A.P.A. Convention Highlights
American Psychological Association
116th Annual Convention - Boston, MA
August 14-17, 2008
These edited reports were originally posted to the
Current Topics, Therapy Online, and Cyberpsychology list-servs, August 2008.
2008 Convention Highlights:
Grand Theft Childhood | Opening | Malcolm Gladwell
| College Success, Love, Hate, More |
My Life With Asperger's
My Space, You Tube, Psychotherapy, Relationships... | Aaron T. Beck - 2008 | The Mind and Brain of Voters
"Asynchronously Live" from Boston
I was very careful to take accurate notes during these presentations (including several pithy verbatim quotes), using handouts and/or photos of graphics to verify my notes.
I apologize for any remaining errors or typos, and will be happy to immediately correct any mis-quotes, misattributions or mis-spellings brought to my attention. I welcome presenters' submission of additional online references which are relevant to (or mentioned in) these reports. Thanks, and... Enjoy! I hope you find this slice of psychology interesting and informative.
APA CONVENTION REPORT #1
August 14, 2008
Asynchronously Live from Boston!
14 August 2008
Hi, and greetings from Boston!
Asynchronously Live from the APA Convention -- APA's 116th -- reported on
in virtual real-time, hopefully providing those who cannot be at the convention here & now, with a sense of the live interactions and presentions.
Here are some nearly-live reports from just a few of today's APA events, hopefully providing a flavor of this huge gathering of psychologists, some of the "themes" which APA has been developing (and I've been following), and a taste of the energy and excitement people are buzzing about still, in the restaurants and hotels of Boston.
Here we go, with a few of the quot;main events" for the organization (like the opening ceremony, late in the day) and a few of my own choices which of course reflect but a fraction of "what's out there" in the world of psychology, particularly for students and new psychologists, in this rapidly changing landscape for healthcare/mental healthcare.
More on this later, from APA leadership, the mayor, and a Kennedy...
My goal is to "share psychology" and provide at least a sense of this year's annual convention experience, using imagery, transcripts, and my own take on some of the "hot topics", so as to give a feel for the event as it is still happening,
being reported on by the media, etc. As always, this year brings with it social unrest, internal debates among psychologists about the role and future of psychology, many new students participating (a large group of Fulbright Scholars attending and presenting this year too), and many exhibitors - largely book publishers and practice-oriented test developers, drug companies, relaxation device makers, etc. Lots of handouts too: brain sponges a perennial favorite along with pens, brochures, and this year, cookies everywhere!
I hope some or all of this will allow you to share some of the excitement of "being here" and experiencing both the diversity of psychologists as well as the pleasure of hearing from the experts about new and important trends and research tracks, along with education, training and practice issues.
Without further adieu, here's a sampler from today, 14 August 2008, Boston Massachusetts, in the new, very imposing (and distant from downtown hotels!) Boston Convention and Exhibition Center (BCEC).
1140 - Discussion: Humanizing an Inhumane World - Grand Theft Childhood: Videogame and Media Violence
Chaired by Dr. James Bray, with Drs. Lawrence Kutner and Cheryl Olson, participants.
James Bray, a former APA President, began by introducing Dr. Kutner, who is well-known to media psychologists and known to many as the author of those wonderful NY Times columns called Parent and Child, which inspired me and which I used as "handouts" to give parents, before the Internet began its rule.
Dr. Bray noted the fortuitous coincidence of Grand Theft Auto the video game being released at the same time as Dr. Kutner's book, which refers to this very game, and related phenomena.
Bray called this "an important book" which sheds some light on a multi-billion dollar industry which has its share of both defenders and detractors.
With that, he gave the podium to Dr. Lawrence Kutner, leaving him with THE question to consider, so it seems,
"Are video games good or bad for kids?"
Lawrence Kutner: The answer is 'yes'. Obviously it's not so simple or one dimensional. [There are some who think "letting out violence" through games is healthy, "cathartic", cleansing; others think it teaches disinhibition, anti-social modeling, &/or dissociation.]
The media, said Dr. Kutner, have historically embraced, collectively, what turned out to be alarmist spin, reminiscent of the days of Congressional testimony in 1949, where our country's legislators were upset about several comic books of the day - now classics - which they were convinced would lead to all sorts of terrible consequences by "glamourizing" violence and influencing teens.
Long before that, in fact there was big concern about "the terrible influence of the new media: the paperback novel". Dr. Kutner concluded that, aside from looking at individual events and people, there is a cultural context too, in which "the media" always seems to panic, historically, when new media types are introduced.
Next, Dr. Olson was introduced, as co-author of the Grand Theft Childhood book (with Dr. Kutner) and as a distinguished Harvard professor with some very interesting findings coming out which are relevant to "media psychology".
Dr. Olson clarified first that her doctorate is in public health. She is working as a researcher, along with Dr. Kutner, in a medical setting (Mass. General).
She offered a "condensed book version" which gave a sense of where some of the research has focused, and is headed, in an environment where there is a push for public policy. Studies have already been done which look at the relationship between violent games and "cop killing". As more refined studies are done, however, it seems that the media are often innaccurate in the reporting. One of the early findings was that contrary to what people may have thought, the killers in the Columbine High School assault were really "not into video games".
Like Dr. Kutner, Dr. Olson too is interested in learning more about the power of context. She explained that she "wanted to explore what patterns of behavior could be observed" in speaking with parents, teachers, and others. What she found is that "there's no information out there on what is 'normal'." And looking still at context, parents were asked what they were most concerned about, in terms of influence on their children. It was not "video games" as some monolithic entity. In fact, people (adults and teens) do look at specific games and evaluate the context for, and type of, violence. "There's a difference between killing aliens and zombies", in a fantasy context, versus graphically decapitating people.
Next question: "What about different kinds of violence in the context of different kids?"
[Yours truly picked up on this later, asking about different types of personalities and tendencies to dissociate/disinhibit from game-life into real-life, etc. Another question.]
Dr. Olson described her study of video games and young teens (age 13 and 14), which involved an extensive survey of over 1250 7th and 8th grade students from both high and low socioeconomic status environments in Philadelphia and South Carolina. A similar survey was completed by approximately 500 of the teens' parents.
Drs. Kutner and Olson had also run some focus groups with approximately 50 boys and 25 parents. It was not until after the survey results, however, that they realized how many girls were frequent players of GTA as well (i.e., "played a lot over the past six months"). [Thank you, Dr. Kutner, for further clarifying this!]
The study yielded a great deal of data and the researchers, Dr. Olson explained, are still combing through it in myriad ways. "In our 32nd summary", she said with a smile, it was found that 2/3 of boys had an "M" score of equal/greater than 1*. The #1 attraction in video games for the boys, was Grand Theft Auto, followed by sports-based videogames.
For girls, #1 was The Sims, and #2 was Grand Theft Auto. (Some of the boys berated Sims as being yucky, people-oriented stuff, with kissing... And then there's the debate about the boys exposure to the GTA "main message".) Dr. Olson shared that it was a shame that the earlier focus groups were only on the boys, because she now thinks, as girls were also interested in Grand Theft Auto, it would be fascinating to look at whether girls and boys play the games differently [or have different experiences or goals!].
One interesting finding was that the more "M" games* -- those rated with "mature" content -- which the girls played, the more likely to find reports of social problems, especially bullying. Boys who played a lot were less likely to be bullied.
Other questions arose as patterns and surprises emerged. Could some of the game-playing frenzy be "self-medicating for depression?" Very complex, obviously.
Next, the larger issue of motivation became a focus. [See last year's presentations by Zimbardo, Beck, Farley and others, about group and system pressures leading to evil, hate, and horror.]
Motivation is very complex: Why are games played, for example, and why are specific ones chosen? It can be a group experience, an individual may be looking to deal with stress, "get your anger out", etc. Dr. Olson has heard reports by teens of how, if they were really stressed and angry, they'd get the cheat codes for a game and just blow everything up. At the same time, some reported they learned that actions have consequences which attend bad behavior. In sum, it's all still a "sandbox-type environment".
We're still learning, and there's so much to learn in a rapidly changing social and world context.
Next Dr. Kutner spoke, beginning where Dr. Olson had left off, describing several other findings - and questions - which have emerged from the study, and particularly from the focus group feedback. For example, boys were asked, "Are there any games you shouldn't play?" The boys said SIMS. The researcher asked why, was it not violent enough? But the answer was actually "They do things with people" (as opposed to fantasy), like kissing. There was a big disagreement in one focus group. How old should one be before playing such games?
One said 8, one said 100. If you could invent a game, what would it include? "Cool costumes", "I'd rule the world", "No homework"...
Now as to the big media response, it was fortuitous that Grand Theft Auto 4 was released at precisely the same time as the book, with the game becoming the most popular game EVER. But, in keeping with history apparently, the level of debate about violent media's impact on behavior still remains superficial, at least in the popular press. It's a "hot topic" nonetheless.
What often happens is "distorted coverage" gets picked up by the "blogosphere" (a word Kutner said would have just stymied his editor at the NY Times years back), and travels from one person to the next, akin to the old game of 'telephone' with a new distortion or omission/substitution with each new relay, until the report gets back and "it's not at all anything I would recognize".
Dr. Kutner shared that he too is fascinated by some of the focus group feedback. One student wrote back (about a book which was named), "I'd buy this book if I could read".
Both he and Dr. Olson also got some inappropriate personal attacks and/or overtures.
[Such is the nature of adolescence and response to authority?]
Journalists sometimes have reasonable expectations about ways in which video games can exert a "good" or "positive" influence. What is most expected? Better hand-eye coordination, for example. But it can also offer young minds a chance to set up a society via a game. "Video games are a medium and they can be very useful".
With that, James Bray took the podium again (I'm not being literal!) and shared his own observations of a 16-year old son as he actively relates to others using new media. Now he invited audience questions.
QU: What about the context, the peer context? [Peer pressure, etc.]
A: (Kutner) - Teens were not only drawn to games which portrayed "good versus evil". In fact they were found to be attracted to the complexity of characters. [Avatars for alter-egos??] For boys, the playing seems to be a marker of social competence.
A:(Olson) - Moral choices are engaging too. You can become a good guy or bad guy.
Also one learns problem-solving skills. [This is a hallmark of intelligence for Sternberg, as he would speak about later today.]
Q: Didn't the Columbine shooters model from Doom?
A: Yes but... this game has been shown to relate to motor skills and shooting [but not to induce imitative behavior]
[My Q on disinhibitition/desensitization; A: Interesting point, ripe for research.]
James Bray commented that from his perspective within a medical school, obesity is presenting as a big problem. That may be one outcome which is not good from video games. Exercising only the thumbs while eating snacks doesn't bode well.
Dr. Olson commented that in fact TV "seems to be a greater contributor" to the public health environment, as it is a passive activity and one which is constantly presenting ads for junk food.
Dr. Kutner concluded as did Dr. Olson, that the dynamics are complex. We're living in a time when violence is up again, after years of a downturn beginning in the 90's. There continue to be new research directions (e.g., Savage) but still, in general the overall body of evidence is not conclusive. The best 3 predictors still seem to be violence at home, violence in the community, and being dropped on one's head.
Something to think about.
Humanizing an Inhumane World - College Success, Love, Hate, More
Frank Farley presenting award to Robert Sternberg [Photo by Fenichel]
This was a relaxed and interesting, hopeful hour with Dr. Robert Sternberg, now dean of Tufts University College of Arts & Science, after a distinguished career at Yale, and a lifetime of thinking and writing about "intelligence". He was introduced by Dr. Frank Farley as "the most prolific living psychologist", having written over 1200 articles and 100 books. They tried to do the math - rather impressive!
Sternberg summarized his past "triarchic" theory of intelligence, as Farley jested that Sternberg always found 3 factors to explain everything, like love, hate, & IQ.
Sternberg's current interest, having come from being the student told that he had no potential to being a scholar, to now being dean of a college, is: college success. Obviously, he is not enamored of any single test to predict success, be it IQ or SAT/ACT. (They predicted his failure!)
While still at Yale Sternberg launched a project (Rainbow Project) to "improve our prediction of people who would really make a positive contribution to the world". He knew that SAT success was too narrow an indicator of capability or potential, and that world leaders like Ghandi, for example, may never have been seen for their potential based only on a test score. So he set out to further explore attributes which related to large-context success.
[Be sure to catch keynote speaker Malcolm Gladwell as he shares his own fascinating take on success, coming up next at the opening ceremony .]
Sternberg's goal was to tap into more than "analytical and memory skills". Sternberg developed a measure to tap both analytic thinking and creativity, like captioning a cartoon, or writing an essay on the topic of "Beyond the edge of the octopus' sneakers", or seeing a movie with social dilemmas (romantic and practical) and then asking for a solution.
He tested 1000 students approximately, across the U.S., attending all sorts of colleges and universities. He looked at analytical, creative, and practical problem solving. What he found was: "Multiple choice tests tend to measure multiple choice thinking".
His Rainbow test produced test differences smaller than SAT differences, reduced ethnic group differences, and improved prediction of academic success. He thought the SAT people would love his rigorous study, which was published by the Journal of Intelligence. Instead, his funding was cut off, with his test said to be "impractical" and impossible to scale up to the need.
He got an icy reception at Princeton too. Such, it seems, is "the business"
of testing. It's big. But universities do have clout: When California threatened to pull out of the SAT system, where there had once been "no economic incentive to change", now SAT's were redeveloped to include a written section.
Meanwhile, Sternberg was eager to move in new directions. Having been an acclaimed academic and expert on intelligence, he was enticed by the opportunity to play a direct role in influencing student success (and/or its prediction), which he's now had a chance to do at Tufts, where he was pleasantly surprised to be embraced in his efforts to develop new admissions strategies.
Ultimately, his tests (now part of the "Kaleidoscope" project) were added as a supplement to the high-stakes SAT-type tests, and optional.
But the results have been good for students and for the school. He is gratified that now there is a better way to look at creative aspects, wisdom, practical and analytical skills, as he has often wondered in important life situations, "how can some people be so smart and still be foolish?" Conversely, some people are very creative, but don't get a chance to show it.
He taps this by asking applicants to write essays on some hypothetical topics like "The End of MTV" or "The mysterious Lab". For practicality, he may ask an applicant to tell how they convinced a friend of something, or describe a passion in High School not yet fulfilled, and how it might come about.
Results so far: The first year of acceptances where some were helped by the optional tests: 50 per cent opted to take them, and SAT scores of accepted students went up about 5 points/year. It was good for diversity, and it also helped the applicant pool: "the bottom 1/3 dropped out". Those with poor scores/grades may have been intimidated by the additional application option, and the very strongest students would likely be accepted anyway. Importantly, students who were "Kaleidoscope" applicants did just as well as those who were accepted for other reasons.
A few more points: Sternberg spoke of being crushed by some of his own test scores which he believed were based solely on "book memorization", and the disparaging reactions of professors. [Albert Ellis also wrote scathing condemnations of education based on rote memorization.] Think about what is most important for psychologists to be successful - things like relating to people, grant writing, whatever... things not tested.
Dr. Farley turned to the other topics listed, particularly love and hate. Sternberg recounted his work in the 1980's studying love and intelligence. With love, he found 3 factors of importance - intimacy, passion, commitment. All 3 in combination is love.
Without one ingredient it's something else. (Passion is infatuation without commitment; commitment without intimacy is "empty love", etc.) Next his thinking evolved to "love as a story", with different "constellations of triangles" leading to different types of relationships: The Prince and Princess, the business partner, the science fiction buff into weirdness, the collector (of people), etc.
He came up with about 2 dozen "stories". [Archetypes?]
In the 1990's the context was that "more people were killed in genocides since World War II" and Sternberg began wondering, "What ever happened to 'never again'?" It seems as if there are so many people who "love to hate", and as someone who lost "1/2 my family tree" to hatred (Hitler) he was concerned to see the new rise in genocides.
Now he evolved a "duplex theory of hate", with 3 components:
- Negation of intimacy (These victims are like vermin, insects, dregs of our society, it's ok to hate them.)
- Passion. (Someone smashes into your new car; you arrive home a day early to find your spouse in a compromised situation.)
- Commitment. (They do bad things to us; we have to act against our enemies, enemies of G-d, etc.)
Q: Any feelings about the work of Zimbardo, regarding hate and evil?
A:"Where we agree is: context really matters. [There is] an interaction between the person and the context. Not everyone becomes a terrorist."
Last Q: [Me, inquiring how he grades the non-SAT portions of the applications he gets]
A: "We use a rubric." There is more than one rater (with good inter-rater reliability) and the things they look at include the extent to which the essays are novel, responsive, organized, logical, and balanced.
And onto a fun event, not one I'll devote time to except to say it was fun, and positive.
Danny Wedding, Frank Farley, Judith Kurianski (the syndicated talk-show host),
former CEO of APA Ray Fowler, and Debbie Joffe Ellis (widow of Albert Ellis, whose sing-alongs were legend) took turns sharing both psychology-related humor and some slightly more serious thoughts about the power of laughter in abating stress, etc. Ms. Ellis shared some of Albert Ellis' early essays - including raging tirades directed at teachers and professors who wanted 'parrots' rather than scholars in his estimation. Other highlights included some sight humor by Ray Fowler (who donned a parrot hat!) but basically it was an hour of fun, jokes about psychology legends and everyday life, etc. Dr. Kurianski shared some of the things she hears from callers and added some of the things she heard herself, growing up.
All good fun. With some old friends and colleagues, and many people just dropping in to see what this was, the annual Division 46 (media) event called "APA Comedy Jam".
OK, lastly for today, a main event to be sure:
OPENING CEREMONY AND KEYNOTE SPEECH
APA President Alan Kazdin presents award to Edward Kennedy,
for a lifetime of dedication to healthcare. Son Patrick accepts.
The opening ceremony was the "big event" organizationally, with awards, opening entertainment (The Boston City Singers) , greetings from APA President Alan Kazdin and CEO Norman Anderson, a welcome and "Psychology Week" proclamation from the mayor of Boston (Thomas Menino), welcome from MPA president Karen Postal, a lifetime award to Edward Zigler, and then the Keynote Address, by Malcolm Gladwell, New Yorker journalist and author of Tipping Point and Blink, both of which profoundly impacted psychologists, policy-makers, and others in their keen use of research and observation to describe real-life experience and decision-making.
Of note, APA CEO Norman Anderson announced (you're hearing it "here" first!) that APA Council has just yesterday [8-13-08] approved a new mission statement for APA. (The honored award recipient said gee, he liked the old one!) ;-) It's not out yet, but will be soon! Other highlights organizationally include near completion of a "comprehensive rebuild of APA.org" giving the site a "huge role" to play, already coming off of a CIO Magazine award (Top 100 organizations) for the use of "innovative, effective, information technology use"
with the APA's web service, PsycNet. The APA headquarters also just won an award - the TOBY ("The Office Building of the Year"), given by a real estate group.
Dr. Postal said she is "very concerned about the lack of mental health services for children", something with which I and many others whole-heartedly concur.
Accepting an award for Sen. Edward Kennedy was his son Patrick (also in Congress), who conveyed the appreciation of his father - who he is said is doing well and is eager to see passage of the pending mental health parity provisions. The proclamation refers to Kennedy's "great wisdom, tenacity and foresight",
and his being "a champion of the common man". Patrick Kennedy spoke a bit on the politics of healthcare and how important basic services are; for his father, "it's been all about prevention, that's what my father is about." He thinks of great programs like "Meals on Wheels" and thinks mental health needs to be provided along with Head Start.
He addressed the issues within Medicare ("There's parity and then there's parity - not only for the service but for the pay... there are not enough therapists" and some people may wait up to 5 years. So there is a battle now over allowing "out of network" providers if none is available within, and covering the cost: "No phantom payments" and services for those in need. In this new bill, if passed,
"GAO will provide oversight. Insurance companies hate this", as business hates mandates. But "why should insurance companies make the decisions" on treatment? He responded to the drone about "medical necessity" by challenging insurers to find one diagnosis in the DSM IV which was spurious or not a real disorder. They could not.
*NOTE: There will be a huge rally on Sept 17, after Congress returns to session Sept.8. Paul Wellstone's son David will bring the Wellstone bus to the Capitol.
"We need to pass this parity bill, and with urgency", said Kennedy.
Edward F. Zigler then received an award for lifetime achievement (including his championship of Head Start) and he spoke about his interest in integrating research and social policy. He praised Ted Kennedy's commitment, and said he looks forward to reading the new mission of APA. He concluded by observing that
"science, professional practice, and what others forget but not APA - providing services to society" - these are important tenets. He addressed new psychologists in particular: "Be aware of just how smart you are and how much you know; there's a lot of truth in that old saw, 'knowledge is power'."
Keynote Address: Malcolm Gladwell
Malcolm Gladwell. [Photo by Fenichel]
This inspiring author began with a response to his being introduced as 'a self-described psychology parasite', tapping into psychology as the focus of his hugely influential books. He is about to release a new book (hearing it here first again?!) in November, called "Outliers", and that's mostly what he talked about today, the inspiration and content for this work.
Using anecdotes about the rock band Judas Priest, Gladwell shared that "for the past 6 years I feel like I'm playing in a tribute band for academic psychology", as that's where much of his narrative is drawn from in describing research. (Clearly his instincts are blink-like accurate, too!) We were invited to all go out and "buy the book in triplicate", with a grin reminiscent (with his mass of curly brown hair) of young Bob Dylan.
The book is "all about where successful people come from". (He could discuss this with Sternberg!)
Gladwell said he's still enmeshed in all the thinking about the book, since "like [doing] a graduate thesis, everything relates to what's filtered through the prism of your thesis".
It's a book inspired by his interest in Goldman Sachs, the brokerage firm, and its leadership since being founded by Marcus Goldman in 1869. It was humble at first, in the years before the depression. The main protagonist of the book is Sidney Weinberg (born 1891), one of 11 children born to a bootlegger and living a tough life in Brooklyn - being knifed and ending up dropping out of PS 13 at aged 15 among the highlights. He got a job at the Goldman Sachs firm, as an assistant janitor, and worked his way up, catching the eye of Sachs, who in turn sent Weinberg to school for penmanship. Sachs saw potential, put him in the mail room, then he moved upward evermore. He ended up being managing director of Goldman-Sachs for 39 years.
A rags to riches story.
And that's where Gladwell zooms in. What do we make of it? Are rags a prerequisite for riches? If so, does that make poverty a type of advantage? Andrew Carnegie thought about such things, saying "abolish luxury if you please... but leave alone poverty... honest poverty". So that's one view: poverty offers a kind of lesson. But "today we have flipped it" and we're more inclined to see rags as an impediment.
"Poverty isn't seen as redemptive any more; it's seen as some type of disability." And we are impressed when people overcome it, against great odds. The Horatio Alger story.
Gladwell said he hopes to make "two small, hopefully provocative points".
First, our interpretation of "success" is often economic. Secondly, the 19th century position was fundamentally psychological: attitude and motivation were every bit as important as socio-economic status (SES).
Question #1: Are we willing to concede so much ground to the economists?
Question #2 has to do with Sidney Weinberg. It doesn't make sense. A short kid, disadvantaged, a despised outsider...
How did he do what he did? Who is he? Weinberg couldn't even use a slide rule, the equivalent of using email today.
Well, he was charming. FDR called him "the politician". Weinberg ended up playing a huge role in war preparation. He took on skiing challenges (despite being a non-skier). Roosevelt wanted to make him Ambassador to the USSR, "perhaps one of the most important positions in the world at the time". And Weinberg spoke "truth to power", as the magnates of power [as in "Being There"] "viewed it through the prism of, 'if YOU can make it, you MUST be good!'".
Gladwell went on to speak about the "links between Learning Disabilities and entrepreneurship", a bit different than past ideas about Einstein, Rockefeller, etc. Gladwell mentioned the founder of Kinko's, a dropout like Weinberg, in his case because of severe dyslexia. In fact, his research suggests "1/3 of successful entrepreneurs had a diagnosis of LD". This includes Charles Branson (Virgin Air billionaire), an exec of CISCO working in Silicon Valley but unable to read email, and Charles Schwab.
"The number of these people is quite extraordinary" when you look into it. In one study, around 80% of successful people (with disabilities) were talented in sports. They learned to *compensate* and to work with people. It's important to (1) make connections with people; and (2) delegate. One big factor in companies failing to grow is having an owner who won't delegate.
One needs to adapt to challenge. Gladwell recalled the old saying that "what won't kill you will make you stronger". So then, why not set up "structured disadvantages" just as we've been attending to structured advantages?
Sure to displease some, Gladwell noted the "disappointing" research in areas like "class size", where it has been found that there's "not much bang for the buck" in smaller class size - except at a young age and with certain types of students. No impact is seen until lowering size by 10 or more students. Why is this? We tend to think it's simple - if a teacher has more 1:1 time per student that's great. "But what if less individualization leads to self-reliance?" [Collaborative learning within groups of students can also be successful and "efficient". - mf]
Other implications of thinking in terms of advantage vs. disadvantage: What if one has a choice of attending (his examples; don't shoot the messenger!) Harvard versus Kansas State U. Harvard brings advantages, for sure. But maybe Kansas State brings more advantages. After swallowed pride, one might decide to work hard and do well.
"Most Americans absolutely refuse", Gladwell observed, to act on this dynamic about advantages versus disadvantages. And "what if we could produce dyslexic children, for their advantages. Would we?"
Unless/until we become more open to such thinking, "we're all in danger of turning ourselves into economists, and I cannot imagine a worse fate for psychologists."
The end... for today.
Tomorrow: We'll see, some fun, and some more interesting/relevant topics. Hopefully some of this will be
something you enjoy.
Good night, regards from Bean Town USA, "asynchronously live" from the 116th annual APA Convention.
DAY 2. APA's 116th Annual Convention.
Asynchronously Live from Boston!
The room was packed this morning for this one, which maybe should not have been surprising. A unique and "successful" person, almost in the way described yesterday by Malcolm Gladwell, a self-described "freak" named John Elder Robison presented a dynamic and fascinating account of...
"My Life With Asperger's"
This was a presentation which was truly unique and quite illuminating, in the tradition of Temple Grandin and Tony Atwood, famed for their overcoming powerful challenges and sharing their brilliance and their creativity with those interested in their *abilities* rather than only their *dis*abilities, no matter how striking they may be.
Psychologists and non-psychologists alike, including the legions who were fascinated by The Curious Incident of the Dog in the Night-time (a fictionalized account of a high-functioning autistic-spectrum child) will likely find this man's real-life story equally compelling.
His book and website offer much more, but here's his own condensed life story, first-hand.)
A long-time interest of mine, it does seem as if Asperger Syndrome (AS) is truly becoming much more widely recognized and appreciated.
John Elder Robison (Photo by Fenichel)
Plenary Address #2149
MY LIFE WITH ASPERGER'S - as told first-person, by John Elder Robison.
Mr. Robison introduced himself, very humbly and graciously (as he faced a sea of psychologists), as someone who had spent nearly 40 years "pretending to be normal" as best he could, until diagnosed with Asperger Syndrome at the age of 40. Throughout his childhood he could not relate to others and found comfort with machines. His amazing story which followed began by noting that from his unusual beginnings he ended up creating fire-breathing guitars for the heavy-metal band Kiss, and then designing toys (including the precursor of Nintendo).
He paused to express his awe of all the professionals around him, with so much "legitimacy" that it made him, who feels himself "an outlaw" by comparison, to be "just so honored". Humble, but then increasingly comfortable and animated with addressing this large audience, he paused first for a moment to share how he couldn't help noticing all different kinds of stripes and ribbons on badges. Even the publishers of his new book (Random House) were there with badges, saying "Exhibitor". He noted that he's "only" a non-member guest, and while clearly he's now become comfortable talking about his giftedness for some things, most of his life was spent feeling damaged or freakish, despite being so successful and trying to appear "normal" with mixed success.
"I grew up in the 50's/60's. Nobody knew what Asperger's was. If you were a kid and didn't fit in, the doctors would say 'he'll outgrow it'. If not, then they threaten you - with institutions. Both of my parents did time in North Hampton."
Both were respected academics, as well, which gave him a chance to be "eccentric" and also have university settings to explore, where his parents' colleagues were also tolerant and acceptant of his being different.
"In school they'd say 'leave him alone, he wants to be by himself'. As a grownup I know it's not true. What I see is children like me who are just crushed. I was called Monkey Face, 'retard'... and we didn't know what to do about it."
One thing "in my favor", he said, was his father's position (chair of philosophy at a university) and his mother's teaching/painting lifestyle, plus also "being in a college town" with many academics who enjoy hearing precocious children talk about bauxite properties and so forth. [See my study guide on AS which includes a classic NY Times article describing this precisely, what is often described as "The Little Professor" syndrome.]
Looking back now, Robison says it's a wonder he didn't end up completely nonverbal in his early years. School almost did that to him, and other children. He had a strong preference for "intellectually agile people" and thus was more comfortable with adults than peers. This was for his entire youth - "Today kids like me grow up and get diagnosed at an early age". He, however, ended up dropping out of high school "because the teachers were becoming the real enemy. What put them over the edge [the teachers] was my love for machines, and for transportation." He got a motorcycle for $25, unregistered, and while others rode bikes, he drove this to school and then proceeded to try to stow it in the school courtyard so the police wouldn't see it.
After finding school unsatisfying (and clearly feeling unwelcome) "I went out and I found the world of musicians. Like many kids, I loved music. I have always had the ability to *see* music, I see the flow of the waves. [Note this is similar to some musical savants' description, as featured on 60 Minutes and other TV shows.] While enjoying music he was also enjoying how he'd been seemingly "adopted" by the university's engineering department, the son of a faculty member, "like a pet", and he was fascinated by all the equipment, machines, etc.
"Twenty-five percent of engineers, we now know, might be called Asperger Syndrome. I *knew* they were freaks!". (For him that's not always a negative; he sensed a kindred spirit on some level.)
Robison began seeking music-related work, and went to Woodstock (music festival) and Boston, and ended up working for a sound company and being around the equipment and bands, including Black Sabbath, Roxy Music, Pink Floyd, the Kinks, Judas Priest and others. If you listened to their records, he said, "you heard my strange sounds". His talents were being discovered and tapped by rock stars and sound engineers. "For an Aspergerian misfit like me, the music biz is a great place to be. [Some of the band members] were obviously freakier than me!
All coked up, speed, whiskey and beer..." Once he was watching a guitarist digging into his guitar body and Robison asked him what he was doing. The guitarist (from Kiss) "said he wanted to make a guitar blow fire". Robison immediately said "that's not how" to go about it, that he needed to build a metal compartment lined with asbestos and accommodating of smoke bombs. The next he knew he received a FedEx package with a Gibson guitar and his mission to do it. Obviously it worked and the band was known for years for their pyrotechnics. But they were unusual people, thought Robison, clearly not Aspergian (his preferred term over "Aspy" which reminds him of a snake) but "seriously neurologically different, too."
Other adventures included his collaborating with a friend whose gift was welding, and studying medieval weaponry, and then building a working catapult which could hurl a fuel pump 1/4 mile. He and his friend also had an interest in casting body parts and one day casted a set of arms and hands, fingenails and all, and then planted them in the ground so there were "Andy arms" growing from the ground.
Returning to his blossoming rock music career, he found it striking that "I played every concert venue in North America and I didn't speak to a single girl." Same with drugs - they were everywhere around him, but especially sensitive to their evils given how he'd see his father become mean when imbibing alcohol - he avoided drugs and alcohol.
In the late 70's Robison decided he wanted a "real job" and he went to Milton Bradley, with his track record in music innovation, and sought a position. Milton-Bradley at the time was just becoming more electronics oriented in their toy line, with games like "Simon", and the beginnings of speech recognition toys. The company was eager for electronic applications. They saw his work with Kiss, hired him, and his transition from rock music to the corporate world began. Very quickly, "I found there were a lot of freaks there too, in the engineering department. We had a good time there." He ended up developing something called "microvision" which is the basis for Nintendo and the first talking toys and toys with speech recognition.
"Aspergians are good with creative things", he understands well now. But sadly for him, "They promoted me. Now I got budgets and employee reviews. They told me 'you're a smart guy but you're not a team player'. I said 'Of course not! I was designing circuit boards at age 13 and I wasn't on your team.'"
His conclusion, after the inevitable result of this Aspergian candor: I was failing here too, the corporate world. No matter that he was now a division head, etc. He quit. And he set up his garage to accommodate custom work on Rolls Royce engines. Hey, "they're good machines!". He ended up creating Robison Services which in turn became the largest independent service company of its type in the Northeast. And, "they didn't come to schmooze and talk about the kids", which was not his gift. They wanted their machines lovingly cared for.
One recent client was a psychologist. Nowadays, there is much greater awareness of Asperger Syndrome and various spectrum features. The psychologist gave him a book, by Tony Atwood, a subjective account of his life with Asperger's.
[An article and link to his site are on my AS reference page, here.]
Reading Atwood's book - a first-hand account of Asperger's Syndrome - "was so wonderfully liberating! To read that am normal... for what I am". He explained that he prefers being called "Aspergian" over "an Aspy" as it's more "distinguished", less snake-ish, and when he asks himself what the ever-logical Spock (of Star Trek) would think, "I'm sure he would refer to the Aspergians." OK, that's settled for me!
One big factor in his continuing self-growth and self-acceptance, he reflected, is that "now I get feedback". He enjoys sharing. He told the hall full of psychologists and students and parents,
"When young people come in, they might be Aspergian, and when they look at the floor and can't go on, it's very easy to point out all the stuff that's wrong to the parent. Keep in mind: it's a lot more work to find the *good* parts, but to do so is much more rewarding!
For example: Finding a six year old is a math prodigy... Keep in mind, some people do regress, but there are many high functioning autism/Aspergians who get *better* with age! "
Robison suggests visiting his website where one can find photos there, by his parents, documenting how *he* was functioning 40 years ago, by himself, in the sandbox: "A lost,miserable boy." He wished he had a video clip. "I was worse than many people I see now. [But] think of me and Temple Grandin.
You just never know."
He ended by revealing how he'd had a revelation about neurological functioning when he learned of a new treatment at Beth Israel/Harvard, called Transcranial Magnetic Stimulation (TMS) and he in fact "captured" two of the team to attend his presentation, there in the room. He was very excited about what happened to him after treatment he volunteered for, as a "guinea pig". Lo and behold, he said, "like 'Flowers for Algernon', now with the change I can go into a room with 50 people and engage 49. It's completely upside down!" Before he'd be the one in 50 who could not engage the other 49. "It's like magic that you can supplement with therapy", he said.
Harkening back to Sternberg's notions of analytical, practical, creative intellectual ability, clearly this was someone before us who was brilliant in several spheres.
As Sternberg and Gladwell both addressed - the phenomenon of *success* seems both constitutional and contextual. Here's a "lost miserable boy" considered a freak who has succeeded both economically and in terms of self-knowledge and (increasingly) self-acceptance.
I bought his book ("Look Me in the Eye") later, and chatted briefly with him. He autographed it, too: "For Dr Mike, a fan of Aspergians like us. JER. Woof!"
Noam Chomsky -
Unfortunately, though I rearranged my hectic day to be able to hear Noam Chomsky, while getting to at least one other mainstream psych and/or cyberpsychology nugget, Chomsky had an emergency - his wife was gravely ill and he could not leave her. He did participate via phone, with some difficulty, and fielded several questions about what we need to do to "humanize" the world. Basically he railed against the hypocrisy of saying as a society we're against things like terrorism when we put war criminals in charge of counter-terrorism. (This was a reference to an Ambassador).
The connections broke, and though we heard him well, he struggled to respond to questions, and stayed on the theme of needing to restore our integrity on the world stage, as a nation. Hmm, I wonder what he would have said and done were he present. Alas no, so I headed out soon to attend a two hour CE session on ethics and professional considerations in our new age of communication technology. It's entitled "My Space, You Tube, Psychotherapy and Professional Relationships - Crisis or Opportunity?"
ASYNCHRONOUSLY LIVE FROM APA -
Boston, 15 Aug 2008
Greetings from Boston. Here's a quick report on a symposium which I attended today on a subject near and dear to my heart, a "current topic" in psychology, and also relevant to "online therapy" and "cyberpsychology". Like Sternberg, I have my triarch!" ;-)
Symposium: My Space, You Tube, Psychotherapy and Professional Relationships -
Crisis or Opportunity?
This was a well-attended continuing education symposium presented by a panel of ethics experts, including Dr. Jeffrey Barnett, who has been editor of a scholarly journal series about ethics in practice today, Stephen Behnke, Ph.D., JD, director of the APA ethics office, David Powers of Loyola, who studies training models in the Internet age, and Keren Lehavot, a graduate student who won an award for her work in ethics, where she explored academic & personal use of social networking sites.
There were several recent studies and statistics shared; here are some of the key findings and the 'main idea', straight from the event today.
Dr. Barnett noted that he learns a great deal by observing his teenage daughter and is fortunate to be able to consult with her as an expert.
[As I've described elsewhere recently, I was quite impressed with how a teen responded so poignantly when I asked about comfort with multi-tasking and using multiple devices, etc.: "We don't know anything else. What do you expect? You had television and the telephone. We grew up with cell phones, computers, and Internet." Cameras now, too.]
One thing his daughter underscored for Dr. Barnett was that whatever one wants - or reveals -
"it's out there on the Internet. And everybody can see it."
- MySpace is the 6th largest "country" in the world" with more monthly visitors than any other site, and with
the most rapid growth of any Internet site in history. (Rosen, 2007)
- 73% of US adults are now online, 55% with broadband connections.
[Our saturation and bandwidth/speed lags as a nation behind much of the world still, fwiw!]
- 82% of college students own their own computer.
- 72% "check their email at least once a day". [The speaker quipped: C'mon! Only once a day? We know better! :-) ]
And now: ethics issues. They impact all of us, as individuals as well as organizations, for example APA, and its lists and data, etc. There is attention always to boundaries, confidentiality, etc. On a personal level, Dr. Barnett observed that if he puts up photos of his vacation to Maui, with limbo dancing contests and romps on the beach, etc., he takes a risk. If it's "out there" even on a page you think is private, could a client access it? And then what?
As a training issue, we may need to *anticipate* what would apply in such a situation. Does an ethical code apply? Yes, in terms of beneficence, maleficence, etc. In other words, whatever might come about one needs to be concerned about the client's wellbeing first.
Relevant standards in discussions of online presence and behavior include privacy & confidentiality, boundaries, and informed consent.
Now we have a question (which I and others have also posed) of "is it ethical to be on a client's 'friends' list? Some say, 'But I work with teens. There are benefits there!'" This may be true [and I can attest to the potential first-hand] but "you also need to look at the risks". For example, in an academic context, "am I altering the professional relationship? You don't want to share everything with everyone.
There need to be some limits, and we need to anticipate some consequences." Even with email, used routinely to confirm or change appointments appointments, etc. "It's a great tool but clients need to know the limits of confidentiality" too. (I.e., informed consent) He personally avoids "information transferring via the Internet". [Of course HIPAA controls some of this security issue too.]
Of course it's not only Internet technology; phones too raise concerns, and even some toys apparently can intercept phone discussions.
Need we be extreme here? "Are we allowed to have a personal life?"
- "If I'm on an admissions committee, should I google applicants, or take a look at YouTube?" [This evoked quite a bit of discussion and some audience questions/comments.]
- "What about clients searching for us online?" Again, "we need to be careful about what we put out there." [One comment in the audience was about the value of intentionally putting out info, rather then fearing it - my response was/is that calling-card type sites are just that, and if the goal is truly to attract attention, Google can help with that.]
Answer: "Yes, but we need to be mindful". And "you can't take it back" once it's out there.
Some may have been thinking this sounds very rigid, but the point made next was that the APA ethics code is NOT 100% rigid. There are situations where multiple relationships or boundary crossings may be appropriate, acceptable, maybe even valuable.
Some say they will be friends with former clients - but what if they need treatment again and want to resume?
On the other hand, there are ex-students who send him pictures of new babies. Is that wrong?
As for "self disclosure" generally, there are different types, from deliberate sharing of personal information to "automatic" give-aways, like wedding bands, an accent, pregnancy... Certainly all are self-disclosing. Zur (2008) describes 5 types of self-disclosure. Aside from the accidental there are also what may be inappropriate types of disclosures and some online activities may invite
a disinhibition or even unintentional sharing of personal information.
Is MySpace one such example? Again: "We need to be thoughtful."
"Boundaries are porous"
Some say they only allow "friends" they know, but this can be of limited value, in practice. [On several lists, APA and ISMHO among them, there have been recent discussions about this specific dilemma, and possible solutions, like having private and public pages of Facebook.]
Where do we go from here?
And with this broad overview and laying out of some provocative/evocative questions, the floor was handed to Keren Lehavot, who shared some "hot off the press" empirical data from her own work and reviews of the literature.
Ms. Lehavot's presentation was entitled "Graduate students' use, misuse, and nonuse of social websites". To begin with, she reported that 82% of undergrads now use online social networks (Caruso & Salaway, 2007) . There seem to be both pros and cons. An obvious pro: it's effortless. Cons include questions about ethics. She mentioned the issue of it not being unusual for professors to google students. But is it really ethical, or just one of those many "grey areas"? (Lazarus spoke about this in a recent journal article - sometimes it's not ethical to ignore the true needs of a client, or their culture, by being rigid.)
A key concept is privacy. On one hand the Internet is a public domain. On the other hand, we do have expectations. Again the example: "googling students". Is it perhaps unethical? What about the principle of autonomy? Shouldn't we have the right to access the Internet?
In Lehavot's study of 302 graduate students (82% of whom were student therapists), 37% had a MySpace profile, 33% Facebook, 20% "other social websites".
(Interesting comments were made about the way Facebook evolved from .edu addresses only to being more open, while the reverse is true for MySpace. MySpace, would you believe, is still only 4 years old!)
67% said they use their real name on MySpace. Sixty percent protect their personal information by limiting access to "friends". The operational question for most people is, or should be, of what goes online -- be it photos or personal information -- what would we want our friends to see? Lehavot asked the question.
Basically students were comfortable sharing both photos and info with classmates, but more than 4x as many would be Uncomfortable sharing the photos with faculty, and almost twice as many would be uncomfortable sharing personal information.
(Not surprising?) Interestingly, 29% of student therapists said they'd posted photos they'd not want their clients to see, and 36%
said they'd posted information they would be uncomfortable about being seen by clients.
Other quick stats:
In sum: Be mindful of what you do!
7% of student therapists surveyed said they'd been informed by a client that they (clients) had gotten info about their therapist online.
27% of the therapists did some online "fact-checking" of clients' statements, visiting MySpace pages for example - to see, as one example, if clients were being truthful with them.
8 of 10 Americans use the net to verify or find health information. (This was one of the first and most robust findings about Internet use.)
Training and modeling professionalism in the Internet Age
David Powers addressed the implications for faculty members, fondly recalling a favorite description of Facebook given to him by a friend who first welcomed him there, something to the effect of "Welcome to Facebook, where narcissism forcefully collides with wisdom".
He reiterated what Dr. Barnett said, that ethical codes provide a "general theoretical frame" but not specific details to navigate new types of situations. Dr. Powers tells his students not to put up anything online that they wouldn't want to have up on a big billboard in the Quad.
Loyola College has a series of "statements of professional behavior" which begin in one case with the directive to "refrain from posting unprofessional statements or pictures that may be viewed by clients, supervisors, instructors or colleagues". Reasonable, no?
Some key points to be cognizant of included the challenges of accurate communication, for example:
"You lose tone in email". [Of course one can work at developing compensatory skills! This area begs study!] ;-)
Dr. Powers then presented some slides of public Facebook pages. At the membership pages for interest groups pertaining to psychology,
most groups had small numbers of members. "Psychologists against SPSS" (as of a few days ago) had 265 members. "Psychologists are HOT" has 2, 054. (Who would've known?)
While the group is public, individuals' pages may be designated as friends-only, or private - yet the group's public "splash" page randomly rotates pictures of its members - with names. Using a number of examples,
Dr. Powers made the point about the need to understand the nature of online communication with the attendant issues not only of
privacy and confidentiality, but also about the need for familiarity with online behavior, and one's own online presence, in order
to strive for "e-professionalism". Clearly his own university has shown awareness and commitment to professional practice of
the faculty, and the implication is that other institutions need to be cognizant and proactive as well. His conclusions:
The last speaker was Stephen Behnke, APA ethics director.
- Faculty are generally unaware of what's e-happening, especially beyond email.
- So far the focus of discussion and guideline development has been on confidentiality and email.
- Social networking technology makes the public/private distinction less clear.
- Development of faculty guidelines and social networking use may be helpful for faculty and students.
- These guidelines should be mindful of the power differential between students and faculty/supervisors, as well as of professional
Dr. Behnke began by saying he was impressed by the richness of the *cultures* which are seen among online groups. He also noted that we'd barely mentioned the ethical area of research in this Internet age, and clearly this is an area of importance as well.
Time was drawing to an end, so following Dr. Behnke's recap of key issues, the panel did a brief Q&A. The questions involved dating web sites, the dynamic of anonymity, the diagnostic potential for working therapeutically at the computer with child/teen clients, gambling disorders and narcissism.
In conclusion Dr. Barnett reiterated that "this is really new stuff. It IS the cutting edge. Some of the ideas being discussed today might influence future ethical principles", discussions, etc.
I smiled, knowing it's already underway, particulary in education and increasingly reflected in practice and research. I was pleased to see mainstream APA discussions as well as student and faculty research and training getting up to speed in reflecting the 21st Century.
This is going out to the very quiet "Online Therapy" list as well as general psychology list, as this clearly has implications for the evolution of online mental health services, certainly in the U.S.
Regards from "BeanTown", Boston Massachusetts.
16 August 2008
Asynchronously "Live from APA"
Onsite reports on select samplings of the 116th APA Convention, this year in Boston.
It is Saturday, and a nice sunny day after a few afternoon and evening storms the past few days.
Here now, one more time (for now) a sampling of psychology from a few of the shining lights. In part blind luck, I did manage to be in a few places at the same time (without splitting!) as one event ended early and I was able to catch part of the "plan B" event which I really wanted to catch too. Lastly there was a lot of buzz among the media psychology pros I spoke with, excitement about the appearance today of Drew Westen. Who is he? An expert on "the mind of voters" and how the spin machines manipulate messages (or not) in an effective way.
But first: the legendary Aaron T. Beck.
Aaron T. Beck 2008
Continuing Discussion with Dr. Frank Farley
Aaron T. Beck (Photo by Fenichel)
In what has now become a very popular and memorable tradition, Dr. Beck -- famed for his numerous "Beck Scales" and "father of cognitive therapy" -- drew a huge crowd of admirers, including many psychology students. A psychiatrist by training, Beck was introduced as "the man who slew Freud". He immediately responded that in fact he had long *embraced* Freud, until he (Beck) "managed to take a risk" and defy some of the Freudian tenets, for which he "paid a price". But he was a believer. And now his own focus on belief itself has truly eclipsed Freud, as the introduction playfully suggested, because Beck's methods enjoy empirical validation.
Dr. Farley began by stating the obvious, that Aaron T. Beck really needed no introduction.
So he proceeded right to the presentation, also in the interest of time. (Beck had to leave a few minutes early.)
Beck began by commenting that "I always enjoyed having a dialogue with Albert Ellis" at these gatherings.
[You can get a sense of these historic discussions in the collection on my site, including the discussions in 2000 and 2002.]
Beck also acknowledged the presence of Debbie Joffe Ellis, Ellis' widow, who was here to hear Beck as well.
Dr. Farley invited Beck to share what's new and noteworthy for us to know about.
Firstly, Beck has 5 books coming out imminently, some new editions and some first releases. One coming out soon is on suicide. (He has apparently become very familiar with DBT and reality therapy and a few other approaches which are in sync with his own ideas and techniques.) A re-release is coming of his "first child" - his classic "Depression: Causes and Treatment".
Aside from being very busy with books, Beck has continued to become more involved with understanding and treating schizophrenia. He sees us have having gone through "the year of the brainless mind, when the focus was not organic but on thinking". It was thought that if we could identify and release unconscious drives, the symptoms, paranoia, could be resolved". He recalled the time when unconscious homesexual wishes were believed to be a root cause for psychoses.
He was feeling it was becoming a "dismal failure" continuing forward in this line, until about 10 years ago when, in the UK, he came across a study claiming that 78% of schizophrenics were being treated successfully - with cognitive therapy.
This was exciting, such a possibility, and he has continued to follow and expand on such studies.
One finding of the studies was that patients with the *positive* symptoms of schizophrenia (hallucinations, delusions, etc.) were indeed seen to be improving in daily functioning; however there was little impact on the *negative* symptoms (the "5 A's", such as anhedonia, asociality, etc.).
"The brainless mind had become the mindless brain", so it seemed. Now 95% of the emphasis involved diseases of the brain.
In the end, "drugs and therapy [together] seemed to be consistently more successful with the positive symptoms".
Psychotics, Beck said pointedly, do indeed have brains, but "they also are people, and they have attitudes and thoughts and beliefs, just like other people do."
Over time Beck would watch patients sitting and smoking, listlessly. He'd wonder about the sense of defeat, and the underlying belief that "there's no sense in taking a risk because I might fail. It's better not to do something then to do something because I might fail at it."
Several brain-oriented studies suggest that a constellation of symptoms are related to neurological deficits:
- Negative symptoms
- Poor quality of life
- No goal seeking
- Giving up
In some controlled studies a "key factor" - in statistical terms one which soaked up much of the variance - was "negative attitude, probably stemming from actual failures, where the quality of life deteriorated."
So now, Beck was thinking, we have a "psychological hook" for a trigger of negative symptoms: "defeatism". But at the same time, "You can't talk a schizophrenic out of an attitude. You have to go at it indirectly".
What do they want? "They would like to work, have money, have relationships..."
Asked "what about hallucinations", can't these be especially distressing? Beck replied that the effect of them may not be as bad, in relative terms.
"One patient said he could no longer read, he was unable", due to his lethargy, &/or defeated attitude. That was his main complaint. He was given a paragraph to read, and he found he could do it. When this happened, "you would see a shift in attitude" and he became more active. "The more active, the more the attitude change, with change in behavior and in symptoms."
Beck is now doing a random/control study with a treatment and non-treatment group, testing this paradigm. Thus far he is seeing improvement, people beginning to get out and go to the library or gym, or possibly being able to attend a job training program or some type of work.
Treatment with former college students has shown success as they return to college. Also he is seeing some of the more listless patients moving from group homes into independent living situations. "The whole quality of life is improved. It's the most exciting thing so far."
The floor was opened to the audience who queued at an open microphone.
Here I'll just summarize:
Question on working with schizophrenics who function in the mildly MR range, who exhibit aggressive acts and behaviors, using CBT.
Answer: Emotional control is really a big facet. We have to train them in anger management. This can be done in a session, for example recreating the situation where they're frustrated, or easily angered, and simulate a situation. You may try to first convince the person that anger is unproductive. Teach them to use self-talk: 'It doesn't pay to express these feelings because I'm only going to get in trouble'. Learn to take a walk." Etc.
Beck used this to segue into an example of a case where there was serious dysfunction due to PTSD, a soldier back from war:
Patient: I'm irritable, I yell at my wife, I'm having terrible nightmares, flashbacks... I'm going to end up a deadbeat, or I probably will kill myself.
Dr: What led to this? Tell me what happened.
Patient: I can't do that sir; if I do I will cry.
Dr.: It's ok.
Patient. I can't even drive. If I see garbage cans it reminds me of roadside IED's. And I can't talk to people.
Dr.: Tell me about the flashbacks.
Patient: I came across 3 soldiers in Iraq, huddled around their comrade's body, just staring "catatonic"-like. He had a big gash in his head, brains exposed... The 3 soldiers began to talk with me about their lost friend and somehow started to feel better, talking about him.
Dr. B: You should feel *good*. You helped!
Pt: But I should have done more! I should have...
Dr.: Nobody could have re-assembled his brains, nobody.
The soldier began to cry.
Dr: You did something good.
"He kept in therapy and his nightmares diminished, along with his flashbacks. It was all the guilt."
Q: from audience - I am a student in public health, and wonder about CBT applications in a preventive context.
Beck: Primary prevention is ideal. One of my colleagues - Seligman - is working in schools with children at high risk for depression. Ken Dodge did a study on children prone to act out in school [and ] developed a psychoeducational program which did have an impact on acting out.
Very few psychologists and counselors have actually had training in CBT. We're doing training now with the VA, with the idea the counselors will be more helpful. This is secondary prevention. We need to be sure there is proper training. For 6 months they get stringent supervision [which includes use of taped session transcripts]. Right now, Philadelphia has a great Medicaid program.
Q: I work in a trauma center for terrorism victims. How do you deal with parents feeling guilty for the loss of a child?
A: It's not something I've specifically thought about... it's difficult. I once spoke to such a group of parents whose children were killed. It goes like this: 'If only... If only...' A boy took a shortcut on his way to school. Crossed the railroad tracks and was hit by a train. 'If only I'd gotten him up earlier'. Should've, would've, could've. The only thing I can think of is to go through what they think they would have done differently to get them to realize that they simply had no control over the situation and were not responsible.
Q: Is there a relationship between Seligman's work and CBT?
A: Actually we meet once a month and have these discussions. From a positive CBT perspective, we have to teach them what they have control over and what they don't, the positive part. That they *do* have control over some things. [Sounds like Ellis, too!]
Beck gave an example I'd heard before, but now (to me at least) it sounded more like DBT (with empathy!), with the "dialectic" component encouraging less extreme reactions. There was a distinguished patient of Beck's with a deep depression after having been passed over for a Nobel prize. Beck drew a circle on a blackboard and asked how important it was getting that prize, in his life. "Eighty percent", the patient said. "Do you have children?" Beck asked. "Fifteen percent".
"Do you have much to do with your children?" No, not really much opportunity...
"And how was growing up for you?", Beck asked the patient.
Pt: I didn't have much contact, actually.
Beck: And how did that make you feel?
Beck: Is it possible that your children feel like that too?
The patient began to light up and declared that yes, he was going to spend more time with *his* son than his father spent with him.
Beck: OK, so how important in your life is your son?
Beck: And do you enjoy time with friends?
Pt: Yes, I like to play tennis. OK, 40%
Beck: That's 100%. What happened to your wife?
And so it went until in the end things were more proportioned for a positive and realistic outlook.
"This is positive psychology in a CBT way", Beck said, getting at root causes directly through experience.
Q: How can we deal with fixed delusions?
A: First a disclaimer: It doesn't work with everybody. People with fixed delusions are not going to take kindly to being told their delusions are just delusions. (What Beck has done in such a situation is to avoid being patronizing but help establish a framework which is conducive, and positive.) The therapist says, I'm sorry, I really don't understand what you're saying, as I don't have the same experience.
The patient liked this, as he's not being told he's crazy and dismissed. The therapist continues: "You know, the more you empower yourself the less intrusions will bother you. " The clever patient asks, "Are you saying they're not real?" and Beck replies, "it doesn't matter if they're real or not". The therapy is the same. And the patient becomes steadily more active, and the symptoms lessen.
Beck recalled how one patient had become absorbed by the meaning of some letters he saw on a bus going by: G, O something, T something. It must be a cryptic message from G-d. Go to something! But where? It turns out the letters were GOTS - Greater Ontario Transit System.
Q: There are big debates on outcome studies, efficacy, etc. They say a relationship is a necessary but insufficient component of therapy. What do you think?
A: People with moderate depression can benefit from mostly supportive relation-based treatments, like Rogerian methods. "You can get some cognitive change with an empathic therapist. There's some kind of transformation. Acceptance works. With more severe disorders, however, acceptance doesn't carry it. Technique becomes critical.
With mild to moderate depression there are 'common factors'. Empirical evidence is that techniques matter."
Also, you can compare supportive vs. cognitive restructuring treatment. It may come out similarly. However, with supportive counseling only we see regression in a year, but with cognitive therapy they keep improving. It seems they develop the tools to deal with problems.
Q: How has your life experience colored your perception of the current political landscape?
A: Beck said he's only good at this after having a chance to speak to the players individually, and finding out what their "automatic thoughts and beliefs" are.
Q: I'm a grad student interested in the use of therapy animals, which have in fact been found effective in treating anhedonia, increasing ADL and socialization, etc.
Ever thought about this?
A: I have not, but I will!
Q: Where can one get training - besides the Beck Institute?
A: There is a network, and he can provide specifics on request. His daughter Judy is now doing the workshops at the Institute.
Q: Can you speak to the role of empathy in successful CBT?
A: "I think it's really critical. You can set an agenda, teach the tools of the trade, but with the more difficult patient you really need to be able to imagine yourself in the patient's shoes. 'What would I do?' 'How would I react if I failed?'" Incidentally, Beck added (to some laughter), "some of the best therapists may not be terrific researchers".
Q: Any brief therapy model for CBT?
A: Some patients get better in 1 or 2 sessions, others need a year.
Beck briefly mentioned some of the genetic work being done which may help future targeting of symptom treatment. It seems as if a "hyper-reactive amygdala" is somehow related to negativity. There are a few ongoing studies testing this.
Beck was asked about his experience with paraphilias, which was limited, although he had some experience with incest and has seen promising results working with the parents - for example focusing on the underlying belief of the father, e.g., "It's best for her, it prepares her for real life and and who better to do this than a father who cares for her?"
Q:Have you done any more work with Borderline patients?
A: DBT seems to have done quite well in the treatment of BPD. More has been done than with CBT. "It takes a long time to get the get the type of result you want". There's also "schema therapy, a CBT variant" which can also be long-term. "The psychologist has to be flexible, kindly but stern... and teach the patient self-control without being demeaning." In some ways, it is easier to work with schizophrenics, delusions and all, than borderline personality disorders.
Dr. Beck needed to end the session a bit early, so I dashed off to catch the end of a nearby symposium on non-traditional modalities of treatment, including bibliotherapy, cinematherapy etc. I missed the first part -- about online counseling (which I was told used some of my own material)-- but caught the tail end of a look at cimematherapy and a review of bibliotherapy research. Lucky me! I was able to attend two symposia at the same time without a need to "split"! But I did miss the first 2/3 of the 2nd symposium: on use of media as therapy supplements.
Alternative Treatment Methods and Modalities
The bit which I caught of the symposium on alternative modalities as therapeutic supplements was on bibliotherapy, and the various impressions which people typically have of what this entails: "Self-help prescription" [British NHS] and "Reading your way to mental health" [Wall Street Journal] are two examples of why devotees are enthusiastic about therapeutic potential. In fact, in the UK their National Health Service embraces self-help as a cost-effective treatment option, one which might be in the form of a "prescription" for a book which is held on reserve in the local library. Stuart Fischoff presented an overview of Cinematherapy - covering for the presenter who was absent, and then Lawrence Balter spoke about his area of interest, bibliotherapy.
The question, in this age of evidence and efficacy, is: does bibliotherapy help? Unfortunately there is no strong evidence to support a definitive response. One (2008) study which Dr. Balter cited had in its conclusion a call for more research, but also noted that such methods "might well hold some promise as a useful adjunct for the busy practitioner." Dr. Balter has published numerous children's books with the idea of providing a tool which is age and situation appropriate. There have in been some studies which demonstrate, in particular, a positive effect in terms of ameliorating a specific type of problem behavior via how-to books for parents. The results were that although more effective than wait-list status, even more of a positive effect was obtained with a group therapy condition.
In terms of the future, when thinking about providing supplemental (non-f2f) treatment tools as bibliotherapy or self-help tools/prescriptions, think about this:
There is still a lack of evidence to support use of some interventions in particular situations. It is important to ask, therefore: Can it hurt? A "cautionary note" was sounded also about the risk of missing the need for "necessary and adequate help" and also of "negative attributions" where the unsuccessful self-helper will become increasingly self-blaming for failure to get better. On the other hand.... the issue of "functional credibility" sometimes takes on a large role, and "self-help is not going away any time soon.... It's aspirational, it's anecdotal, but it's not sufficiently empirical."
- "Know your populations". People are caught in all different types of situations, and the studies aren't specific enough.
- Is a person self-administering bibliotherapy or working with a psychologist or someone else?
A last comment or two was made on the power of film, which shares a status with
Reading in this regard: "Film is the new literature, the literature of the 21st century. People don't discuss book chapters, they talk about movie scenes." [And YouTube clips! -mf]
Research shows that "laughing helps, crying helps... there are physiological factors" and the power of humor and sharing feelings is well known. The "3 E's" of movie therapy are "entertainment, education, and empowerment". Films provide canvases where they talk about the same issues as your patients are deal with. They can parallel or illuminate a process. "Projection, Identification, and Discussion". Some examples were shared of powerful movie scenes having strong impact on a viewer, for example being shaken and determined not to return home. The speed and power of feelings being evoked via film can be powerful, and "a sort of immersion experience".
A few thoughts were tossed about: "TV as a Rorschach", the cultural infatuation with "Family Guy", the news coverage of a travelling garden troll, and more.
Suggestions for further reading included Dr. Danny Wedding's "Movies and Mental Illness" for a different perspective: the media's depiction of psychology/mental health. A site worth visiting (said the speaker) : Cinematherapy.com
My last big event of today (and this year's convention, in terms of symposia), was a presentation by the legendary Drew Westen, who is a bright, witty political analyst (among other things) who presented on "the mind and brain of the voter", and analyzed the ways in which parties and candidates are using word association and other strategies to send overt and 'subliminal' messages.
DISCLAIMERS: 1) I do my best to take verbatim notes and rely on additional handouts and individual speakers to help ensure facts & numbers are reported accurately. If I have erred in any quote or presentation of data/findings etc., I would be happy to correct the report upon being informed, and I welcome additional references/comments by individual presenters. 2) Drew Westen, whose presentation follows, very quickly and clearly stated that while politics and public opinion were the focus, in no way was it intended to be partisan or suggest any endorsement of one or another party or candidate. Similarly, I endeavor here
to report on the presentation and refrain from partisan/political endorsement or position.
Asynchronously Live from APA 2008
16 Aug 2008
Invited Plenary Address # 3346
Drew Westen: Inside the Mind and Brain of the Voter: The Presidential Campaign of 2008.
I was lucky enough to converse with some media psychologists during the conference, and over the 2 days I heard several references to an exciting-sounding presentation on an important topic: Presidential elections, and beyond that, the ways in which issues and positions get engraved in our social lexicon via "spin" and focused messages... this was the topic: How hearts and minds are manipulated by the media and political spin doctors, and how the general public reacts.
Dr. Westen - who has a new book out entitled "The Political Brain" - began by saying that his presentation would be non-partisan. While the audience may have reflected its own (diverse) response to various film clips and anecdotes, there were certainly examples of many blunders by both major political parties, and within parties among candidates. If nothing else, what was presented was fascinating for the look at how psychology gets put to work deliberately and otherwise in putting out messages to an electorate.
What makes people vote for a given candidate? Beyond that, how easy is it to manipulate public opinion through clever advertising with hot buzz words and word associations? How is it that words (e.g., "liberal") once beloved, are now radioactive? How can one present a position on things like abortion or economic circumstances, immigration or education, without invoking frightening images, and (within the political context) providing a candidate with an effective sound byte to ingrain into the public's consciousness? Think: "right to life" vs. "women's rights", "surge" vs. "war", "victory", "flip-flop", "liberal" vs. "progressive", "conservative" vs. "evangelical", etc.
It was clear why the large room was packed and people had been buzzing: Dr. Westen was engaging, spoke quickly and with wit, and gave anecdotal examples as well as video clips, which included his "worst of breed" nominations for getting out the right message for the moment.
Drew Westen, introduced by panel chair Sharon Brennan, began by having the audience take part in an "experiment" where we were to memorize 3 pairs of words, and then say the name of a car (as a test &/or "distractor item") and then the name of a laundry detergent. Almost everyone chose "Tide", after being "primed" by exposure to several words such as "moon" and "ocean". His point was made. We hear the same buzz words and associations, or "networks" of word associations all the time, in ads for detergent and ads for our Presidents.
What are the psychological principles at play here, and how are some campaigns exploiting the power of the media in successful ways while some get nowhere with their efforts at generating voter enthusiasm? This report, along with Drew Westen's presentation, is non-partisan, and he made that point. And in fact, his illustrations of the good, bad, and ugly presentations of candidates poked equal fun (on their own, usually) at people of all persuasions, politically.
Following his word association demonstration, he showed a video of a news anchor making a slip so that he mouthed a sexual slang word rather than a similarly sounding word. Examining the clip we could see that he was following a type of internal linguistic script and where his processing went awry because of similar sound sequences having upset his pattern of speaking. (You had to be there. This article is intent on being not only non-partisan, but also G-rated!)
One of the strengths of the GOP (Republican Party) has been their "brand recognition" as the party of democracy, small government, etc... but as news followers clearly see, the "brand" is no longer selling on name alone, and people are inclined to vote for personal priorities being represented, and for ideals - including "this person has values I believe in" and "I feel I can trust this person to lead us in the right direction".
The good news for Republicans who are confronting a tarnished brand now, is that Democrats don't have a viable "brand" either. So you know the level of discussion now: it's about the future, core values, and leadership.
There are constraints on Democrats, such as how to approach guns, even on the heels of recent gun massacres. The numbers are in: 75% of Americans believe in the right to hunt, and the right to protect one's family.
Stated like that, that's an impressive core belief. Worded differently, however, we find that 100% of parents questioned said they want their children to come home safely from school. Clearly there is room here for some reflection on implications. But the right notes have to be sounded, and people doze off with discussions of 12 point plans and complex plans which only vaguely relate to core issues. Al Gore did not help his efforts to reign in gun access by saying 'I believe in registering new handguns but not old ones'. "Is there a principle?"
Republicans "always lead with their principles". Democrats lead with policy: "Here's what I believe in" versus "Here's my 12-point plan".
Other bad ideas include talking about S-CHIP rather than "children's health". One needs to better explain "universal health care" in trying to promote it. The first problem is the phrase, which like "liberal" has been turned into a catch phrase for communism or socialism, "socialized medicine" devoid of choice, etc.
Westen would not use the words "universal health care", since our network of associations almost invariably connect this to "socialized medicine" and "bad".
What would happen if there was a push for "a family doctor for every family"?
Unfortunately for Democrats, they often "work on the plan but not the language".
The Republicans have become masters at their version of "instant messaging".
[However they have not exploited the Internet as well as Democrats, and their Presidential standard bearer for change does not know how to use a computer.
Many pundits are wondering the extent to which the Internet factor will exert a role.]
Another example of how hot-button words get connected to a network of associations and responses: abortion. "If you say 'reproductive health", they say "baby killer". That outweighs it. But you could win by 20 points if you speak instead about a woman's "right to choose".
Americans (85%) are religious. One might acknowledge and use this in several ways, as we can observe in the daily news. This could be framed differently as well: One side might focus on "the woman's right to choose versus God's right to choose", and the other might reply "I just don't like the idea of the government telling a couple when they should start a family". Choosing one's "network" of associations can change one's effectiveness. "The difference between winning and losing depends on what networks you choose to activate".
One needs to be aware that there is cultural and historical context as well. While many people embrace a "woman's right to choose" as a core human right, it was a central theme of the "women's movement", very powerful, but in a different time. Words and networks change over time.
Too much detail turns people off, notwithstanding the inevitable calls for "details", often from the media. Gore was seen as doing fabulous in a debate, but even after listening to it 100 times, it's not easy to recall the points. Listening to Bush, who was seen as (technically) a much poorer performer, it is clear that he came across as a person who knew what he wanted, whereas Gore was talking about actuaries and assuming people knew what they are. "Simplicity... tell people you mean it."
Competence is not a big factor in persuading people to vote for them. What is? Passion. The best predictors of garnering votes are:
- Feelings towards the principles of the parties (You can't just think "liberal" and "conservative" these days as shorthand for "what I believe in" since the GOP managed to poison the word "liberal".)
- Feelings toward the candidate.
- Feelings towards attributes - leadership, trustworthiness, etc.
- Feeling towards policies of the candidate - something particularly important for the single-issue voter.
- Facts about the candidates policies. [Interestingly, this factor alone has very little predictive power.]
Looking ahead at the dynamics of this election, the Republicans have no choice but to deal with their "branding problem" now, and they are out of practice changing (a huge theme in this election!). Plus, when one reviews the brand's performance these past 7 years, it seems things didn't work out so well in terms of delivering.
More advice to candidates: Don't play up having gone to Harvard or Yale.
It seems our country has "an anti-intellectual bent". Bush followed this rule: He went to Andover, Yale and Harvard, and ran as a "common man", buying a ranch the year before running. He was never called on this. Even Rumsfeld reinforced the anti-intellectual message: (Paraphrasing) - "You have to work with the brain you have and not the brain you wish you had". Message?
And what are voters truly seeking?
Briefly, with time running out, and the crowd urging him to go on, Dr. Westen showed a few video clips illustrating the worst of the offenders against his rules of effectively using networked word associations.
The #1 prize of this year's political season, for worst idea, goes to the Christmas-time ad which had Hillary pulling off leafs from the tree with the wish-list of things she wants: Universal Health Care (she could've stopped with that, the worst-possible buzz phrase), Bring Troops Home, "Where did I put universal Pre-K?", etc. She distilled her grand ideals into precisely the words and phrases which have already been effectively poisoned by the very effective GOP media machines. In contrast, her rival Obama had an ad with his family gathered around a tree, simply wishing everyone a blessed Holiday, no politics, no poisonous words.
Which one was more effective, in terms of pushing positive buttons?
- I want someone who shares my values.
- I want someone I can trust.
Another golden rule of successful campaign management, one which we can freely observe in action every day, watching the ads and candidate sound bytes in the news: There are 4 dynamics you must master in order to succeed:
Returning to the example of Hillary Clinton's Christmas ad, and the anatomy of a bad psychological message, follow up study suggested that the result of the ad was that it reinforced a perception of her as "opportunistic". Hers were not the top issues of the pollsters but she placed them out there during the primaries. How did they relate to the strong feelings of Iowans at that moment?
- What story are you telling about yourself?
- What story are you telling about the opponent?
- What stories are your opponents telling about themselves?
- What stories are your opponents telling about you?
Obama's ad, more effective than hers and engendering a smile in almost everybody as his daughter took some air time, had "virtually no substance and was one of the best ads of this political season" with the fireplace, little girl, tree, etc. "It was impossible not to smile". He gave a balanced, ecumenical message, invited us into his home, and thanked the audience for inviting him into theirs....
"I don't think it's an accident he won the Iowa caucus", Westen said.
There was a brief Q&A, as the session wound up quickly, with the next symposium due to start momentarily. He continued
with the audience in the hallway, eager to get his thoughts on a variety of hot political topics.
And on that note, I am packing up the notes and computer for now and soon working my way towards sleep and home, not necessarily in that order.
I will add some of the links speakers referred to as I find them, and of course correct any errors I become aware of, immediately. I neither condone nor refute the presentations or personal opinions of others; I am merely sharing what was said and hopefully providing a sense of the very stimulating and informative discussions.
DISCLAIMER #3: To the best of my knowledge my notes are verbatim and accurate, but should any errors be brought to my attention I would be grateful and quickly make appropriate corrections.
I hope you enjoyed this sampling of Psychology 2008, and as always, I welcome thoughts, comments, corrections.
Regards from Boston and the final hours of the 2008 APA Convention. Tomorrow I'm planning on a last quick visit to the exhibits
and then a quick family visit before taking off. I'll be editing and hunting for fotos on my way home and afterwards, and present
a more polished version than possible in these late-nite, asynchronously live reactions to the day's events. More to come.
Hope you found something of interest in this armchair look at the 2008 APA convention.
Michael Fenichel, Ph.D.
INDEX OF 2001 APA Convention Articles:
Behavioral Telehealth | E-biz of Mental Health | 2001: A Cyberspace Odyssey
INDEX OF 2002 APA Convention Articles:
CyberSex & Cyber-Infidelity | Beck & Ellis 2002 | Behavior Therapy | CyberPsychology | E-Ethics
2003 Convention Highlights:
Full Text | Beck 2003 | Quality of Online Health Info | Sternberg's Vision
2005 Convention Highlights:
Opening Session | Pioneers of Behavior Therapy
Distinguished Elders of Psychotherapy | Legends Discuss Psychology | Online Clinical Work | Town Hall Meeting
2006 Convention Highlights:
Opening | Online Psychotherapy & Research
| Psychological Vital Signs
Advances in Cognitive Therapy
Brok on Chaplin |
Conversation with Aaron T. Beck - 2006 | Dr.Phil |
21st Century Ethics | Media: Town Hall '06
2007 Convention Highlights:
Humanizing an Inhumane World | Opening Session
| Albert Bandura |
Linehan, on Suicide
Psychology's Future | Conversation with Aaron T. Beck - 2007 | Evil, Hate, & Horror
CURRENT TOPICS in PSYCHOLOGY Q&A Teaching Tools APA 2000 2001 2002 2003 2005 2006 2007
Copyright © 1996-2011 Michael Fenichel
Last Updated: Sunday, 02-Jan-2011 17:37:22 EST