impairments for the person.   Loosely defined, when practitioners and policy makers discuss SMI’s they are talking about schizophrenia spectrum disorders, bipolar disorder, and major depressive disorder.

It is true that people regard most things, such as novel or different experiences that they are not familiar with or that are clearly out of the norm with some hesitation.  These experiences are hard to classify, and that is something we like to do as human beings.  We are not sure how these experiences are going to turn out and hence the unpredictability makes many people uncomfortable. This means that when it comes to people with mental illnesses we base our perceptions of folks with these problems on several factors that all mutually reinforce each other. 

Individual with serious mental illness often struggle with housing, indeed about 1/3 of the homeless population is estimated to have some form of serious mental illness. Employment opportunities for individuals with SMIs are limited, even more so for individuals with residual symptoms that may require adaptations to their work environments such as quiet spaces, more frequent shorter breaks etc.   This means that we often do not have contact with a person with SMI.  They are not working alongside us, are not living next to us and are not going to the same gym.  The media representations of folks SMI are invariably negative and are often related to violent incidents that have been committed by these individuals.  When we do recognize individuals with this otherwise often invisible disability in the street, or in our local corner store, we are often put off or scared because something in the person’s appearance and behavior seems “off."  This activates previously formed attitudes and beliefs; our stereotypes are activated and we keep our distance. 
It is true, that some people do not seek services for their problems and indeed deny that they have mental health problems, even with strong and overwhelming evidence to the contrary.  The problem of “insight," or rather the lack of insight into illness,  is far from being accepted as simply one of the symptoms of a mental illness (and personality disorder).  If mental illnesses would be less stigmatized would more people seeks services?  If services provided choices in the type of care that people wanted and needed would more people seek them?  These are questions that research can and has started to address.

We also need to understand that the vast majority of people with serious mental illnesses do not choose to be homeless.  They also do not choose to have few prospects to achieve a meaningful present and future.  The choices you make are contingent on your past experiences, your dreams and hopes, and opportunities.   We need to give folks more opportunities which would also allow people to having real meaningful goals again.  Meaningful goals often lead to a stronger commitment to these goals and an acceptance of responsibility for one’s life and choices.  Individuals need to be given more hope and need to learn how to become hopeful again.   Positive life experiences need to replace past negative experiences .
We also need to acknowledge that there are already many folks working alongside us with well managed serious mental illnesses, including such serious problems as bipolar illness and schizophrenia.  These folks may not feel comfortable telling us about their diagnosis due to fear of being stigmatized or discriminated against at their jobs, even in spite of theoretically having the protection of the Americans with Disabilities Act. These individuals need to be welcomed into our workplaces, school boards etc., and encouraged to talk about their experiences.  We all need more role models of individuals who have either overcome significant challenges or are doing mostly well despite ongoing challenges,  as we have enough coverage of people who are not.

It seems that the problem of stigma needs to be address on multiple fronts in multiple ways, and many of these efforts are under way.   But we are all responsible in this endeavor.
To me, one such inspiring act occurred when Kjell Magne Bondevik, the former prime minister of Norway (1997-2000 and 2001-2005), told his country in 1998 that he needed to take some time off from work due to an episode of serious depression seemingly related to work burnout and stress.  Interestingly, he received overwhelming support from the Norwegian people and his fitness for his position was only questioned by a few other politicians, who in turn were criticized for their requests.

Of course most people with mental health problems are not prime ministers, but this at least proves the point that mental health problems can affect anyone.   In 2009, he noted “We must create an environment…where it becomes as easy to talk about mental health as it is to talk about a physical illness or condition…It must be as easy to return to your workplace after a mental breakdown as it is to return after a physical illness.  And we must take more seriously all kinds of harassment… in schools and in the workplace.”
We all need to do more to combat stigma.  Talk to your friend or family member when you think something is going on with them.  No seriously, at least ask the person if they are okay, they can always tell you that they do not want to talk about it, or that everything is alright.   Do not discriminate against qualified applicants with mental health conditions.  When you see someone standing at a bus stop with 20 shopping bags, inappropriately dressed with weird make up and muttering to themselves, think about how this person was once someone who went to school and wanted to be a hairdresser, a chef or an accountant.  How this person may have played an instrument, had a pet, and hated to get up early in the mornings for school.  Also think about that if you are mental health professional; professionals hold similar attitudes towards individuals with SMI as in the general population. If you are a teacher, see if you can include information on mental illnesses it into your curriculum. Speak up if you hear other people talk about people with depression as "weak" or "whiny."  

Educate yourself. Learn that the overwhelming majority of individuals with an SMI are neither violent or dangerous, in other words that  “the absolute number of assaults committed by psychiatric outpatients is low." Read one of the many excellent first person books out there.  If you are a person with a psychiatric disability or a family member get involved in some advocacy that works for you and is important for you. 

And you know, when someone paces up and down on the subway platform, clearly not muttering into a Bluetooth headset, and then of course sits right next to you on the subway, it might just be okay.  Because even though the person may keep fiddling in a strange and obsessive  manner with one of his ears, and then turns to you and asks you if you have a jar of Vaseline on you for his ear, that was it really.  He wanted to borrow a jar of Vaseline. Some people need a tissue, he needed something else.  I just politely said “Nope, I don’t, sorry."  And he politely said, “thanks."  

Monday, September 9, 2013

Framing Syria: The Psychology of Pro vs. Anti U.S. Intervention

Stephen R. Poteau, Ph.D.

This is not meant to be another well-worn politicized psychology piece highlighting the differences between Democrats and Republicans, but instead, a reminder of how psychology affects the attitudes of citizens, both Democrat and Republican alike, regarding foreign policy. The big news these last few weeks has focused on Syria and how the U.S. is poised for action. There is no doubt that Bashar al-Assad has used chemical weapons on his own people, and that is a tragedy, but there are many atrocities committed on foreign soils that we, as a nation, were/are comfortable ignoring (e.g., genocides in Cambodia,[1] Rwanda,[2], and Bosnia,[3] to list only a few examples). What underlying psychological processes are responsible for our neutral, supportive, or opposing stances when it comes to U.S. foreign policy?

The psychological research on framing isn’t new, but in areas like attitudes toward politically charged issues, it has a much more recent history. Simply put, the psychology of framing is the examination of how the presentation of something (e.g., emphasizing losses or gains) biases choices/behaviors and attitudes. Since comparisons have been made between the situation in Syria and the missteps we took in going to war in Iraq,[4] a look at the framing of the issues surrounding the Iraq wars may shed light on why nearly 60% of Americans oppose a U.S. intervention in Syria, according to a Reuters poll[5] (only 9% are supportive and 30.2% are supportive if chemical weapons had been used by the Syrian government).

A framing study in 2008 examined a multitude of factors that influenced attitudes regarding the Iraq wars (Borrelli & Lockerbie), and found, for example, that when asking Americans whether or not they support the Iraq war, merely mentioning U.N. or international support for U.S. involvement in Iraq lends American citizens to be much more likely to support the war. However, when the same question is posed with a mention of a lack of international support, American citizens are not supportive of the U.S. engaging in the Iraq war (Borrelli & Lockerbie).  Applying these framing effects to the Syria question, not only is there a lack of international support for our proposed intervention,[6] but there is also a lack of interest among U.S. politicians (across both parties) to wait for the U.N. to inspect chemical weapon sites,[7] which may ring eerily reminiscent of WMDs in the days George W. Bush was in office (as I write this my phone buzzed with the CNN headline, ‘Clothing and soil samples collected after Syria gas attack tested positive for sarin, UK PM’s office says’[8]).
Questions regarding support also skewed in favor of the Iraq wars if they were framed in such a manner that Hussein’s threats to Saudi Arabia, WMDs, or terrorism were mentioned (Borrelli & Lockerbie, 2008). Similarly, as noted, there is an increase in support for a U.S. intervention in Syria from 9% to 30.2% when sarin is mentioned. There is talk of terrorism in the form of a response from Hezbollah directed at Israel should the U.S. intervene in Syria, but the majority of media outlets have dubbed the repercussions (largely emanating from Syria, Russia, Iran, and China) to a U.S. intervention as exaggerated and unlikely to transpire.[9] In fact, in an article inaptly titled,‘5 Possible Repercussions of a U.S. Military Strike on Syria,’ ABC news addresses only 4 repercussions (the 5th repercussion is that there is no repercussion!). The other 4 repercussions noted are softened or muted by policy wonks.  Obama’s appeal to action in Syria hasn’t gained traction in the psychology of Americans possibly because his claim that there is a direct threat to our own national security[10] isn’t as convincing as WMDs and terrorism after 9/11. The semantic framing of the Iraq war as the ‘War on Terror’ by the Bush administration appealed to American psychology as the confrontation of an evil and irrational adversary that is lacking in the media coverage of the Syrian conflict (Harmon & Muenchen, 2009).

One very interesting finding in the study of the framing of the Iraq war was the effect of the names of the political actors in the forefront of the conflict (Borrelli & Lockerbie, 2008). An explicit mention of George H. W. Bush or George W. Bush led to an oppositional stance on the Iraq war, while explicit mention of Saddam Hussein led to increased support for the Iraq war (Borrelli & Lockerbie). The authors suggest further study into why the American psyche is affected in such a curious manner, but there appear to be parallels with the current Syria situation. Though there is a good amount of coverage of Assad, the dominant theme of the U.S. news cycle revolves around Obama (e.g., Obama pressing/almost ignoring Congress to push forward with a U.S. intervention, Obama versus Putin at the G-20 summit over Syria, etc.). Perhaps this framing with Obama as the dominant focus of the U.S. media coverage of Syria has dampened support for a U.S. intervention just as it did when George H. W. Bush or George W. Bush was mentioned in the context of the Iraq war.  
Framing effects are much more pronounced when attitudes are not strongly held, but maybe after 9/11 and the Iraq and Afghan wars, attitudes regarding foreign policy have calcified into a non-interventionist mindset among the American public. To think we are no longer susceptible to framing effects, however, would be naïve and dangerous. There is a wealth of research on attitude change suggesting that a more elaborate type of thinking can elicit lasting attitude change less resistant to persuasion, while focusing on superficial things like the characteristics of the speaker will lead to only temporary attitude change (Petty & Cacioppo, 1986). Maybe we, as the American public, should consciously engage in a more elaborate processing of issues that are central to the well-being of our country. Maybe we should dare to eliminate or at least blunt framing effects when it comes to such pertinent issues like whether or not we should go to war in Iraq or whether or not we should intervene in Syria.

Borrelli, S. A., & Lockerbie, B. (2008). Framing Effects on Public Opinion During Prewar and Major Combat Phases of the U.S. Wars with Iraq. Social Science Quarterly (Wiley-Blackwell), 89(2), 502-522.
Harmon, M., & Muenchen, R. (2009). Semantic Framing in the Build-Up to the Iraq War: Fox versus CNN and other U. S. broadcast news programs. ETC: A Review Of General Semantics, 66(1), 12-26.

Petty, R.E.,& Cacioppo,J.T. (1986). The elaboration likelihood model of persuasion. Advances in Experimental Social Psychology, 19, 123-162.


Monday, August 12, 2013

5 Things a Psychologist Should Tell a New Parent (but rarely does)!

Jessica Glass Kendorski, Ph.D.

As a psychologist and mother of two, I have had the opportunity to read copious amounts of psychological research on parenting and children, while simultaneously experiencing the new parent anxiety that I must employ every available resource to ensure my children are happy and successful. Parents are bombarded with tons of advice and information, and the amount of options available can be enormous and overwhelming. This can create a sense that we must do everything to ensure that our children have the best start to life possible, paired with the anxiety of the possible regret we would feel if we missed something.
Of all the things parents are told they should do here are a few things that parents are rarely told. (Note: Some of this information applies to children who are developing typically. If you have a concern regarding a child's development you should contact a medical professional).
1.       Your baby can’t and probably should not read: Babies are born to discover their world through exploratory learning and social interaction, and are quite good at this. Reading to your children at an early age and throughout childhood is essential to developing early language skills and social/emotional development. However, programs that overly stress academic learning at a young age are not particularly helpful to children since the brain is not ready to handle this task. As Dr. Sam Wang, Associate Professor of Neuroscience at Princeton University points out, "Language is acquired quite well before the age of 6, but trying to force your children to read before the age of 4 is an effort that doesn't work very well because the brain is not very well-equipped to tell the letter 'b' from the letter 'd' and so on." Trying to force a child to perform a task that he/she is not developmentally ready to perform could cause frustration, which may lead to inappropriate behavior and hindering the innate curiosity to learn. It is important to understand typical development and learning readiness rather than trying to teach children tasks which they may not have the skills to perform.

2.       Maturation Is A Wonderful Thing: And will eventually solve many of a child's current behavior and social difficulties. There is a tendency as humans to believe things are permanent. Children will and should perform many behaviors that would not be appropriate as an adult.  As opposed to focusing exclusively on these behaviors, adults should take note of how they view and respond.  Let's take toddler biting as an example. Biting tends to be a very normal part of a toddler's repertoire, as they do not have other ways to communicate and express frustration. How we respond to this fleeting stage of biting is important (See: It is equally important to place this developmental stage in perspective, understanding that as communication and social skills develop, the biting and other inappropriate behaviors will decrease. Take heart, for this too shall pass.

3.       Sometimes Time-Out should be put in Time-Out: Time-out is effective in reducing a behavior IF used appropriately, and sometimes it is difficult to use the right way. Time-out by definition is time-out from reinforcement. More specifically, a child needs to be engaged in something reinforcing for a time-out to be a successful consequence (specifically reducing the behavior). Case in point, if you ask a child to eat his broccoli and he refuses, and you send him to time-out, in essence you are removing him from the dinner table and the sight of the revolting (in his eyes) piece of broccoli. You may be doing exactly what he wants you to do, which will have the effect of increasing the likelihood that he will refuse to eat broccoli the next time it is presented. However, if your child is having a great time on the playground and hits another child and you remove him from the playground (assuming he wants to be there), that should be an effective use of time-out to reduce hitting behavior. Additionally, there tends to be an overuse of time-out and subsequent neglect of other quite effective methods for supporting the challenging behavior of children. Techniques such as teaching behaviors that you want to see (eating nutritious foods and why); Reinforcing specific behaviors (eating vegetables, keeping your hands to yourself);  And reinforcing a low preferred behavior (eating broccoli) with a high preferred behavior (eating a cookie), known as the Premack Principle. Time-out is one tool in the parenting bag of tricks, there are many others.

4.       Gifted is rare: You know the saying "Everyone thinks their child is a genius?" Well it's likely true and we do. But guess what, geniuses are extremely rare. A child can have high intelligence, be an excellent student, have talents in a variety of areas, and still not be gifted. This is likely because different states, counties, and districts, have varying criteria for how they define giftedness (some correctly identify gifted children better than others). Often, truly gifted children will require some form of support in school in specific areas of difficulty related to high intelligence/giftedness. Although the specific definition of giftedness varies, one thing most agree on is its rarity.  As Dr. Stephen Pfeiffer, Professor at Florida State University states "a generally agreed-upon definition, gifted children are those who are in the upper 3 percent to 5 percent compared to their peers in one or more of the following domains: general intellectual ability, specific academic competence, the visual or performing arts, leadership and creativity." So parents, it's okay that giftedness is rare and your child may not be gifted. It does not take anything away from your highly intelligent 6 year old, or your 7 year old superior violin player. On the other hand, if you feel your child is gifted, it is essential to notify the school to ensure that the necessary supports for learning and social development are in place.

5.       Parenting does not have to be perfect: Parents will mess up and that is okay. It's not about perfection in parenting but rather about fixing the areas where there has been an error. Recent research has shown that maternal warmth and nurturing is one of the most important areas in a child's development, specifically brain and hippocampus development. A recent study published in Proceedings of National Academy of Sciences, observed how parents responded to their children during and following a stressful situation. These same children returned for MRIs of the brain years later, and the results revealed that children with mothers that were rated as more nurturing had larger hippocampi.   As Dr. Charles Raison, Associate Professor of Psychiatry describes:"Why is this finding important? Because more than any place else in the brain, when it comes to the hippocampus, size matters. Other things being equal, having small hippocampi increases your risk for all sorts of troubles, from depression and post traumatic stress disorder to Alzheimer’s disease.  If you’ve got depression, having small hippocampi predicts that you won’t respond as well to antidepressants as well as depressed people with larger hippocampi."  It is not necessarily about perfection in parenting, but about nurture and warmth.

The takeaway, we as parents should do our best to do right by our children, but should not be consumed with anxiety that we have to do everything and always be perfect. When children watch the adults in their lives correct the mistakes that they make, it begins the modeling process for how children will respond to their mistakes. Engagement, encouragement, warmth and nurture go a long way (and we can put down the flash cards)! It's time for parents to receive encouragement for all of the things that they are doing correctly, rather than another self help book on the things they could be doing better. Parenting well is essential, and parents should take strides to improve. However, if parents are consumed with the anxiety of trying to do it all, it may in fact block parents from learning and implementing the things that are essential.


Wednesday, July 31, 2013

Authenticity, the Mahler 9th, and the Pursuit of Perfection

Bruce S. Zahn Ed.D ABPP

I vividly remember the first time that I heard the Mahler Symphony No. 9, in the early 1970s, with Carlo Maria Guilini conducting the Philadelphia Orchestra.  Guilini was an elegant and distinguished Italian who had carved an admirable opera and symphonic conducting career, and was genuinely beloved by most musical artists with whom he worked. He was a man who conveyed sincere passion and deep inspiration to his fellow musicians. That was brought into sharp focus when I heard him conduct during the performance that I attended.  Guilini accomplished his magic completely by memory - nearly 90 minutes of complex symphonic music written to convey the composer's last musical argument articulating his angst, neurotic doubts, and thoughts about mortality in a world at the turn-of-the-19th century that was changing before his very eyes. I can still see Maestro Guilini waiting for what seemed like at least 30 seconds of silence after the very last quivering note, standing on the podium with his eyes closed, sweat pouring down from his forehead, then turning from the orchestra and nearly staggering offstage in emotional exhaustion.  I was so overcome by the beauty of the symphony itself, Guilini's magnificent performance and the emotion of the moment that I did not have any recollection of how perfectly or imperfectly the musicians had executed the musical notes on the printed score. It was a moment in time that stood frozen forever in my mind and my heart.
During the course of my life, I have been privileged to have heard many subsequent performances of this great musical classic of the 20th century. Conductors I have heard perform it include Levine, Kubelik, Haitink, Bernstein, and Von Karajan.  In addition to live performances, I have collected and heard scores of other performances on CD by conductors too numerous to mention here. But for the purposes of this brief essay, I would like to focus on live performances recorded by two of the greatest interpreters of our time: Leonard Bernstein, and Herbert von Karajan. Both performances were captured live with the Berlin Philharmonic Orchestra and have been issued on CD by Deutsche Gramophone.  I heard Bernstein lead this work with the Boston Symphony Orchestra at Tanglewood during approximately the same time his recording was made, and I also heard von Karajan perform it with the Berlin Philharmonic on tour at Carnegie Hall in New York City. The von Karajan performance and recording has been dubbed by critics as one of the greatest symphonic recordings of the 20th century and a true desert island masterpiece.  The Bernstein performance and recording is unique in that it was the only time that he, a Jew, ever agreed to appear in Germany to conduct the Berlin players. The Berlin Philharmonic at that time was von Karajan's orchestra, and they were considered to be peerless among the world's elite symphony orchestras.

When it was announced that the Berlin Philharmonic was coming on tour to the US with a series of concerts at Carnegie Hall, I leapt at the opportunity to get tickets to hear the aging maestro conduct the great Mahler 9th. It was like trying to get tickets to a Rolling Stones concert, with hours and hours of dialing and redialing TickeTron until I finally got through and scored my tickets. When the day of the concert came, people were lined up outside of Carnegie Hall flashing hundred dollars bills wanting to buy tickets from scalpers or ticket holders, as if their very existence depended on hearing that symphony. If you've never heard a concert inside Carnegie Hall, it is truly one of the world's miracles of sound. Wherever you sit, you can hear perfectly homogenized sound with every detail in high relief. It truly is one of the great experiences of a lifetime and an opportunity to hear great music played in one of the greatest venues on earth.  Von Karajan was the epitome of the German ideal of control, precision, and perfection in every technical aspect of musical performance, and he drove his orchestra to produce musical performances that reflected those ideals. If the Philadelphia Orchestra was considered to be the Rolls Royce of orchestras, then the Berlin Philharmonic was the Lamborghini. The combination of hearing this orchestra, with this conductor, at Carnegie Hall promised to be truly an exceptional experience.
Von Karajan was known as an obsessive perfectionist who sought to control every detail of musical performance and production in pursuit of glorified perfection.  His ideals and values of perfection may be seen within the context of the Germanic history of idealization of the ultimate quest for beauty in its purest essence.  In many cases, such demand for perfection might lead to mannered and self-conscious performances that are more reflective of perfection in sound itself, to the detriment of "soul" in the music, but for this conductor, he was often able to combine mastery of sound and beauty of musical expression. That said, I recall feeling a bit let down after von Karajan's performance.  Sure it was perfectly gorgeous, but frankly, it left me more than a bit cold. It stood in stark contrast to Guilini's gut-wrenching traversal for me, and gave me something to ponder for many years about the value of perfection, and whether or not that is an ideal worth seeking at the expense of authenticity.

Several years after the Carnegie Hall performance and subsequent recorded performance from the Berlin's concert hall, the Philharmonie, Bernstein's live performance with the Berlin Phil was released on CD on the same record label. The recording quality is quite different, not as smooth and balanced as the von Karajan, but more noticeable is the raw emotion and lack of technical perfection. It was a gritty performance, full of emotive, heart-on-the sleeve breast-beating for which Bernstein was famous. Indeed, Bernstein used to say that when he was on the podium, he felt as if he WAS Mahler, experiencing all of his pain and ecstasy in the moment. There are some rough instrumental attacks and jagged entrances-not at all the type of pretty, yet somehow emotionally sterile playing from the very same orchestra that von Karajan elicited. It was Bernstein at his best, an exhausting performance of emotional extremes, dragging the listener through the composer's personal torment until he reaches reconciliation with death with breathtaking glimpses of the horizon beyond earthly life and ultimate peace.
What is the point of this musical treatise and performance review, and what does it have to teach us about psychology?  First of all, it goes without saying that beauty is in the eye of the beholder, and that perception is everything. I am only expressing my personal views about these performances and the meaning that I extract from them. That said, I think that it can tell us something about the advantages and disadvantages of demanding perfection in our own lives and activities, and give us something to consider when we are trapped by our efforts to desperately pursue the illusion of perfection at the cost of authentic self-expression in the here and now. For sure, the more that we pursue perfection in our lives, the more likely we are to be disappointed by its slippery nature.

Unlike conducting a symphony orchestra, not all of the variables at our disposal are usually under our complete direct control. Human error is part of our daily experience. We live with imperfection in every moment, yet the more that we tell ourselves that it is a requirement in order to validate our worth, the more frustrated and depressed we may be. On the other hand, living in the moment and expressing ourselves without self-consciousness can be incredibly liberating, albeit challenging. There is a direct parallel here, in my mind, to the principles of Acceptance and Commitment Therapy.   Steven Hayes, in his popular workbook, Get Out of Your Mind and Into Your Life[1], articulates that ACT is about developing a willingness to embrace every experience that life has to offer by feeling emotions completely, based on personal values that matter the most to each individual.  These ideas were also expressed many years ago in a book called the Inner Game of Music[2], which many conservatory musicians have been exposed to in order to mediate the conflict between seeking the perfect performance AND emotional authenticity. In essence, the take away from this book and the training that it promotes is that the more that one strives for perfection, the more one becomes self-conscious and self-critical, and less free to maximize self-expression, risk-taking in the moment, and emotional authenticity. Ironically, striving for perfection opens one up to a greater possibility of error, as one remains distracted by hypervigilance! The willingness to take risks and the willingness to embrace the possibility of one's imperfection actually enhances the experience of being in the emotional moment, increasing authenticity and self-esteem. A fascinating paradoxical byproduct of this is that technical performance can be enhanced.

So what lessons can we take away from these observations? Surely with the emphasis today on technical expertise, precision, and outcomes, many of us strive for the ideal of perfection. However, this does not necessarily equate with satisfaction, self-esteem, self-confidence, and genuineness in self-expression. The ability to live in the moment, knowing that at any time we might hit a wrong note, make an awkward entrance, or even be a little sharp or flat, elevates our experience and enriches our interactions as authentic beings in an imperfect world. And that should be music to almost anyone's ears!

[1] Hayes, S. & Smith, S. (2005).  Get Out of Your Mind and Into Your Life: The New Acceptance and Commitment Therapy.  New Harbinger Publications.
[2] Green, B. & Gallwey, W. T. (1986).  The Inner Game of Music. New York: Doubleday.
Bruce S. Zahn Ed.D ABPP- "Celebrity" Guest Blogger. Professor and Director of Clinical Training in the PsyD in clinical psychology program. He is a former trumpeter, having studied with Seymour Rosenfeld, second trumpeter with the Philadelphia Orchestra, during his youth.  He is an avowed classical music and opera fanatic, with a penchant for the music of Gustav Mahler and Anton Bruckner, among many others.  Students are invited to swing by his office almost anytime to catch a daily concert when he is not in meetings or engaged in class preparation.

Thursday, July 25, 2013

You, Me, Myself and I: Candy Crush Saga is “ruining” our lives!

Petra Kottsieper Ph.D.

I never thought it could happen to me, until the sister of a close friend offered me a little taste of it.  Sure I had known about it, seen other people do it, but I thought I was immune, until that day, that day when I was handed an iPhone and told to play a game of Candy Crush Saga.  Now I find myself absently staring at my phone, will forgo a new episode of a real life crime TV show, and sometimes sneak in a game before my first cup of coffee. I am in need of help, and apparently so are 15.5 million other users who play this game multiple times a day to reach or crush one of the game’s 385 levels.  My hairstylist in level 60, the receptionist on level 90, and one of my girlfriends who I never thought would touch an iPhone game is in level 30.
If you are not familiar with the game, I suggest you read this brief article published through ABCNews[i], which does a great job describing the game and outlines two main reasons why it is so attractive.  The first, the game has tons of built in social aspects; you can link the game to Facebook, compare your scores to your friends’ scores, and also get your friends to give you extra chances when you have run out (in lieu of waiting). The second, the game is fun and challenging, exploiting our natural tendency for pattern recognition in a cute puzzle matching game.

Perhaps what is really most ingenious about this game is that it is both “ethical” and “unethical.” Apparently the game’s creator King, stated that the game could be played in it’s entirety at no cost.  But in order to do this, you have to be either really, really good, or you have to have PATIENCE with a capital P, which is where the “unethical” part comes into play!  This is because at each level of the game you get 5 chances to get it right and if you do not, the game locks you out.  Then it gives you the option to a) buy more levels, b) get them from a friend, if you play the game via Facebook, or c) WAIT.  And it not only makes you wait, which confused the hell out of me when it happened the first time, but  it varies the wait time, sometimes it is 30 minutes, sometimes less, sometimes more.  This can become a minor crisis when it is 12am and you are super close to finishing a given level. You barely missed it on your last try, and now what?  Do a load of laundry and then continue?  Grade some papers? Play with the kittens? Go to sleep and try again the next day……….. , right!
What is even worse, when you are ready to move to certain levels, for example 36 or 51, you cannot.  Some levels have additional barriers built into the game.  Now, again, if you do not want to buy yourself to the next level, or rely on friends for extra chances, you need to play “3 mystery quests”, in order to be able to continue.  However, as I recently learned doing this, you can only play 1 quest PER DAY.  Talk about needing P.A.T.I.E.N.C.E. now!

Apparently there are enough people, who are not willing to or are unable to wait, and handsome amounts of money are being made on an ostensibly free game.  Which seems fair, given someone created this game, and keeps developing it; and most things in life made for our entertainment by other people cost money. However, what is “unethical “about the game is that the developer so expertly exploits several aspects of our human condition, including some behavioral principles that we probably all recognize from our undergrad intro to psych class. (Of course, I am also open to the interpretation that I am just annoyed that someone is getting rich on what we psychologist research and teach…….but that is another blog post.)
Initially, you will most likely be pulled into the game because humans have an innate need to perceive or see patterns, a basic function of perception to order, sort, and make sense of incoming stimuli.  Once you are playing, learning principles and possibly some of your personality traits/tendencies start operating on your behavior.  The early levels are not too easy as to be unchallenging but are still relatively easy.  Your interest is kept up, because at each level some type of learning is involved, given you have to figure out the specific objective of each level.  This requires some slight variation in your strategy via insight or trial and error learning.  When you meet a level, even if you need many attempts, you are reinforced by your experience of success aka a bit of a rush of your dopamine system (accompanied by little mini explosions on your screen and all sorts of other cutesy things).  The dopamine spike occurs, because you are activating your brain’s “pleasure center” by having met a goal and unlocking another level of the game. In these situations extra dopamine is your friend, as it will give you pleasure, which in turn makes you persevere to and through the trials and tribulations of the next level.   I am sure that when a friend of mine, who was apparently stuck on a level for 3-months (!), finally succeeded, her dopamine rush, was a bit like the Niagara Falls.

The game also has an element of “chance” and unpredictability built into it.  When you crush some candy, new candy appears.  The candy’s type and color is variable and seemingly unpredictable, which can make a big difference to your particular game.  It is the polar opposite from an experience we may have all had: the refrigerator experience.  You open the fridge, there is no ice cream.  You open it again, still no ice cream, you might open it again, but eventually you stop and resign yourself that it will not magically appear.  Your behavior is extinguished.  Not so in candy crush.  Here your crushing behavior is sort of intermittently reinforced on a micro level.  You are merrily (or desperately) crushing away, and every once in a while the King game god's gives you the right candy you needed just in that situation. It has been known for a long time that intermittent reinforcement works best when you have already established a behavior and want to maintain it, in other words this will keep you crushing away….. pop and pop and pop.
Levels become progressively more challenging, but now you have also build skill and hence this game appears to perfectly illustrate the concept of “flow” first outlined by M. Csikszentmihalyi.  What this means for gaming was outlined nicely on a blog written by Sean Baron in March of 2012, where he noted that Csikszentmihalyi found that when a person’s “skill is too low and the task too hard, people become anxious. Alternatively, if the task is too easy and skill too high, people become bored. However, when skill and difficulty are roughly proportional, people enter Flow states.”[ii] Baron went on to outline four conditions that help promote a flow state that game developers should consider, and consider them they have- in Candy Crush Saga.
But to go back to my original point, flow or rather the ability to experience flow, is interrupted in this game on purpose at many different levels. And that brings me to back to the “unethical” part of the game, except of course I say this in jest, because we all get manipulated knowingly or unknowingly all the time.  So Candy Crush Saga is exploiting our need for reinforcement, for mastery and for flow….. Is it also addictive in the true meaning of the word?
How many of you have stayed up until 3am and had to get up at 6am and were subsequently sleepy and unproductive at your job all day?  Have you used the money you were going to buy a birthday present with to purchase additional games?  Oh, you are exaggerating you may say reading this.  You may say, psychologists and mental health types always have to diagnose everything.  After all, buying additional levels in Candy Crush Saga is “relatively” cheap and therefore can be easily excused, at least by people who can afford a $5 special coffee several times a week.  Spending a dollar here and there is hardly going to ruin most peoples’ lives.  However,  the mechanism underlying your need to buy the next Candy Crush Saga level instead of waiting , are not all that dissimilar alas probably less intense and less life shattering than urges to keep gambling, or even using substances.  It has been found that gaming indeed can be addictive, just as gambling, sexual activity and internet use. Preliminary research indicates that in individuals who are addicted to online gaming the same neural substrates are utilized as in individuals who have a substance abuse addiction (Ko et al., 2009). Of course, the operative descriptor here is that this study used individuals with a gaming addiction.  I am absolutely not saying at all that the 15.5 million people are who are playing candy crush saga several times a day have a gaming additction.  What I am saying is that some of them might be, or might become addicted.  I am also saying that maybe those of us who fall into the non-addicted but definitely impulse control challenged group should not be so quick to judge people who do become addicted to certain behaviors, or substances.   We might also want to learn about how we are manipulated and why this work so well!
Finally, the game can teach us a very important albeit possibly unintended lesson, which is how much patience we have, and how to delay our gratification.  A whole host of positive outcomes are associated with our ability to self-regulate and delay gratification, and maybe therein lies one of the biggest gifts of this game. But wait, before I go into that, I just gotta cram in one quick game…..
Note: If you think you, or a loved one, is addicted to online or other forms of video gaming, please read this paper for a review and treatment options. Also please contact a mental health professional, who is qualified in the treatment of these types of behaviors.
Griffiths, M. D, & Meredith, A. (2009).Videogame Addiction and its Treatment.Journal of Contemporary Psychotherapy.

Ko, C.-H.  ,  Liu, G.-H. ,  Hsiao, S.,  Yen J.-Y., Yang, M.-J., Lin, W.-C., ….. Chen, C.-S.(2009). Brain activities associated with gaming urge of online gaming addiction. Journal of Psychiatric Research,  43,  739–747.