Everyday Psychology

Here's the back story: a famous, well-respected psychologist writes a hugely complex journal article and then gives an interview to TIME Healthland online. The interview is as confusing as the journal article, and great controversy ensues in the profession.

Are people being mislead and confused? Are they being harmed? Does he have a valid point?

First, about the harm: yes, some people are going to read this as a confirmation of their pre-existing belief that psychotherapy is a waste of time. But that is not so much harm. People who are distressed and who realize that it might be a good idea to speak with a professional are going to continue to seek help. They are the ones who will actually benefit.

Does Dr. Kazdin have some good ideas? Yes. He spends a lot of time talking about the fact that psychological disorders and emotional troubles take a terrible toll on society and on the health of individuals.

He also thinks that therapists should be able to offer a "portfolio of interventions." It is not at all a bad idea to use smart phones and the internet and other technologies to provide some treatments, as he suggests.

Dr. Kazdin is in favor of prevention and in favor of expanding treatment options. He wants more people to be trained.

So where does this article go wrong?

I have written about this before: "Psychologists Reject Science? ... Oh My!"

That article was about a movement in the profession to create a new model for understanding mental illness, a model that views science and the scientific method in a very narrow way.

The goal of the "empirically based treatment" movement is to say that there is one particularly correct way to evaluate the usefulness of treatment. They say that the only measures that should be used are like the ones they use to test new drugs: randomized controlled trials ("RCTs"). And from that follows the assertion that therapy isn't worth doing if you don't deliver the treatment according to a standardized protocol.

That in turn means that psychologists all should be trained in some specific way and that we need new training standards to make that happen. As for those of us who studied liberally and broadly in preparation for our work in understanding the human condition, well, some of us are just too old to catch on to the new way of doing things.

This article tries to incorporate that entire agenda. The journal article reads like a master treatise on the state of mental health in America and the difficult path towards salvation. Kazdin et al are advocating for the "Machine in the Garden," the technology that will transform the human condition.

Where Kazdin and others go wrong is in believing they can fully operationalize what is typically a unique and essentially human interaction.

There are certainly times when it is relevant to focus on the diagnosis and the symptoms and to apply techniques that have proven their worth in a head-to-head matchup with a drug and a placebo. "Cognitive Behavioral Therapy" done right and by the book is a godsend for many.

For most people, however, the decision to talk to someone and to be honest is a very personal decision and a very personal matter.

It's like when you call your bank or tech support: you're sitting there punching those keys, doing whatever you can to get connected to a human being.

People benefit from therapy in a number of ways and for different reasons. It is not like speaking to a friend or a family member and it is something different than having your blood pressure checked or your tonsils removed.

Early in my training, I was told that what people want when they seek a psychologist's help is someone who will be honest with them. People are relieved and strengthened not because you trained them to tolerate their anxiety or to brood less about their disappointments. People are relieved when they know that someone has listened to them and understood them, and when they experience themselves trusting someone.

The metaphor for the psychotherapeutic process is sometimes that of a sanctuary, a place of safety, and sometimes that of a crucible, a place where work can be done. There are other metaphors that can be applied, but the consistent finding from the science is that individual therapy works ... for many individuals and in many situations.

Sometimes, it is useful to drag out a protocol and to apply some empirical treatment rules. More often, people benefit from treatment because they have found a personal guide, rather than someone with a guidebook.

Is individual psychotherapy bound for the dustbin of history? No, not at all.

People in distress are not going to stop seeking personal solutions to their personal problems, just because some empiricist claims there is a better technology. Psychologists are not the type of professionals who would ever ignore the science. But we are also not the type to seek simple solutions to complex problems or to understand things narrowly when a broader perspective is called for.

The number of clinicians who use "the couch" instead of a chair will always be limited. That does not mean that the lessons learned from "the couch" will be lost or that we are soon to see the end of TAU: "therapy as usual." Even though you can't put it in a bottle, prescribe it and market it, it remains a proven method.

When Leadership Fails: What seems to be the problem at Sacramento State?

2011-06-24T13:34:00.000-07:00

In the past few years, Sac State has spent and wasted well over one million dollars on lawsuits that could easily have been avoided. These are text book examples of what it costs when management ignores workplace harassment. It’s a text book example of what happens when leadership fails.

The most recent case to hit the news (see story) has actually been going on since 2005. After spending money on four investigations and who knows how much in attorney fees, the campus ended up paying $900,000 to three female professors. And it’s not over yet.

It’s an issue that could have been put to rest five years ago at hardly any cost at all. You have to wonder if It was anything other than administrative incompetence that has kept it going.

What happened is that three female professors reported that students had come to them with complaints about Professor Wilfrido Corral. He was sexually harassing students. The three professors reported the complaints, as required, and four students came forward. An investigation found their complaints to be valid, and one student got a $15,000 settlement from the University. But things got ugly after the the three professors complained. As described by campus attorney Dawn Theodora: "Corral basically went on a vendetta against them … they were just doing their jobs.”

So first we have harassment, and then we have retaliation.

And what did the campus Human Resource managers do about Professor Will Corral? Well, basically nothing. They put a letter of reprimand in his personnel file (a letter that would later “disappear”) and they made him take the sexual harassment training that all staff are required to take anyway.

The legal documents suggest that a turning point came in August of 2006.

Before any of the other faculty knew about the investigation or the findings, Corral was elected to be the new Department Chair. Corral took the reins early and started retaliating against the whistle blowers. And then in August, he was seated as Chair.

The women didn’t seem to understand why someone who preys on students and retaliates against whistle blowers would be seated as a Department Chair. Why would the campus allow someone like that to maintain a position of power? They complained even more when he took control.

Handling what had now become an ugly affair were Human Resources Vice President David Wagner and Associate Vice President Kent Porter. On the organizational chart, they sit right below President Alex Gonzales.

Porter woud later tell an investigator that they spoke to the woman who complained the loudest. They were: “trying to explain … that human resources had taken the appropriate action against Corral.” He thought the woman was just “not letting it go.”

Dave Wagner told the investigator that maybe she didn’t know about the letter of reprimand, and so she “probably felt that nothing was done.” Wagner said that “she views everything as black and white” and “probably believes that Corral should have been fired.”

Obviously, he should have been fired, perhaps maybe just to protect students. And if for some reason he wasn’t to be fired, why would they grant him a perch from which to prey?

Peter Lau, the campus Affirmative Action Officer met with Wagner and Porter about this. Lau told the investigator that there was “no policy in place that would allow them to remove him or otherwise prevent him from taking the Chair position.” So it was like they didn’t know what to do.

Porter was in the meeting when the decision was made, but in discussing it later, he “could not recall who was responsible for making the decision to allow Corral to assume the Chair.”

Obviously, the decision was the responsibility of Dave Wagner, the Vice President for Human Resources, He was in the meeting as the high man on the organizational chart. Referring to the fact that Carrol had sexually harassed students, Wagner later recalled that “it was difficult to determine if the conduct by Corral was unwelcomed.”

Maybe it’s true that the two students who accepted Corral’s dinner invitation welcomed the invitation. But it is hard to imagine that they wanted him to hit on them, or talk about being a “sex addict” or to “talk about doing it doggy style.” It is certain that they did not welcome that as dinner talk. The complaints from the students were well founded.

Years went on and it wasn’t resolved and just got worse. Corral would retaliate and the women would complain and there would be investigations and nothing would change. There was mediation and there were meetings with the Provost, Joe Sheley (the other No. 2 man on campus). Eventually, two of the professors who complained retired early, totally stressed out.

Why is this case still unsettled, even now in the Summer of 2011? It continues because of administrative incompetence.

The generous interpretation is that despite their positions, Sheley, Wagner and Porter just didn’t get it. They didn’t get that there was anything wrong or that these things just fester and don’t go away. Sheley later told the investigator that he “does not believe anyone at the University overlooked the issues or concerns with respect to Corral.” Perhaps not, but they didn't seem to understand what it was that they were looking at.

Wagner and Porter described the situation as an “intradepartmental policy dispute,” a “personal dispute,” and an “interpersonal issue.”

It had apparently become that. It became personal. The women were angry that their complaints had been ignored. They were in pain, it wouldn’t stop and there was some sporadic use of abusive language.

But that wasn’t the problem. The problem was that there had been no remedy for the retaliation. It was no longer about the original complaint regarding the harassment of students, now it was about the fact that Corral had gone on the attack against the women “who were just doing their jobs.”

Retaliation is illegal, and juries treat retaliation more seriously than even harassment and discrimination claims.

Jurors tend to have a hard time when someone says that they were mistreated because of their status or who they are. The jurors think: “they treated everybody badly, it wasn’t because she was a woman.” On the other hand, in retaliation cases, jurors naturally understand when someone says they were mistreated because they complained. Most people are cautious about complaining, they know what can happen. And juries know that it’s not right and that people shouldn’t be bullied.

The problem at Sac State is that the campus treated the problem like it was “failure to communicate.” They treated it like the women were the problem and that their complaints were about nothing more than the ordinary tribulations and minor annoyances that often take place at work and that all employees experience.

There is no general civility code for the American workplace. Skilled leadership and good judgment are required to to know when complaints are serious and how they should properly be handled. Sac State just didn’t get it, and the problem only got worse.

Eventually, the women sued, at a cost to the campus of at least a million dollars. The women got $900,000. The campus has defended that payment as having been made in good faith. The campus had to admit that the women deserved the money.

As for Corral, he’s what’s keeping it going now.

Eventually, after years trying to avoid the problem, the campus had to actually fire him. So now he’s suing the campus. You can just wait to hear his attorney say: “in all these years, the campus never did anything … they didn’t think he did anything wrong.”

Campus attorney Christine D. Lovely said in a hearing that he was fired for “immoral and unprofessional conduct,” which is exactly what the women complained about in 2005.

The problem at Sac State is that this is not an anomalous case. It’s not something out of the ordinary. There is a case to be made that at Sac State, complaints about abuse are routinely ignored and that the behavior is tolerated or effectively condoned. That is what seems to have happened in the case above and the generous interpretation is that it was the result of mismanagement and bad leadership.

In the past few years, the campus has had to settle other lawsuits that are eerily similar to this. They’ve settled with people who had the resources and the stamina to take the matter to Court. That’s public information. What is not public is how many people with valid complaints gave up. We also don’t know how many didn’t even bother to complain, knowing that nothing good would come of it?

There is a pattern here, or perhaps a few. If you read the cases, you can see in each one that with just a bit of good judgment and a bit of leadership courage, these matters could have been handled effectively at little or no cost. People wouldn’t have been troubled and the campus wouldn’t have done damage to itself.

What seems to be the problem?

See: "When Leadership Fails" for an account of another, similar case at Sac State.

When it comes to psychological health, management just doesn't get it.

2011-06-22T10:31:00.000-07:00

When it comes to the psychological and mental health of workers, managers tend to think they are doing everything right. Employees would typically beg to differ.

That is the implication of a new study released by the Canadian Conference Board and reported in the Canadian press (see source note caveat below). The report title was: Building Mentally Healthy Workplaces.

I haven't read the full report,* but the data look good. They surveyed over a thousand people and did a fair number of in-depth interviews. They surveyed almost 500 executive managers and slightly more workers.

Here is the big finding: while 82% of managers said that their company "promotes" a psychologically healthy workplace, 70% of workers said they didn't.

It's a huge disconnect in perceptions, and it makes you wonder if management ever really "gets it."

Workers know when they are suffering from psychological health issues and they know what their organization did or did not do to help. Their perceptions can be trusted.

I have written before about studies showing that managers typically do not pay enough attention to the people they supervise. They are usually too busy paying attention to the people above them, those who can affect their careers. This study is consistent with that observation, and in addition, it says that the managers aren't even aware of the problem. They apparently think everything is OK and that things are being well-handled.

Karla Thorpe, the lead author on the project told the press that "managers are actually very confident in their skills and abilities to help employees ... they say they're very comfortable having conversations with their staff" about personal concerns and difficulties. Most of the employees interviewed thought the opposite. Most of them said that their supervisors don't know much about mental health issues or psychological difficulties. They don't talk to the workers and the workers are not comfortable talking to them.

For this study, "mental health issues" were broadly defined and included "ordinary" depression, stress and anxiety disorders. Some people surveyed had experienced significant mental illness. Whatever the case, it is certain that many of them were troubled because of workplace stress and that it was a productivity problem for most of them. When people are not healthy, they don't perform as well, even though it costs the same to employ them.

This is a fundamental issue with respect to organizational competence.

Organizations invest in human talent and can't afford to waste it. Ignoring the health of the worker goes right to the bottom line. In the workplace, psychological health is the big cost factor when it comes to safety and productivity. That is where the big money is lost or saved.

In Canada, just like in the U.S., the majority of those who can't work and have to take time off because of health concerns are taking time off on disability because of psychological problems. There are huge numbers of people who suffer work related psychological troubles in any given year.

Most managers believe that they are competently managing the well-being of their workers. Only 26% of workers would say that their supervisor "effectively manages mental health issues."

The importance and the cost to every organization is such that for a manager, this should be a fundamental competency, tending effectively to the human talent.

For the study's authors, the take away message is that an organization cannot afford to waste talent and that there are steps to be taken. There are various ways organizations should be proactive in reducing the stigma, preventing hostility and retaliation, and providing support.

The prescription is all good and sensible, but it doesn't go far enough.

Yes, people should be cared for effectively. Whether it is because of organizational values or just the bottom line concerns, companies have to assume some responsibility to help their workers.

It is not enough, however, to help them when they are troubled. You need to help them when they are well and to keep them psychologically healthy. At least half of the time, when a worker is becoming emotionally disabled it's about something that's going on at work. It could also be something that is happening at home because of something gone bad at work.

The critical action step to be taken by an effective manager in a competent organization is to make certain that workplace stress factors are properly managed and resolved.

It's not about too much work or too many deadlines. It's about the things in the workplace that demoralize people and drain the satisfaction from work.

People suffer from work when they have complaints that no one will listen to or problems that no one will solve. It's when they say to themselves, "why won't someone take care of this?!" that they start to go mad. People lose faith in the organization when management doesn't solve things or take care of stuff. People start to wonder if things will change and why they are working there.

People cannot deal with stress when it doesn't seem worth it, and that's when it costs the organization.

The Canadian study supports the idea that a psychologically healthy workplace is good for business. This is well known. What they have identified, however, is something more. It's a fundamental flaw in the business or organizational model. What they have shown is that management does not understand the problem, and even worse, they don't know that they don't understand it. They don't know that they don't know what to do.

The report argues that organizations should do more to support workers who are hurt or harmed psychologically. I would argue that organizations should do more to keep them from harm.

*There is a hefty fee to read the 74 page report. This article is based on the press released summary from the Canadian business think tank.

The DSM: more like the Boy Scout Handbook than the Bible

2011-06-20T08:47:00.000-07:00

The Diagnostic and Statistical Manual is being revised. Often described as the psychiatric bible, there are plans for the DSM to be released in a 5th Edition. It is a work in progress.

Naturally, people ask: "if it's like a bible, why would it need to be revised?"   And then they wonder: "Am I suddenly going to be cured or suddenly declared mentally ill?"

Years ago, psychiatry declared that no one was neurotic anymore. For the DSM-5, they are planning to eliminate any reference to hysteria, which means they will finally get Freud completely out of the consulting room.

Do you tend to get angry and upset, more so than most people? Then you might soon be suffering from "temper dysregulation disorder." If your kid is troubled or disturbed, there will be a new label for that, something other than the catch-all phrase, "bipolar."   If you lose interest in sex and can't get started, there is a diagnosis for that too.

People in the professions argue about whether and how the DSM should be revised.

There is a concern that if any changes are made, it will suggest that they didn't get the science correct the last time around. That uncertainty could cast doubt on the entire psychiatric enterprise. Psychiatry has gotten it wrong before, most famously when it classified homosexuality as a mental illness just waiting for a cure. This adding and deleting of disorders will be the part of the argument that will get the most attention in the press.

For psychiatry, there is no end of critics. For the field in general, there is no end to the "alternative theories." The alternative "paths" to health and understanding range from the plausible to the fantastic. The fear is that change could sow doubt and confusion.

There is also a concern about the fact that the DSM is meant to represent consensus judgment. In other words, it is being done "by committee."   That would perhaps be OK if everyone agreed, like in the way that everyone agrees about the symptoms of a cold or a heart attack.

In the case of the DSM-5, there is deep disagreement at a number of levels, including at the level of basic measurement. Part of the argument has to do with whether or not we are looking at categories of disturbance (like pigeonholes) or dimensions of pathology, with each person's troubles being made up of different, individual elements.

The stakes in this process are high.

The last time the DSM was revised, the committee said that kids could catch bipolar too, just like adults. In response, there are now many more "bipolar" kids taking medications. All drugs that alter mood or mind have risks, and those risks can be hard to judge in the case of a growing brain and a developing mind.

Yes, some kids need medications. But medications have become too handy as the cure for everything. That is a risk factor in itself, especially when it results in a failure to also seek psychotherapy. No child on meds should be without a therapist, period.

Lurking in the background of the DSM revision process is the pharmaceutical industry. Markets may open or close for them. Messages may need to be changed. They do sell drugs, don't they? Suspicions about profit motives have already infected the debate about how we diagnose.

To those in the intellectual leadership of psychiatry, a branch of medicine, the stakes have to do with the very definition of mental life.   NIMH (the National Institute of Mental Health) is intent on defining everything mental, emotional, and behavioral as "clinical neuroscience," like a collection of circuits and chips in our brains. From the definition of human psychology, the goal is to remove thoughts and ideas, attitudes and perceptions, and learning and development. Actually, the goal is to explain the psychological in terms of the biological hardware.

This movement began in earnest in the 1990's, a period that was officially dubbed the "Decade of the Brain." Many believed that the focus on the brain was leading to a mindless psychiatry. That is perhaps the key problem presented for psychiatry in formulating a new diagnostic manual. There is absolutely no way to get the science of mental life correct if the first step is to eliminate reference to the mental. It's not just neuroscience. It's also psychology.

In considering the controversy surrounding the diagnostic changes, we really have to ask: what is the purpose of the manual?

There is in fact a need for complex, rigorous, narrow and detailed criteria for research purposes. But in clinical work, the goal of understanding and describing the individual is often better accomplished by broader categories, unique qualifiers and unique symptom descriptions. In clinical work, the ultimate objective is to arrive at a diagnostic formulation that fits the individual patient and that provides a way to plan for treatment. You want to understand and describe the person, not the pigeonhole.

In the end, I expect that the DSM-5 will be a useful guide. I think it will be like the Boy Scout Handbook. It will not be written in stone and it will not tell you what do in every unique and specific situation. It will guide us through many diagnostic dilemmas and it will provide fundamental data about how those people have come to be troubled and how they are having difficulties in life.

One of the things I remember best from my Boy Scout Handbook was how to treat a snake bite. They wanted you to sterilize a knife, apply a tourniquet, cut open the victim and use the snake bite suction cup from your snake bite first aid kit to suck out the poisonous venom.

That advice has long since changed, and for good reason. It was like field surgery.

There is no reason that the DSM should not change as well.

Why are we so fascinated with murder?

2011-05-24T12:47:00.001-07:00

The public is endlessly fascinated with murder. When it’s on the news, we may recoil in shock and horror, but often and in other media, homicide is a source of entertainment.   We wonder why people kill and we are intrigued by the ways in which the deed is accomplished.

In the real world, there is in fact a practical duty we share in understanding the means and the motivations for crime. Understanding is necessary for prediction, prevention and protection.

But the popular fascination with homicide goes far beyond the practical. The story lines are a staple of art and literature and a subject for both drama and comedy. The murder mystery is often most compelling when it abandons reality and is framed in fantasy.

The crime of murder is a most fundamental taboo and also, perhaps, a most fundamental human impulse. In the Book of Genesis, Adam and Eve's original sin is quickly followed by the original crime: Cain's slaying of his brother Abel. In Exodus, the law is handed down: “thou shall not kill.”

We all know that murder is a crime and that sometimes killing is justified. Self-defense is an example of justifiable homicide. In real life, every killing demands that we pay attention and decide: was this murder or was it something else?   Under the law, homicide is not at all just a matter of black and white or absolute condemnation.

In every case, there is an assessment to be made about the enormity of evil involved. Was it a first or a second degree murder or was it some form of manslaughter? Was it the act of a “normal” person, or the act of someone criminal or someone deranged.

To answer that question, we usually look to the motive. Why did they do it? What would enable them to kill or drive them to the deed? How did they decide or did they even think about what they were doing? When it comes to murder, there are many reasons why.

When people kill for profit or excitement or to terrorize others, we know that it is simply evil. It’s more complicated when there are other motivations.

When the killing involves some some feeling or emotion we all share, we call it “a crime of passion.” And then we wonder, was it a common passion or an irrational one? Was it an impulse we all might experience? Was it an act that we might understand or somehow excuse?   We all know what anger feels like and can imagine various degrees of rage. Anger is a normal passion, so we have to wonder if it might also be an excuse. The same applies to jealousy.

We are fascinated because we wonder: would I have felt the same way, had the same impulse and would I have done the same thing? Would I have felt justifed?   Would I have I have controlled myself? Was there nothing that could have stopped me or something that should have stopped him?   Sometimes, there is a very fine line between "normal" human passion and evil intent, between a loss of control and a desire to let loose.

Some years ago, a woman named Ellie Nesler walked into a California foothills courthouse and shot to death the man who had sexually molested her son. It was in the national news and even on Oprah. People were debating: was it vigilante justice and cold-blooded revenge, or did she kill in “a heat of passion” that might have overwhelmed the sensibilities of any common man? The defense argued that she had been driven mad and was insane.

This happened in Gold Rush country where you can still find an awful lot of the Old West. The jury said she wasn’t crazy and convicted her of manslaughter. It was in fact a cold-blooded killing, but the jury understood her passion and her impulse. What Ellie said to me when I interviewed her was: “anybody in their right mind would have done the same thing.”

Our fascination is driven by all of the many complexities that are to be found in the motive for murder. Even when we are certain that the intent is simply evil, there are still all of the degrees and forms of evil to be examined.

People are also naturally intrigued by the infinite number of ways the crime can be committed.

The variables involved are almost infinite: Was the victim targeted or doomed by chance? Was it planned in advance or a sudden undertaking?   Was the method crude and stupid or was it clever and sophisticated?

We are also fascinated by the investigation: Were the suspects many or was it someone acting alone? Were the clues subtle or obvious? Did the investigation require science or logic? Did the detectives rely on intuition or insight, acute powers of observation or just hard work? Was the perpetrator the usual, obvious suspect, or was it the person no one would ever suspect? When the investigation is over, we still have to ask: did they get the right guy?

In real life, we also tend to focus acutely on whether or not it could happen to us. I am certain that no one is going to kill me for my fortune, but I am not so certain about my safety when I read about a senseless shooting of an innocent bystander or a burglary gone wrong that left the homeowner dead. We pay attention because we want to know if we are safe.

In the end, I think the fascination with murder is natural because there are so many different ways to judge each crime. We wonder about the victim, about the perpetrator, and about the circumstances. We are intrigued by the motive and the method and how they got away or how they got caught. We wonder who would be capable of the crime and whether they are “normal” like us or hopefully quite different.

In the real world, we are fascinated because of the powerful emotions aroused when we consider the fate and fortune of the victim and the pain that remains for their survivors. In reality, it is the cold realities that draw and demand our attention.   We actively seek the clues that tell us that we are safe, that it couldn’t happen to us.

Murder is fascinating whether it’s real or not. Every case creates a set of questions to ponder.    In the real world, we need to be intrigued and aware to remain safe. We need to examine each case and judge for ourselves: was this a matter of primal instinct or some unnatural act? Was it a matter of evil intent, a result of human fraility or a justified response to threat or provocation?.

When it’s art, all of those questions make it what we call a “thriller” or a “mystery.” When the body is real, the “thrill” may be gone, but the questions and the fascination remain.

The campus safety threat they don't tell you about

2010-09-01T23:49:00.000-07:00

Colleges and Universities are required by law (the Clery Act) to disclose campus security policies and crime statistics. This information may provide parents with some measure of comfort when sending children off to college, but knowing the odds of your child becoming a crime statistic does not mean you should assume that your child is safe. Hazards still remain, and as I have argued in my comments about "helicopter parents," as a parent you need to help your child understand and cope with the risks.

More than 25% of students drop out before completing their freshman year in college. Stress and depression are common reasons.

A young college student will be confronted by many stress factors. Many of these actually represent challenges to be faced.

But there are two stress factors that are matters of safety and not just something for a young adult to deal with on their own: sexual harassment and bullying.

A study published in 2005 by the AAUW (American Association of University Women) found that almost two thirds (over 60%) of college students have been subjected to some form of unwanted behavior that the students themselves thought was a form of sexual harassment.

From that two thirds, if you take out those who complained about jokes, gestures and looks they found disturbing, there are still 28% (almost a third) who have suffered some type of "serious" assault.

The study notes that some forms of assault are "relatively" uncommon. For example, "only" 11% reported having been cornered, blocked or followed in a sexual way, and "only" 6% had been been encouraged to do something sexual in exchange for a better grade or a recommendation. But what the authors noted is that even when you are talking about "only" 6% or 11%, that means there is a huge number of actual cases and incidents.

Are students troubled and disturbed by these experiences? Yes. Except in the case of jokes and gestures, almost all of the students said that these experiences are upsetting.

Do they typically report these events to campus authorities or administrators? No. Only 7% will tell a campus employee.

Is this just a matter of students harassing other students? No. The AAUW report concluded that while it is much more likely that students will suffer at the hands of other students, 7% report having been harassed by professors.

Again, 7% is not a big number in relative terms (according to the report), but it is huge for those who are the victims. And it is an exceedingly huge number if you even just think about it for a moment. If 7% of students say that they were sexually harassed by a professor, that's 70 out of 1000 or seven hundred students on a 10,000 student campus.

Students surveyed for the AAUW study said that they were particularly distressed when the perpetrator was a faculty member. Not only does it involve a betrayal of trust, but it also generates a range of fears relating to academic progress and success.

Obviously, you don't want to scare and alarm your children, and you don't want to add this to the list of things that keep you awake at night when your they go off to school. But you want to discuss this with your children.

It's not that difficult. All they really need to know is what they should have learned in high school, if they had been paying attention:

if it makes them uncomfortable, they don't have to put up with it;
sexual harassment could come from another student, or it could come from a professor;
if it happens, they need to tell someone and talk about it.

The thin line between sanity and the safety net

2010-09-01T16:53:00.000-07:00

Driving to the post office today, I noticed that one of our neighborhood schizophrenics was out on the sidewalk, but not in her usual spot. A very slight and petite woman, her clothing is usually augmented with multiple plastic grocery bags. She carries many more such bags with her, apparently having failed to obtain a grocery cart. She typically lays out multiple scraps of paper on the sidewalk and in the gutter. Driving by, you can see that they are covered with her writings, which are not in an English character script. Sometimes she holds up a scrap or two of paper for display while talking to cars or whomever, or to no one at all.

It’s an ordinarily sad sight, but she appears in no distress. She does not have the sun-leathered skin or the grime encrusted clothing of a homeless person.

Today, I felt there was reason to worry. She was in the shade, but it was still just the noon hour in Sacramento and the thermometer was already close to 100.

On my way back, she was in the middle of the street with her plastic bags strewn about. It’s a four lane street with a turn lane in the center. A man was near her, gesturing for her to return to the sidewalk while speaking on his phone, presumably calling 911. There was nothing more to be done. Either she would find her way back to the sidewalk or the Sheriff’s cruiser would soon arrive.

I had another stop to make. When I came out, she was out of traffic and back in her usual spot, on the corner in the sun. I wondered how she could tolerate the heat while encased in plastic.

The woman is obviously not sane (I’m not using that term in its legal sense). Had the Sheriff arrived, there is a good chance she would have ended up in the back of the patrol car. It would be nice to think that she would then get a ride to County Mental Health to enjoy a 72 hour respite from her daily toils.

That is not, however, what would have happened. Our clinics are more or less closed. Those people still capable of getting help on their own are going to the hospital emergency room. The other day in Sacramento, two such patients were put together in the same room to wait, and there was a fight or an assault or whatever.

Those who are incapable of seeking treatment on their own are now taken to Jail. They are always good for some misdemeanor charge that can be dismissed after they have been seen by the Jail Psych service. But if they struggle, resist or cause problems while being “arrested,” there is inevitably a more serious charge to keep them in Jail and to be resolved by the Courts.

Once that person is in Jail, there is a good chance that I will be appointed to see them. No, my task as a psychologist will not be to help them. I will be paid to determine whether or not they are competent or sane enough to navigate the Court system. Often, that’s not an issue. But there are a lot of times when these people can’t find their way out the door, even when it’s opened for their release.

Today, in too many parts of California, there is no fine line between sanity and the safety net because there just is no safety net there at all.

We let preventable problems get worse and then deal with them where it costs the most.

When we fail to spend on fundamental quality of life services like mental health (and the list goes on), it just costs us more in the long run. The way I think about it, if your roof has a hole in it, you don’t save any money by letting the rain come in.

The County can’t spend and the State can’t spend because they don’t have any money.

The Republican Party in California says that there will be no new taxes of any kind. They actually speak for a lot of people, and because of the vote requirements for a budget, they can block almost anything.

This is not good. It is not good to have a mentally incapable woman at risk for entering the criminal justice system only because she wasn’t given a bit of psychological help when it was needed.

For a community, it is a moral as well as a practical failure. In a community, if your safety net has a hole in it, you don’t save money by letting people fall through. You would have to be insane to think that you would.

People don’t like taxes? They don’t like fees? They don’t want to spend money?

We’re beyond the point of no choice. Things need to be fixed.

This blog is about everyday psychology

2010-09-01T15:13:00.000-07:00

I am a professional psychologist in independent practice. Most of my work is in the criminal justice system. I am trained as a clinical psychologist, not just as a psychotherapist. Before I specialized, I studied the field of psychology broadly and conducted research. I have expertise in a number of areas.

I started writing and posting articles here a few years ago.    I write when I have time and I write about things that happen to be of interest to me at the moment. I have never meant this to be an everyday thing, although it is everydaypsychology that I like to write about.

In some way, everything in psychology has something to do with everyday life and everyday experience.

Psychology is concerned with how people perceive the world around them and how they react to it, how they grow and how they learn, and how they relate to others and function in groups. Psychology is about how people think, feel, and behave.

That is a definition that includes a lot of what we might encounter in everyday life, whether at home at work or in the community.

A lot of what we know in the field of psychology seems like it should just be a matter of common sense. Actually, very little of it is just that simple. Our most fascinating insights are counterintuitive: not what you would expect.

A lot of what people think they know about psychology seems to be common sense but is actually more like personal opinion.

When I communicate as I do here in my professional role, I try to keep my personal opinions out of it. Whenever I say something about what people should do or how things ought to be, I try to ground my argument in fact, theory, science or professional experience.

Some of what I write is of more personal interest to me. Some of the topics are just things that captured my imagination.

I hope you find it all useful and interesting.

pgm.

When Leadership Fails

2010-04-22T23:55:00.000-07:00

About twenty years ago at Sacramento State (California State University, Sacramento: CSUS), the campus administration learned that an engineering professor had been harassing a recent graduate in a very overt manner. The male professor had developed a "friendly" relationship with a heterosexual male student and was upset when the kid realized he was being "chickenhawked" (the professor was making a sexual advance). The alum told the professor that they would no longer be friends and the professor began stalking him and trying to ruin his career.

Cici (my wife, and the Director of Career Services in the College of Engineering and Computer Science) got involved when the alum's employer complained that Professor Miroslav Markovic was engaging in some rather strange and bizarre behavior. Actually, the behavior was scary and traumatic.

The campus administration was fully informed about the situation and basically did nothing. As it would become known later, this was not the first time that Professor Markovic had tried to "hook up" with young male students, and it would not be the last. Markovic was a tenured professor and he was therefore "protected" or "tolerated." No warning was ever given to other students.

In subsequent years, there would be many other complaints about Markovic. From off-campus, employers wanting to contribute to the campus development complained about strange and potentially threatening emails he sent. Women and minorities complained about how he treated them in class. There was an incident in which he went in to a rage and destroyed projects students had built. From off-campus, there were more reports about him "doing it again," trying to develop inappropriate relationships with young men.

And then there were the reports about his having assaulted staff members and having threatened to shoot others.

Cici got involved because students and employers came to her with their complaints. She also complained when Markovic called her a "bitch," and when he threatened her and when he assaulted her. She complained about him a lot during the past 15 years or so because the campus taught her that these are matters that must be reported. She also complained because she thought the campus would do something, that the leaders would lead, and because she wanted to protect her students.

While all of this was going on, Cici was also trying on a regular basis to get reclassified. She wasn't being paid what the men were being paid to do similar work. She actually had been promoted once, many years ago when she founded the Career Service office in engineering. But that promotion was taken away when she returned from maternity leave.

Now it could be that Cici was never promoted like the men simply because of gender discrimination. It certainly wasn't because she was less productive as an employee. Like the men who did similar work, she taught classes and counseled students. but she also created an entire program of services.

The other possibility was that she was held back in retaliation for being a "whistle blower." That's how the Sacramento Bee would describe it.

In the Fall of 2008, Cici hired an attorney and in August of 2009, she sued Sac State. She was pushed her over the edge when Markovic threatened to shoot a pregnant staff member. She reported this to Kent Porter, the Vice President of Human Resources, and he did absolutely nothing. He didn't investigate, take action or warn staff.

Nine months before she filed the suit, her attorney wrote the campus and demanded that they do something about Markovic. President Alex Gonzales never responded to that letter, but the campus did hire attorneys to investigate. The investigation confirmed much of what Cici said about Markovic, but until the lawsuit was filed, the campus hid the reports.

The leadership failure in this case went up and down the line, from the Dean of Engineering Emir Macari, through the head of Human Relations, David Wagner, and to the President himself. Cici was screaming about a hostile work environment and nobody would lift a finger to either acknowledge it, resolve it or simply do something to avoid an embarrassing lawsuit.

After Cici filed the lawsuit, Markovic immediately "retired." The campus Affirmative Action Officer also retired in short order, right after he wrote a letter confirming that Cici had in fact been subjected to a hostile work environment. He had the investigation reports.

Right after she filed the lawsuit, Cici was told that she could no longer teach any of the classes that she had been teaching for 25 years. The campus said it was a union issue: she wasn't classified properly to do the job she had been doing all those years.

This looked like more retaliation, despite what the campus said. The irony is that for no good reason at all, the campus shut down a program designed to help students get jobs on graduation - they shut it down right in the middle of the worst recession in generations. Accreditation teams have described Cici's career program as "a model for the nation."

In January of 2010, after Cici had been off work for five months (spending much of her time relieving stress with Yoga classes), the campus finally settled. You can read about the settlement in the Sacramento Bee.

Clearly, in the end, Cici "won." She got rid of the professor, received a meaningful promotion and obtained a settlement that was enough to cover her costs. The un-reimbursed psychic toll was tremendous, but Cici is back at work, doing what she loves to do. She has received nothing but positive support for what she did, and there was a lot of support.

Somebody had to do something and the leadership on campus failed completely. It cost them some money, but more importantly, they squandered their status. It was all completely preventable.

Did Sac State learn anything? Nah ...

Human Resources VP Kent Porter handled the settlement negotiations for the campus, and he was just plain pissy about it. The campus position was that Cici was just an "overzealous" employee, a nuisance to be dealt with.

And after it looked like it was over, Markovic was invited back to campus to enjoy the privileges of a retired professor, an "honored" professor emeritus. Human Resources told the IT technicians in Engineering that Markovic would be coming to campus to have his computer fixed. The day he was scheduled to arrive, three employees took the day off because they didn't want to see him again and didn't want to have to fix his computer. They were among those who had been threatened by him.

Consider that for a moment. The leadership knows that this guy created all kinds of turmoil. They have investigative reports saying that people are afraid of him. They know that he creates stress and discomfort for other staff. And what do they do? They ignore the well-being of their workers and treat him like he's done nothing wrong. Markovic threatened to shoot people on campus! What's not to get about that?

I don't think he will be returning to campus. After the lawsuit was filed, Markovic kind of disappeared for a while. He was named in the suit but couldn't be found to be served. The day he showed up on campus again, the process server was sitting there waiting for him.

There's just a bit more to the story. After Cici was back at work, she was speaking with an employer. He told her that he had recently spoken to Dean Emir Macari and that she should apologize to him. Obviously, her boss Macari was bad mouthing her in the community.

Cici complained to the head of Human Relations, Vice President David Wagner. When she settled the lawsuit, the campus insisted that no party could speak ill of the other. She also complained about Markovic being invited back to campus.

Dave Wagner's response? Markovic had a right to be on campus. Essentially, to hell with the well-being of the employees.

About the bad mouthing? Well, Dave Wagner basically just noted that she had, after all, sued them and publicly so.

What should Cici have expected? In the end, she should have expected nothing more from the leadership at Sacramento State than she had ever seen in the past.

The "leaders" at Sacramento State seemed to have learned nothing, so what do we learn?
This is a companion piece to three of my other posts. I think this story illustrates: that employers often don't pay attention to their employees; that it makes no sense to talk about work related stress unless we talk about the organizational causes; that rather than "treating" those who are affected, we need to change the environment; and that even when employees suffer hostile work situations, and even when they complain, "leaders" often fail to get it.

Here are my thoughts on those topics:

Is your boss paying attention to you?
Burnt-out on stress management? It's time to change the organization.
Workplace stress: Does anyone hear the workers screaming in their cubicles?

This is a shorter and final version of an article I posted some time ago, while this was all in play. The earlier version provides more detail and basically tells the whole story. If you are interested, it is still posted here. Additional materials, including the news stories and the 200 page lawsuit can be found here.

Clues to personality found in Austin plane crash pilot's diatribe

2010-02-18T16:00:00.000-08:00

Before crashing his airplane into an IRS building in Austin Texas, 53 year old software engineer Joseph Andrew Stack posted a lengthy note online. It begins: "If you're reading this" - thereby leaving no doubt that his acts were planned over at least some period of time. It is dated today, February 18th, 2010, and before it ends, he makes clear that he does not expect to survive his violent act.

Across the internet news sources, his statement has widely been described as a "manifesto," which is a statement of aims or intentions. At the document source The Smoking Gun (which is where I found the text), it is correctly referred to as a "diatribe," which is defined as a "bitter speech or writing."

I am writing this now because a TV news crew asked me to comment on the story as it was still breaking today. Much more will be known about Joe Stack in the coming days. But for now, there is much to be learned from what he wrote.

Here are some of my first thoughts:

Was he crazy?

In some sense, anyone who commits an act of domestic terrorism, while believing it is justified, is crazy in some way. In his writing, however, I did not see indications of delusional thinking or a clinically disordered thought process. There are some hints of paranoia of the type that are common among those with anti-establishment attitudes and beliefs, but there is none of the irrational and delusional paranoia that one would expect from a psychotic or schizophrenic individual. He didn't say that the IRS was targeting him specifically or that the IRS put bugs in his bed or was communicating with him through laser beams.

His writing is essentially coherent, although it is rather self-contained and self-referential. In other words, you need to understand his world view to know what he's talking about. It would have made more sense to him than to anyone else, and he assumes that you know and understand the things that he thinks he knows.

Is his writing the work of an irrational mind? Not in a clinical sense.

Was he insane?

That's a legal conclusion, not a clinical one. That question will never be tested in Court. In legal terms, the sanity question is: did he know what he was doing and was he capable of knowing that it was wrong? From his writing, there is no reason to doubt that he was sane ... in a legal sense.

So if he's not crazy, does that mean he's a normal average guy?

Obviously not. What you see in his writing is evidence of a "personality disorder." Also known as "character disorders," these are long-standing, deeply ingrained patterns of thinking, feeling and behaving. These disorders are formed from a person's attitudes, values and beliefs.

Ordinarily, we say that these characteristics are part of one's "personality style." When a personality style is disruptive or maladaptive or a source of problems and troubles, then we call it a disorder.

What about his personality was disordered?

What you see in his writing is that he was a self-righteous, grandiose, resentful and narcissistic individual who tends to externalize blame and responsibility for his shortcomings and failures. We also see that he was striving for power and omnipotence in the face of his fundamental human inadequacy.

How do we see that?

Let's start with his first line, where he writes: "why did this have to happen?" This is a classic assertion of non-responsibility. Rather than saying that he "did something," he is saying that "something happened." It is external to himself, something about which he is suggesting he did not have control. He could have written instead: "you are probably wondering why I did this."

Stack goes on to say that his writing is meant to be a form of "therapy," adding that "there isn't enough therapy in the world that can fix what is really broken." At first, you think he is saying that he tried to get help and it didn't work. But as you read on, you realize that he does not see himself as one who is broken or in need of help. It's the world around him that is beyond fixing. He's OK, the "system" is not. The therapy he is talking about is not for him, it's for the broken system.

In the first paragraph, Stack signals that he feels a sense of powerlessness and futility. Even in writing about the reasons for his impending act of terror, and before he tells us that he is actually trying to accomplish something by his death, he says that the writing exercise might actually be "pointless."

He also gives us an indication in the first paragraph that he is feeling a sense of anger. His comment is that there is "a storm raging in my head." What is interesting is that he does not refer to this feeling again. Instead, he simply provides a history detailing why he is so angry. And as he details how he has suffered and been abused, from the earliest days of his childhood, he makes it clear that it is all the fault of others. In essence, he is saying that his anger is righteous and justified, rational and reasonable. No where is he at fault or to blame. He is telling us that he worked hard, struggled mightily and always tried to play by the rules of the game. He is telling us that it is the game itself that is not fair, that the rules were stacked against him, and that while he was honest and forthright, he never had a chance and never caught a break.

His grandiosity is evident in many ways. The line that captures it best is his comment about moving from Lincoln California (the Sacramento region) to Austin Texas. He said that he moved, "only to find out that this is a place with a highly inflated sense ofself-importance and where damn little real engineering work is done." He is saying that he knows best. He is a highly skilled and knowledgeable engineer and everyone else is some type of hack.

We see the grandiosity also in his over-intellectualized analysis of the tax code he complains about. He lets us know that he has studied it and absorbed it and that his understanding must certainly supersede that of the experts who administer it. He refers us to an online resource describing these complex issues (having to do with the difference between employees and independent contractors) and refers to that resource as "our discussion," as if it is his work and his thinking. In referring to his obsession with the tax code and wasted efforts in trying to change it, he says that "the best we could get" was nothing at all. What he is saying is that he is not a lone crusader, but instead a central player in a movement. He refers to those in the movement with him as members of "disorganized professional groups," telling us again that in whatever he does, he is surrounded by incompetents.

Stack's fundamental narcissism is seen in his view that he is nothing other than a successful and accomplished individual whose failures in life are (again) entirely the fault of others. And from his letter, we learn that his failures are significant. He refers to a failed marriage, a lack of success in business, the loss of his retirement funds on two occasions, and an inability to secure wages commensurate with what he believes he deserves. The troubles he got into with the IRS are not, in his view, the result of his having failed to take care of business. He positions himself as responsible and successful, even while he documents his failings. He tells us through his analysis that he knows better than everyone else. He is the one who sees through everything and understands the corruption. There is nothing that he did wrong, because like any narcissist, he is not one who can do wrong.

Where does the striving for power and omnipotence come in?

Read the final paragraphs where he begins to talk about the justification for his act of terror.

Even though he says that he has "just had enough" (i.e., he's mad as hell and isn't going to take it any more), he does not formulate his actions as an expression of his rage. What he says, in essence, is that he is standing on principle and that he is undertaking the journey of a hero. His hero quest is cast in mythic terms, including where he aligns his purpose with the struggles of "the blacks and poor immigrants." Earlier in his note, he cast himself as one who was in sympathy with the struggles of the union workers in the "steel mills of central Pennsylvania." Most people will say that his act was cowardly. In his message, he has cast himself instead as a brave soldier in the fight against the man.

When he tells us what he hopes will come of his act, we see that in his view, it is political. He is not a pathetic loser who has failed and given up. He is not saying that he could no longer tolerate life or the frustrations he created for himself. He is not describing it as an act of despair or despondency.

What he is telling us in his final paragraphs is that his intent is to spark a revolution. His claim is that he is one of those who is "dying for their freedom in this country." He is suggesting that others will follow his path and that it is through this ostensibly selfless act of heroism that things will actually change. Violence, he says, "is the only answer." He sees himself as one who is willing to act to "stop the insanity." As I read it, he is not talking about the insanity raging in head. He is talking about the insanity that ails the country as a whole.

What he is striving for, in his formulation, is the significance and the power of martyrdom. His life, as he describes it, was unremarkable, unaccomplished and insignificant. His dream is that he will become a beacon and an icon. Referring to himself as the one who will light the fuse (and the lamp), he says: "I can only hope that the numbers quickly get too big to be white washed and ignored that the American zombies wake up and revolt." He expects that "people wake up and begin to see."

What is the significance of this type of pathological narcissism?

As I said above, he is not describing himself as despondent or as a victim of despair. He is not saying that his existence has become so painful that he chose to tear reality apart through an act of horrific violence. Through intellectualization and political affectation, he is denying that his motives are common and base or that he was simply discharging his anger and frustration. His intention is to elevate his battle to a higher plane of sanity, describing it as a noble cause. He is telling us that he is acting in response to a purity of heart.

The narcissism belies his entire argument. Indeed, it is exquisitely an act of self-aggrandizement for him to have even thought that anyone might accept or endorse his rationale (anyone that is, except for other lunatics). The narcissism tells us that it is really all just about him. Because he is such a noble character (in his view), he is justified in inflicting harm on the innocents in the building.

My argument that he is a fundamental narcissist helps us understand how a seemingly rational individual could commit such a horrific crime. Narcissism is the essential psychodynamic underpinning for the anti-social personality. Individuals with this personality type are also commonly referred to as psychopaths, sociopaths or common criminals. They are individuals who seem to care not at all about others, people like Bernie Madoff, who seemed to have no inhibitions or sense of shame or guilt when it came to stealing great fortunes. They don't experience guilt and they are deficient in their ability to feel remorse. Their needs and desires are so important, and their desires for satisfaction and gratification are so great that they have no reason to care at all about the feelings of others. Where they live, in their minds, is at the center of the universe. They have no need to empathize and so they feel entirely free to victimize.

The point is that no matter how he chose to rationalize his actions, there was nothing at all noble, heroic or transcendent in what he did.

Is that really why he did it? Is that really what it's about?

Probably not. His words and his explanation are not to be trusted.

His statement is a self-indulgent form of intellectualization. He is telling us that he was rational and acting with good cause. His purpose in writing seems to have involved a desire not to simply be written off as another angry lunatic who couldn't cope with the adversities one naturally faces in life. It is certain that he would have bristled at being described as just another "disgruntled" figure who decided to indulge his fantasies and satisfy his rage.

But that is what we are left with when we look at what he did. In a perverse way, acts of violence are often self-indulgent and self-fulfilling. It is probable that as he flew towards his victims, he felt a sense of power, purpose and satisfaction beyond anything that he ever experienced during the course of his miserable life.

In reading his "manifesto," I am reminded of the scene in the movie Michael Clayton when the character played by George Clooney finally accomplishes his heroic task. A man asks him who is he is, and Michael Clayton replies: "I am Shiva, the God of Death." That is the status, I believe, that Joe Stack was seeking to achieve.

This wasn't an heroic act, as Stack suggests. This was not, as he tells us, a matter of his choosing to stand for the good. In a sense, it wasn't even a political act. That is just the veneer he applied. This was in all likelihood just a way for him to relieve his frustrations and to achieve the sense of power, potency and significance that eluded him in life.

So was it really just about anger and rage, frustration and hostility?

That is not what I would focus on. There are many who commit explosive acts of violence and who can be described as having "over-controlled hostility." They can't cope with their anger, it builds up, and then, like with a pressure cooker, they explode. In those cases, there is often an immediacy to the crime and traces of the rage to be found in the evidence.

I'm reminded of a case I worked on a few years ago. A "really nice" man watched as his marriage imploded, and without explanation he stabbed his son forty something times and then bludgeoned him further with a hammer. The man survived, and to him, his acts were entirely incomprehensible. Joe Stack, on the other hand, contemplated his act and prepared for some time. It was deliberate and entirely intentional. His note tells us that he is not a man who "exploded in a fit of rage" or that he is a person who "lost control" of his senses.

His note tells us that he nurtured his anger and probably took pleasure from it (again, in a perverse way). He did not simply "go off" and act on impulse. He made a decision and coldly created a document that he thought would serve as his excuse.

The anger cannot be discounted. But the anger has to be understood in the context of his having let us know that he was self-righteous, resentful, grandiose and narcissistic. Whatever rage might have consumed him, he let us know clearly that this was nothing less than premeditated decision.

Was it a crime or an act of terror?

It was an act of horrific violence. Technically, it was a crime, but that term does not satisfy our need to understand or categorize his behavior.

What he wrote is that it was a political act. What he implied is that it was an expression of the mythic-heroic ideal. He wanted to be remembered as "Joe the Revolutionary." He signed his note: "Joe Stack (1956 - 2010)," as if his were a life complete and he would be an historical figure.

He placed his crime in a political context. He offered it as an act of war. He fired a shot against his own government and against a civilian population. Call it treason or call him a traitor. And call it what he said it was: a politically motivated act of war intended to inflict civilian casualties and to serve as propaganda, rather than to achieve a strategic goal. For that, there would seem to be no word better than "terrorism."

Could this really be part of a movement?

There is in this country today, it seems to me, a gathering storm of mindlessly angry people who are "fed up" for reasons they can barely explain. There are people in the media who are telling them they should be angry, and perhaps more importantly, that they should be afraid.

Fear and loathing is not unexpected in times of economic turmoil, distress and uncertainty.

What concerns me is that some people have come to identify the government as an enemy of the people. They are grandiose in their belief that they understand it all better than anyone else. They are self-righteous in their indignation and in their resentment. They express a sense of entitlement, arguing that they have a right not just to their own opinions, but also to their own facts. They shout until no one can hear them and then complain that no one is listening. They expect their individual voice to prevail and then complain that they have been denied representation. They do not wish to contribute to the common good, but demand all the benefits they have been promised. Like Stack, they bemoan corporate greed while demanding that greed be unfettered.

No movement that takes it self seriously should find inspiration in the death of Joe Stack. He demonstrated that he is simply part of the lunatic fringe. A movement has to stand for something other than chaos and anarchy. If we say that his act symbolizes anything more than his individual psychopathology, then what it symbolizes is nothing more than death, despair and defeat.

Will others be inspired?

Let's hope not. Let's hope that what he inspires is a return to sanity and an end to the craziness. Let's hope that he gives us reason to restore civil discourse, to recognize that social and political nihilism is not a philosophy of any type, and that domestic terror is not part of the solution.

In his diatribe, Joe Stack wanted us to believe that in his abject failure, he had achieved success. It's as if he listened to only part of what Bob Dylan once sang ("there's no success like failure"), without bothering to stick around and hear the end of the lyric: "and failure's no success at all."

On camera: Dr. Mattiuzzi speaks about the Phillip Garrido case and the victim Jaycee Lee Dugard

2010-02-12T11:30:00.000-08:00

Recorded on February 11th, 2010. KXTV Channel 10 News in Sacramento.

Comments about recent case developments and the Stockholm Syndrome, and comment about Patty Hearst. The raw video:

And the story as it appeared on KXTV:

Psychology in the Emergency Room: psychotherapy reduces return visits

2010-01-28T01:41:00.000-08:00

The "medical cost offset effect" is well known and has long been documented. In brief: when emotionally distressed medical patients receive therapy, they tend to reduce their utilization of all forms of medical care, and it saves money.

A recent demonstration of this cost saving strategy is of particular interest because it focused on patients who were admitted to the emergency room. Published in the Canadian Journal of Emergency Medicine, the study was titled: "Intensive short-term dynamic psychotherapy to reduce rates of emergency department return visits for patients with medically unexplained symptoms: preliminary evidence from a pre-post intervention study."

More typically, studies of this type focus on patients seen in the offices of general practice physicians, even though many have tracked subsequent hospital visits as an outcome measure.

In this case, patients who arrived at the emergency room with "medically unexplained symptoms" were referred to a therapist, and on average they were seen for about four sessions. One of the study's authors noted that among patients arriving at the emergency room with chest pains, there are no physical findings in three out of four cases.

The patients who were referred to therapy were matched with patients who had similar rates of emergency room utilization or who had presented with similar complaints. The implication is that this group (those who come in with chest pains that tests could not explain) tend to seek medical care quite regularly. In the hospital where the study was conducted, the identified patient group was averaging 4.6 emergency visits per year!

What was the outcome? The result was an almost 70% reduction in return visits to the hospital. According to the lead author: "For every 100 people seen by the staff psychologist, there will be 300fewer emergency visits a year, which adds up to a huge savings andreduction in unnecessary tests."

These results are not at all surprising. If you are distressed, depressed, experiencing anxiety and having a panic attack, you are likely to have shortness of breath and to experience chest pain and perhaps light-headedness. Of course you are going to call or go to the emergency room.

If you resolve the feelings and understand the emotions that lead to panic and anxiety, or if you relieve the stress that might be causing distress, the chances are that you are not going to panic and end up needing emergency medical care.

That is one of the reasons we know that therapy works. It saves money.

Those people are like this, these people are like that ... our tendency to "ascribe" traits to others

2010-01-06T14:57:00.000-08:00

It's a real common tendency, describing certain people as being a certain way. We all do it. We all "ascribe traits" to others.

Sometimes it's a matter of convenience. Sometimes it's a matter of necessity. As we navigate the social world, it's often necessary to make judgments and decisions based on our assumptions about the people around us.

You can imagine situations in which you might need others to provide help. In those situations, it helps to assume that people will be helpful. It happens all the time while you're driving. You assume that when you need to make a merge or a lane change, people will accommodate your needs when you turn on your turn signal. If you are struggling with your luggage in an airport, you want to assume that someone will be willing to help, before you look around and express your immediate neediness.

In an article that appeared some years ago in the Journal of Research in Personality, Professor David Funder noted that "most people have pretty definite ideas about where they and the people they know fall on a variety of trait dimensions like friendly-unfriendly, cautious-bold, and so on."

But in making judgments like this, we are also prone to making errors when we assume that people have certain characteristics or tendencies, or when we fail to take into account the particular situation in which they find themselves.

What Dr. Funder found is that the "tendency to ascribe traits" to others is in itself a measurable psychological trait. In other words, some people tend to do it more than others.

When you are judging someone else (trying to say how they are, what they are like, or how they might act) you can make a judgment based on what you think "those people" are like. Instead, you can also think to yourself: "it depends on the situation."

If you say "it depends on the situation," your judgment is said to be state-related ("it's the state they're in"). If you say "that's just how that person is," your judgment is said to be trait-dependent ("they're always like that").

Whether you are more or less likely to make either state or trait based judgments is itself a trait that is related to your to your personality characteristics.

In general, people are more likely to say "it depends on the situation" when they are making judgments about people they know well. If someone is just an acquaintance, rather than a close friend, you are more likely to say that their behavior is the result of their traits. In other words, the better you know someone, the more flexible and forgiving you are when you assess their behavior.

The really interesting finding is that those who are less flexible in their judgments of others also tend to be less well-adjusted themselves. Those who tend to say that others do things because of their personality traits tend to have less adaptive personalities themselves. Those who judge others in a rigid way are found to have less charm and appreciation of humor, to be less considerate and sympathetic of others, to be more sensitive to criticism, to be fussier about small things, and to be less warm, cheerful and interesting as a person. Those who tend to ascribe more traits to others also tend to be more anxious, less confident and less capable of dealing with stress than others.

Yes, it is important in life to make judgments about the personality traits of others. Sometimes it helps us understand people and situations. But, it is often more important to understand that everyone is an individual and that anyone might react differently in different situations.

Keep in mind that we tend to be less flexible in how we judge people we don't know. Which tends to suggest that when we say "those people are like this," we are more likely to be making an error in judgment. Keep in mind also that those who are harsh in their judgments are less likely to "have room to talk."

Anti-Depressant medication may not be an effective treatment for mild or moderate symptoms

2010-01-05T15:44:00.000-08:00

Almost 7% of the population will suffer from clinical depression in any given year. For those who seek treatment, the most common treatment involves a course of anti-depressant medications, typically prescribed by a general practice physician.

A new study published in the Journal of the American Medical Association finds that the effectiveness of medication varies significantly, depending on the severity of the depressive symptoms. Those who suffer from severe or major depression benefit "substantially." When the depression is mild or moderate, the medication does not produce an effect that is greater than the benefit obtained by taking a placebo.

This is already in the news and bears comment.

1. Individuals reading this should not assume that they should suffer in silence or fail to seek help. If for any reason you think you may be depressed, take the Psyris Depression Screening at the Psychology Resource Information System (psyris.com).

2. If things in your life are not right, or if you are not feeling right, it typically makes sense to see your physician to make certain that you are not suffering from some type of medical or dietary condition.

3. This new study does not mean that treatment will not be helpful or that you shouldn't try medications. Until you consult with someone, it's hard to know if your feelings of depression are severe, or simply part of the expected ups and downs in life.

4. As a psychologist, I would never recommend that someone feeling depressed should simply start taking a pill. It is well established that psychotherapy is an essential component in the treatment of any mood disorder. If your physician is telling you that your condition warrants the use of medication, then it is certainly the case that you should be seeing someone to talk about how you are feeling. If you need medication, you also need to talk to a therapist.

This is an important study for a few different reasons.

First, the fact that the placebo performs as well as the medication in mild and moderate cases reminds us that depression is not simply medical and biological in nature. It involves thoughts and psychological processes. It is not just a type of "brain disease." It has to do with your mind.

Second, the fact that medication is effective in more severe cases reminds us that depression can involve medical factors as well. Sometimes medications are necessary.

In general, what this study confirms is that the treatment should be designed to meet the needs of the specific, individual patient. Psychological health care will always be a component of that treatment.

Depression is common and it can be severely disabling. It is highly treatable. No one should suffer in silence.

Take the take the Psyris Depression Screening at the Psychology Resource Information System (psyris.com)!

Update (01/14/2010): The blowback from the JAMA depression study has started. Writing in the New York Times, Richard A. Friedman, M.D. has challenged the findings, arguing that the question is much more complex. He says that this new study "does not stand up to the mountain of earlier evidence" showing that medication is effective for a "wide array of depressed patients."

Some of his points are well taken (e.g., the original study only looked at two particular anti-depressants). Other points are less compelling (e.g., he disparages the well established "meta-analysis" method, or at least how it was used in this case). His primary point involves an endlessly complex theoretical issue that empirical science has not resolved: what is the meaning of the placebo effect?

Perhaps most importantly, in my view, is that Dr. Friedman gives short shrift to the importance of psychological care in the treatment of what is typically a psychological problem.

Dr. Friedman's final comment was: "there is no question that the safety and efficacy of antidepressants rest on solid scientific evidence."

His earlier statement perhaps deserves more attention: "antidepressants are not panaceas, and their advocates have sometimes been overly optimistic about their efficacy."

Stress and Depression reduce worker productivity ... new study, old news.

2010-01-04T14:17:00.000-08:00

I saw it in the paper the other day, and then it came into my email box from a few different sources.

There's a new study out demonstrating that when workers are depressed, or when they are stressed at work, they are not as productive.

I read it carefully, thinking there must be something new to the story. But no, there's nothing new to report. Writing in the American Journal of Health Promotion, Professor Debra Lerner reported the findings from a study sponsored by the Tufts University Program on Health, Work andProductivity.

According to Dr. Lerner, depressed workers are:

"often very fatigued and have motivational issues. Theyalso may have difficulty handling the pacing of work, managing aroutine, performing physical job tasks and managing their usual workload."

Commenting on this "new" study, Harvard Medical School Professor Ronald Kessler said that these findings:

"are consistent with a growing body of evidence that depression has important adverse effects on work performance, both absenteeism and on-the-job performance."

This is not part of a "growing body of evidence." Instead, it's an established fact, repeatedly demonstrated. We've known this for years!

Dr. Kessler also commented that studies are "beginning to show" that workplace intervention programs aimed at distressed workers are cost-effective. Once again, it's entirely old news ... decades old.

Do companies profit from workplace wellness programs focusing on psychological health? Is there a payoff? Anyone in corporate America who doesn't know the answer to these questions hasn't been paying attention for the past thirty or forty years.

This study did include one interesting finding. It said that the cost of stress and depression may be greater than most all other health related concerns affecting workplace performance, except for "musculoskeletal problems and insomnia." What the study should have pointed out, however, is that there is a significant correlation between back pain and distress and that insomnia is a symptom commonly associated with depression. Factor that into the equation and you are left with the conclusion that stress may be the single most important workplace health concern.

What should also be factored into the equation is an awareness that depression is highly treatable and that workplace stress is largely the result of workplace conditions that can ordinarily be fixed.

The take away message for anyone reading about this study should be this: There is money to be saved and money to be earned by paying attention to the psychological health of workers.

Are you a distressed or depressed worker? I have two online screening tests you can take at the Psychology Resource Information System: psyris.com ... one is a depression screening instrument, the other asks about your psychological well being. Both are brief and both are free (and anonymous).

I have been a psychologist for more than 25 years

2010-01-01T10:48:00.000-08:00

I have been working in the field of psychology since 1976, starting at the Master's level.

In 1982, I completed my doctorate degree at the Berkeley campus of the California School of Professional Psychology (CSPP-Berkeley). I have been licensed to practice as psychologist, and to use that title, since 1984 (California License PSY8693).

By the time I completed the Ph.D., I had worked for 4 years as an assistant to a forensic psychologist and had interned for three years in community mental health centers. After finishing my studies, I was a staff psychologist at the California Youth Authority for almost five years.

Before pursuing a doctorate, my studies were concentrated on research in the areas of perception, working memory, attention and cognitive processes. My subsequent training was primarily in the field of clinical psychology.

I practiced for a number of years as a psychotherapist, but my career has been largely focused on conducting diagnostic interviews and evaluations. For the past 15 years, I have worked almost exclusively in the field of criminal forensic psychology. I have qualified as an expert witness throughout California and also in Federal Courts.

Throughout my career, I have retained an interest in health psychology and I have lectured frequently on the connection between health, stress and well-being. In this regard, a particular focus of my writing has been on the assessment of depression, anxiety and wellness.

My interests in the field are broad and my fascination with the science of psychology is enduring.

My professional profile and a link to my resume is here.

Psychologists Reject Science? ... Oh My!

2009-12-02T17:30:00.000-08:00

The psychotherapy community is all atwitter about an article (1) recently published in Psychological Science in the Public Interest, an article that purports to describe "psychology's failure to develop as an applied science."

The article by Baker et al wanders across a range of topics while making a variety of assertions. According to the authors:

Psychologists are "deeply ambivalent about the role of science and research."
Psychologists are "not accountable to anyone and are unconstrained by procedural guidelines or practice standards (except, perhaps, for the prohibition regarding sexual relations with a patient)."
Rather than being licensed to practice independently, psychologists should "have their practices monitored to ensure adherence to good standards of practice."
Psychologists don't know if their work is of any value to the patient.
Rather than listening to science, psychologists tend instead to view experience as important and to view "each patient as unique."
During training, psychologists spend too much time on "arbitrary breadth requirements" (i.e., we're too broadly educated), too much time actually working with clients, and not enough time studying "molecular genetics."
Some of the most effective psychological treatments can be delivered "without highly trained personnel," or by health educators "with little or no prior experience" who have "received only a modest level of training" in the treatment technique.

"Dolphin-assisted therapy" is not likely to ever pass scientific muster.
Psychotherapy causes global warming .

Ordinarily, this article would have been widely ignored and roundly dismissed as the naive polemic that it is. But before they went to press, the authors hooked Newsweek Science Editor Sharon Begley on the story and it became an issue. You can't really blame Begley for buying it. It's pretty juicy stuff for the popular press: "psychologists reject science" and use "dolphin therapy."

Begley's assessment was that this publication signaled a "fight brewing among therapists," one that was "getting ugly" and where "the gloves have come off." Her assessment was dead wrong.

The argument that Baker et al made is tired and old, and therapists did not start taking up arms. Instead, what I observed in a series of online discussion groups is that psychologists turned their attention to reviewing and discussing the science. Research that might not otherwise have been carefully studied became widely discussed. Contrary to expectations, psychologists did not reject science. They embraced it anew.

A consistent theme in the responses to the Newsweek article was the concern that the public might take this criticism of psychology seriously, and that it might discourage people from seeking treatment that they need. Historically, only about twenty percent of individuals suffering mental or emotional distress will seek or receive help. For those who do not obtain assistance, the costs can be measured in many ways.

What this is really about (3). The Baker et al article is the latest attempt by the "empirically supported treatment (EST) movement" to plant its flag. What this movement argues is that when it comes to psychological therapy, the only thing that really counts are the procedures and techniques that are employed. And in order to "earn EST status," a therapeutic approach must demonstrate its effectiveness via one particular research method, the "randomized clinical trial (RCT)." This is the method that you would use if you were studying the effectiveness of aspirin, but it is only one of a number of scientific methods that can be used to inform practice.

The EST proponents say that RCT is the "gold standard" of research methods and are essentially saying that treatments should be designed and selected not on the basis of theory or demonstrated potential, but instead, on the basis of the research method used to study them. Commenting on this, Dr. Larry Beutler (who is extensively published on psychotherapy outcome research) said:

"the effort to identify EST or research informed psychotherapies is viewing evidence through the lens of a single or preferred research methodology, when there are several competent methods available ... the scientist has fallen prey to worshiping the method rather than the 'truth.'"

It is in fact the case that EST research is significant and useful, as one among a number of scientific approaches. For example, the finding that for the treatment of depression, cognitive behavioral therapy (CBT) works just as well (or better) than medications has been enormously important in establishing that "talk therapy" works. But this research method has also tended to obscure other important and significant factors that contribute to effective practice. Yes, the techniques work and the cookbook is handy, but that doesn't mean that CBT is always the best treatment for depression or that everyone walks into the clinic with a specific problem that meets the "strict inclusion and exclusion criteria" demanded by the EST/RCT prescription. In arguing that psychologists reject science, Baker et al chide clinicians for sometimes believing that "each patient or prediction problem is unique."

One of the things that has been obscured by the EST research is that other forms of treatment work just as well. The randomized clinical trial method compares a treatment to "no treatment" and a placebo condition (the placebo can be something like an educational program or a waiting list). A number of "meta-analytic" studies (a statistical technique that combines the results of hundreds of studies) have shown that in the real world, the prescribed cognitive treatments are no better than TAU (that's "therapy as usual"). The evidence is compelling that in the real world, outside the lab, psychodynamic, insight oriented, problem focused and relationship based treatment strategies are often more effective than procedure-driven cognitive strategies.

The reason "empirically proven" procedures are not always best is simple: people are complex, as are the difficulties they suffer. People seeking care have different personalities, different life situations, different life experiences and different coping styles. The "fit" between the patient and the therapist makes a difference, as does the the "fit" between the patient and the methods chosen. Some therapists have more experience in helping people solve problems and more skill in adapting their approach to the needs of the individual. And the "placebo" factor cannot be ignored: it makes a difference if the client has confidence in the person providing care and if they hope and expect to obtain benefit.

The EST movement dismisses all of the above as "non-specific factors," elements of the treatment process that should be ignored because they cannot be randomly assigned for the purpose of an experiment. These factors are considered to be part of the error equation. The EST assumption is that for research purposes and for "scientific" purity, the therapist doesn't matter and the person doesn't matter. In their view, all that matters to the scientist is what the therapist actually does. That is the type of "science" that they say we have rejected.

What psychologists have not rejected (not for a moment) is the use of both theoretical and empirical science to inform practice and to provide a foundation for our work. The research that tells us that therapy works also tells us that these "non-specific factors" are meaningful and significant and worthy of study. In a review of the literature, Dr. Larry Beutler had this to say about the "non-specific factors" that the "real scientists" dismiss as error:

"If, as we have proposed, these aspects of character, preference, fit, and expectation contribute more and stronger predictive power in outcome assessments than the technical aspects of the interventions, then they are the treatment."

In saying that psychologists reject science, a central datum for Baker et al is a finding that more than half of clinical practitioners will say that their experience is more important than the research, or that experience should be given equal weight. These authors would perhaps be dismayed to learn that all 50 States and the Canadian Provinces have bought in to this assertion. To practice, they all demand that we be well trained and amply experienced. They demand supervised experience in order to protect consumers, rather than assuming that anyone can practice competently just by being taught a few empirically validated techniques.

The licensing boards also demand that psychologists be broadly educated in the science of psychology.

What's the take-away message?

If you are troubled or distressed, anxious or depressed, it makes good sense to seek help or to talk to a psychologist.
To help you decide if you are in need, here is a brief psychological health questionnaire and a brief depression symptom inventory. Both provide guidance as part of the results.
In most cases, therapy will help. Therapy works (that's what Consumer Reports and the U.S. Surgeon General say).
The therapist's experience is one of the things you should consider in choosing someone to work with. How you get along with the person isn't the only consideration, but it is something to consider and think about.
You don't need to say "I need this specific treatment I read about in Newsweek." What you need to do is to talk to someone to help figure out how best to proceed.
There are some brands of treatment that people will say are special and unique, miraculous and wonderful, and guaranteed to work. Be careful about those. Yes, there are some empirically validated treatments that are of proven effectiveness for certain conditions. But there are some therapists (including some psychologists) who sell methods and models that either don't work or that can be harmful. In most cases, what you should be looking for is TAU (Therapy as Usual).
TAU might be short-term and problem focused. Or it might need to be longer term and focused on more fundamental personality change. An experienced therapist can help you decide on a course of action. There are a lot of variables involved.
If you are depressed, your therapist might recommend some things that have not been the subject of rigorous scientific validation: eat right, get more exercise, try some relaxation techniques, go to yoga, stop watching so much TV, keep a journal, take a vacation, buy a dolphin ...

Final Comment: In the days since the Newsweek article hit the stands and brought this "inside baseball" argument to the attention of the general public, Dr. Baker has gotten an op-ed piece published in the Washington Post. Yesterday, his co-author Richard McFall was featured on NPR's Science Friday show. The EST movement is on a roll. As I said, it's an old topic of discussion and not one that is of practical significance. What is of practical significance is that therapy works and can be recommended. In response to being accused of rejecting science, psychologists are going to continue to review and discuss the science.

Notes:

(1) Baker, McFall and Shoham. Current Status and Future Prospects of Clinical Psychology: Towards a Scientifically Principled Approach to Mental and Behavioral Health Care. In: Psychological Science in the Public Interest, November 2009. (return)

(2) Actually, I just made that up. They didn't really say that psychotherapy causes global warming. But you should know that psychoanalysis (that's where you lay on the couch) does have an unnecessary carbon footprint. When you lay on the couch, they usually put a tissue paper under your head. All that paper, all those trees ... it all points to global warming. (return)

(3) For much of the discussion that follows, I have relied on the following article: Beutler, Larry E. Making Science Matter in Clinical Practice: Redefining Psychotherapy. In: Clinical Psychology: Science and Practice, September 2009. (return)

The Psychology of Netflix

2009-09-23T13:47:00.001-07:00

Netflix has just awarded a $1 million prize to an international, seven member team of engineers, mathematicians and computer scientists for solving "the Napolean Dynamite problem."

You know how Netflix tells you: "if you liked that movie, you're sure to love this one?" That's what the prize was about.

Three years ago, Netflix launched a contest to try to find a better mathematical algorithm to predict what you like. More than fifty thousand "contestants," many of whom formed teams, tried to find a solution. People from all around the globe (186 countries!) participated.

On the face of it, it seems rather simple. People rate movies (1 to 5 stars), and from those ratings and the ratings of others, it should be simple to say what they like. But it's actually not simple at all. There are all kinds of different reasons a person might like one particular movie and why they might like or hate movies that are very similar or entirely different. And there are all kinds of different people rating the movies. Netflix has tons of data (i.e., movie ratings), and those numbers come from "people like you" and people who are nothing like you at all.

The problem is: how do you crunch the numbers when there are so many variables involved? How do you make sense out of all those ratings when you have so much "variance" floating out there that you can't account for? It's like the old saying, "there's no accounting for other people's tastes."

The million dollar prize was to be awarded to the person or team who could come up with a better way to crunch the numbers and the goal was to make the predictions just 10% more accurate than what they were. That's no simple feat.

Clive Thompson wrote a detailed article about the contest last year (November 21, 2008) in The New York Times Magazine. The contestants who got a quick jump on reaching the goal were using a statistical technique called "singular value decomposition." This wasn't a new form of math. It's a variant of an established statistical method called "factor analysis" in which a researcher takes huge chunks of information and boils them down to just a few factors.

This method is commonly used in research on human judgment and perception. When people make a choice between two things (are you going to buy the Mac or the PC?), they will typically say they had a hundred different reasons. In reality, it usually boils down to just two or three factors, or maybe even one.

Clive Thompson called it "the Napolean Dynamite problem" because it turns out that this is one of the movies that makes the math so hard and disrupts the whole system. "Miss Congeniality" and "Lost in Translation" are two other movies that are on that list. They are movies that people don't just "either love or hate." They're movies that are particularly good at stirring up all types of conflicting and maddeningly inconsistent reactions.

So what does this have to do with psychology? I think it was said best by an AT&T scientist, Chris Volinsky, who was quoted in the New York Times article. Describing his work on the Netflix prize, he said: "we're teasing out very subtle human behaviors" while trying (in the words of Clive Thompson) "to draw exceedingly sophisticated correlations and offer incredibly nuanced recommendations."

"Teasing out very subtle human behaviors" is exactly what the science of psychology is about. And it can be argued that this contest had everything to do with understanding and predicting human behavior.

There are psychologists whose work would seem to have nothing to do human behavior. There are psychologists who do hardly anything other than study and publish mathematical equations, and then tell the rest of us how to conduct research. More importantly, they tell us how to make sense out of the numbers we gather in our research. When I was in graduate school, I turned in a take home final exam question on which I wrote a five page essay. I got an A on the paper, but I understood the question in a completely different way than the guy who sat next to me in class. He got an A for turning in one page of math equations in response to the same question.

Psychology is a science only because we have mathematicians telling us how to make sense out of our observations. And that's the reason that in psychology programs, students have to take all of those dreaded statistics courses.

The math involved in the Netflix challenge is amazing, and for most of us, largely beyond comprehension. It is hugely important to companies like Netflix, iTunes and Amazon, or any company that uses people's preferences to sell products. If they can make relevant suggestions, they're going to sell more. That's why they do it.

What is even more amazing is that they are doing this math with data from just a single and simple "Likert-type" scale. Imagine how much more they would know if they had people rate the movies on five different variables (but then, they would lose information because more people would probably not bother to submit ratings).

That could be the next challenge for a company like Netflix: how do you get more information from just one action of the mouse? Here's my suggestion (and my official contest entry): show the movie cover along with two others and ask the rater to drag the movie to either the first, second or third position. A "paired-comparison" judgment like that could provide tons of information for the math guys to go after.

Will Forensic Psychologists be involved in the Phillip Garrido case?

2009-09-21T11:50:00.000-07:00

A reporter called me the other day to ask a hypothetical question about the parolee, who along with his wife Nancy, stands accused of kidnapping and sexually assaulting Jaycee Lee Dugard. Our conversation turned to a discussion of what might happen as the case proceeds. I mentioned that forensic psychologists would likely be called into the case at a few different phases.

{The attorney for Phillip Garrido has already asked the Court to appoint either a psychologist or psychiatrist to conduct an examination. The Court's approval of that request has been described in the media in a few different ways. The attorney could have just hired someone for this task, without asking the Court. The only reason to have asked the Court to appoint someone is so that the funding would come from the Court, and not from the Public Defender's budget. In El Dorado County, there are currently some real serious budget issues and this is going to be a very expensive case.}

At the current time, we know very little about Garrido's mental health status and history. What we know is that his father has told the news media that he was a "good boy" who changed after a motorcycle accident and after drug use. We know that Garrido wrote on a blog that he developed an ability and/or a device to control sound with his mind. We know that he called Walt Grey, a well known Sacramento TV news reporter (KCRA Channel 3) and told him that he had an incredible story to tell. He said it as if he thought people would welcome his story and like it was a good thing. There is enough in these bits of information to conclude that he is somehow and in someway psychologically disturbed. If it's true that he "changed" suddenly after a motorcycle accident, it could be the case that he suffered some type of brain injury.

We also know that Garrido was described by a psychologist years before as being a "sexual deviant." And, we know that he was previously convicted for a horrific crime.

It could be that Garrido "just" has a warped personality or what we call a character disorder. Whatever his mental health status, we know at least that much from his criminal history.

So will forensic psychologists or psychiatrists be involved as his case proceeds towards trial? The answer is almost certainly yes. Although we know much less about her from the news reports, the same is also true for his wife Nancy, who has also been arrested in this matter.

There are at least three phases in which psychologists might be involved.

Psychologists might first be involved in consulting with the defense attorneys and helping them understand: "what's going on?"

In cases like this, where there are strange circumstances and strange behavior, it is common for defense attorneys to hire forensic psychologists for the purpose of understanding the case and understanding the defendant. The attorney will turn to the available evidence to figure out what the accused might have done. And they will often turn to a psychologist to figure out why the person did it. In a case like this, the motive might be simple, or it might involve a complex set of psychological dynamics. The motive might be of little or no significance as the attorney formulates a defense strategy, but on the other hand, it could be that the attorney needs to consider some type of "mental defense." For many types of crimes, the prosecution must prove that the accused acted with a certain "intent." Even if it seems obvious on the surface, the defense attorney needs to figure out exactly what the person had in mind.

A consulting psychologist is typically able to answer these questions and to make certain that the defense attorney has all the information needed to provide a full, fair and effective defense. One of the first things the defense attorneys will have to determine is whether there is any doubt about the mental competency of either Phillip or Nancy Garrido and whether or not there is reason to pursue an insanity defense in either case. It is something that the attorneys at least have to consider.

If the defense decides that it must "declare a doubt" about the competency of either defendant, two psychologists and/or psychiatrists will be appointed to examine them. The competency question doesn't have anything to do with whether or not they were crazy when they committed the crime. It has to do with whether or not they are mentally disordered now. Competency is about whether or not mental disorder is serving to prevent them from enjoying due process and effective representation. It's about whether or not mental disorder might prevent them from getting a fair trial. If they are disordered in some way that prevents them from understanding the proceedings or that prevents them from working with their attorney in a rational way, then they could be found incompetent.

People often think that competency proceedings are just a defense tactic. But in fact, both the prosecution and the defense have an interest in making sure that the accused knows what's going on. If the question comes up and is not clearly settled, the defendants end up with an issue that they can raise on appeal, a basis for arguing that they didn't get a fair trial.

In competency proceedings, it's sometimes the case that the psychologists will find that the person cannot understand the proceedings. More often, people are found incompetent because they cannot rationally assist their attorney. Often times, this has to do with some crazy idea that they have about how they want to defend their case. They insist that the attorney put on evidence that will certainly lead to conviction, or they insist that the attorney make some argument that is inherently crazy and self-defeating.

As an example, a defendant might insist that their attorney subpoena the President, the head of the CIA and the Prime Minister of Russia to prove that they really did own the World Bank and that the Army intelligence services were trying to poison them and steal their thoughts. Stuff like that often comes up in homicide cases where the disordered offender wants to say that the crime involved necessity or self-defense. In the Unabomber case (Ted Kaczynski), the defense asked for a competency examination because the defendant would not give any consideration to an insanity defense and wanted to argue that he had to do it. In the Garrido case, it could be like the Unabomber situation where the defense decides that the only possible defense is to argue insanity. If for some crazy reason Garrido refuses to at least consider their advice, they might need to express the doubt about his competency.

The doctors who would be appointed to examine him (or his wife Nancy) are not the ones who will make the final decision. They will offer opinions. After their reports are received, the defense and prosecution could decide to submit the matter to the Court and let the Judge decide. If there is a competency trial for either Phillip or Nancy, the prosecution will undoubtedly insist that it be a jury trial and not a trial in front of a Judge. The prosecution will want members of the community to consider the evidence and make the decision.

What happens if either of them are found incompetent for some reason? They would then be committed to a State Hospital for treatment and the case would be delayed. It won't go away and they will not have escaped judgment. The hospital will send them back to be tried as soon as possible, perhaps as in little as a few months.

It may be that the defense attorneys will not raise the competency question. This is one of the reasons they would have obtained consultation from a psychologist early on in the case. It is often the case that I write letters for attorneys saying that competency is not an issue. They put that report in their file and it is never seen unless the issue comes up on appeal.

The third way in which psychologists might be involved is if either Phillip or Nancy decide to pursue an insanity defense. There are occasions when defendants really have no other defense to offer. Sometimes, the evidence pointing to guilt is substantial and overwhelming and the only thing the defense can do is to try to argue that they were crazy when they did it. That was how it was in the Unabomber case.

If the defense enters an insanity plea, two more Doctors will be appointed to examine the defendants. Under California case law, this will typically not be the Doctors who offered opinions in any competency proceeding.

The difference between competency and insanity is this: competency is about how they are doing now (does mental disorder prevent them from receiving a fair trial?); sanity is about how they were thinking when the crime was committed (at that time, did they know what they were doing and did they know that it was wrong?).

The sanity question will be considered by the jury only if they are found guilty. In other words, it will be a separate, second trial. Evidence about any mental illness they might have been suffering can be admitted to the "guilt phase trial" only under certain circumstances and only with certain limitations.

If someone is found to be insane, they are committed to the State Hospital for a period of time that is not any longer than what they would have been sentenced to if they were simply found guilty and sent to prison.

If either of them is found insane, could they ever get out of the State Hospital? The proceedings involved in getting "restored to sanity" and getting out are rather complex. In this case, the short answer is that as a practical matter, no, they would never get out of a locked and secure facility.

What are the odds that Phillip or Nancy might actually be found insane? Not good. It is a judgment made by a jury, reflecting the judgment of the community. This is not a commonly successful defense, no matter what you might have seen on TV. Juries don't like this defense and rarely rule that a defendant is insane unless the circumstances of the case are exceedingly compelling. In the media, we have already gotten a good sense about how the community feels about this crime and these defendants.

The reporter I spoke to about this case also asked me if Garrido might be offered a plea bargain and whether this might be resolved without a trial. My answer was no, there won't be any plea bargain offered. In this case, there is nothing to bargain with. It's not a death penalty case, so the prosecutor can't offer life in prison in exchange for a guilty plea. And given the nature of the case, no prosecutor will offer anything that does not make it certain that Garrido spends the rest of his life in prison. In other words, there is no room for negotiation. In many cases, psychologists provide information about a defendant that helps the DA and the defense understand the case, and sometimes that information is used to help inform the plea bargain negotiations. I don't think that will happen with either of the Garridos.

On a final note, people sometimes ask about the role of psychologists in the criminal courtroom. Some people will say that we are like the "whores of the court." That is not at all the reality. Most of us who do this type of work typically have little or no interest in how the case turns out. We provide explanation, not excuse, and what we do is mostly about insuring that the accused has enjoyed due process. No matter how heinous the crime and no matter how "obvious" it might be that a person is guilty, our system and our values require that they be fully represented and that they get a fair trial. When someone is put away, the last thing we ever want is for someone to say that it was because the system wasn't fair or that the verdict wasn't just.

When Leadership Fails: a short story about administrative incompetence

2009-09-17T20:05:00.000-07:00

This story is a companion piece to three of my other posts:
Is your boss paying attention to you?
Burnt-out on stress management? It's time to change the organization.
Workplace stress: Does anyone hear the workers screaming in their cubicles?

My wife, Cici, has filed a lawsuit against her employer: California State University, Sacramento (CSUS or "Sacramento State").

If you want, you can read the stories written about this action in the Sacramento Bee or the Sacramento State Hornet. The Hornet also published an editorial. The 200 page lawsuit is also online.

Cici has worked for the campus for more than thirty years. For most of that time, she has been the Director of Career Services in the College of Engineering and Computer Science. She was the first to hold that position, and even though she is the only staff member in the Career Services Office, she has created an entire service delivery system. She has developed an extensive network of contacts between the community and the campus and between the engineering school and employers from a wide range of industries and government agencies. She has brought in substantial donations of equipment and funds, and the money necessary to run her operation. She regularly employs a group of student assistants and a webmaster, and she funds the annual Engineering and Computer Science Career Day, along with other special events. Integral to her program of services is a set of career development courses she has been teaching for more than 25 years.

In the stories appearing in the Hornet and the Bee, it says that one of her complaints is that she has repeatedly been denied any "promotion" while serving in this position. It is more accurate to say that she has been denied proper classification, or a classification that is consistent with her job description and responsibilities. Her lawsuit alleges that her requests to be reclassified as an "academic related professional" have been denied in retaliation for complaints she has made. The campus says this isn't so.

Her lawsuit also alleges that she has been refused "academic related" standing in response to gender discrimination. It's a glass ceiling issue (yes, there are a number of men - all men - doing similar but less demanding student service, student advising jobs while enjoying "academic related" status). There are female student service professionals on campus who do have academic status, but they are in health center jobs (licensed therapists), not in student advising.

Cici's other complaints against the campus relate to one particular Professor, Miroslav Markovic.

Cici's problems with Miroslav began in 1991 when a company in Reno called to say that they had received somewhere between 12 and 15 phone calls and two visits from the professor. Markovic wanted them to fire a recent Sac State graduate whom they had hired. It turns out that Miroslav had tried to develop a sexual relationship with the student and was angered when his advances were spurned. The student documented his experiences with Markovic in a letter to the campus in which he said that it was only too late that he came to realize that Markovic was a "sexual predator." His letter made clear that he had been "groomed" (my word) and that Markovic was "chicken hawking" him (as they say in the criminal arena where I work). The situation evolved into threats and stalking behavior. Markovic wrote to one of the student's friends: "I love him, and I do not know why he does not return my love. I helped him so much and he just ignores me … I must get back at him."

It was an alarming circumstance and Cici was drawn into it because the complaints came to her and because the Dean asked her to help straighten things out with the employer. Markovic was placed on leave for a while, but was allowed to return to campus. I have spoken with this student, and 18 years later he is still traumatized by the experience.

In subsequent years, the campus continued to receive student complaints about Markovic. Some students wrote to the administration, but many of them came to Cici. In the school of engineering, she is the only student services professional, the only student advisor. She is the one who helps students with their careers, and usually the complaints were around issues that would affect their careers. One group complained that Markovic threatened to fail them in class if they skipped a session to meet with a company that was coming to recruit and offer jobs. Others documented unfair grading practices.

Many of the complaints came from women who said that Markovic displayed distinctly sexist attitudes in the classroom, telling women that they "don't belong in engineering." International and minority students also regularly complained about classroom discrimination. As she had been instructed to do in her mandatory sexual harassment training, Cici passed these complaints along to the campus Affirmative Action Officer.

In 2002, a hiring manager for a large California utility company (PG&E) called Cici to tell her that Markovic had threatened to smear his company's name if they worked with anyone other than him to hire graduates. Markovic wrote to PG&E and said if they tried to work with anyone else on a project that was developing, they were wasting their time and might as well be speaking with "Osama Bin Laden." That resulted in the loss of a partnership that PG&E was developing with the campus. The company walked away, citing the risks involved.

Later in 2002, a Department Chair in engineering took a long list of signed student complaints about Markovic to the campus attorney. Nothing happened in response.

In 2003, a student sent the campus president a letter saying that he thought Markovic was a "loose cannon and a potential danger to students." He said that while in a tirade, Markovic told the student that Cici had "slept her way into her position."

In 2007, a staff member wrote to Cici and told her that he was concerned about her safety. Markovic hadn't threatened her directly, but there was something about the circumstances and the way in which he called her a bitch that alarmed the staff member.

In January of 2008, Cici and I both met with the Campus Affirmative Action Officer, Peter Lau. A utility company hiring manager had recently told Cici that "it was happening again." He had good reason to believe that Markovic was again "chicken hawking" students. The industry contact assumed that "everyone knows." It was certainly no secret off-campus.

Peter Lau said he would open a 60 day investigation. Six months later, he wrote to say there wasn't enough evidence to do anything. Summer vacation began.

On the day Cici returned from summer break, a staff member told Cici that he was planning to quit. He had been on campus all summer and was demoralized by having to interact with Miroslav on a regular basis. In the engineering building, there is no shortage of people who have been abused by him.

The very next day, Markovic forcefully and intentionally bashed into Cici at a reception. Actually, he bashed into her twice. The message from Markovic was clear: he could do whatever he wanted and get away with it. Which happened to be true. I informed the campus using clear and forceful language.

A few days later, after the campus received my note, Kent Porter, the Vice President of Human Resources wrote to the Engineering Dean and asked: "does Cici want to pursue this matter?" I received a copy and wrote back that she has pursued this before, to no avail, and that it was time for the campus to do something. I outlined the history.

Cici then spoke to the campus police. They said it was an administrative matter. Two weeks later, Kent Porter wrote and said she hadn't done anything to report the incident. Cici informed Porter that she had spoken with the police. Porter wrote back and said that "if" she had spoken to the police, they could do something. Porter invited her to tell Human Resources what had happened. Somehow, he couldn't hear the screams coming from her office.

On September 24th, 2008, Cici called Porter from her office. A fellow staff member was there with her for the phone call. That woman was aware of what was happening and told Cici that during the summer, Markovic had shouted at her and threatened to "get a gun and shoot her" (not Cici, but the pregnant staff member). They said they were afraid and Porter asked them how tall they were.

In early October, two other people on campus (one a student and the other a staff) told Cici that Markovic had recently threatened to shoot them. Cici called the police. Porter was no longer responding to her calls or emails.

By December 2008, Cici had hired an attorney. The attorney sent a lengthy note to the campus president, Alex Gonzalez. The president didn't respond, but the campus hired an investigator.

Six months later, in May of 2009, affirmative action officer Peter Lau wrote to Cici and told her that based on their investigation, when Markovic bashed into her (nine months earlier) it must have been an accident. He said that she had never suffered any retaliation from the campus and that she had not been subjected to any gender discrimination relative to her employment classification. It was a "we covered our ass" letter.

We don't yet know what the investigator actually found. The letter Cici received basically just said that none of her complaints would be taken seriously. Nothing was said and nothing has been said about the fact that staff members might be upset about a faculty member threatening to shoot them.

While this was all happening in Fall 2008 and Spring 2009, the campus decided that Cici could no longer teach her classes (which are integral to her program of services), at least not under her own name. She would no longer have access to her class rosters and could no longer report grades.

The campus had ample notice that a lawsuit was in the works. A few days after Cici filed the lawsuit, in August 2009, the campus canceled all of her classes except one (students were already enrolled). The course they didn't cancel is a required class. It was given to a professor who immediately wrote to Cici and asked how to teach the class.

Why did the campus cancel her classes? She can't teach the classes she's taught for 25 years because she's not classified as "academic related." That's what the campus will say. The campus will say it's a union issue. Even though she meets the criteria, the campus repeatedly refused to classify her as having academic status. Then, they took away all of her classes because she didn't have academic status. Catch 22.

What did the campus do in response to the three reports it received about Markovic threatening to shoot people? Nothing. It's not like this is Virginia Tech.

What happened to Markovic? He retired a few days after Cici filed the lawsuit. But in the interim, in the Spring of 2009, while the campus was ostensibly conducting an investigation, the campus made him a member of a really important project team. Sac State has teamed up with the Sacramento Municipal Utilities District (SMUD) to create a "Smart Grid" institute to go after what they expect to be millions of dollars in Federal stimulus money. The State Energy Commission has already promised 2 million in seed money. After all of the harm he had done to faculty, students and staff, and to the reputation of the campus, the Dean of Engineering, Emir Macari made him part of the team.

How do things stand with Cici? After reading in the newspaper that Markovic had retired, Cici returned to work on the first day of the Fall 2009 term. She thought he was gone. He was still there. She left and remains on leave. Cici doesn't know what is going to happen next. Yes, she sees a therapist, and spends a lot of time at the yoga studio. She's doing what one needs to do to "manage stress."

After Cici returned to work and found that Markovic was still there, I wrote to President Alex Gonzalez. The campus attorney, Edmundo Aguilar responded: "I disagree with your characterization of this situation as a 'workplace hazard and safety' issue." He told me that I should speak with Cici's attorney if I have any further concerns. In other words, he doesn't understand that workplace stress is a safety issue and apparently doesn't want to hear any more about it.

Long story short? If not before, then certainly in August of 2008 - that's more than a year ago - Sac State should have heard the screams coming from one of its employees. In my view, this series of events confirms my argument that workplace stress is primarily a result of leadership and organizational failure. This was a situation that could easily have been resolved.

Why did Cici sue? Ask her, and what she will tell you is that she didn't want to see any more students hurt. When a student draws a bad grade in a class just because she's a woman or because he's a foreign student, it affects that student's entire career. When a young male student realizes that a "friendly" professor is a "sexual predator," it undermines their sense of self-esteem. There were people on campus who were frightened and demoralized, and somebody had to do something about it. The University wouldn't.

Her program is important to the mission of the campus. It is always cited in the engineering accreditation studies. The last accreditation team to visit to visit the engineering school said that Cici's career services program "should be a model for the country." Her classes, the ones that have been canceled, are an important and integral part of that program. When students come to a University like Sac State, they expect to land a job when they are done. It's not like why they would go to UC (the University of California).

How will the story end? I don't know.

Updates:

On September 21st, the campus Affirmative Action Officer wrote and confirmed that the University had allowed Cici to be subjected to a hostile work environment, in violation of law and policy. He retired a few days later.

The campus attorney has left his position with the University.

The University has hired an outside attorney, David Tyra, to handle this matter. He has asked for additional time to respond to the lawsuit and is expected to file a response on October 17th.

In mid-November: Rather than filing a response, the campus attorneys and the HR VP Kent Porter met with Cici's attorney to try to resolve the matter. They showed up to the meeting late, unprepared, absent authority and without seriousness of purpose. Markovic is gone, so the first issue on the table was the gender discrimination and classification issue. They just blew that off like it was nothing and said they would have to check with someone who has authority.

In early December: Another meeting. Similar experience. Cici walked out.

Workplace stress: Does anyone hear the workers screaming in their cubicles? Is anyone listening?

2009-09-11T17:00:00.000-07:00

I don't actually know the answer to this question. As far as I know, no one can really say to what extent employers are, as a rule, effective and proactive in responding to the complaints of their employees.

Unless someone files a lawsuit, complaining that their complaint wasn't heard and asserting that their complaint involves an issue of law, there is really no way to know how often the screams of employees go unheard. There are no hard data I can find and no research articles that provide the answer.

What I do know is that workplace stress is ubiquitous. The National Institute for Occupational Safety and Health (NIOSH, which is part of the CDC, Centers for Disease Control) describes workplace stress as one of the 10 leading causes of work-related disease and injury. NIOSH describes it as a safety issue, not just as an unfortunate consequence of work.

In describing the prevalence of work-related stress, NIOSH cites a study by Northwest National Life that found that 40% of workers report that their job is "very or extremely stressful."

NIOSH also quotes a finding from the St. Paul Fire and Marine Insurance Co.: "Problems at work are more strongly associated with health complaints than are any other life stressor - more so than even financial problems or family problems."

In a related post on workplace stress, I argued that workplace stress should be considered an organizational issue, and as NIOSH has said, that the first response should be prevention. In most cases, it is not the necessary and unavoidable stressful events in the work place that cause people harm. Instead, it is the stressors that need not be: those things that could just as easily be changed.

There are indeed workplace stress factors that result simply from the nature and the demands of work. But the stress literature is clear in noting that people will adapt, adjust, thrive and survive in response to even the most extreme stressors, if they have a sense of purpose or a sense of coherence. It is hard to imagine anything that might violate a worker's sense of meaning and purpose more than the experience that management is not listening and that management does not care.

Again, there is no way to know whether it is either typical or uncommon for organizations to be indifferent to the needs of their employees, but if you consider the above in combination, it tends to suggest an answer.

We can say that 40% of workers find their jobs to be "very or extremely stressful." Or on the other hand, you could conclude that 40% of workers operate in the face of toxic conditions that the organization has failed to recognize and remedy. You can argue that workers become distressed because organizations have either failed to remedy unpalatable working conditions or because they have failed to provide the motivation and incentive that would enable workers to maintain health in the face of challenge.

If, as NIOSH says, workplace stress is a safety issue (one of the top ten causes of industrial injury), then consider what that 40% figure means in terms of the safety of the American workplace. And consider what that tells us about the effectiveness of management in providing a safe workplace.

Another way to approach the question of whether or not anyone hears the screams of workers is to consider the fact that some employees feel a need to file lawsuits against their employers. Yes, there are some people who sue because they are just naturally litigious. Yes, there are some who are carrying out personal grudges or other psychological agendas. Yes, there are some who are at fault themselves and seeking to project blame onto others. And yes, there are some who are trying to profit or gain.

The reality, however, is that there are substantial hurdles that exist for those who "want" to sue. There are hard dollar costs involved and there are psychic tolls that can be overwhelming. The idea that it is easy to sue, or that anyone can do it is an idea that has no basis in reality. Sure, it's something that can easily be done if you are the victim of medical malpractice or a medical injury. But it is not at all easy or rewarding if your claim has to do with a violation of your sense of well-being. It is not easy at all if your claim is about mistreatment in the workplace. Years of effort and a complex set of legal rulings stand between a worker and a judgment. And in just about every case, it is the defendant (i.e., the organization) that has the resources necessary to prolong the process.

It is an entirely imprecise measure, but the fact that some workers feel that they have no other choice but to sue tells us something about whether or not anyone heard their complaints and was willing to do something about them.

Some years ago, on the 100th anniversary of the American Psychological Association, I was privileged to attend a lecture by J. Donald Millar, M.D. He was then the Assistant Surgeon General and the Director of NIOSH. He spoke about the science behind the decision at NIOSH to include psychological disorders on the list of leading workplace injuries, noting that the agency had previously been preoccupied with "hard hats and hard science." Occupational stress became part of the worker safety agenda on the basis of three criteria: 1) frequency of occurrence; 2) the severity of injuries; and 3) preventability by available measures.

To illustrate his understanding of occupational stress and safety, Dr. Millar told a gruesome (warning!) story. His daughter was a scientist involved in toxic waste site cleanups and was working at a site where logs (e.g., telephone poles) were chemically treated in large pressure cookers. On opening one of the vats, they found that a worker had been trapped inside and "cooked with the logs."

This is how Dr. Millar told it:

"As a physician in the Public Health Service for 30 years, I've heard lots of things. I have felt the helpless outrage provoked by unnecessary tragedy. Few things really 'get to me.' But I tell you the truth, I simply cannot get out of my mind the image of that worker in there, realizing he was trapped - screaming at the top of his lungs - pounding his fists bloody on the walls of the vat, trying at the extremity of desperation to get somebody's - anybody's - attention, as time and options ran out. Can you imagine how that was? Can you imagine the stress?"

Dr. Millar offered this vignette as a paradigm for workplace stress and how workers might experience their situation. In his words, "clearly this was an extreme case, but I believe it is a valid example of an individual helplessly trapped between an unbreachable barrier and an overwhelming on-rushing threat."

What has always stuck with me about this story is the image of someone trapped in a place where no one can hear their screams. In the workplace, I believe it is more often the case that no one is listening and that no one is paying attention (on this subject, see my post: Is your boss paying attention to you?).

As I said above, I don't know whether there are any data that tell us whether or not management really pays attention or whether or not it is either typical or uncommon for organizations to recognize and remedy stressful conditions.

I'd like to hear your comments on this: in your experience, does management pay attention? Are they listening? Is effective indifference the exception, or is it the rule?

Psychological Health Care: A prescription for health care cost savings

2009-09-07T15:56:00.000-07:00

It has long been recognized that emotional and psychological factors can affect one's health in a variety of ways. What is also known, but not well appreciated is that health plans can actually reduce their costs by providing psychological health care to subscribers.

The fact is that patients who receive psychotherapy tend to reduce their use of other, more expensive medical services. Despite this well documented finding, it is not uncommon for health plans to discourage mental health care usage, at a cost to themselves, to consumers, and to the employers who typically pay for coverage.

National Institute of Mental Health (NIMH) studies reliably estimate that almost 15% of the population will suffer from some type of emotional disorder during the course of any given year. Most of these people are normal and well adjusted and are simply responding to stress or to a crisis in their lives. These individuals are often referred to as the "worried well."

Only about one fifth of these people will actually seek or receive specialized treatment. Most of those remaining will not, however, simply suffer in silence until their symptoms go away.

NIMH researchers have found that the majority will be treated by their primary care physicians in what has been described as the "de facto U.S. mental health system." Health care dollars will be spent, regardless of whether or not specialized care is made available.

That this is the case is not readily apparent. Rather than complaining about psychological distress, patients will complain about physical symptoms which are caused, aggravated or maintained by emotional factors. Many will experience symptoms for which no organic basis exists.

This is not to suggest that the physical distress is not real. It simply means that real physical complaints can result from emotional concerns. While the patient may be complaining about disturbed sleep, headaches, back pain, dizziness, nausea, chest pains, diarrhea, indigestion, shortness of breath or sexual difficulties, the causative factors and curative means are often not strictly medical in nature.

If these sufferers were simply and effectively treated by their physicians, then insurance carriers would have little reason to be concerned about underwriting a de facto mental health system. Concern is warranted, however, because patients suffering from stress tend to use medical services at a disproportionate rate. It is not just that they seek medical care for problems which are actually psychological in nature, but that they use a great deal more care of all types.

Distressed patients use almost twice as many physician office visits, irrespective of their health status. They use more preventive services, more urgent care, and more hospital days, and they suffer more injuries and accidents. Distressed individuals are more likely to receive inconclusive diagnoses, are usually at greater medical risk, and when ill, are more likely to actively seek treatment.

It has been frequently estimated that at least half of all physician office visits are for symptoms that are primarily emotional or psychological in nature.

While obviously a problem, this situation actually represents an opportunity. A leading researcher in this field (and former American Psychological President), Dr. Nicholas Cummings, has argued for years that the systematic use of psychotherapeutic treatment is probably "the most significant untapped source of health care cost savings" available.

It was Dr. Cumming's studies (conducted some 40 years ago in the 1960's) with a population of some 10,000 Kaiser patients which provided the first demonstration of the potential cost savings. The patients were followed for five years. Those using mental health care during that time were matched with a control group.

Cummings found that those who were seen during that time in psychotherapy reduced their use of physician visits and hospital days to an extent sufficient to fully offset the cost of the treatment and to produce a net savings in general medical costs.

I first wrote on this topic more than ten years ago. At that time, there had been at least 58 studies replicating the original findings. Subsequent studies showed reductions in the use of medical care ranging anywhere from 5% to 79%, depending on the design of the service delivery plan.

The conclusion is simple: as part of a health maintenance strategy, outpatient psychotherapy saves money.

Given the above, it would be reasonable to expect that health plan administrators would actively promote the use of psychological health care. It should also be expected that when purchasing plans, employers would demand ready access to psychotherapy and that consumers would demand as much for themselves. In fact, it has remained the case that health plans often discourage the use of mental health benefits and that those who buy their plans give this service little consideration.

In practice, consumers often face a variety of subtle and not-so-subtle disincentives and barriers to obtaining treatment. Large co-payments, benefit limitations and exclusions, understaffed clinics, waiting lists, limited provider pools, complicated referral procedures and treatment review mechanisms all tend to discourage use. In many cases, physicians serve as "gatekeepers," receiving financial incentives for limiting referrals.

"Cost containment" is a legitimate reason to create disincentives. From the research, however, it can be argued that the potential for even greater savings is being wasted.

Even in plans which emphasize "wellness' programs, benefits are generally designed around the fear that once the doors to the therapist's office are opened, endless waves of patients will flow in to spend years on the couch for basically frivolous reasons. Each of these assumptions is wrong.

Do patients seek therapy they really do not need? Rand Corporation health insurance studies have demonstrated what every therapist knows: people seek help because they are in pain and distress, not because they want to contemplate the meaning of life.

Do liberal benefits produce uncontrollable utilization rates? If access to treatment is improved, there are temporary increases, but the rates quickly stabilize.

Do patients remain in therapy forever? Less than 10% of those entering treatment will require and use long term care. The majority respond to short-term methods, and contrary to the fears of the underwriters, they will have no desire to pursue years or even months in therapy. In any case, the fact that some will continue interminably is of little significance given that it is the average number of visits per patient that determines the cost of the service per subscriber. With a handful of patients using long-term care and the vast majority using just a few visits, the averages remain reasonably low, no matter what type of service delivery plan is provided.

What is most important with respect to utilization rates is that they are thoroughly predictable and therefore insurable. The potential direct service costs are not at all unreasonable. And again, if the treatment is not accessible, the dollars will be spent anyway on even more costly forms of care.

What are the implications of the above?

First, it means that if the Nation is in anyway intent on achieving health care reform and saving the money necessary to make it happen, psychological health care should be at the forefront, and not on the back burner.

During the 2009 health care debate, the Mayo Clinic has repeatedly been cited as a model for progressive care and as a cost saving model. A study released this year by the Mayo Clinic noted that over a four year period of time, the total cost of care provided to patients with major mood disturbances (i.e., bipolar disorder), exceeded the cost for patients with chronic conditions such as coronary artery disease and diabetes. And it wasn't the cost of their psychiatric treatments that made them the most expensive to treat. It was the fact that they used all manner of specialty care. The only group of patients that created greater expenses for the system were those who suffered from both coronary artery disease and diabetes.

Second, it means that rather than being viewed as a form of specialty care, psychological health care should be viewed as an essential component of the primary health care treatment system. While much is being said about the critical role of the primary care physician in guiding patients towards wellness and thereby reducing costs, there should be just as much attention paid to insuring that psychological and emotional concerns are attended to routinely and proactively.

A first step in this direction is to insure that physicians are following the recommendation of the U.S. Preventive Health Service for the routine administration of screening devices for depression and emotional well being.

Health care plans have a role to play in this effort. Insurance companies have the ability to shape practice by the way in which they set reimbursement policies. If it were known that psychological screenings will routinely be reimbursed, physicians would be more likely to employ them. When it is known that psychological consultation is regularly available for patients at high risk for emotionally based complications, it is more likely that physicians will include this service in their regular treatment plans.

Rather than assuming that the use of psychotherapy needs to be controlled, health plans should promote its use as part of a marketing strategy and in a spirit of enlightened self-interest.

Third, there is a role to be played by the employers who most typically pay for health insurance coverage. Employers paying for health care coverage should keep in mind that psychological well-being affects the bottom line. When choosing plans for their employees, they should keep in mind not just the cost of the plan, but the cost of stress related problems such as lost productivity, absenteeism, accidents, sick leave usage, disability claims and employee turnover. Those paying for the health plan need to shop on the basis of whether or not psychological health care is a priority.

Rather than viewing psychological assessment and psychotherapy as an unwarranted and unpredictable drain on resources, health plans would benefit from viewing psychological health care as a central component of a health maintenance strategy which seeks to reduce costs by promoting wellness.

Burnt-out on stress management? It's time to change the organization.

2009-09-07T14:30:00.000-07:00

Some years ago, I received a call from an organization that wanted me to conduct a stress-management workshop. I had done this many times, but I found myself hesitating. "Perhaps I could speak to your group about something else," I said.

And then, before I had a chance to think or to stop myself, I heard the words coming from my mouth: "You know, I'm really getting burnt-out on stress management."

I was stunned. How could I say such a thing? As a psychologist, I am in the stress management business. I don't hear my banker complaining about too many deposits. How could I complain about too many people striving for health and self improvement?

After taking time to reflect and consider my remark, I realized what I must have been thinking: stress management is a dead topic, or it least it should be. This was perhaps an unusual thought, but it was also one worth pursuing.

By way of explanation, I should begin with what I usually say about stress. I usually begin by saying that stress is something that everyone recognizes but which few understand or can describe or explain.

We know that stress can cause harm and that it generates costs. In order to account for the harm and the costs, there are four factors that need to be considered as part of the health stress equation:

1. Stress involves a physical response, a physiological state of arousal that prepares the body to take action.

2. The arousal occurs in response to events. They might be big, life change events or just daily hassles.

3. The stress reaction depends on how the events are perceived. Depending on the perception, an event might be considered a challenge or an opportunity, or a disruptive source of distress.

4. Finally, the extent to which stressful events will harm an individual depends on the coping resources that a person brings to bear on the problem.

Given this analysis of the stress and well-being equation, there are in turn four avenues for dealing with the problem.

1. Manage the physical response and change the way you body reacts.
2. Change the events in your life.
3. Change your perceptions or change the way you look at things.
4. Manage stress by enhancing your coping skills.

The list of techniques for managing stress is endless, and for the most part, they serve to illustrate why I have come to believe that stress management is not the correct topic for discussion in the workplace or in an organization.

To manage the physical response: exercise regularly, breathe correctly, get enough sleep, practice relaxation, etc.

To change the events: quit your job or stop working so hard; don't push yourself to be so efficient or to produce and accomplish so much; stop trying to take care of every little complaint your customers bring to you; stop sweating the details and stop listening to all of those orders from the boss.

To change your perceptions: understand that your job and your performance are not that important in the larger scheme of life; realize that deadlines are just artificial barriers to creativity; stop believing that every customer has to be satisfied; understand that there is no essential reason why your company or division has to be the best. In other words, develop a more relaxed attitude about your responsibilities.

To manage stress by increasing your coping abilities: take another week off at a time management seminar; become more assertive so that you don't feel so anxious and upset when you tell your boss what you really think; learn how to get others to do more of the tasks you don't enjoy; and remember to put your feet up on your desk every afternoon and meditate for a half hour or so.

The problem with the stress management agenda is that it starts with the assumption that the individual must adapt to an unhealthy situation. Whenever we talk about managing the stress, we are failing to talk about altering the noxious events that give rise to the stress in the first place. And as can be seen above, the goals of effective stress management are in many ways in conflict with the objectives of good organizational management.

We know that hard work, attention to detail and organizational discipline are required for profitability. We therefore assume that work must necessarily involve stress factors which the individual is responsible for "managing."

Instead, we should realize that demanding conditions are not stressful when they are experienced as challenges. Pressure is something on which most people thrive when they experience the demands of work as personally relevant and meaningful.

In most cases, it is not the necessary and unavoidable stressful events in the work place that cause people harm. Instead, it is the stressors that need not be: those things that could just as easily be changed. The functioning of individuals is impaired by events which if not viewed as "stressors" would otherwise be recognized for what they are: impediments to organizational performance.

Even those who are overwhelmed by the tasks that they face and who believe that they have no control over events will not be harmed by stress if they believe that their efforts are valued and that their work has purpose and is worthwhile. People will adapt and will have no need to "manage" their responses if they feel there is good reason to tolerate the pressures. People can thrive, even in the face of stress, if they experience themselves as having a Sense of Coherence.

Rather than trying to "manage" the problem, or to "therapize" the individuals who suffer from the effects of stress, the intelligent strategy is to focus on changing and curing the work environment itself. As with any other safety problem, the keyword is prevention. This is precisely what the National Institute for Occupational Safety and Health (NIOSH) has said: "Stress management treats only the symptoms of the problem--not the cause."

From the employer's perspective, it is simply good business. If your workers are distressed, you might as well just forget about trying to be competitive.

On the day that I precipitously announced that I was burnt-out on stress management, I was not prepared to offer the suggestion that would have been appropriate to the request. The next time I received such a call, I was ready.

"I would be happy to talk about stress management," I said. "But first, let's talk about what you are doing to enhance worker satisfaction. What are you doing to sustain morale and to improve employee motivation? Let's look at the prevention side first, and then, if you still have a problem, I would be pleased to teach your people how to relax."

Mourning and Mesothelioma

2009-07-28T18:51:00.000-07:00

In my article, How is Mourning Possible?, I discussed some of what we understand about the process of bereavement. I described it as a necessary and normal process, one in which the pain of loss diminishes over time and in which the process serves to keep the pain alive for an extended period of time. There are situations, however, in which the grief may seem insufferable and in which the circumstances of the loss make it nearly impossible to grieve in the normal way. Death from Mesothelioma is one of those situations.

Richard Moyle, the National Awareness Coordinator for the Mesothelioma Cancer Center recently wrote to me to share some of what he has observed among the patients and survivors his organization is seeking to help. This particular cancer is not the only disease that kills in a seemingly cruel way, and it is not the only type of death that seems unfair, unexpected and undeserved. But I agreed to comment on the mourning process in these cases because it is an experience that seems to exemplify some of the peculiar circumstances that can make mouring more difficult, if not relatively impossible.

Mesothelioma is a rare type of cancer, and the only known cause is exposure to asbestos. It is now well known that this naturally occuring mineral is a carcinogen. This was not so well known during most of the 20th century when it was routinely used in military and indusrial applications. Valued for its durability and resistance to fire, asbestos was used for insulation, flooring, piping, in brake linings and in other ways. While the general public, and many working in the asbestos industry did not know about the dangers, there were many manufacturers of asbestos products who turned a blind eye to the risks in order to gain a profit. The majority of diagnosed cases of mesothelomia can be traced back to occupational asbestos exposure. Many of those who were exposed did not know they were at risk and were not told how to protect themselves.

The symptoms of mesothelioma typically emerge 25 or even 50 years after the exposure to asbestos. When the symptoms emerge and the diagnosis is established, it is generally too late for any effective treatment. The symptoms show up when the cancer is already in an advanced stage and the average life expectancy after diagnosis is only about a year. In other words, by the time it is detected, death is almost certain and certain to come in a short period of time.

In the normal course of events, we expect that we might lose a loved one in a natural and inevitable fashion. A person gets old, becomes infirm, and slips peacefully into the twilight. That is how it is supposed to be. In Greek mythology, it was said that the Fates would measure the span of your life when you were born, and it was assumed that their string stretched out to a full span.

Grieving is a naturally painful process. It is even more painful when a life is cut short, and cut short without rhyme or reason.

Think of the young soldiers who die in defense of our country. Whether they are 19 or 54, we all grieve the loss and mourn the fact that they were taken away in an instant. Think then about the young adult whose life is cut short in an auto accident or a random act of violence. We see the same sudden finality, but we are left without the sense that they died for a cause and with purpose and nobility.

One of the factors that can make a loss ultimately more tolerable is the belief that it had meaning. Senseless death makes no sense, and the inability to understand it makes grieving more difficult and the loss harder to accept. The survivors are left not just with the need to unbind the psychic energy that was attached to the deceased, but also with the question of "why?"

Sometimes the "why" question is answered or resolved by the circumstances of the death. The person was drinking and driving, or being foolish or reckless in some other way. It is because of the need to answer the "why" question that we are often quick (when hearing about the death of someone unknown to us) to attribute responsibility to them personally. We tell ourselves that they were somehow at fault to ease our fears that a similar fate might await us or our loved ones: "Yes, it's tragic, but if they hadn't been ..."

Mesothelioma deaths encapsulate a number of factors that complicate the mourning process. It is a manner of death that is relatively sudden and unexpected. During the months that remain after the diagnosis is made, those who will be left behind must endure the feeling of powerlessness, their inability to stop it or prevent it. Rather than being able to view it as a matter of time and fate, there is the awareness that it was preventable. And rather than being able to rationalize the loss by attributing responsibility to the victim ("he should have stopped smoking and drinking"), they see only that it was someone else who made the decision to expose the victim to the carcinogen. It wasn't an accident, a twist of fate, and it was not for some noble purpose. Too often, what they see is that their loss came only because someone else chose to put profit before human decency. And with these feelings in mind, they are forced to watch a loved one endure a tortured and painful passing.

Again, asbestos related cancers are not the only types of deaths in which these experiences are shared. There are many other, similar circumstances. Some of those other experiences of loss also share with cases of mesothelioma the fact that there might be a protracted set of legal entanglements to resolve over a long period of time. When the victim is laid to rest, the family must decide whether to sue and seek redress. If they do, they are taking on another battle that will seem endless and prove frustrating. Rather than attending to the task of mourning - the task of letting go and moving on - they are stuck in a process that is consuming and that keeps the anger alive. When they should be seeking peace or finding a way to forgive, they are trapped by the need to "right the wrong" or to achieve justice. The same dynamic is seen among those who lose loved ones to acts of criminal violence. The need to achieve justice prevents them from attending to their own more pressing emotional needs.

This struggle to obtain redress is not necessarily unhealthy, and in fact, it may be absolutely essential. Anger is one of the feelings that naturally accompanies almost every unnatural death. Legal action almost always takes a significant psychological toll, but as painful and protracted as it may be, it is sometimes the only choice one has for the purpose of putting the anger to rest and getting on with the ordinarily difficult tasks of mourning.

There is one additional aspect of asbestos related deaths that is shared in common with other unnatural ways of passing and that bears mention. When death occurs in this way, there is actually an opportunity to find purpose in the loss, to find purpose where none might seem apparent. We see this all the time: survivors take on the task of raising awareness about a threat that exists. They crusade and campaign to tell their stories to others, to provide warnings, to prevent similar experiences and to provide support to those who suffer from similar tragedies. Along with the ordinary task of grieving and mourning, individuals and groups create meaning for themselves and their loved ones by making their loss a cause. This is healthy, and it is the message that the National Awareness Coordinator for the Mesothelioma Cancer Center asked me to share.

For more on this topic, see my article about grief in unusual or traumatic circumstances: Mourning and Mesothelioma

How is mourning possible?

2009-07-28T16:10:00.000-07:00

This was the title of an article written in 1966 by psychoanalyst Martha Wolfstein. It is considered a classic. I have an old and faded copy of her paper in my files, a copy on which I wrote extensive notes, and that years ago I heavily underlined. I can't say that I can immediately remember much of what she wrote, but I have always clearly remembered the title.

Wolfstein's focus was on the bereavement process in children and the observation that until children reach certain developmental stages, they may actually not be capable of mourning successfully (i.e, without suffering enduring emotional harm). While she was focused on grief in children, what always struck me was the question in the title: how is it in fact possible to suffer the loss of a loved one and to survive psychologically? In the face of great loss, how is it even possible to return to a normal state of well-being?

The process of grieving is familiar, and much of what can be said about it is reflected in the ancient proverb: "time heals all wounds." But there must be something more involved, some psychological process by which time works its wonders on the ailing heart. The death of a loved one is the most painful and grievous emotional wound that we can suffer as human beings. How does it come about that this wound can, over time, turn into just a scar on the psyche?

Our most essential and enduring insights about the bereavement process can be found in Sigmund Freud's famous paper, Mourning and Melancholia. Summarizing Freud's analysis, Wolfstein wrote that grieving involves "a painful and protracted struggle to acknowledge the reality of the loss, which is opposed by a strong unwillingness to abandon the libidinal attachment to the lost object."

Freud's formulation requires some explanation.

First, the term "libidinal" is used here to refer to psychic or emotional energy. When someone is important in our lives, there is a whole range of thoughts, feelings, passions, memories, associations and experiences that are attached to their existence and their presence in our life. Imagine one who is used to waking in the morning with their lover next to them in bed. The simple act of waking and rising involves a series of thoughts and feelings connected to the expectation that this person will be there next to them. That is the reality that they have come to know, and it is a reality to which they have attached their psychic energy.

The loss that one feels when someone close has died is not insignificant or inconsequential. The feeling is not just that someone is gone, but that someone has been taken. In its original use, the word "bereaved" means to be deprived. It means that death has stolen from you.

The task in mourning is to acknowledge that reality has changed and to free up one's psychic energy to invest in new experiences and relationships, or in the new realities of one's life. That energy is needed to connect to the world in new ways, and to the new reality that has been created by the absence of the loved one.

Freud described this process as a struggle, acknowledging that it is painful to let go and (in the words of author Michael Kahn) to "retrieve the psychic energy" from every object, memory and experience associated with the lost person. At the breakfast table, there are memories and feelings associated with the chair in which he sat. Her favorite coffee cup is still filled with the words that she spoke, the way she smelled and the sound of her voice.

In every encounter with a sound, a smell, a word, an image or an object that brings the loved one back to mind, there is an intensification of the feeling of their presence, and also of their absence. This is what prolongs the process. You look at their picture or recall that vacation and you are faced with an intense desire to relive and recall and recover the lost reality. The natural human tendency is to deny the new reality and to infuse the memory with enough feeling so that the loss is undone and the world returns, for a moment, to the way it was. The pain is recalled as you hold the object they touched in your hand and long for them to return.

The process of grieving involves touching the memories, bringing the memories and the person back to life, and gradually connecting to the awareness that in reality, it is something of the past, not the present. Wolfstein described the process by saying that it is a matter of "separating memory from hope."

What we have learned is that it is time, and the repetition of these painful experiences that gradually allows us to attach our thoughts, feelings and psychic energy to new memories, new events and new experiences. In order to "retrieve" the energy invested in the past, one has to suffer the loss over and over again in a number of small ways, prolonging the process each step of the way.

Acknowledging that mourning is possible, Freud said that: "normally, respect for reality gains the day. Nevertheless, its orders cannot be obeyed at once. (Those orders) are carried out bit by bit, at great expense of time and psychological energy."

In his description of the grieving process, Freud also introduced the concept of "introjection of the lost object." What he meant by this was that in order to fend off the pain of loss and to keep the person alive, people seek to believe that the person has become a part of them, a part of who they are and how they think and feel. Originally, Freud described this as a process motivated by a desire to resolve unfinished business with the one who has departed, and he described it as an unhealthy adjustment. Viewed in this way, it would be said that the survivor was haunted or possessed by the deceased.

In later writings, Freud recognized that it is actually healthy, normal and natural for the one who was lost to inhabit a space in the identity of the survivor. Indeed, "introjection of the lost object" may be a universal mechanism for achieving positive psychological adjustment through the grieving process. Viewed in this way, it is a matter of retaining images and memories of the departed, or retaining beliefs, understandings or fantasies about their continued presence in one's life. This process is an explicit part of many religions, Christianity being just one. The idea that someone lives on somehow, or somehow within you, is an entirely healthy and adaptive response. It allows those who survive to call up the internalized images and to take comfort from them. The images can comfort and also guide one along the continued path of life.

Beyond knowing that mourning is possible, it is widely understood by psychology that the process is necessary. Emotionally and psychologically, one cannot survive if their libido or psychic energy is not released from the dead and applied to the reality of life. One cannot be healthy if the internalized images of the departed are allowed to consume all of one's thoughts and feelings. Painful as it may be to endure and to accomplish over time, the goal is to achieve mourning and to avoid melancholia.

Telling them off (or not) on your way out the door: the departure email

2009-03-16T16:05:00.000-07:00

As millions are losing their jobs, there is no end of discussion about how to leave and how to survive.

At Slate.com, author Megan Hustad commented on "the strange psychology of the workplace departure e-mail," questioning the implications of the conventional advice: "just be positive."

I tend to think that it is not such "strange psychology" and that there is more than just a pearl of wisdom in the conventional advice.

In the words of author Hustad, "the parting note that offers nothing but affirmation to (now-former) employer and employees seems ill suited to 2009—and more bloodless than it needs to be. Have we collectively grown so skittish that even those with legitimate grievances won't give voice to their dissatisfaction?"

Her point was that perhaps we have gone too far in maintaining workplace pleasantry and propriety. Perhaps the forced smile and the artificial sweetness is not a good substitute for genuine human emotion. That is what she meant by the "strange psychology," the idea that we always have to be polite, even when departing.

In fact there is research indicating that with respect to employee stress and customer satisfaction, there is a downside to employers' demands that staff keep remain friendly and cheerful, even when they are not feeling it. It takes a toll on workers, and customers know when the emotion is not genuine. Not everyone who walks into a store, office or a restaurant wants to be greeted like a long lost friend. Among co-workers, the person who is always having a great day can be a bit scary - you never know what they are really thinking.

But if you are the person who's on the way out the door with pink slip in hand, you really should think twice about telling everybody what you really think, especially in writing. Perhaps you're angry, or hurt or resentful. Or maybe you're ready to laugh it off or maybe you want to wax philosophical about your fate. Maybe you want to do it like an Oscar award speech, thanking everybody and their dog. If that's the case, don't hit the send button.

Consider this simply as a practical matter. The people who remain behind could be the ones who help you find your next job. They may hear of a new job, or they may come across information that helps you in your job search. You do indeed want them to know how to contact you, but you don't want to leave any impressions that might cause them to hesitate before contacting you.

You also want to make certain that you don't do anything that might cause anyone to question your judgment. Some of those you work with now might soon be in new jobs themselves. They might be starting their own business and looking to hire, or they might be end up in a position where they can recruit or hire others in your field. The way you leave this job may be instrumental in whether you land the next one.

Here are some things to consider:

If you leave angry, you could be the one who reminds them that they hate their job just as much as you did. That increases the burden they carry as they continue. No reason you should remind them. And if they like their job, they're going to think there was something wrong with you.

If you leave sad and dejected, you could be contributing to the common sense of "survivor guilt" that is often felt by those who are spared the knife. If you leave on any type of sour note, some of those who might have felt guilty are going to think to themselves, "yeah, that's a guy who really did deserve to go."

If you leave completely upbeat and positive, thanking everyone you can think of, some of them are bound to think about how you treated them while you were there. Maybe you weren't always so nice. And some will know that you are in a time of hardship and that your expressions of gratitude are not genuine and truly heartfelt. They know you are disappointed and that you didn't just win an Oscar.

You could be philosophical, penning a note of the type that author Hustad described as suitable, a note expressing "existential resignation." The problem is that you don't know how people will react. When you say goodbye, you are speaking to an audience that is scared, scared that they might be next. You don't want to suggest to them that they should be resigned to their fate, or that they shouldn't feel hurt and sad if it happens to them. From you, they don't want to hear that there is nothing to fear.

You also don't want to say this is all just part of the journey of life and that you are looking forward to what ever happens next. That suggests that you aren't planning and seriously focused on finding a new opportunity and your next job. It suggests that maybe you might end up on a beach in the tropics, or wherever else the winds might blow you.

Don't try to be funny or humorous. There is nothing funny about being laid off.

So how should you leave?

My advice is that you leave graciously and effectively, with a seriousness of purpose. Positive is good, but it involves more than "just be positive."

As to how you should do it, I consulted a career adviser, Cici Mattiuzzi, who is now in the process of publishing (on the web) her second text book: The Serious Job Seeker. This is her advice:

Don't wait until the termination notice arrives to start planning your goodbye. Do it now! When you get the notice, it may be too late. Your email account and your contact list may be terminated immediately. So, make sure you have all your contacts and that you have an email address that you will be using for professional purposes (like at gmail).
Don't send anyone any notes until you've taken some time to get some exercise and fresh air and think about what you are going to say. Next week is soon enough.
Let people know that you view this as an opportunity to explore your options, consider new directions or to gain some education, training or experience that you have long considered.
If you have some enterprise or activity already lined up, let them know how you will be actively engaged and involved. Let them know if you have a side business or project that you will be focusing on (this is also an advertising opportunity). If you know what your next career objective is, tell them. Let them know what you are looking for.
Let them know that you would appreciate hearing from them, especially if they have any ideas or suggestions, or if they hear of any opportunities. Ask them to keep you informed if their contact information should change. Above all else, make certain that they know how to contact you by email, and through LinkedIn or some other location on the web where they can easily access your resume.

The departure email is not where you want to share your feelings or look back on the past. It's OK to say that it was a pleasure working with them, that you appreciate their support and/or friendship, and to express "best wishes." But it is not a time to be maudlin or sentimental. By way of your attitude, you want to let them know that you are not depressed and that you have passed The Serious Job Seeker IQ Test.

Zero Tolerance Policies: no substitute for good judgment

2009-03-11T11:19:00.000-07:00

The term "zero tolerance" suggests that it is a consistent, no-nonsense approach, and that such policies must therefore obviously be an effective and beneficial disciplinary strategy. These policies are prominent in the educational system, and so in the interest of school accountability, it is relevant to ask: does it really work?

The American Psychological Association considered that question and created a task force to look at the data and the research. Recently published in the American Psychologist, the Task Force report suggests that when put to the test, the policy flunks.

The analysis focused on five key assumptions underlying the use of zero tolerance policies in the schools:

1. It is assumed that zero tolerance policies are necessary because school violence is increasing and increasingly out of control. The reality is that the rates of violence and disruption in schools have remained steady or have actually declined over the past twenty years or so. Obviously, violence prevention efforts are absolutely necessary to protect against both common place incidents and critical acts of aggression. However, disciplinary policies should be formulated in response to the actual threat, and not in response to the "feeling" that the problem is out of control.

2. It is also assumed that mandatory and inflexible punishments serve to create consistent discipline and clarity in the disciplinary message. In fact, they do not. Within school districts that have adopted such policies, there remains a great deal of variation across schools with respect to how many kids are actually disciplined (or need to be disciplined), and there is just as much variation across school districts with similar policies. Whether or not a school is orderly has much less to do with the disciplinary guidelines than with the quality of teachers and the quality of school governance. Indeed, the quality of the school may be more important that the attitudes and behavior of the students.

3. It is assumed that the removal of disruptive students provides for a school climate more conducive to learning. In fact, the opposite is true. Schools in which expulsions and suspensions are common tend to have less satisfactory school climate ratings and are found to spend a disproportionate amount of time on disciplinary issues. And after taking into account the socioeconomic status of students, they tend to have lower academic achievement rates.

4. It is assumed that zero tolerance punishments will deter those expelled or suspended from misbehaving in the future. Instead, what is found is that those who are disciplined in this fashion will in the future be more likely to continue misbehaving, more likely to drop-out and less likely to graduate. Perhaps it would be justified if some benefit accrued to the school and the student body, but it is not justified if it simply involves making it a problem to be dealt with by someone else.

5. The final assumption considered is the idea that parents and students overwhelmingly support zero-tolerance policies. Here, the data are mixed. Some parents applaud such efforts, especially when the punishment is applied in specific cases that have caused public alarm. On the other hand, there are just as many cases in which parents and other students are left feeling that the punishment was unfair and that some measure of forbearance should have been granted. The concept of "a second chance" is deeply rooted in our consciousness, as is the idea that "the punishment should fit the crime."

School discipline is important. Punishments are often necessary. If it could be shown that arbitrary rules made schools safer or that they eased the administrative burdens associated with exercising discipline, then of course a zero tolerance approach would be recommended. But what seems to make sense does not always in fact meet the test of common sense.

After considering whether or not zero tolerance policies have any unique benefit, the APA Task Force also looked at whether there is a downside or dark side to such policies.

On the dark side, there are important implications. First, it appears quite certain that rather than being "color blind," arbitrary punishment strategies tend to disproportionately effect students of color and students who suffer from various forms of psychological disturbance. Second, there is clear evidence that zero tolerance policies tend to increase the likelihood that those disciplined will end up as clients of either the juvenile justice or criminal justice system. In general, these policies violate the old adage: "an ounce of prevention is worth a pound of cure."

The APA Task Force did not in any way seek to suggest that disciplinary actions are unimportant, or to argue for excuse and tolerance. Instead, they outlined a set of recommendations focused on the benefits of flexibility. In any situation where a disciplinary response is required, there are indeed different and "alternative strategies" to be considered.

With respect to making schools safe, the weight of the evidence shows that there is little benefit to be obtained from abandoning individual case analysis and judgment. There is no apparent benefit to be obtained from arbitrary rules. There are in fact a number of disciplinary alternatives available in any situation. The task is to evaluate every situation on its own merits.

Further comment: As a long-time observer of the criminal justice system, I am particularly aware of the fact that arbitrary rules are counter-productive. Set rules do not provide respect for authority. Justice demands that every crime and every offender should be judged individually. That is what Judges should do.

Arbitrary rules serve to diminish the role of Judges. In the school setting, arbitrary rules serve to diminish the role of the School Principal.

From my perspective, the danger presented by zero tolerance policies (and mandatory sentencing guidelines) is that they provide the offender with an excuse and a justification. Rather than taking responsibility for their behavior, they blame the system for its rigidity. There is hardly anything more dangerous than an offender who believes the system did not afford them justice. Rather than having the punishment serve to correct their behavior, the belief that they were treated unfairly is used as a justification for future misbehavior.

And in the school, I believe that a zero-tolerance policy sends exactly the wrong message. It is often the case that when someone is expelled simply as a matter of course and in a reflexive way, other students will rally to their cause, rather than condemning their behavior.

Authority figures have a responsibility to exercise judgment and discretion. When they wash their hands and abandon that responsibility, they lose respect and credibility in the eyes of those they are meant to guide.

Recession, Depression and Depression

2009-01-06T12:21:00.000-08:00

When the report came, showing that the economy had shed more than half a million jobs in November, the stock market staged a brief rally. The thinking was that with news this bad, surely the government would step in to help. It's like the story of the child who wakes up on Christmas to find a pile of manure: excited, the child begins digging, assuming their must be a pony in there somewhere.

It is not at all likely, however, that those who have been thrown out of work in recent months will be looking to find a silver lining.

There is an extensive literature on the connection between unemployment and psychological well-being, and the news is not good. In a recent report on work and health from the American Psychological Association, it was noted that: "the loss of work has been consistently linked to problems with self-esteem, relational conflicts, substance abuse, alcoholism and other more serious mental health concerns." In every respect, and not just financial, one's quality of life is at risk when unemployed.

The fact is that work is often essential for psychological health. It is the "playing field" for our dreams and aspirations, and an important source of pride and satisfaction. Work is where we find challenges and a sense of meaning, and the chance for self-determination and personal empowerment. It is not just a matter of survival and security. Work plays a complex role in our social lives. It is a link to the broader cultural fabric of life and a regular source of social support.

Clinical depression is a common and expected result of the experience of loss. Beyond the sense of loss, those who have been displaced from the economy can expect to experience shame, fear and uncertainty, and a whole series of stress factors related to survival and adaptation. Imagine what happens to your identity when you are no longer a breadwinner or when you suddenly become dependent on an unemployment check. Imagine the adjustments you might have to make in your lifestyle or your role in the family or your daily routine.

The effects will also be felt by those who remain on the job. Their future is no longer certain, and it is often observed that they can suffer "survivor's guilt." It is a whole new stress at work: "Am I next?" Time that was previously devoted to productivity and engagement will be spent worrying, wondering and watching.

Depression is a genuine and significant health concern. The current unemployment numbers are pointing towards a potential public health crisis.

So how should you respond if you have become one of the "walking wounded?"

First, if you are feeling depressed, don't worry about it. It is normal and expected. There is no reason to worry more about the fact that you are worried. You don't want to be depressed about the fact that you are depressed.

Watch for the signs. What you may notice is: you are feeling sad or empty most days; life no longer feels interesting or satisfying; you can't sleep or you can't eat, or you are eating too much; you are unusually restless or fatigued; you are feeling worthless or guilty; it is harder to think or to concentrate; or you seem to have unusual pain or physical discomfort. These are the symptoms of clinical depression.

If you are depressed, you might also notice that you are drinking more, fighting more often with your spouse, and more likely to be irritable and impatient with your kids.

If you have thoughts of death or suicide, that is the only sign necessary to know that you are depressed.

If you are depressed, don't hide from it. Don't pretend it's not happening to you. Talk to your friends, your family and the people you love. If you are a person of faith, talk to your faith leader.

You also want to stay active. Stick to a routine, exercise regularly and think about working as a volunteer. When you are out of work, a real good use of your time is to go back to school. Classes will keep you occupied, interested and motivated. Education is a good way to fill that hole that is starting to grow in the middle of your work history and to prepare yourself what comes next in your career.

Unemployment cannot readily be cured. Depression, however, can be cured. If it is becoming too much to handle, speak to your Doctor or find a therapist. Get help. Don't be ashamed. (Take the Psyris Depression Screening.)

This recession is going to be deep. The rates of depression are going to rise. The research shows quite clearly that many who suffer emotionally will not fully recover, even when they return to work. We all need to understand that we are facing a pile of manure and that there is no pony to be found.

The task now is to survive, to hold on, and to reach for the future. The best way to do that is to take care of yourself, and to remain optimistic, confident, and filled with a sense of meaning and purpose, despite all indications that this is an uphill battle.

Emotional Intelligence? I'm not feeling it.

2008-12-05T16:01:00.000-08:00

Emotional Intelligence is a confused and confusing concept.

Indeed, a key group of proponents of the Emotional Intelligence (EI) construct recently published a defense of their work in the American Psychologist (September 2008), essentially arguing that the meaning of the term has been subverted. Professors John Mayer, Peter Salovey and David Caruso acknowledged that there is a "schism in the field" and that the term is now being used "in too many different ways" and to "cover too many things."

Writing in the Journal of Organizational Behavior, Professor Edwin Locke worded his criticism more bluntly by asking rhetorically: "What does EI not include?"

It was in 1990 that Mayer and Salovey first outlined their views on EI, suggesting that it represented a distinct set of abilities. The idea that the human skill set involves something more than just IQ was not new at the time, nor was the term "emotional intelligence." What Mayer and Salovey provided was a model that could serve as the foundation for research and a "test" that purported to measure EI. Their focus was on the ability to perceive and understand emotions and to use them to facillitate thinking.

In 1995, Daniel Goleman published his hugely successful book, "Emotional Intelligence: why it can matter more than IQ," and with it's release, the term found a permanent place in the popular imagination and in the annals of pop psychology. What Goleman and others added to the model was the idea that EI can refer to any number of positive personality traits, such as self-esteem, optimism and need for achievement, and any number of social skills, habits and behavioral preferences.

When I was in school, there was no literature on "emotional intelligence," and the term had not yet first been coined. I became aware of the topic by reading Time magazine's cover story on Goleman's work and was skeptical from the start. Everything I read about EI seemed to suggest that it was just a re-packaging of standard and well-established ideas from the psychological literature. And the package wasn't pretty.

Before the advent of EI, we already knew that performance and achievement is responsive to motivation. There was never any question about the fact that there are a variety of different ego-strengths that serve to complement intellectual abilities and to enhance performance. Our ability to describe individuals as having different levels of social and interpersonal skills was never in question. Our understanding of personality traits was already intensely developed. We knew all along that the ability to use insight, introspection and personal reflection to understand our feelings and those of others was useful. A term that was used to describe those who tended to think about their thoughts and their feelings was "psychological mindedness."

What the EI theorists introduced was the idea that there is a specific set of personality traits and/or a specific set of skills relating to the understanding or use of emotions that can be interpreted as "an intelligence." What they violated was the idea that constructs have meaning. In other words, there is a distinction between an ability and an achievement, a skill and a habit, an attitude and a value, a personality trait and an emotional state, and so on. Those distinctions are central to science and theory construction.

In arguing that EI is not a valid concept, Professor Locke put it like this:

"The fundamental problem here is that one cannot 'reason with emotion.' This is a contradiction in terms. Reason and emotion are two very different cognitive processes, and they perform very different psychological functions ... One cannot 'reason with emotion;' one can only reason about it ... what they (EI advocates) are actually referring to is not another form or type of intelligence, but intelligence applied to a particular life domain: emotions."

In their recent American Psychologist article, Mayer, Salovey and Caruso were attempting to defend the idea that one can "reason with emotion," and at the same time, to fend off the pop psychology advocates of EI who have hijacked the term and essentially defined it as including anything at all psychological. An author and hiring consultant says that the "ability to learn from mistakes" is a form of EI. Another says that if a manager has a "democratic" leadership style, that is an example of EI. The ability to make friends and to control impulses have also been added to the definition of EI.

While there are certainly many recognizable competencies that help us navigate life, it makes no sense to say that everything that is not a function of IQ is a function of EI. "Emotional intelligence" has come to bear little resemblance to what we would ordinarily refer to as either an emotional function or an intellectual one. Mayer, Salovey and Caruso say that "managing emotions" is part of the EI equation. Conceptually, it makes no sense to say that emotional control is any type of "intellectual task."

So what sustains the use of the term EI?

As researchers, Mayer, Salovey and Caruso are professionally invested in their model and wish to reclaim it for a scientific purpose (by the way, they believe that EI is best measured by their commercially available test instrument).

In the pop psychology field, EI serves an industry of authors and consultants, ready to sell their insights.

And in the popular imagination, EI is the concept that levels the playing field. In the words of Professor Locke, EI is about "egalitarianism: redefining what it means to be intelligent so that everyone will, in some form, be equal in intelligence to everyone else." EI consultants have floated the notion that success and performance in life requires everything but actual intelligence: you don't have to be smart and you don't have to be a rocket scientist. "Joe the Plumber's" common sense is just as good as a Harvard Law degree. Intelligence and scholarship are simply the values of the elite.

In the end, it remains quite obvious that raw intellect is not necessarily worth as much as some give it credit for. Intelligence is not a substitute for good judgment. Practical wisdom does not follow from the conferring of a degree. My gardener tells me things that make sense that I would never have figured out on my own. The guys who were described as "the smartest guys in the room" are the same ones who brought down the Enron Corporation. Great political failures have been perpetrated by those who were chosen because they were the "best and the brightest." The "absent minded professor" is a well-known stereotype.

For many of life's endeavors, intellect may be necessary, but not sufficient. Does the concept of "emotional intelligence" provide a satisfactory explanation for whatever else is necessary? I'm not feeling it.

Is your boss paying attention to you?

2008-08-20T13:44:00.000-07:00

Probably not, he doesn't need to.

Above, the choice of the pronoun "he" was intentional. The article I reviewed for this post appeared in the American Psychologist and was focused primarily on the tendency of people in power to view their subordinates through stereotypes, rather than bothering to understand them as individuals. The assumption that the boss is a man is a stereotype.

When Princeton University Professor Susan Fiske wrote the article, her emphasis was on the fact that stereotypes function as a powerful tool for controlling people. To illustrate her research on the control function of stereotypes, she used work place examples of gender discrimination and sexual harassment.

What I want to focus on here is what Dr. Fiske had to say about why those in power are not likely to pay attention and to get to know their subordinates as individuals, why they tend to lump them into categories.

The simple fact is that people pay attention to those who have power and control, those who can have an impact on their lives and effect their fate and their future. "Attention follows power" is how Professor Fiske described it.

In any organization, it is easy to observe that those at the bottom will spend a lot of time watching and thinking and talking about those at the top. The employee is motivated to construct a unique and detailed portrait of the manager because the employee wants to be able to predict what the leader might do in any situation. What the employee "knows" about the supervisor may or may not be accurate, but it is simply natural for a subordinate to have a clear picture in mind for the sake of survival.

On the other hand, because the leader does not necessarily depend on the subordinate for approval, success or promotion, "he" has a lot less riding on his ability to understand or appreciate what's going on with the followers. The "clueless" boss is a stereotype that appears to be grounded in reality.

There are two other reasons why those in power may not bother to form accurate and detailed impressions of those who are below them on the organizational hierarchy.

First, those in power simply have more people competing for their attention. At some point, the situation involves information overload (or TMI, "too much information"). The strain on their capacity to pay attention to everyone is also amplified by the fact that those in power are busy focusing their attention on those with even more power.

The other reason has to do with motivation. Those in power are typically motivated (if not expected) to control and dominate others. As noted, stereotyping can serve as a form of control. Those without power have even less power when they are perceived as relatively nameless and faceless. The research also indicates that leaders may be motivated to ignore others either because they are "power hungry" or because they have a precarious sense of their grip on power. When groups of employees are in revolt against leadership, those in power can be even more likely to tune out the noise.

The tendency of those in leadership positions to compress their perceptions of subordinates is not just "a guy thing." It is the result of powerful social structures, fundamental cognitive processes, and individual personality dynamics.

For the organization, the downside risk of oblivious or "clueless" leaders is that leaders do in fact depend on their employees in a variety of ways. The fate of the organization can be tied to the actions of individuals at the very bottom of the power structure. That is obviously the case when those on the bottom rungs have to interact with the public. Less obvious are the situations in which leadership fails to pay attention to how employees experience the work environment.

Every organization is concerned about work place stress, but too often, complaints are dismissed with convenient generalizations (e.g., "he's a whiner" or "it's just a personality conflict" or "she's just too sensitive"). Professor Fiske provided examples of companies losing major sexual harassment suits because they weren't paying attention. Perhaps more common are situations in which companies lose their investment in valuable employees because they either quit or suffer stress related disabilities. Employees who are unhappy and misunderstood are probably going to say bad things about the company before they leave, and even worse things afterwards. That's not a good thing from a PR standpoint.

What can an organization do? From my reading of the literature, it appears that the most useful way to motivate leaders to pay attention to the powerless is to highlight and amplify the sense of interdependence. When the employees are stake holders in the company or when the leader's success is dependent on the judgment of subordinates, those in power are more likely to invest energy in employee appreciation. When leaders are held to account for maintaining commitment and satisfaction among subordinates, they will suddenly have a reason to pay attention to those at the bottom.

Helicopter Parents: disturbing trend or urban myth?

2008-08-15T10:37:00.000-07:00

This is a shorter version of an article I posted in the Spring, updated for back-to-school and off-to-college time. The original article (more discussion of the research and references to the "empty nest") can be found here.

Permission is granted to re-print this article if the credit line at the bottom is included.

It's back-to-school and off-to-college time. Soon, we will be hearing stories about college freshmen and their "helicopter parents." These are the parents who hover and can't let go, the ones who are overly involved, overprotective and excessively supportive.

This story has been written many times. In a November 2006 MSNBC online article, a college counselor was quoted as saying that the "problem" of hovering parents "has now reached epidemic proportions." In a March 2008 Sacramento Bee article, a college counselor estimated that the rate of parental hovering stands at 30 percent and is increasing 2 to 3 percent a year. An online guide to college life offers a list of "signs and symptoms" so you can check to see if you suffer from this disorder. If you help your kid write a paper, or provide extra money, you may be afflicted. On the Today Show in October 2007, "national mom expert" Stacy DeBroff said that this problem afflicts 60 to 70 percent of "all" college parents and advised that some may need to "get help."

There are actually three reliable sources of data on this topic, each based on large scale studies.

Surveying SAT applicants, the College Board found that there is "little evidence of extreme or intrusive parental involvement" and that "much of the reported parental involvement is actually very positive and supportive."

The Higher Education Research Institute (HERI) has reported that on measures of parental involvement, more college students said that they received "too little" help from parents, rather than "too much." A sizable majority said that they received the "right amount" of help.

Finally, the National Survey of Student Engagement (NSSE) showed that when parents maintained frequent contact with their children and helped them deal with problems on campus, the students were more engaged in the academic process, maintained better study habits, were more satisfied with their college experience and reported having gained more from college.

A USA Today story from Februray 2007 touted "what's believed to be the first scholarly research on parents who hover too closely over offspring." This "scholarly research" was based entirely on interviews with 50 "college officials." In other words, it was nothing more than a collection of anecdotes. College advisers and administrators obviously have stories to tell. They have seen the extreme examples.

The reality is that there is no disturbing trend or epidemic to be observed. Obviously, there will be cases in which parents go overboard. But the hovering actually seems to be more of a problem for educators than for students. Administrators have to deal with the parents who complain.

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

What colleges and universities should be concerned about are all of the students who enter and then fail. The average retention rate for entering freshmen is less than 75 percent.

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

Paul G. Mattiuzzi is a psychologist and developer of the psychology resource information system: psyris.com. An extended version of this article appears at his blog: everydaypsychology.com.

Why do people kill? A Typology of Violent Offenders

2008-07-30T16:37:00.000-07:00

At various times, I have been asked to lecture on the topic: why do people kill? Why do they commit murder? How do we explain acts of violence. The following is not an exhaustive explanation. It's a handout I use when I speak about different types of killers and the motivations for different crimes. But it describes many, if not most types of homicide and most acts of violence. It describes most of the killers and most of the violent individuals I have interviewed.

Chronically Aggressive Individuals

Easily frustrated, limited or poor impulse control
Frequently express anger or hostility
Resents authority, defiant with supervisors.
May express hostility through “passive-aggressive” behavior
Believes violence and/or aggression are legitimate responses to various interpersonal problems in life (i.e., if someone provokes you, you fight back)
Although they might never admit it, pleasure or reinforcement is derived from the expression of anger (i.e., it feels good to blow someone off; it makes you feel alive; it gives you a sense of power)
Often display the characteristics of a “stimulus seeker” - they engage in bold, fearless, or reckless behavior and are prone towards substance abuse
Most typically, violence occurs in a situational context: an offense, fight, or disagreement
Sometimes just get carried away in a particular situation (domestic violence, child battering)
Less likely to engage in acts of unexpected “explosive” violence

The Over-Controlled Hostility Type

Rarely display or express anger - they don’t cuss or yell, and may be offended by such
Emotionally rigid and inflexible: appear to be polite, serious, and sober, rarely “loose” or jocular
Cognitively rigid and inflexible: very strict about interpreting rules; usually go for the letter, rather than the spirit of the law
Morally righteous and upstanding: see themselves as “good people”
Often judgmental: see others as “not such good people”
Non-assertive or passive; their passivity causes others to take advantage of them
Anger builds up like in a pressure cooker, before they explode
After the violence, people say that they never expected it, “he always seemed like such a nice guy; he was always so quiet”

The Hurt and Resentful

Feel that people walk on them and that they are never treated fairly
When they are passed over, there is always someone else to blame
Things are easier for everyone else: other people get more and have more advantages.
They do not accept criticism well
In response to reprimands, they develop grudges, which are sometimes deeply held
They are often whiners and complainers, as a matter of attitude
They wallow in their victimization and are psychologically impotent
Violence occurs because they hold grudges and are “impotent” to deal with their anger in other ways

The Traumatized

Aggression occurs in response to a single, massive assault on their identity
Something happens that is potently offensive, absolutely intolerable, and which strips them of all sense of personal power
The essence of their existence (or their manhood) will be destroyed if they do not respond
Violence is predictable & preventable

The Obsessive

Immature and narcissistic individuals who demand or crave attention and affection
Absolutely cannot stand to be deprived of desired gratifications, like a baby who cries because mother removes the breast
When deprived of love, they continue crying: repeated phone calls, following the object of their obsession, etc.
As frustration continues, they escalate: “dead flowers”, punctured tires, suicide gestures
Violence because: “if I can’t have her, nobody can.” ... or: “if she won’t have me, she won’t have anything.”

The Paranoid

Jealous Type: Delusionally believes their lover is unfaithful
Persecuted Type: Delusionally believes that people are out to get him
Typically engage in behaviors which make their paranoid beliefs come true
Delusions may reach the point at which the person is grossly out of contact with reality (may be insane).

The Insane

Rare: does not understand the nature and quality of their actions.
More typical: fundamental misperceptions of reality, incapable of rational behavior, delusional beliefs deprive them of the ability to know that their behavior is wrong, beliefs and perceptions are incongruent with reality.
Twisted, psychotic beliefs about what is right, what is wrong, and what is necessary.

The Just Plain Bad & Angry

A combination of most of the above (except for insane): angry, hostile, jealous, resentful, impotent, and disturbed individuals, who are socially isolated, socially inadequate, and who feel worthless
May be seeking attention
May be seeking revenge

What is psychological health?

2008-07-30T14:49:00.000-07:00

Psychological health is important with respect to how we function and adapt, and with respect to whether our lives are satisfying and productive. In the end, psychological health and well-being basically has to do with the question: "how are you doing?"

While questions like "how are you doing?" or "how is your mood?" capture the essence of psychological health, psychologists have found that it actually involves two separate issues. There is an upside and a downside, both of which need to be considered.

The upside involves two factors: is your mood generally positive, and do you enjoy a number of "positive emotional ties." In other words, are you happy and do you have friends? In addition to feelings of emotional satisfaction, a positive mood also depends on whether or not you generally feel calm and peaceful.

On the downside, emotional well-being involves three factors: do you suffer anxiety, are you depressed, and do you feel like like you have lost control and can't do anything about your feelings. This is the experience of psychological distress.

Although there are two parts of the equation, for general purposes it can usually be said that distress and happiness are two sides of the same coin. Usually, people are either happy or they're not, and if their mood isn't good, they are often distressed to some extent.

It is also important to know that psychological health is an issue quite different from mental or emotional disorder. The research on well-being concerns itself with the feelings of normal individuals and subjects from the general population. When we talk about psychological health, we are referring to how ordinary people are doing in life. In other words, if you are feeling distressed, that doesn't necessarily mean that you are mentally ill.

Ordinary life often presents the individual with extraordinary challenges, complexities, setbacks and hardships. Psychological health concerns itself with how you cope, how you are doing in response, and whether you find life to be interesting and enjoyable. Although life is better when we are feeling good, there is no avoiding the fact that there will be ups and downs.

What is the best way to assess your state of well-being? Take a few minutes to fill out the brief Psychological Health Index at psyris.com.

This questionnaire is a modified version of an instrument developed by the Rand Corporation for use in a variety of health and medical outcome studies. It is a short version of a longer "test," and even though it is just a few items long, it has proven to be a remarkably useful way to ask people: "how are you doing?" ... "how is your mood today?"

My own research has demonstrated that how you respond to the brief Psychological Health Index is significantly correlated with your perceived personal health status. If your score on this instrument is negative, you are more likely to have more physical health complaints.

I ususally advise people to take this test every now and then, and not just once. Things change and feelings change. In the same way that it is a good idea for healthy individuals to monitor their blood pressure on at least an occasional basis, it's a good idea to keep an eye on your mood. Mood is a vital sign.

Leadership Research: are we asking the right questions?

2008-07-18T20:20:00.001-07:00

The research literature examining, defining, analyzing and exploring "leadership" is vast. But does it focus on the most important question? A recent study published in the American Psychologist suggests that while we have learned a lot about how someone comes to be perceived as a leader and to have a successful career, we have not paid similar attention to whether or not "successful leaders" actually serve to create effective organizations.

There is no question at all about the fact that leaders can have a huge and significant impact on organizational dynamics. We recognize certain individuals as natural born leaders because they stand out as individuals who can create organizational culture, generate commitment, motivate workers, enhance cooperation, effect employee satisfaction and make sure that everyone is on the same page. We know a lot about why some leaders have consistently positive approval ratings. Endless studies have examined why some leaders are widely admired and how their leadership abilities have positively influenced their career trajectories.

But there is another question that is more typically left unanswered. In their article, "Leadership and the Fate of Organizations," Robert B. Kaiser, Rober Hogan and S. Bartholomew Craig looked at what has been studied and what has been left unexamined. What they found is that the leadership research has "overwhelmingly focused on how leaders influence individual followers" and groups of followers.

What Kaiser and his colleagues noted is that while we know an awful lot about the role of leadership in "how the team played," we actually know little about the role of leadership with respect to the big question: "did the team win?"

When studies of leadership focus on outcome events, they typically focus on the effectiveness of the group. The problem is that it really doesn't matter how effective or successful the group is, unless they beat the other guys.

For the most part, leadership studies have not focused on objective outcome measures. Instead, they tend to focus on how the leader is perceived. A dull and boring manager producing consistent returns on investment would not be considered a leader. A dynamic and inspiring figure who rises through the ranks will be highly rated for leadership abilities. Most often, leaders gain approval because of how others "feel" about them and how they make others feel about themselves and their groups. We identify individuals as leaders for emotional reasons, and not necessarily on the basis of rational and objective measures.

In what is described as the "derailment literature," it has been found that many bright and capable individuals fail to advance, while others succeed because of their ability to "manage impressions." Those who advance are perceived as being leaders. Those who simply perform quietly, constantly, routinely and as expected are often overlooked. While it may be that "leadership" is the holy grail relative to advancement, it remains the case that as many as half of all executives fail to deliver as expected. This failure rate results from the fact that they are chosen because of their approval ratings, rather than actual leadership abilities. Managers are often chose because of impression, rather than substance.

The "take home message" from this study is that charisma and career success are not good measures of leadership ability. Approval ratings are subjective, and they are no substitute for measures of actual performance. Those who succeed in being perceived as leaders are consistently found to enjoy great career success. And they are well liked and appreciated by those who are called to follow. But at the end of the day, no matter how well the team plays, you still have to ask: did the team win?

What we have here is a failure to communicate

2008-03-12T12:11:00.000-07:00

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

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

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

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

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

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

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

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

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

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

Helicopter Parents: disturbing trend or urban myth?

2008-03-11T15:56:00.000-07:00

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

(A shorter version of this article can be read here)

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

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

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

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

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

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

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

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

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

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

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

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

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

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

So what do we learn?

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

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

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

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

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

The psychology in art. What can we learn?

2008-02-08T13:53:00.000-08:00

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

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

The Gulf Stream

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

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

Breezing Up

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

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

Fog Warning

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

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

ooo0ooo

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

Is clinical psychology an overrated career?

2008-02-06T23:49:00.000-08:00

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

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

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

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

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

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

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

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

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

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

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

Is Dr. Phil actually a psychologist?

2008-01-29T15:08:00.000-08:00

Article summary:

Dr. Phil is a Doctor. He has a Ph.D. in Psychology.
Dr. Phil is not a psychologist. He is not licensed as a psychologist.
Dr. Phil used to be a psychologist. He used to be licensed.
He cannot practice psychology, and what he does is not actually the practice of psychology.
Yes, he can call him self Dr. Phil.

This article was written soon after Dr. Phil involved himself in an incident with Britney Spears. When he stepped off the stage and into someone's real life, he almost got himself in trouble.

The profession of psychology has no problem with what he does, although some disagree with how he does it. You should judge for yourself.

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

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

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

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

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

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

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

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

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

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

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

Two things.

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

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

So is Dr. Phil going to be disciplined?

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

What's probably going to happen?

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

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

About his apparent violation of California's psychology licensing law - the fact that he represented himself as being trained, educated and qualified as a psychologist? My guess is that at most, the BOP might issue a warning letter and probably won't even do that. Psychologists and the BOP are in fact concerned on a daily basis with serious business. Dr. Phil is in the entertainment business and the field of pop-psychology.

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

Did Dr. Phil really and intentionally mislead the public?

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

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

But still, I don't think he was being dishonest. I think it is more accurate to suggest that he was trying to cleverly walk a fine line. If he were adequately familiar with the law, I think he would have done a better job of walking that line.

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

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

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

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

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

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

California's own Dr. Marty Greenberg, former President of the BOP also appeared. His opinion: the hospital visit and the public statement about it isn't a matter that the law covers or will be concerned about.

As I suggested, nothing will come of any complaint.

Stressed out on campus?

2008-01-28T09:36:00.000-08:00

In 2007, a young man at Virginia Tech killed a number of his fellow students. Many were quick to suggest that he was "stressed out," upset or having a bad day. But as details emerged, we learned that this was not a case of someone who was "pushed" over the edge and "couldn't take it" anymore. Instead, what we learned is that the killer was a deeply disturbed and chronically troubled individual whose emotional life was punctuated by morbid rage and twisted anger.

A disturbance of this intensity is absolutely not something that could just happen to any of us. But it reminds us that we should all pause and think about the stress factors we face in our own lives. Even as memories of this event fade, we should all reflect on the pressures we face and how well we are doing in maintaining a sense of well-being. It is always a good time to ask: "what is stress?"

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

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

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

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

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

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

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

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

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

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

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

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

My other online project

2008-01-23T14:57:00.000-08:00

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

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

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

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

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

psyris-ads ... position openings, continuing education, books, groups, services, offices and everything else.

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

Is existence too painful to endure?

2007-04-18T11:30:00.000-07:00

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

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

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

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

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

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

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

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

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

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

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

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

The Sense of Coherence

2007-04-18T09:21:00.000-07:00

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

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

The sense of coherence is comprised of three factors:

• a sense of comprehensibility:

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

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

• a sense of manageability:

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

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

• a sense of meaningfulness:

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

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

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

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

Why did the astronaut crash to earth?

2007-02-07T14:26:00.000-08:00

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

2007-01-18T10:59:00.000-08:00

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

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

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

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

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

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

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

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

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

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

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

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

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

Does Therapy Work?

2006-11-30T16:23:00.000-08:00

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

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

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

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

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

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

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

Yes. Therapy works.

Why do kids commit murder?

2006-11-26T14:51:00.000-08:00

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

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

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

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

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

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

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

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

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

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

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

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

Follow up comment: My discussion above about the "demand for respect" that is often involved in youth violence has often been a point of discussion among those who have discussed this article with me. I wanted to add here a quote from a column by Leonard Pitts from the Miami Herald, who was writing about a gun play incident involving two NBA players, Karl Malone and Gilbert Arenas of the Washington Wizards. It happened in December 2009, and while it was essentially just horseplay, weapons were brandished. After noting that "the leading cause of death for black men 15 to 34 is homicide, usually at the hands of another black man," and after noting that the two players involved were both African-American, Pitts had this to say:

"Granted, stupidity knows no color. And yet ... it is difficult to think of these two guys whipping out guns like something out of Dodge City and not see shadows of all of the other men of the same heritage and age group who once were here but now are gone because they regarded guns in the same profoundly unserious manner. Because they saw them not as tools of hunting or self-defense but, rather, as toys - as argument settlers and point makers, as extensions of their personal reproductive gear, as a means of demanding respect."

I wanted to capture this quote because I think it reflects the source of a lot of youth violence: acts not necessarily intended but behavior that got out of hand for no reason at all. January 2010

Can loneliness affect your health?

2006-11-16T16:21:00.000-08:00

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

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

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

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

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

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

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

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

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

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

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

Does the handshake matter?

2006-11-09T15:15:00.000-08:00

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

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

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

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

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

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

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

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

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

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

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

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

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

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

2006-11-03T15:33:00.001-08:00

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Who's that elephant in the mirror?

2006-10-31T08:27:00.000-08:00

It's all over the news: an elephant at the Bronx Zoo looked in a mirror and recognized herself. I think everyone would agree that this was quite a feat. Think how many times you've gotten up in the morning and seen a stranger in the mirror. It's news because it's an important demonstration of animal intelligence.

Read any of the news stories and what you will learn is that this is an evolved and advanced intellectual capacity. Humans can do it, and so can dolphins and the great apes, but most other animals (including monkeys) cannot, or at least no one has been able to demonstrate that they can. Some animals will recognize an image in the mirror as being similar to them, and some will react as they might in a social situation. But it is rare to find an animal that can relate to the mirror image as a representation of themselves.

Obviously, the scientists from Emory University, the Yerkes National Primate Research Center, and the Wildlife Conservation Society did not simply ask the elephant: so how do you think you look today? Instead, they put a mark on the elephant's face that could be seen by the elephant only in the mirror. They knew that the elephant recognized it as her own image when she repeatedly touched the mark on her own face. This has been tried with elephants before, but never before with a huge, almost lifesize mirror.

There is much that can be said about this capacity: it is a cognitive prerequisite for some types of empathy and altruistic behavior. And it contributes to some types of complex social interactions that have been observed before in elephants.

What it brings to mind for me, however, are a series of cognitive abilities that distinguish us as humans and that we often take for granted.

For example: we have the ability to recall the past and to bring it back to mind. There are some ways in which animals can demonstrate a sense of loss, but there are none that grieve over death in the way that humans do.

We can think about the future: establishing goals, anticipating rewards and maintaining a sense of hope. We can also experience disappointment when our hopes and our dreams do not become reality.

We can develop a sense of purpose or a sense of meaning, the belief that things really matter or that there is some reason for our existence. We have a sense of history and we are able to reflect upon the fact that we exist.

We can also entertain in our minds the choices that are available to us, the options, possibilities and opportunities that make up daily life.

There are some who say that animal behavior is not that much different from the human experience, that animals display emotions and that they have feelings. The excitement surrounding the elephant in the mirror should remind us of how truly remarkable it is that we have such advanced intellectual abilities. We are the only animal that can worry about the past and take joy in our hopes for the future. That is what makes us human.

Perhaps, rather than being amazed that an elephant saw herself in the mirror, what we should be amazed about is the fact that a group of scientists were able to devise a method for determining that an elephant could recognize herself in a mirror. What is amazing is that humans recognize how amazing this is.

Internet safety: do kids really know what's going on?

2006-10-30T15:05:00.000-08:00

You would think that the current generation of young kids would have a fairly good understanding of how the internet works and how it functions as a social environment. After all, kids today have been logged-on for most of their lives, and it seems that they are on the web almost all the time. It turns out, however, that their understanding is not what we would expect and that their experience alone is not sufficient to insure that they will be able to remain safe on the web.

Writing in the journal Developmental Psychology (September 2006), Professor Zheng Yan of the State University of New York described a series of studies concerned not so much with how much children understand, but with how they come to learn about the the complexities of the internet. Dr. Yan focused on factors that influence children's learning about the internet.

An important distinction highlighted in the article is the difference between understanding the technical complexities of the internet and understanding the social complexities. To be safe on the net, kids probably need to understand both perspectives.

On the technical side, there are questions about whether kids know that their home computer could be hooked up to computers anywhere in the world, or that the identities of those who communicate with them might be disguised. Do they know how much information they send out everytime a web page is delivered to their screen? Do they know that hackers might be able to track their activities or that "cookies" are not just something you eat with milk?

On the social side, there are questions about whether kids know that they might not be communicating with the type of people with whom they would ordinarily feel safe, or that there are people out there who might be trying to take advantage of them. Do they know that the email that seems to come from the maker of their favorite breakfast cereal might actually have come from a predator or a thief from far away? Do they know that when they answer a survey, they might be giving up information about themselves that can later be used to target them? Do kids really understand the implications of the fact that "on the internet, no one really knows that you're a dog?"

What Dr. Yan found is that the length of time a child has been using the internet does not really serve to increase their knowledge about either the technical or the social aspects of the web. The frequency of internet use does not provide for much improvement in their technical understanding, but it does help some with respect to their understanding of the social threats and complexities. Instruction about the web, even if provided informally, also helps children understand the social dynamics of internet use. With younger children, however, instruction does not help as much as we might expect.

By and large, the most important factor in how well kids understand the complexities and dangers of the internet is simply their age. In other words, as children mature, they become more aware, just as in every other aspect of their lives. By the time they reach early adolescence (7th or 8th grade), they should generally be capable of understanding internet dangers as well as a typical adult might, which is not to say that they actually do understand. The prevalence of internet scams is ample proof that many adults remain just as vulnerable as many teenagers.

Dr. Yan did not intend his work to provide a prescription, but instead, to provide a way of looking at the factors involved. What can be suggested from his work is that telling younger kids to be careful is probably not going to provide the measure of safety that parents would like to see. Before adolescence, kids should be monitored and observed, and parents should be involved. In the teenage years, it should not be expected that children will be safe, just because they have been at it for a long time.

And at any age, the findings suggest that the more kids know about how the internet works at a technical level, the more capable they will be at recognizing the social threats - the ways in which they might be used or manipulated. Social maturity proves to be the most important factor in keeping kids safe on the net. And as we all know, during the teenage years, kids do not really have the social sophistication and social maturity to fend for themselves in the absence of parental judgment and involvement.

Red State, Blue State: is it a state of mind or just the colors on a map?

2006-10-24T15:22:00.000-07:00

Looking out on today's political landscape (i.e., in 2006), it's hard to imagine a time when social scientists would have said that "ideology" had nothing to do with personality styles, or that the differences between the left and the right are not that great. There was such a time, however, at the end of World War II, when the study of political and ideological differences was said to have become irrelevant for psychologists. Today, we are well past the point of being able to say that left or right, blue or red, everyone is really just the same.

This topic is the subject of a recent article by Professor John T. Jost of New York University, published in the American Psychologist (October 2006) under the title: The End of "the End of Ideology." His argument is that shared attitudes really do matter, that shared beliefs are not just situational or issue-specific, that beliefs form enduring patterns, and that beliefs do in fact motivate people to act. Liberals and conservatives are in fact different, not just in terms of their opinions. To some extent, they are also different at the level of personality style.

Professor Jost looked at four issues that relate to whether or not political ideology is in fact an important focus of psychological study: (1) do people maintain a set of core beliefs? (2) are people motivated to act in response to their core beliefs? (3) are liberals and conservatives really different? and (4), is there any psychological underpinning to the differences in belief systems that are shared by liberals and conservatives?

It turns out that when asked, most individuals will identify themselves as having a core ideological orientation, generally either liberal or conservative. These orientations appear to be generally stable over time and to be reflected in a variety of opinions about specific issues.

As to whether or not these attitudes have an influence on behavior, it has been found that whether someone says they are liberal or conservative is one of the very best predictors of how someone is going to vote.

As to whether or not there really is any difference in the values of the left and the right, the most stable indication has to do with attitudes toward equality and tradition. Conservatives are more tolerant of inequality, viewing it as the result of hard work or character. Liberals are less beholden to authority and tradition, and are more willing to challenge the status quo and to demand change. Conservatives are more receptive to social control. Liberals are more likely to endorse policies that provide for social and economic equality.

At the level of personality, one of the more persistent observations in psychological research has been that conservatives tend to be more dogmatic and authoritarian, and rigid in their attitudes. This observation has been rejected by some who argue that in the end, liberals are equally up-tight and fixed in their ways. A more current and useful distinction (advanced by UC Berkeley cognitive scientist George Lakoff) is that the two sides are distinguished by whether or not they adopt either a "strict father" or "nurturing parent" view of moral discipline. Other findings suggest that liberals will score higher on scales measuring openness to new experience and the tolerance of ambiguity, and that conservatives are more likely to be conscientious and orderly. One interesting finding, developed through systematic observations, is that "the bedrooms of conservatives were more likely to contain organizational supplies such as calendars, postage stamps, and laundry baskets, whereas the bedrooms of liberals were more likely to contain art supplies, books, CDs and travel documents." Observations show that on average, the work spaces occupied by conservatives tend to be better organized and tidier!

One of the more intriguing findings regarding liberal-vs-conservative personality styles is that conservatives display a greater fear of death and other threats to personal safety and social stability. This finding correlates with the fact that conservative politicians have been able to benefit by raising fears about terrorism. It also explains the well-documented fact that following 9/11, there was indeed a shift in the population towards conservatism. The downside to this is that those who identified or shifted towards conservatism, also tended to suffer depression and post-traumatic stress at levels significantly greater than those who identify as liberals. In times of threat, the fear of threat is a vulnerability.

Is there any harm in people adopting an ideological perspective from which to view events and issues? The research suggests that it is probably a very natural human tendency. What is of concern is that it can leave us divided, rather than united, and that rather than contributing to political and social sophistication, ideological adherence tends to breed distortion, oversimplification and selective processing of information. Be that as it may, it is certainly not the case that ideology is dead, or that as Ralph Nader famously claimed in 2000, there is no difference between the right and the left.

What is Psychology?

2006-10-10T06:00:00.000-07:00

Psychology is a scientific discipline -- the study of human behavior.
Psychologists study the biological, physiological and genetic causes of behavior, as well as the emotional, social, and developmental factors involved.

In general, psychology is concerned with how people perceive the world around them and how they react to it, how they grow and how they learn, and how they relate to others and function in groups.

In other words, psychology is about how people think, feel, and behave.

As a profession, psychology involves the application of knowledge. We take what we learn from scholarship and research, and apply that knowledge to the problems and challenges faced by groups and individuals.

Most people encounter our discipline through the work of a clinical psychologist, a professional who is concerned with helping people live healthy and productive lives - someone who helps people solve problems of living or resolve mental health problems.

What is a Psychologist?

2006-10-10T05:00:00.000-07:00

In a university, a psychologist is a professor who teaches or conducts research in the field of psychology.

Outside the university, the title "Psychologist" is reserved in the same way that the terms "Attorney" and "Physician" are limited. Anyone calling themselves a "Psychologist" or who practices psychology must be licensed by the State.

Most of the research in our field comes from university based professors, rather than from psychologists who are in practice. Some psychologists teach and practice, and also conduct research.

Except in academic settings, a psychologist is someone with a psychology license.

Licensing protects the public from individuals who might call themselves psychologists or practice psychology without proper qualifications.

Psychologists must have a doctoral degree, usually a Ph.D. - Doctor of Philosophy - or a Psy.D. - Doctor of Psychology. Some qualify with an Ed.D. (Doctor of Education).

In addition to a doctorate, a psychologist must also complete a specific number of hours of supervised training. Generally, this will involve two to three years working in clinics or hospitals before finishing the Ph.D., and at least one year of intense, full-time training after the degree is completed.

Psychologists also have to pass licensing examinations.

After graduation from college, it takes a minimum of five to six years to become a psychologist. It can often take six to eight years. Most psychologists have produced a doctoral dissertation, which is an original research project and a book length discussion of that research.

After the license is obtained, one may use the title "psychologist " and may practice using the methods, techniques and knowledge of our field.

What do psychologists do?

2006-10-10T04:00:00.000-07:00

Psychologists have many skills and provide many different types of services.

Clinical Psychologists provide counseling and psychotherapy. They work with people who have life adjustment problems, and also with those who have emotional disorders or mental illness. They provide treatment for people of all ages and to families and to groups. Psychologists provide treatment for depression, anxiety, phobias, panic disorders, eating disorders, stress related problems, relationship problems, and severe mental disorders.

Clinical Psychologists provide diagnostic assessment or "testing" services. Using interviews, questionnaires, and measurement tools, they can chart an individual's skills, personality features and personality style, emotional status and emotional style, or problems they may be having in adjusting to life. These measurements are often essential for clarifying the diagnosis of a mental illness or an addiction.

Educational Psychologists, School Psychologists, and Clinical Psychologists provide "psychoeducational" testing. With the use of IQ tests and tests of academic aptitude and achievement, they can identify academic strengths and weaknesses. Sometimes these tools are used to identify "gifted" students, and sometimes they are used to identify specific learning disorders or developmental learning problems. Evaluations relating to learning issues also frequently involve the assessment of Attention Deficit Disorder (ADD) or Attention Deficit, Hyperactivity Disorder (ADHD).

Health Psychologists and Clinical Psychologists seek to understand the relationship between medical complaints and psychological factors. They assist in preparing patients to cope with surgery and to adjust to medical problems. They work with patients who are having difficulty meeting the social and emotional demands of their medical treatment. They also provide treatment to individuals whose medical problems are related to psychological and emotional factors, or who are suffering from chronic pain.

Neuropyschologists diagnose mental and behavioral problems that are related to brain injuries. Using precise tests of mental functioning, they can determine how the brain is functioning and how and where it might have been injured as a result of trauma.
Forensic psychologists provide consultation to Courts and attorneys in all different types of legal proceedings. Many work as experts in the area of criminal law. Others provide expertise in personal injury suits, sexual harassment cases, child custody matters, and workers compensation cases.

Organizational Psychologists focus on the productivity of groups and individuals in the workplace. They work to improve the functioning of organizations, and to promote the health of individuals within the organization. They also conduct research on "human factors" or the interaction between people and machines.

Sports Psychologists provide training to enhance the performance of teams and individual competitors.

Psychologists work to understand and improve the functioning of human beings at home, at school, at work, at play, in their religious pursuits, and in society in general. Psychologists are involved in every aspect of human thought, feeling and behavior.

Are all therapists psychologists?

2006-10-10T03:00:00.000-07:00

No. In addition to psychologists, there are other licensed professionals who can provide therapy and counseling.

Are all therapists with a Ph.D. also psychologists?
No. The Doctor of Philosophy degree is an academic award of the highest level - awarded in many different fields - but the degree is not enough to qualify someone to become a psychologist.

There are some marriage family therapists and social workers who have a Ph.D., and who can call themselves "Doctor," but who are not trained or licensed as a psychologist. Some therapists have Ph.D. degrees in fields that have nothing to do with psychology. "Dr. Laura" is a good example. She is not a psychologist and she is a Doctor of something that is completely unrelated to this field.

Is a "psychotherapist" the same as a psychologist?
No. Marriage counselors and social workers often use the title "psychotherapist," but they are not psychologists unless they have a psychology license. Most clinical psychologists devote at least part of their time to the practice of psychotherapy, but they will usually identify themselves correctly as a psychologist.

In a physician's office, you might receive care from a "physician's assistant" or a "nurse practitioner." The care you receive will probably be entirely adequate. But you wouldn't say that you actually "saw the Doctor." Practitioners who identify themselves only as "psychotherapists" are usually not psychologists.

What's the point?
The point is that if you are going to see a therapist , you need to know what type of license they have and what profession they belong to.

Often times, when people are distressed and seeking help, they fail to ask or to understand what type of professional they are actually seeing. If everything goes well, it is perhaps not much of a problem. But if there is a problem with the treatment, it can become very important to know.

Any psychologist from whom you seek consultation will be pleased to discuss their education, training, and credentials. And any therapist you see should tell you what type of license they have. Don't be afraid to ask.

Psychologists and other professionals

2006-10-10T02:00:00.000-07:00

There are certain services that only a psychologist can provide. But there are other professionals who also provide therapy and counselling, and whose "scope of practice" overlaps with that of psychology.

Clinical psychologists diagnose and treat mental and emotional disorders of all types. They also assess and provide psychotherapy and counseling for problems of living and relationship problems. Psychologists work with individuals, families, groups, and organizations. They often use "tests" or measures of mental abilities and personality factors.

To provide comprehensive care, psychologists are trained to consult with a patient's medical doctors. Psychologists may also admit patients to mental or psychiatric hospitals, and serve as a patient's primary care taker in that setting. Most people encounter psychologists in a private therapy office.

Psychiatrists are medical doctors specializing in the diagnosis and treatment of mental and emotional disorders, typically with the use of medications.

There are a number of mental and emotional conditions for which medications are a recommended, sometimes necessary part of treatment. In most all cases, someone receiving medications will also want to be seen by a psychotherapist, especially when the problem involves stress, depression or anxiety.

Primary care physicians also routinely provide mental health care, usually for common forms of depression, stress, or anxiety. Sometimes they will provide brief counseling, and often times they will prescribe medications. For patients in need, the family physician is an important referral source and a link to other mental health professionals.

Licensed Clinical Social Workers are identified as an LCSW. There are actually many different types of social workers, but only a licensed social worker (LCSW) with a Master's degree in Social Work can provide clinical services in independent practice. LCSWs provide therapy for all types of conditions, but they are distinguished by their training in dealing with practical problems of living.

Marriage Family Therapists are identified as an MFT or MFCC (in California). Their license requires a Master's degree. Marriage counselors provide assistance to troubled children and families, and to individuals coping with troubled relationships. The scope of practice for marriage counselors is often broadly interpreted, but strictly speaking, they provide treatment for mental and emotional disturbances only when they relate to issues within a marriage or a relationship, or with a child.

Registered Nurses are valued and important members of most mental health treatment teams, and also provide assistance to distressed individuals as they interact with them in medical offices, hospitals and clinics.

Pastoral Counselors and Clergy meet many needs for many individuals.

Psychologists and Prescription Medicines

2006-10-10T01:58:00.000-07:00

As a rule, psychologists do not provide medications and are not allowed to write prescriptions.

But there is more to be said on this topic.

In the United States, there are a handful of psychologists who are authorized by the Department of Defense to provide prescription medications for the treatment of mental illness. The U.S. military recognizes the need to have psychologists fully involved in the treatment of mental disorders.

Psychologists licensed in the States of New Mexico and Louisiana can also provide prescription medications. To do so, they must meet very specific training requirements and be supervised by a physician.

The American Psychological Association is actively engaged in efforts to create a broader privilege for psychologists to prescribe medications. Understandably, but perhaps not wisely, this effort is generally being opposed by the Medical profession.

As more psychologists are authorized to prescribe medications, this privilege will be limited to a very few who have obtained specific and appropriate training, and a special and limited license.

Many psychologists are already experts on psychotropic medicines. Many provide consultation to general practice physicians on medication issues, and psychologists are among the leaders in the research in this area.

Psychologists are persuing the prescription privilege because in many parts of the country, there is a definite need for additional services. Many communities do not have enough psychiatrists to meet the needs of the mentally ill. This is true in heavily populated states, including California, and it is especially true in rural America, on Indian Reservations, and in urban areas with high densities of elderly, poor and immigrant populations. There is also a need in our prisons and State mental hospitals.

General practice physicians often provide necessary medications, but many do not possess the special expertise required for treating psychological disturbances. Even in cases of general depression - a condition that is common and that can be devastating - research has repeatedly found that most general practice physicians are not adequately prepared to provide accurate and effective diagnoses.

Psychologists are seeking the prescription privilege because there is a definite need, and because psychologists are uniquely qualified and available to respond to this demand.

As a profession, psychology is preparing to assume a limited prescribing role through research and through the establishment of training programs.

Psychologists may provide prescription medications for the U.S. Military and in the States of New Mexico and Louisiana. But in California, a psychologist is not allowed to write prescriptions.

This is what the State of California, Board of Psychology has to say on this topic:

California psychologists cannot legally prescribe medication. This prohibition is established in Section 2904 of the California Business and Professions Code.

Often, consumers seeking mental health services are taking medications or suffering from conditions that could be treated very successfully by medications prescribed by a physician. Psychologists are often the first mental health care providers assessing and treating such consumers. Indeed, many psychologists have extensive training and experience in the applications of medications. Psychologists may discuss medications with a patient. A psychologist may suggest to a physician a particular medication to be prescribed by a physician. However, the ultimate decision as to whether a patient should receive medication lies solely with the physician. A psychologist may engage in a collegial discussion with a patient's physician regarding the appropriateness of a medication for the condition being treated. A psychologist has primary responsibility to monitor the patient's progress in psychotherapy which includes assisting in monitoring the changes which may be attributable to the medication in the patient. Psychologists should maintain a close consultative relationship with physician care givers in order to assure appropriate overall treatment of the patient.

There are many psychological conditions which manifest themselves in physical symptoms. There are physical problems which have psychological symptoms as well. The best interests of the patient demand that psychologists work closely with primary care physicians and psychiatrists who are prescribing medications to the patient of the psychologist. While a psychologist's responsibility can include involvement in limited aspects of a patient's medications, the patient's physician is the only person who may lawfully prescribe the medication for the patient. reference: www.psychboard.ca.gov/medicate.htm