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What do I mean by that? The ‘Nonverbal Level.’ What I mean is traumatic experiences that occur before the development of language, or around the time when language is just developing. People who experience these early traumas, often times medical experiences, tend to develop a wide range of difficulties. Most notably, difficulty with self-expression.
I’ve talked a little about early traumatic experiences before. In some ways a person’s emotional development becomes “fixed” or “fixated” at the age at which the trauma occurred. In may other ways they may fully develop (intellectually, physically, etc…).
I met a fellow professional at a conference a few years ago who shared that she had developed an intense aversion to all kinds of fruits and vegetables after an extrended hospital stay at the age of 2. There was no conscious memory of this experience. But her mother told her that she loved fruit and vegetables before going into the hospital, and after being in the hospital would never touch them again. Now, when I met her, she was 40 years old! She had never eaten any fruit or vegetables since that time. And could not do so. She would immediately gag.
She told me a little about her early medical experiences that she learned from her parents. I made a slightly unprofessional comment, “I bet you are extremely ‘gaggy.’” In other words, she has a hypersensitive gag reflex. She said, “Yes, I always have been. I can’t eat any fruit or vegetables without gagging. It’s the texture.” Now, this was related to the fact of being in the hospital for many months, and having tubes down her throat at this very early age.
Now, many people who have very early traumas (traumatic births, early medical traumas in the first couple years of life, etc…) have extreme difficulty in expressing themselves. It may be just talking at all that’s a problem. It may be specific to emotional expression. Regardless, there is almost always a problem in this area.
So, if you have a child who has to be in the hospital at a very young age, the best I can tell you is be there for them as much as you possibly can. Provide a great deal of reassurance and physical comfort (hugs, kisses, touch, etc…). Talk to them. Be soothing. You cannot completely erase the traumatic nature of the experience, but you will reduce it draumatically.
There is one thing that is virtually guaranteed….if you go to a mental health center, you will probably see a psychiatrist for medication. In my private practice probably 10-15% of my patients take medication. When I worked at a mental health center, it was closer to 90-95%. What accounts for this vast difference?
1. In a mental health center, the assumption is that patients will be referred for medication. It is the basic assumption. There is also a financial insentive. Mental health centers get paid more for the services of psychiatrists than therapists or psychologists. Funding is ALWAYS a very important issue in mental health centers.
2. In private practice, most of the responsibility falls on me (instead of a system). I explain the options to my patients, that they may be interested to try medication, but as long as the problems do not represent a serious risk (loss of job, harm to self, ect…), medications may not be warranted. Although it is a very individual decision. So far, every patient I have seen that comes to me first without being on medication, does not start on medication. The majority of those who are intially on medication are able to get off of the medication eventually.
3. Expectations… All shrinks are human beings. They have different expectations of their patients. They have different expectations about what is possible with psychotherapy. They have different levels of knowledge. They have different levels of comfort. They have different views of human nature. These factors are critically important in how psychotherapy unfolds with a patient.
4. What seems to be much more important than diagnosis is a willingness on the part of the patient to keep coming in to treatment, to think about what is discussed in session between sessions, and to have a genuine motivation to make changes. Now, certain diagnoses sometimes make these things less likely (severe schizophrenia, severe bipolar disorder, or severe personality disorders for example). However, if these things are present (the positive factors), the diagnosis is much less significant.
5. Psychiatrists often “diagnose for the medication.” The FDA approves drugs for specific diagnoses. Nobody likes to be sued. So, psychiatrists often bend or distort the diagnosis in order to justify the medication they want to try. See my previous post, Diagnosing for the Medication.
So, while the desired medication is more important than symptoms at times for psychiatrists, for some therapists and psychologists, what is more important is a willingness to seriously consider what is talked about in-session, a willingness to follow through with recommendations, and a willingness to believe that psychotherapy may be helpful. To a great extent, the actual symptoms a person has are less important than these factors.
Now, I’ve seen some folks with the most rigid belief systems (such as blantant paranoia and fantasies of revenge), that are only addressable on a spritual basis. Absolutely nothing else works at all–believe me, I’ve tried. But, when they consider their thoughts in the context of their belief in God, they are willing to acknowledge the distortion and errors in their thinking. There are times when a person’s difficulties can be addressed in nothing other than a spiritual realm.
Fear and anxiety have to do with the future…something that has not yet happened. With fear, the danger is real…something bad could very likely happen. With anxiety, the imagined event is extremely unlikely to happen. Fear and anxiety feel different. If you’ve experienced both emotions intensely, you may know what I mean.
When a tiger is snarling at you, and looks poised to pounce, you don’t feel anxiety…you feel FEAR. It’s not a fear of snarling tigers, it’s a fear that the snarling tiger is going to maul you to death. It’s adaptive…it prepares you for action…to run away or to fight (Gavin De Becker’s Book, The Gift of Fear is a very good explanation of the purpose fear plays in our lives–minus the evolutionary psychology aspect).
Some examples of anxious thoughts are, “I’m going to make a complete fool out of myself.” “I’m going to be so embarrassed.” “I just have a feeling something horrible is going to happen.” “I think there is something wrong with my mind.” “I must be going crazy.” “This plane is probably going to crash.”
Some examples of fear-related thoughts are, “Uh oh! If I fall, I’ll probably die! [standing on the edge of a roof]“ “That dog is going to bite me! [snarling dog running at you]“ “This might be it. [car careening out of control]“
So both fear and anxiety share things in common. They are both ‘danger signals’ as Freud called them. And they both serve a purpose. Anxiety and fear both tell a person, “something is wrong be careful or be ready for action.” Just like physical symptoms are a communication, “I’m hurt…Something is wrong with my foot…[and so forth].”
Anxiety may not seem to serve any consciously identifiable purpose, but it does serve a purpose. The purposes are many and varied. Sometimes, it serves a purpose of keeping a person’s rage or anger in check. In other words, if they were to really speak their mind, there would be very negative consequences. Sometimes it is to force a person who is overly independent, to start to depend more on others. Sometimes, it is to maintain a less than mature way of dealing with the world. Sometimes, it is purely a communication about something traumatic that happened in the individual’s past.
Again, it is very specific to the individual. Sometimes the anxiety is organized around a traumatic event. Such as a person who had an early trauma with their testicles, might have unusual anxiety about their eye “balls.” They might have frequent dreams that involve balls (Chinese eggs, basketballs, footballs, and so forth). All of these concepts are connected on an unconscious level. That’s just an example, and the forms it can take are unlimited.
But to reiterate, anxiety is about things that are very unlikely to actually happen, and fear is about things that very likely could happen. Anxiety can develop in the vastly different experiences of human beings. Fear has to do with something that very well may happen.
Now, an interesting thing is that a moderate amount of anxiety is adaptive. ALL normally functioning human beings have some anxiety. It actually makes you work harder, and prepare more for the future. It becomes a problem when it starts to interfere with your ability to function. At that point, you want to seek some help.
In Feedback from Other People–Part I, the discussion was largely on how to take negative feedback from other people. In this post, I will talk about how to take positive feedback.
Now, it’s good to be humble. It really is. But don’t confuse being humble with an inability to accept positive feedback. Some people already have a fixed idea about themselves, “I’m defective.” “I’m a failure.” “I’m worthless.” “I never do anything right.” “People who give compliments want something from me.” And so forth.
Some people when you compliment them will respond with something like, “Eh… I was just lucky.” Some will just mutter and look at the floor. Some will become embarrassed. Some will respond with sarcasm, “So, what do you want?” The appropriate response is, “Thank you. I’m glad you liked it.” “Thank you. I’m happy I’d could help.” “Thanks, I appreciate that you noticed.” And so forth.
Now, the interesting thing is, when you start responding appropriately to compliments, you start to believe the compliments. Outright rejection of compliments, is a way of maintaining a certain view of yourself. It may be very negative. It may also be a way of maintaining a very negative view of other people, “People who give compliments want something.” Most often, people are just expressing that they have recognized your abilities. They don’t want anything, and they aren’t “just trying to make you feel good.” So, you’ll be safe with giving one of the appropriate responses.
Now, when people have a very deeply ingrained way of looking at themselves, they automatically reject any positive information about themselves, and accept anything that is negative. This is a distortion, or filter on the way that they think. By beginning to accept positive feedback, you can start the work of changing how you think about yourself.
Take the simple test on my Intelligent Design blog to find out.
There is a theory in psychology that says that we learn how to think about ourselves by what other people think of us (The Looking Glass Self). This is somewhat of a different way of saying, “You believe what other people think about you.” Or an even deeper level, “You believe what you think other people think about you.”
Now there is some truth to the notion. But it’s hardly the whole picture. It ignores the fact that we develop the ability to accept or reject feedback from other people. And, we invent feedback that is not spoken. This invented feedback is an interesting thing. Where does it come from? It comes from the person’s own mind. On some level, this is what they believe about themselves. This is the psychological defense mechanism of projection.
It is important to consider feedback from other people. Sometimes, we need to make some changes in how we see the world, how we think, and how we act. But, we need to keep in mind the difference between what is spoken by another person, “You need to work harder,” and what is projected, “She thinks I’m a lazy bum.” We have a natural tendency to want to take the perspective of another person. And this is an essential part of our humanity. But…but….here’s the catch. This is a place where our own conscious or unconscious thoughts about ourselves can be transferred to other people.
Maybe you’ve heard a saying similar to this:
“His opinion and 75 cents will buy me a cup of coffee.”
Now, some people seem almost completely immune to receiving, or responding to, feedback. These are people at the extremes…Extremely paranoid, extremely dependent, extremely independent, extremely ineffective, or extremely effective individuals. Sometimes, this immunity to feedback from others can be very adaptive (for extremely effective and extremely independent people). But other times it is very maladaptive, for the rest of the folk. So, if you are very effective in your life (you have a successful career, relationships, and are able to enjoy yourself), and don’t put a lot of stock in the feedback of others, you’re doing fine. But if you fall into any of the other categories, there may be a problem.
Some people have an excessive desire to please others. These people tend to be more dependent, and often engage in anticipatory projection, “If I don’t please everyone, they will hate me.” Some people are paranoid, “Everyone hates me and is out to do me in.” Again, this is projection, and a distortion in thinking called “Mind Reading.” The excesively dependent person also does a lot of mind reading, but not as extreme. Extremely ineffective people will excessively apply a variation of the quote above, “I’m just creative. I don’t have to fit in. Work is for ’squares.’”
So, the most important thing is being able to be flexible. There will be times when you accept actual feedback, and there will be times when you reject actual feedback. And by that, I mean what people actually say. Not what you imagine they say–not what you read in their minds from your own thinking. There are times when you will want to accept and respond to feedback, “She’s got a point. I need to change.” And, there are times when you may think, “His opinion and 75 cents will buy me a cup of coffee.” One way you can determine whether the feedback is something you want to respond to is evaluating the personality of the person giving the feedback. Do they fly off the handle with everyone? Do they always give negative feedback to everyone? Is their opinion respectable? Do they seem to know what they are talking about? Or, is it just something about them as an individual that caused them to give the feedback they did?
Now, I’ve focused mostly on accepting or rejecting negative feedback here. I’ll write a future post on accepting or rejecting positive feedback.
Guilt is defined as,
“an awareness of having done wrong or committed a crime, accompanied by feelings.”
“I’d define it more as,
“the perception of having done something wrong with accompanying feelings…it may be appropriate or inappropriate.”
Regret is defined as,
“sadness associated with some wrong done or some disappointment.”
I’d define it more with,
“realistic mild feelings of sadness associated with a realistic evalutation of something done or not done.”
We all make mistakes. We all sin. We all do wrong. It’s inescapable. If you don’t feel or believe that, you’re a psychopath. But for the rest of us, we feel it. Sometimes as an adaptive regret, sometimes, as maladaptive guilt. Not to say that feelings of guilt cannot sometimes be adaptive, because they can. Only to the extent to which they result in a change in future behavior. You can only learn from your past experiences and make appropriate adjustments.
And adaptive way of looking at things would be,
“I did wrong. I shouldn’t have hit her. I will do everything I can to avoid doing anything like that again.”
A maladaptive way of looking at things would be,
“I’m such an ass. I hate myself. I shouldn’t have hit her. I hate myself.”
There’s nothing truly adaptive in that statement. There is no future orientation. It serves no purpose. It is useless. It can often end up being manipulative,
“Honey, I hate myself. I treated you badly. I know I’m an ass.”
And the response,
“That’s okay. I know you were just angry. I shouldn’t have made you so angry.”
So, you can guess what happens next in this scenario. Completely predictable. He beats up on her again. He says he feels like an “ass” and she forgives him. Now lets see the difference with regret.
“I’m sorry I hit you. I feel very badly about that. I’m going to get some help. I know I have an anger problem. I think we both need counseling too. Let’s get counseling. I’m going to get counseling for myself too.”
Now, it’s not just the words. It’s the actually following through on the words that demonstrates that genuine regret is felt. If the words are not followed through on, it is a manipulation. Irrelevant, and maladaptive pattern that will be unlikely to change.
So, the moral of the story is, that when you do something wrong, you learn from it. You feel some sadness about what you did, and you look forward. You think to yourself that in the future you will handle a similar situation in a different way. You have asked God for forgiveness, and you trust that He has given it. You realize that you may fail, but you are ever committed to changing and improving. That’s the best we can do, and no better.
I’ll start out with combat veterans to illustrate a point. Some combat veterans will come to feel intense feelings of guilt about something that they did or didn’t do while in combat conditions.
“My buddy was about a foot away from me when he was shot. I should have done something.”
“There was shooting all over. A guy was running towards us. I yelled for him to stop, but he kept running toward us. I shot him. I later went out and looked and it was a 12-year-old boy who was unarmed.”
“I commanded my men to go on patrol that day. Half of them got killed. I should have known better. It’s all my fault. People died because of my mistakes.”
Research shows that people generally make the best decisions they can at the time with the information that they have. After the outcome is seen, people will often come to believe that they should have forseen the negative outcome. They look back and judge themselves based on what they know NOW, not based on what they knew THEN. Most of the time, intense feelings of guilt involve a distortion of responsibility. It fails to take into account actions of others and unpredictable occurences. So, the reality is that a person often bears some degree of responsibility, but they take 100% responsibility. Their actual degree of responsibility may be more like 30%, or some other percentage, but it is rarely truly 100%.
I’m all for taking responsibility, but this intense guilt involving a distortion serves no useful purpose for a person. If you’re a Christian, you ask for God’s forgiveness. The hardest part for folks is often forgiving themselves. If you’re a Christian, you have no right to judge yourself. That’s God’s job. Ask for forgiveness, and trust. It’s really…really…hard sometimes I know. But that’s the place you want to get to with your guilt.
So, when thinking about guilt you want to truly consider what you knew THEN, not NOW. The fact that you feel intensely guilty implies that you learned something after the fact that you did not know at the time. So, it’s good that you know that now. All you can do is take what you have learned and go forward. Learn from what happened. That serves a purpose. Intense guilt does not…
Milton Erickson, MD, was the worlds foremost expert on the application of hypnosis to resolving emotional problems. Often, Erickson employed the therapeutic metaphor in order to promote the unconscious resolution of a patient’s problems. He often did this by telling stories, that on the surface, appeared to be just a story….but in actuality nailed the crux of the patient’s psychological problems on an unconscious level.
He had polio. He was not expected to live through the night. The doctor told his mother this in front of him. Now he thought that was awfully unkind to be saying to his mother and in front him him…the soon to 
be deceased. He could only move his eyeballs and talk to some extent. He got his mother to rearrange his room so that he could see out the window. He explained that this was so that he could see the sunrise. He stayed awake all night long staring out the window, just waiting for the sunrise. He wanted to prove that doctor wrong. He lapsed into a coma for awhile after seeing the first light of day. He had done it…proved that insensitive doctor wrong. But that was only the start of the battle….he was left with only being able to move his eyeballs and nothing else. So, he began to learn to be a very keen observer of people….what else did he have to do?? He learned that his sister could say ‘Yes’ when she meant ‘No,’ and say ‘No’ when she meant ’Yes.’ He learned to identify each family member from the specific pattern and sound of their footsteps. He learned how babies learned to move and walk from watching his infant sister. Now he figured that we all have unconscious memories for learning how to move and explore the world. Because we all had to do this, and this is just what he did. By watching his baby sister, he re-learned what he already knew. So after about a year or so, he got to where he could crawl. At that point, he purchased a canoe. On his own, he paddled the canoe 1200 miles down the Mississippi river….at times pulling the canoe behind him over sandbars while crawling. By the end of the trip, he had gained enough physical strength to walk and carry the canoe over his head! Later in life, he developed an active case of polio again, and was bound to a wheelchair. Even though he was in immense physical pain, he continued to work with teaching and treating patients. He could barely breath or talk, but continued working with every ounce of his strength.
Now, some people are kind of naive. If you are, you may or may not be aware of it. Others are rigidly skeptical…their first position is disbelief. Folks are usually not fully aware of how rigid they are. I remember I was at a 
workshop for the American Society of Clinical Hypnosis. One of the presenters was talking about his experiences with Milton Erickon. One day, Dr. Erickson told him that in order for him [Dr. Erickson] to keep teaching this individual, he [the student] would have to do something different. He told him that he was to climb ‘Squaws Peak,’ and to go into the desert. He was to keep looking until he found a Boojum tree. Dr. Erickson said something like, “It’s spelled bujoom. No, bojum. No, bojam. No, boojam. No, Boojum. Yes that’s it. Boojum.” And then he [Erickson] told him [the student] that when he saw this Boojum tree, he would think to himself, ‘That’s not a tree. It’s impossible!!!” And while he was considering that impossibility, he was to look around and identify the ‘creeping devils.’ He explained that some people don’t believe they exist, but he was pretty sure that this student might be able to find them. So, the student went up Squaws Peak, and into the desert. He kept driving until he saw the weirdest thing. He didn’t even know what he was looking for. But when he saw it, he thought, “That’s not a tree. It’s impossible!!” And while he felt completely confused, because this was exactly what was predicted by Dr. Erickson, he began to look around on the gound. He saw the strangest cactus….a cactus that grew horizontally and then bent up. He knew this must 
be the ‘creeping devil,’ and now knew they existed. He could only speculate about the reasons that Dr. Erickson had him do this, although it appears plain to me. It didn’t really matter if his conscious mind knew or didn’t know. His unconscious mind did know….and the necessary changes were made as I could see from his current personality.
Now, I believe God designed us with incredibly complex minds that have self-corrective mechanisms built into them. I believe that within each individual, there are all the resources and knowledge needed in order to resolve the patient’s difficulties. All that’s needed is the mobilization of those unconscious resources. As Dr. Erickson explained, “It’s not what the patient doesn’t know that’s the problem. It’s what they know, that they don’t know they know.” In other words, each individual has gained a great deal of knowledge about themselves and the world that they have forgotten conscious, but have not forgotten unconsciously. When that information is utilized effectively by the unconscious mind, the individual’s difficulties can be resolved. This can happen when a patient is asleep and dreaming. This can happen when they are eating breakfast and staring off into space. This can happen when they are walking down the sidewalk and seem to become less aware of what is going on around them. This can happen at any number of times when it is most appropriate….and I have seen this happen any number of times…and delight in the surprise of patients when it occurs….
I think I’ve said before that early traumas result in a fixation, in one way or another, at a certain age emotionally. That said, there is something that is incredibly healing about love….always….if it’s real. Despite the early traumas, being truly loved is one of the most therapeutic things that can happen to a person. It helps to remove the emotional fixations at an earlier age. You cannot have a truly mature adult relationship and be fixated at an earlier age emotionally at the same time.
Unfortunately, many folks gravitate to the type of person that will only reinforce or strengthen their difficulties. He may be the most outgoing and talkative guy. Or she may be the most physically attractive. But what matters more is what’s on the inside. Is he or she sensitive, caring, loving, patient, and kind? You have to wonder a bit about the most outgoing person at a party.
I teach my patients to please stay away from the following…especially women..
1). Stay away from the smooth talker. The charmer… The most outgoing fellow who appears to have no anxiety about talking to you.
2). The shy fellows have more restraint, stability, and emotional control. Don’t go for the first person who comes up to you.
3). Stay away from folks who have a history of drug, alcohol, or legal problems. You are opening yourself up for an unstable relationship. What you want is someone who is stable.
4). Sometimes folks have a bit of an addiction to instability. It gets their adrenaline pumping. It’s exciting. It’s kind of like riding a roller coaster. Through this out the window….and learn to tolerate ‘boredom.’ You may feel bored with things that most folks find to be ‘normal,’ but you need to learn how to tolerate this if you are ever to have a stable relationship.
5). Love is not just an emotion. I encouter this so often that it’s almost universal. Love is a great deal more action than it is feeling. As the Bible defines love, “Love is patient, love is kind and is not jealous; love does not brag and is not arrogant, 5 does not act unbecomingly; it does not seek its own, is not provoked, does not take into account a wrong suffered, 6 does not rejoice in unrighteousness, but rejoices with the truth; 7 bears all things, believes all things, hopes all things, endures all things.” (1) Now, where is the feeling here? Maybe under the surface a bit, but secondary to ‘action.’ Love is a choice and is composed of actions to a much greater extent than folks in society today want to believe.
6). Make sure he or she is pretty close to your intelligence level. If you don’t have this, you will have trouble respecting your mate.
7). Make sure there is not a pattern of instability in relationships. If the person you are dating has a history of short-term and stormy relationsips, you can probably expect more of the same.
8). Learn about your patterns. If you always chose the wrong fellow or the wrong gal, you may want to date someone who is the opposite of the person you would normally chose. You will do better if your feelings ‘grow slowly,’ than if you ‘fall deeply in love at first sight.’ You’re much better off if you find your feelings slowly growing than being intially extremely intense and fading with the more that you get to know the person. You’re better off if you find that the more you learn about a person, the more you like them…and not the other way around.
You may be able to ‘be your own shrink to some extent.’ I’ll tell you why I call myself a shrink. It’s probably different than most. I look at my role as ’shrinking’ the significance of the negatives in a person’s life. In psychotherapy, this is done in two ways. The first is releasing the emotion attached to negative experiences (Freud called this catharsis), and the second way is by adding as many positive things as possible to a person’s life.
Almost anyone can do the second thing, and I’ll tell you why it is so important. When you add something positive to your life, you ’shrink’ the significance of the negatives. The reason is that your life is no longer made up of ‘all negatives,’ but also now includes positives. This may be something very enjoyable that you can do. This may be something that brings you satisfaction and fulfillment. It may be your religious beliefs. Regardless of what it is, you want to add positives to your life. It gives you something to look forward to when times are bad, and allows you to ’shrink’ the significance of the negatives.
Now, you can’t completely ‘be your own shrink,’ but you can do the ’shrinking’ that I talked about earlier. You can shrink the negatives by comparison, but for help with shrinking the negatives, you may need a professional to help you do that.
Recently, many psychologists, psychiatrists, the general public, and the media have been becoming more aware of bias in pharmaceutical research. The most recent work found that researchers design the study in order to favor the medication that is sponsored by the funding source. In this post, I will talk about some of the problems with pharmaceutical study research design.
The Placebo Washout Phase
Nearly all studies of pharmaceuticals, at least psychotropics, include an initial phase in which people who respond (read benefit) from a sugar pill are excluded from the study. So, if in the initial phase, they get better on placebo, they are excluded from the study. Purportedly, this is to remove an unimportant variable. But what this does is amplify the effects of the medication in the actual study. So, the drugs end up looking like they have a greater effect than they actually have. You end up with a group of folks who purportedly do not respond well to placebo taking an active drug versus a sugar pill. If you are going to run this type of study, the results need to state, “For people who are poor responders to placebo, the drug proved to be moderately efficacious.” That would be a more honest way to present the results, but I have never seen this occur. The exclusion of ‘placebo responders’ amplifies the effect of the ‘drug.’
Use of Percentages in Results
I have seen a number of popular drugs tested against placebo and the only statistics you find in the article to be “percent who achieved remission.” You read the whole article and the only thing presented is percentages and statistics to tell you if the percentages who fall into certain groups differ. This is also done so that the drug looks better than placebo. As an example, please see my previous analysis of on a study of antidepressants (Prozac) in children.
The Double Blind is not Blind
The double-blind research design is considered to be the ‘gold standard’ in pharmaceutical research. It is purported to be the most objective and best way of determining whether or not a drug has efficacy. The double-blind experiment is accurately described on Wikipedia:
Double-blind describes an especially stringent way of conducting an experiment, usually on human subjects, in an attempt to eliminate subjective bias on the part of both experimental subjects and the experimenters. In most cases, double-blind experiments are held to achieve a higher standard of scientific rigour.
So, the assumption is that the researchers do not know which group the study participants have been assigned, and the participants do not know which group they have been assigned to. Ah….but there’s a problem here. Previous research with antidepressant medication, reveals that both patients and doctors are pretty good at figuring out which group they are in, most likely because of side effects.
Some Solutions to the Problem
If you are reading pharmaceutical research that does not include a check to see if the blinding actually worked (in other words ask the researchers or physicians what group they think the participant is in and ask the participant what group they think they are in), uses a placebo washout phase, and only uses percentages or stats to tell if the percentages differ, be very skeptical of this research. Irving Kirsch has proposed a model for research that includes an ‘active placebo,’ in other words a drug that produces side effects, but in theory does not act in the same way as the drug. This should help to actually insure the ‘blind’ of the study. Finally, when research is funded by a pharmaceutical company, you need to be very skeptical of the results. If researchers are going to receive pharmaceutical industry funding, they need to be blind to the ‘who’ is funding them.
I have continued my psychological study of atheism, and have more to add on the subject (see Part I and Part II). Severe loss during childhood or adolescence and childhood unhappiness also appears to be a factor in the making of an atheist. However, this research was published in 1932, and to my knowledge has not been replicated or studied further. While the research is somewhat scant, there have been some studies that have revealed interestingly demographic and experiential associations with atheism. One study found that half of younger atheists had lost one or both parents in childhood and had an unhappy childhood and adolescence. (1) I would speculate that the rising divorce rate is a factor in current development of atheism, because on average this would result in a greater degree of absence of the father.
While the study cited above is interesting, this study is from 1932, and has not been repeated recently to my knowledge. There have been many cultural and sociological changes since that time. That said, there is some evidence to support part of the assertion of unhappiness.
“In representative surveys of the U.S. population in the 1970s and 1980s, the unaffiliated were found to be younger, mostly male, with higher levels of education and income, more liberal, but also more unhappy and more alienated in terms of the larger society.” (2)
In the US, more men than women are atheists 7% (men) versus 1.3% (women). (2)
So the factors most associated with becoming an atheist are (not ranked in order of significance):
1). loss of a parent in childhood
2). unhappy childhood/adolescent period
3). younger age
4). male (almost 7 times more likely)
5). have an avoidant attachment style
6). had relationship problems with their father (see Some Psychological Aspects of Atheism).
7). some women have had traumatic experiences with clergy (Probably for men to, but this hasn’t been studied.)
8). higher education and income
9). more liberal in political beliefs
10). more likely to self-identify as an intellectual elite and place a high value on intellectual achievement
So, it’s important to keep in mind when speaking with an atheist that they may be quiet familiar with pain and suffering personally. In my experience, they may be unlikely to reveal this and point to purely ‘intellectual’ reasons for their atheism. I’m not saying that they don’t have some intellectual reasons, but I am asserting a strong psychological component to becoming an atheist. Often, there appears to be a strong component of anger fueling their beliefs, of which they may have little awareness. It’s interesting to me, the split between men and women in atheistic beliefs, and I’m not sure of the explanation for that difference.
As an update to Part II, take a look at Paul Zachary Meyrs website (Note he eschews his Christian name for “PZ”). In particular, take a look at the comments to see if you can see the elements outlined in Part II of this series.
(1) Vetter GB, Green M: Personality and group factors in the making of atheists. J Abnorm Soc Psychology 1932–1933; 27:179–194
From time to time I plan to post summaries of recent interesting news in the fields of psychology and psychiatry. This is the first installment. I also provide my perspective, opinions, and observations.
Neonates in Intensive Care Endure Painful Procedures, Mostly Without Analgesia- A recent study found that infants in neo-natal intensive care experienced an average of 16 painful or stressful procedures per day. And that 79% of these were without analgesia. Very slowly, more practitioners are becoming aware of the long term consequences for traumatic experiences as an infant including the birth process. Unfortunately, the quackery of the ‘re-birthing’ movement has caused many practitioners to develop excessive cynicism to these notions. Even though people have no conscious memory of these experiences, there are unconscious memories that result in a number of problems in later life as a result of early traumatic experiences. I’ll write more on my clinical observations of early traumas in the future.
Childhood Nutrition Linked to Adult Intellectual Function- Okay, you’re a parent. You are not your child’s friend. Many parent’s nowadays are confused about their role. They want to be ‘friends’ with their child. That is not the role of a parent. The role of a parent is to educate a child, love a child, and nurture a child’s soul in the ways of the Lord so that they will be prepared for life’s challenges. So the kid says, “Yuck!!! I don’t want to eat it.” Show and explain that “big people,” adults, love to eat fruits and vegetables because ‘they make you smarter and stronger.’ As a child, I came to identify with my grandfather, who LOVED the fruit and vegetables that were grown in his garden. I think that nutritional changes are a key component of mental health. This must always be addressed in treatment. If you address this early on in a child’s life, you give them intellectual, and maturity advantages throughout their lives. Please do so. Fast food, such as McDonalds, Burger King, etc… are out of the question. But, please, do not take the easiest path with regard to parenting. You may think you are doing your child a favor, but you are not!
Relaxation Training for Anxiety: A Ten-Years Systematic Review With Meta-Analysis - The notion is that you ‘cannot be anxious and relaxed at the same time.’ For many people, relaxation techniques are very effective in helping you cope with anxiety and stress. For others, it is not effective at all. There is some evidence that meditation is more effective than relaxation as this article notes. Relaxation training is very different from activities that you may find relaxing. It is much deeper than that. But for some, relaxing is also seen as a threat. Psychotherapy with a competent psychotherapist can help you uncover why relaxation is so scary to you.. It may be a medical experience, “Just relax, this will be over in a minute.” And the word relax becomes associated with pain. There are many other variations on why people have trouble relaxing. If you have trouble learning relaxation techniques, you may require long-term psychotherapy to help resolve unconscious aspects that lead to your inability to relax.
Early Treatment of Migraine With Combination Therapy Effective, Well Tolerated- Headaches are a complex phenomena. This research shows that medication is very helpful compared to placebo. However, in my practice, it is very important to address the psychological factors of headaches. I remember one fellow who developed intense and severe ‘migraine headaches.’ This was described as a stabbing sensation that started in the back of the head. As a result, he would fall down on to the floor ’sobbing’ as a result. In analysis, it was uncovered that the location of the pain was exactly the same as when his father, ‘beat my head against the wall.’ After his head was beat against the wall, he fell to the floor sobbing. Now, sometimes headaches are a result of constipation or poor nutrition. You need to drink water ONLY, and stay away from soft drinks. It doesn’t matter if they are diet or otherwise. Diet soft drinks are somewhat worse actually. If you need caffeine, get it from coffee or tea. Eat high fiber cereal for breakfast, bananas, and orange juice for breakfast (every day). The article doesn’t say these things obviously, but these are things I have found to be very effective with my patients.
Wine Is Healthy In A New (Or Old) Way – The Last Psychiatrist has an interesting article on how wine consumption effects digestion. I’ve always thought that the combination of food and drink was very important in the health effects of what was being consumed. This article provides more evidence along those lines.
Everyone doubts themselves from time to time. And at major life transitions, doubt is an extremely common thing. When a child goes from junior high to high school, they doubt themselves. When a high school student transitions to college, they doubt themselves. When a child attends a new school, they doubt themselves. When you get a new job, you doubt yourself.
But for some people, they have deeply rooted feelings of defectiveness. And it’s not technically correct that they “feel” defective, but rather that they think they are defective and that results in a number of different emotions (sadness, shame, anxiety, anger). For some people, their whole way of seeing what happens in the world is organized around their beliefs that they are defective. Jung developed the notion of a ‘complex’ that was later also used by Freud. More recently, the notion of a ’schema’ has arisen from cognitive therapy (or Schema Focused Cognitive Therapy), which has many similar characteristics to a complex.
A complex is described as “In Jung’s use of the term, a complex is literally a grouping of parts around some central emotional theme. For example, if you had a leg amputated as a child, you might develop a complex about it. Your complex might involve all the thoughts and emotions built up over a lifetime about the absent leg and the impact it might have had on people’s reactions to you, your opportunities in life, or anything else relating to the amputated leg. Unlike Freud, Jung did not assume most of these complexes were sexual in nature. A complex was due to some twist or turn in life that had a big emotional impact on a person.” (1)
A schema is described as “a mental structure that represents some aspect of the world. This learning theory views organized knowledge as an elaborate network of abstract mental structures which represent one’s understanding of the world. Schema theory was developed by R. C. Anderson, a respected educational psychologist.” (2)
In the Bible, it explains that,
“9(H) That which has been is that which will be, And that which has been done is that which will be done. So there is nothing new under the sun. 10 Is there anything of which one might say, “See this, it is new”? Already it has existed for ages Which were before us.” (3)
Psychologists often lose this perspective on things. But the fact of the matter is, most often, they are just using different words to describe things that have been observed by others. They feel important for their ‘ground breaking’ discoveries, but all they have really done is re-label concepts that have been explored and understood by others. The Last Psychiatrist would call this narcissism.
There are a number of ways that a person may develop a defectiveness complex. Problems with motor skills, problems learning how to walk, problems with a sensory system (such as vision or hearing), learning disabilities, and other problems that may occur during childhood. Sometimes there is an early severe fever that results in motor or learning problems. Sometimes there is an acute physical problem. Regardless, it is something that must occur early in life. What tends to happen is that all subsequent things that happen are filtered through this ‘complex’ or ’schema’ and are seen by the person as supporting the fact that they are defective.
I remember one woman who developed Rocky Mountain Spotted Fever as a child. As a result, she was uncoordinated and clumsy. So, she was constantly reminded of the fact of her ‘defectiveness’ by bumbling clumsiness. Subsequently, all things that happened in her life were filtered through this belief and frame of reference. She never had the confidence to ask for a raise, or seek a job that was consisent with her true abilities. She never had any luck in relationships because she expected others to discover that she was defective, and drove men away because of this. All of these things were seen as just more evidence for her defectiveness. Now, the person doesn’t usually have a conscious awareness of how this developed. But unconsciously, it influences how they interpret things in their lives, what they remember from the past (their personal failures), and their expectations for the future (continued failure, rejection, etc…).
These difficulties often take several years of treatment in order to resolve. The ‘complex’ or the ’schema’ is well defended within the individual and extremely difficult to challenge. The individual often develops information supporting their notion that they are defective despite any evidence to the contrary. The explanation that this is a ‘complex’ or ’schema’ often helps the indvidual come to the realization that their view is distorted based on beliefs that were developed through early life experiences. Once they develop this insight, they can begin to understand and change the ‘complex’ or ’schema’ that has been so self-limiting in their lives.
Interestingly, the notion of a ‘complex’ was developed by Carl Jung (a psychoanalyst), and the notion of schema-focused cogntive therapy has been expounded by Jeffrey Young 
Although I’m not keen on some of Jung’s notions (such as the collective unconscious and archetypes), I’m not one to ‘throw the baby out with the bath water.’ I have to largely agree with the following statement from Jung, “The patient who comes to us has a story that is not told, and which as a rule no one knows of. To my mind, therapy only really begins after the investigation of that wholly personal story. It is the patient’s secret, the rock against which he is shattered. If I know his secret story, I have a key to treatment.” (4) I find this to be exactly the case in treatment with my patients. My mentor likes to quote the old proverb:
“For want of a nail the shoe was lost.
For want of a shoe the horse was lost.
For want of a horse the rider was lost.
For want of a rider the battle was lost.
For want of a battle the kingdom was lost.
And all for the want of a horseshoe nail.”
In treatment, I try to find the nail. Once the nail is found, the battle is won. It’s not necessarily won right at the point that the nail is found, because we have riding, battle, and defense of the kingdom left, but it is the pivotal point around which the treatment revolves. There are many reason’s which people come to feel defective, and the discovery of this reason is the nail which leads to the ultimate success of treatment. And, I think the notion of war is appropriate to psychotherapy. It’s a war against the emotional difficulties of the patient, and often entails numerous battles. Sometimes, the enemy is more easily vanquished, and other times, the battles are ongoing and intense. So, God be with you, in your own battles.
Remember the verse from the Bible, “I can do all things through Christ who strengthens me.” (5) You may well need this strength to win your battle. But, I believe in you and the power of God, as I believe in my patients. Fight the good fight, and keep working hard to get to a better place in your life.
(1). http://www.psywww.com/intropsych/ch13_therapies/jungian_therapy.html
(2). http://en.wikipedia.org/wiki/Schema_%28psychology%29
(3). Ecclesiates 1:9-10.
(4). Jaffe and Jung
(5). Philippians 4:13
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