Psychology Research

The latest edition of Neuron has a fantastic tribute to the recently departed amnesic Patient HM , “probably the best known single patient in the history of neuroscience”, covering the scientific work he participated in and what it has told us about the structure of memory. The piece is by respected memory researcher Larry Squire and he tackles HM’s personal history while also reviewing his contributions to science through numerous landmark studies. It can be said that the early descriptions of H.M. inaugurated the modern era of memory research. Before H.M., due particularly to the influence of Karl Lashley, memory functions were thought to be widely distributed in the cortex and to be integrated with intellectual and perceptual functions. The findings from H.M. established the fundamental principle that memory is a distinct cerebral function, separable from other perceptual and cognitive abilities, and identified the medial aspect of the temporal lobe as important for memory. The implication was that the brain has to some extent separated its perceptual and intellectual functions from its capacity to lay down in memory the records that ordinarily result from engaging in perceptual and intellectual work. The article is fascinating not least because it dispels a few common myths about HM – such as the original study showed the hippocampus was necessary for memory when HM also had the amygdala and parahippocampal gyrus removed and so it wasn’t possible to say which were most important. It also notes that the original studies over-stated how much brain was removed owing to the basic knowledge of neuroanatomy that existed at the time. Link to ‘The Legacy of Patient H.M. for Neuroscience’. Link to PubMed entry for same.

Wired has an interview with author Maggie Jackson who’s recently written a book called ‘Distracted: The Erosion of Attention and the Coming Dark Age’ in which she argues modern life and digital technology constantly demand our attention and are consequently damaging our ability to concentrate and be creative. The trouble is, I just don’t buy it and it’s easy to see why. The ‘modern technology is hurting our brain’ argument is widespread but it seems so short-sighted. It’s based on the idea that before digital communication technology came along, people spent their time focusing on single tasks for hours on end and were rarely distracted. The trouble is, it’s plainly rubbish, and you just have to spend time with some low tech communities to see this is the case. In some of the poorer neighbourhoods Medellín, my current city of residence, there is no electricity. In these barrios, computers, the internet, and even washing machines and telephones don’t exist in the average home. Pretty much everything is done manually. By the lights of the ‘driven to digital distraction’ argument, the residents should be able to live blissfully focused distraction-free lives, but they don’t. If you think twitter is an attention magnet, try living with an infant. Kids are the most distracting thing there is and when you have three of even four in the house it is both impossible to focus on one thing, and stressful, because the consequences of not keeping an eye on your kids can be frightening even to think about. The manual nature of all the tasks means you have to watch everything. There is no timer on the cooker, so you need to watch the food. The washing has to be done, by hand, while keeping an eye on everything else. People call all the time, because, well, there is no other way of communication. Street vendors pass by the house and shout what they’re selling. If you miss out on something, it might mean your days food planning has gone down the drain. On top of this, people may be working to make a living in the same building. Running a shop, mending stuff, selling food, or whatever their business might be. The difference between this, and the “oh isn’t email stressful” situation, is that you can take a break from email and phone calls. You can switch everything off for an hour so you can concentrate. You can tell people you won’t be available. For people trying to work and run a family at the same time, not only are the consequences of missing something more important and potentially more dangerous, but it’s impossible to take a break. A break means your kids are in danger, your family doesn’t get fed and you’re losing money that buys the food. Now, think about the fact that the majority of the world live just like this, and not in not in the world of email, tweets and instant messaging. Until about 100 years ago everyone lived like this. In other words, the ability to focus on a single task, relatively uninterrupted, is the strange anomaly in the history of our psychological development. New technology has not created some sort of unnatural cyber-world, but is just moving us away from a relatively short blip of focus that pervaded parts of the Western world for probably about 50 years at most. And when we compare the level of stress and distraction it causes in comparison to the life of the average low-tech family, it’s nothing. It actually allows us to focus, because it makes things less urgent, it controls the consequences and allows us to suffer no more than social indignation if we don’t respond immediately. The past, and for most people on the planet, the present, have never been an oasis of mental calm and creativity. And anyone who thinks they have it hard because people keep emailing them should trying bringing up a room of kids with nothing but two pairs of hands and a cooking pot. Link to Wired interview with short-sighted digital doomsayer.

A quote from a recent Wired article that discusses a project to create a computer architecture based on the neurobiology of the brain. It sounds suspiciously like it’s based on Dr Theopolis from 70s TV series Buck Rogers in the 25th Century : In what could be one of the most ambitious computing projects ever, neuroscientists, computer engineers and psychologists are coming together in a bid to create an entirely new computing architecture that can simulate the brain’s abilities for perception, interaction and cognition. All that, while being small enough to fit into a lunch box and consuming extremely small amounts of power. Just because you didn’t mention Buck Rogers in the grant application, it doesn’t mean we don’t know what you’re up to. I mean, I’d love to recreate the magic of ‘Planet of the Amazon Women’ too, but you’ll need more than a fully conscious cognitively aware AI than runs off two AA batteries. If you’re completely mystified, and / or under the age of 30, you may want to check out this clip on YouTube. Dr Theopolis is the, er, lunch box like-AI on the table. He usually hangs round the neck of the annoying android Twiki. On a slightly more serious note, I just checked out Kwabena Boahen’s Stanford talk where he discusses exactly this sort of project to create neurally inspired computer chips. Definitely worth a look. Link to Wired article on cognitive computing. Link to Kwabena Boahen’s talk on neurally inspired chips.

The African lungfish Protopterus , from A Text-Book of Zoology . Standing before the Linnean Society in 1839, the celebrated British anatomist Richard Owen delivered a detailed description of a strange new creature. Owen called it Lepidosiren annectans , an African relative of an eel-like animal that was found by the Austrian explorer Johan Natterer in the depths of the Amazon jungle in 1837. The naturalist sent two specimens back to the Vienna Museum where they were quickly described by Leopold Fitzinger under the name Lepidosiren paradoxa . Fitzinger considered the organisms to be “perennibranchiate reptiles”, meaning that it was a primitive amphibian that did not undergo metamorphosis. Instead, according to the author of a helpful Living Age column, it remained “a gill-breathing, muddy, fishlike groveller, all the days of its life.” The animal Owen had was different,* but it was similar enough to Natterer’s specimen to allow for a close comparison of this important new genus. As a Philosophical Magazine summary of Owen’s lecture reported; Mr. Owen observed, that since the time of the discovery of the Ornithorhynchus [duck-billed platypus] there had not been submitted to naturalists a species which proved more strongly the necessity of a knowledge of its whole organization, both external and internal, in order to arrive at a correct view of its real nature and affinities, than did the Lepidosiren … According to Owen the Lepidosiren was a fish, a creature close to the “perennibranchiate reptiles” but more suitable as a link between cartilaginous fish (like sharks) and the “malacopterygians” (fish like the aquarium favorite the birchir ). Owen’s assessment was eventually confirmed by other scientists, but it was still often presented as an extremely primitive “reptile” (i.e. amphibian) or as the “missing link” between fish and amphibians.** Indeed, Lepidosiren was a “transitional form” that took naturalists by surprise during a time when thoughts of evolution were percolating through the scientific establishment. Even stranger, however, was the claim that in the steaming depths of the Amazon were gigantic individuals of these lungfish that regularly preyed upon large prey at the water’s edge. A December 1847 issue of the newspaper The Friend relayed the report of L.A. da Silva e Souza that the lake Padre Aranda in Brazil was home to creatures called minhocoes that “dwell in the deepest part of the lake, and have often drawn horses and horned cattle under the water.” The creatures were also reported to inhabit Lake Feia, and the local people said they were giant worms that “cause[d] animals to disappear by seizing them by the belly.” The skull of Lepidosiren , from The Illustrated Natural History . (If it reminds you of Dunkleosteus , just wait until next week.) Much of the information from this report came from a widely-reprinted paper by M. Auguste de Saint Hilaire, who had collected anecdotal evidence about the creature during his visit to the region. At first he thought tales of the monster had been inspired by a kind of electric knifefish, Gymnotus , but the local people were already familiar with this animal. A better fit, Hilaire said, was the Lepidosiren which had, of course, been first discovered in the Amazon. Anatomical investigations had revealed just how wicked the jaws of the peaceful-looking lungfish were, and perhaps there was some gigantic form haunting the rivers and lakes of Brazil. Hilaire closed his report with a plea for his fellow zoologists to visit the area to unravel the truth; Zoologists who travel over these distant countries will do well to sojourn on the borders of the lake Feia, of the lake Padre Aranda, or of the Rio des Piloes, in order to ascertain the perfect truth–to learn precisely what the minhocao is; or whether, notwithstanding the testimony of so many persons, even of the most enlightened men, its existence should be, which is not very likely, rejected as fabulous. Hilaire’s colleagues did not seem to be in any rush to confirm his hypothesis, but the minhocao continued to be mentioned every now and then in the scientific and popular literature. The first follow-up report would be delivered by the German entomologist Fritz Muller nearly three decades after Hilare’s notice. As reported an 1878 issue of the Popular Science Monthly (itself a summary of a report that appeared in Nature ) Muller had heard that a fish three feet across was spotted along a river in Brazil. When the person who saw it went to get others, however, the animal disappeared. The party that rushed to the scene only saw the burrow the animal made in its efforts to escape. Similar disturbances of the soil were later seen about six kilometers away, but this was a third-hand anecdote Muller had received from another German who lived in the area. Other reports of churned soil and immense burrows were commonly heard in the region, though, and Muller concluded that theywere made by a gigantic lungfish. Even so, no concrete evidence of the monster fish was found and like Hilaire he could only urge his colleagues to look into the phenomenon further. The reports of Hilaire and Muller must have had some influence as the minhocao appeared in a number of books and periodicals. According to J. Hampden Porter the people who shared the landscape with the giant worm-fish believed that it conspired with the jaguar against humans. Indeed, it was said that some people were so scared of it they had abandoned good fishing grounds out of fear. In a compendium of sea-monster tales by Fletcher Bassett it was said to be an amphibious member of a number of mythical water monsters of the Amazon, so large that it made the water rise when it slipped into the water. (The destruction that such a creature might cause was also alluded to, oddly enough, in the book Days on Staten Island .) It even was mentioned by Jules Verne in the story The Giant Raft , and this is especially significant because some authors took Verne’s story as a primary source. All of these references are rather fleeting, however, and the reports by Muller and Hilaire remained the most detailed. Did anyone ever catch a minhocao? According to an article in Good News in 1878 a boy caught a fish that was three feet across in an area where burrows nearly 10 feet wide had been found. Careful reading, however, reveals this to be a bastardized version of Muller’s report. The author of the article apparently mixed and matched various bits of previous anecdotal reports and conjecture to make a new story. The only original part of it was the author’s speculation that “that [the minhocao] may be a relic of the gigantic armadilloes which in past geological epochs were so abundant in South Brazil.” (This report was cannibalized for the “Table Talk” section of Gentleman’s Magazine that told its readers that proof of “gigantic cuttlefish” had recently come to light. It compared the minhocao to cephalopods, extinct marine reptiles, snakes, and prehistoric armadillos.) As the aptly named article ” A Fish With A History ” stated, the tales of the minhocao were probably based upon the Lepidosiren but taken to extremes for one reason or another. This is made all the more plausible by the way the stories switched from being about a worm-like fish that devoured livestock (Hilaire) to an enormous creature that burrowed in the earth (Muller). During the time between Hilaire’s and Muller’s papers it had been discovered that some species lungfish could cocoon themselves in mucus to wait out the dry season in underground burrows, and this discovery appears to have changed the focus of the stories about the minhocao. That the anecdotes about the creature were not consistent and no specimens had been captured certainly hampered the case for its existence. Perhaps the last of the minhocao was heard in 1894 in a Natural Science article about Lepidosiren . It barely garnered a mention, for despite all the fantastic stories it was never found. There was no reason to think it truly existed, although why such a mythology developed remains an open question. The increasingly-inaccurate reports of the animal in English periodicals can be explained, but where did the legend of giant killer lungfish first spring from? *[And, if I am not mistaken, later turned out to belong to a different genus. Owen had previously briefly described the specimen under the genus name Protopterus in 1837 and this distinction was later upheld.] **[I usually detest the phrase "missing link", but here it is appropriate. The discussion over the affinities of Lepidosiren / Polypterus were going on in the days before On the Origin of Species . Evolutionary language was commonly used in reference to them and Owen certainly cast them as transitional forms, yet the mechanism that affected the transition was missing. It could just as easily be said that the Lepidosiren was a result of God's desire to fill nature up and make sure there were no great gaps in nature, a vestige of the Great Chain of Being into which the fish would have fit.] Post-Script : This post was an off-shoot of some other research I have been conducting, but it is rather strange that I forgot that the remains of an enormous extinct snake, Titanoboa , were announced this week. Titanoboa slithered through the ancient Amazon, and while I am in no way making a connection between it and the minhocao, I am surprised that I did not think of it while writing this post! See the posts by Ed , PZ , Jake , Darren , and Rebecca for more. Read the comments on this post…

The latest Nature Neuropod neuroscience podcast has just hit the net, with a great selection of discussions and interviews covering everything from pheromones and sexual attraction to the impact of poor quality sleep on memory. This final section on an intriguing and recently published study found that even mild disturbance that didn’t wake the sleeper but knocked them out of deeper sleeper into the shallower sleep stages could still disrupt the retention of material learned the previous day. However, as I am remarkably tired myself I need as much deep sleep as I can get, so I shall leave the rest of the podcast as a voyage of discovery. Enjoy! Link to Neuropod home page with audio. mp3 of latest podcast.

I’ve been generally happy with the reviews of my new book Obsession: A History but a recent one requires a response. Dag Agins’s in The Huffington Post . writes that when someone tries to cross the line between science and the humanities, that person ends up pleasing neither side of the divide. He particularly criticized my effort to show a continuity between obsession in the culture at large and obsession in a person. Agins tells us that we must never blur the clinical with the cultural and he ratifies the idea that diagnoses have to be somewhat rigid to clearly demarcate the pathology from the sociology. Yet, he ends up making contradictory remarks about diagnoses, saying that they are just labels and strategies, but then asserts that they are necessary. I want to respond to his objections. There has for too long been the feeling that only people "in" the sciences can critique the sciences. This is a strange point to make since science prides itself on being an unbiased search for truth with all parties allowed to make inquiries and subject results to strict oversight. The objection that only scientists are allowed to criticize scientists is therefore a violation of the claim to objective truth. In fact, the role of the humanities is not simply to provide novels and poetry for doctors to read, but to teach and explore the use of language, the logic of an argument, and necessary grounds for rhetorical persuasion. No one disputes that the data are the data, but interpretation always intervenes between data collection and scientific conclusions. So we need to look at Agins language and reasoning itself: "…psychiatric categories are merely labels for clusters of symptoms, but it’s also true that psychiatric categories of some kind are absolutely necessary in the clinic as a guide for what sort of behavior to expect from a patient. A psychiatric label is simply a practical device to assist in treatment." The summarization of his own data here isn’t even logical. If diagnoses are "merely labels for clusters of symptoms," or "practical devices", then how can they be "necessary" in any scientific or rigorous way? If we said that "electrons" or "super novas" are only labels or devices, we would no longer be in the realm of science. If we are to examine such a cluster of symptoms as if it were a real thing, as we might in analyzing the neurochemistry or brain structure of people with OCD, then shouldn’t we have a stronger sense that a diagnosis described a real thing rather than a cluster of symptoms? Agins goes on to explain that although there isn’t very good science now to explain what OCD is or how it works, nevertheless "people who are distressed by psychiatric symptoms do want and need treatment" and therefore "diagnostics and treatment must be constrained by pragmatism, by what seems to work." So in the end, Agins is saying in effect, "OK, we don’t know what causes OCD or how the brain works in this disorder, but we have to do something since people come to us for help, and so we are forced to invent diagnoses that aren’t proven by any rigorous system so that we can try treatments that ‘seem’ to work." But the reality in OCD is that not only is there no diagnostic rigor but there are poor outcomes for patients who face a lifelong battle with the disorder. The best controlled statistics show that a third of patients get better, a third get worse, and a third remain the same. Anecdotal evidence is much more enthusiastic on the part of practitioners, as one would assume it would be with many websites for clinics claiming, without any controlled evidence, that their success rates are close to 70 per cent. Is that science? Just because clincians are in the trenches doesn’t mean they have the clearest view of what they do. Sometimes an educated observer from outside the specific profession can fly over the battlefield and get a better sense of the lay of the land. In fact, scientists are very good at one thing, detailing the increasingly narrow and specific mechanisms they study. What science isn’t very good at, and where it needs people from the humanities-historians and sociologists of science, is in articulating the big picture and making logical claims about the implications of their particular discoveries. Don’t be fooled when a scientist tells you to keep out of his backyard. It’s not done in the interest of science. It’s done to protect the backyard. © 2009 Psychology Today. This RSS Feed is for personal non-commercial use only. If you are not reading this material in your news aggregator, the site you are looking at is guilty of copyright infringement. Please contact blogs@psychologytoday.com so we can take legal action immediately.

You’re deadlocked. He thinks it’s your problem; you think it’s his. You’ve been going over what happened, how it started, and who started it. But you aren’t budging. So forget the past. Move on to right now. Right now you’re upset. But then, he says he is too. You feel really put out; but then, he claims he does too. Well, OK, forget right now. The point is to figure out what to do about it. You tell him that with a small gesture he could solve it. He tells you it would be far easier for you to solve it. You say he’s stubborn. He says you are. Past, present, future-you’ve covered it all, and you’re still nowhere. Is there anything left to talk about? Anything you haven’t taken into consideration? There is. And it could be decisive, though it’s no wonder you haven’t talked about it. Call it your reserves. Imagine an indicator level on your self-esteem-your dignity meter, your egometer, your self-worth gauge. Everyone has one. The needle fluctuates through the day. Get an enthusiastic e-mail from someone you respect, and it goes up. Waste fifteen minutes looking for your lost keys, and it goes down. Take a tease to heart, and it goes down. Make ‘em laugh, and it goes up. Little things, big things. Over the day, but over the years too, the readings change. You may deny you’ve got one; you may ignore it; it may be operating completely in your unconscious; but something in you monitors it. And if your reserves get low, there’s a visceral warning, a sense that you can’t really take another hit to them. In a fight, the unspoken issue may be simply that one or both of you can’t, or won’t, take any more disappointment with yourself. No way. You can’t afford it. We act as though a debate is on the presenting issue and that issue alone, as though all we’re ever doing is looking for what’s right, what’s accurate, what’s honest. But we can’t be. Below the surface of all exchanges, there are potential threats to our dignity, some of which come at very bad times. There are costs to acknowledging that we’re all monitoring our dignity meters, but there are benefits to acknowledging this too. She’s irritated about some software program your company makes. She has finally gotten through to you in tech support and doesn’t mind letting you know that she’s frustrated. This software is making her feel like a chump, and that’s the last thing she needs right now. In a way, though, she’s lucky, because she can justify her frustration without ever admitting that it’s not just the software-it’s that her reserves are low too. She doesn’t think about her reserves or yours, but just blasts you. But you, this is your first day back at work following a week of mourning after the biggest trauma in your life. You’re fragile as can be. Sure, she’s annoyed about the software, but if she knew the state of your reserves she’d be much kinder. Self-esteem reserves aren’t the only ones. There are optimism reserves too. If you’ve been through a lot, you can’t really afford more dashed expectations, more terrible news, more stories with downer endings. Friends and I are going to see a movie together and are deciding which one. There’s one I’ve been wanting to see, but it’s a little gory. My friend is squeamish, and I tease her. Why is she such a wimp? Why isn’t she brave, like me? Well, actually she’s braver than me. If I knew what she has been through, I wouldn’t ask, and I sure wouldn’t tease. Ignoring her history and the reserves she’s left with, I look braver. Heck, I’ve had it so easy, I don’t even know that trauma can thoroughly satiate one’s appetite for downers. She suggests that we go see some Bollywood import. I scoff at Bollywood movies with their supersaccharine endings. How can people go for such hokey crap? I’m a sophisticate. I want to see movies that deliver the harsh truths. Yeah, well, if I dealt with harsh truths all day like much of Bollywood’s developing-world audiences, maybe I wouldn’t have as much of an unrequited appetite for harsh truths. I’d want an escape. As it is, ignoring our respective reserves, I escape into a sense that I’m the one brave enough to stand harsh truths. Religion too. I’m so over such pie-in-the-sky malarkey. God the merciful, happy endings-I’m way too realistic and tough to believe in that stuff, right? Those who buy into religion must be real wimps, so in need of comfort that they’ll allow themselves to be suckered into believing stories that make no sense. Again, this is true only if I compare myself to believers out of context. If my life were anything like the life many believers suffer through, I’d crave hope the way they do. Ignoring reserves, I’m tougher. Factoring in reserves, I’m weaker. Reserves are overlooked and yet are often decisive in the choices we make and the fights we fight. Why don’t we factor them in more? The short answer is that they’re very hard to factor in accurately. The long answer, in another article. © 2009 Psychology Today. This RSS Feed is for personal non-commercial use only. If you are not reading this material in your news aggregator, the site you are looking at is guilty of copyright infringement. Please contact blogs@psychologytoday.com so we can take legal action immediately.

At a time when there is so much to admire in our new President, here’s another aspect to applaud: Barack Obama’s lifestyle is a perfect model of energy generation. He’s accomplished a herculean task over the past year; achieving more than many of us could hope to in several iifetimes. Looking at his lifestyle from the point of view of a physician, it’s no mystery to me where he gets his incredible mojo. Just look at his actions over the past week as an example. Over the inaugural weekend, in what had to be some of the most intense days of his life Obama found time to exercise, do community service and attend religous services; he didn’t drink coffee or alcohol (two beverages many of us would be tempted to lean on in hectic days), his inaugural luncheaon eschewed inflammation-causing red meat for fish and poultry and he spent time with family. By all accounts this was not atypical behavior for Mr. Obama. Even during the most brutal days of campaigning he said exercise was his coffee, rarely missed a day at the gym and proclaimed his favorite snack to be pistachios and fruit. This is exactly how a person needs to live in order to constantly generate and replenish their energy. If you are beginning to feel like Obama is superhuman and impossible to emulate, think again. Everyone can achieve this level of energy generation one step at a time. This is exactly the kind of lifestyle I advocate my book and 21 day plan, The Source . For more than a decade I have researched the science of energy generation in order to help my patients with fatigue, and designed my plan for energy generation so that anyone can expand their physical and mental resources and have more vital energy. During the swearing in, many people marveled at Obama’s calm. Well, remaining calm in the face of stress is a sure sign that a person is a master of energy generation. Not only did Obama appear to stay in control of the stress that most likely accompanied the highly charged situation of having the nation’s eyes on him, but he gave some wonderful clues as to how he does it. In his speech, Obama asked us to deepen our lives with service and selflessness. It’s exactly that sort of giving to others that brings energy into one’s life. A calm and abiding spirit, wholesome non-inflammatory foods, exercise, spirituality, a cleaner environment, love and forgiveness are the pillars of health. If you want to begin on the path of positive energy on which Barack Obama has traveled such a great distance, you can. Take a look at my book, follow the 21 day plan, and begin to feel energy flowing back into your life.    © 2009 Psychology Today. This RSS Feed is for personal non-commercial use only. If you are not reading this material in your news aggregator, the site you are looking at is guilty of copyright infringement. Please contact blogs@psychologytoday.com so we can take legal action immediately.

I want to apologize in advance for this post, which is really an esoteric debate between therapists. Yet I urge present and potential consumers of psychotherapy to skim it, along with Dr. Diamond’s cited post, to appreciate the importance of doing your own research on the ideology of any psychotherapist you might hire. Most therapists have websites that, with careful perusal, indicate whether they rely on dogma or research. You can also ask them directly whether they do objective follow-up evaluation of their work. To escape the blind spots inherent in all our professional ideologies, therapists must be able to frame hypotheses drawn from those ideologies in empirical terms and, whenever possible, test those hypotheses with real-world data. Otherwise we merely derive assumptions from other assumptions of the ideology, which reduces it to the status of dogma, i.e., there is no way to know it is true apart from our faith in it. A few of the fundamental scientific questions for psychotherapy are: "What are the sources of the data on which the therapist bases hypotheses, how valid and reliable are those sources, and how do you know that your ideological blind spots are not influencing your observations and interpretations of the data. These fundamental questions bring us to the major reasons why it is not the therapist’s job to tell clients whether their anger is "appropriate." First of all, the term, "appropriate" is a social construction, contextually-dependent and embedded with personal and cultural biases. More important, if the therapist does not objectively test hypotheses, he interprets data through the blurred lens of his own ideologically-biased assessments of the client. (To put it in terms Dr. Diamond prefers, how can the therapist ever really know that he is not projecting?) Still more important, the descriptions of their experience that angry clients make in the artificial environment of psychotherapy are inaccurate , as demonstrated by the empirical evidence of substantial cognitive and memory impairment that occurs during anger arousal. To the extent that their accounts even approach accuracy, they are woefully incomplete , omitting all other perspectives and mitigating information. Just as therapists can suffer confirmation bias in regard to their ideologies, angry clients suffer acute confirmation bias when it comes to their anger – because they feel like victims, they process only confirming evidence, ignoring all disconfirming evidence. Angry clients can easily sound like they are married to Norman Bates’ mother – they’re just minding their own business when she hacks at them with a kitchen knife. Videotapes of anger occurring in real-world interactions show that it differs greatly from the way people describe it after the fact. (More on the relevance of real-world interactions later.) In short, the therapist has no way of knowing whether the client’s description of his anger in real life is contextually "appropriate." The crucial point here is that the therapist doesn’t just validate the client’s anger but also the construction of reality that makes the client feel like a victim. In other words, the grandiosity of the therapist who doesn’t test hypotheses validates the narcissism of the client. To be sure, everyone is narcissistic when angry. In the adrenalin rush of even low-grade anger, everyone feels entitled and more important than those who have stimulated their anger. Everyone has a false sense of confidence (if not arrogance), is motivated to manipulate, and is incapable of empathy, while angry. The therapist can hardly validate the sensations of anger without also validating (at least in the client’s mind) the distorted construction of reality associated with the sensations, as well as the motivation for retaliation that go with anger arousal. Evidence Dr. Diamond agreed in his original response to my post that there has been a worrisome increase in anger and violence in recent decades. He attributes it to the suppression and repression of anger. He cannot support that hypothesis with mere ideological iterations; rather, he needs to present objective evidence that suppression and repression of anger are on the increase or at least that there was an outbreak of infantile suppression of anger 20 years ago. (Something in the water supply got into breast milk?") If he can establish that, he then has to explain why reasonable people should suppose that increased suppression/repression has caused the increase in anger, rather than facts like children viewing 11,000 murders on TV before the age of 14, wide-spread media glorification of anger-displays, and other potent effects of modeling demonstrated in the social psychology research literature. If Dr. Diamond really believes that we have more anger now because we more often shame people for experiencing anger, he needs to count the number of angry displays by "heroes" highlighted in the news and entertainment media. Our heroes freely display a righteous, passionate anger, while the villains are passionless psychopaths. The all too familiar stereotype of masculinity, very much a product of cultural conditioning, proscribes only one emotion for men, and that is anger – any softer emotion is unmanly . In contrast, women are permitted to express all emotions except anger, which is oppressively deemed unfeminine. So if the hypothesis that attaching shame to anger causes pathological anger is to be supported, women would have show a lot more of it and, subsequently be acting out more pathologically than men. Of course, the empirical literature shows the opposite. To merit credibility, Dr. Diamond’s hypothesis that "narcissistic wounds" cause problem anger, like the suppression/repression hypothesis, would have to account for the observed increases in anger. Are we to believe that parents started wounding their children more two decades ago, when the steam engine theory of emotions and that infamous psychodynamic derivative – blaming parents – was well established in the vernacular? Of course, the heaviest blow to the "childhood wounds" hypothesis is the empirical finding that most abused children grow up to be fairly good parents, no angrier than anyone else. Emotions are not Steam Engines Dr. Diamond is correct in noting that the 19th Century steam engine view of emotions was, indeed revolutionary and widely accepted by therapists for quite a while, but it was never accepted by scientists. A revolution also occurred in medicine around the same time, yet Dr. Diamond would not expect his personal physicians to use 19th Century methods and techniques in their treatment of him. Therapy clients have the right to similar expectations of their therapists. As I understand Dr. Diamond’s rendition of the steam engine theory, "appropriate" anger should be experienced and expressed – but not acted on , as the retaliation motive of all anger would risk turning "appropriate" feelings into inappropriate behavior; in other words, it’s good to feel but not do . He also seems to think that suppressed/repressed "appropriate" anger, like egg salad, eventually turns rotten when stored somewhere in the body, where it "festers" and causes inappropriate anger. Functional MRIs show what happens when a person experiences anger – within or without conscious awareness – but, alas, do not show where or how it builds up and festers. We can measure other kinds of invisible festering by things like white blood cell counts and depleted immune system functioning. If there were such a thing as festering anger, it would show up in elevated rates of cortisol in the saliva. I know of no such empirical confirmation of the fester hypothesis. I’m curious to learn how, apart from dogma, Dr. Diamond knows that suppressed appropriate anger festers, indeed, knows it with enough certainty to risk the iatrogenic effects of validating the anger of angry clients. Certainly the empirical literature – as opposed to those early 20th Century case studies embedded in dogma – indicates that there is no lasting therapeutic benefit of catharsis and that anger expression worsens anger problems. Neurological evidence vs. conceptual descriptions Dr. Diamond’s term, "pathological anger," is a conceptual description. (At least it is more precise than "appropriate," which piles personal and cultural prejudices on top of conceptual blind spots.) Neither "pathological" nor "appropriate anger" has neurological meaning; it makes no sense neurologically to distinguish between pathological and appropriate anger. Habituation, an observable phenomenon, occurs through repetition; hence the expression of "appropriate" anger has the same habituation effects as the expression of inappropriate anger. Expression of anger doesn’t let off steam or get anything out of your system; it gives you a temporary amphetamine ride that reinforces the synaptic association of vulnerability with anger arousal, entitlement, and motives for retaliation. This bears repeating: through habituation effects, the expression of anger is conditioned to occur in response to gut level feelings of vulnerability that are not subject to higher and much slower cognitive judgments about the presumed childhood source of the vulnerability. When it comes to regulating anger, inferences about Mom or other remote "sources" of anger will be too little too late. Viable psychic theories must account for neurological evidence, not merely dismiss it as "another way of looking at the same thing." In fact, anger is not nearly so complicated and difficult an emotion as Dr. Diamond suggests. It is a simple response to perceived vulnerability in the face of perceived threat. Some authors have developed convoluted ways of thinking about anger and hyperbolic ways of describing it (e.g., "existential integrity"), but those merely justify or cover up the empirical shortcomings of their ideologies. Notably, none of the convoluted ways of thinking about anger predict anything verifiable about the phenomenology of an emotion that is observed and measurable in all animals, emanating from a region of the brain common to all animals. Real-world interactions In the fog of trying to distinguish "appropriate" from inappropriate anger in the consulting room, Dr. Diamond misses the real-world significance of emotional interaction. One law of emotional interaction is negative reactivity , which can be understood in this way. If you approach a person – or an animal – with anger (appropriate or not), what percentage of the time can you expect a negative response? Another law relevant to aggressive emotions is feed-back escalation . Anger is not for ties – you do not want to hurt the saber tooth tiger as much as it hurt you; you want to destroy its capacity to hurt you. People (and animals) who receive anger cues do not match them but top them, which is why anger escalates so quickly in real-life interactions. The angry person interprets other people’s negative reactions to his anger as unfair and deserving of retaliation, which prompts a like response in the other. There are two naturally occurring antidotes to the reactivity and escalation effects of anger in human and animal interactions: fear and shame. Fortunately for other animals, these important emotions still serve that healthy function. But we humans have developed a fear/shame phobia – most of the time we choose the temporary power of anger over the transitory powerlessness of fear and shame. (That is why, in the course of an ordinary day you will witness far more displays of low grade anger, resentment, agitation, and irritability than fear and shame.) Thus fear/shame phobia is implicated in the observed increase of anger, along with empirically supported hypotheses about social modeling and social conditioning, the high contagion of aggressive emotions, and a growing sense of entitlement that makes us think we have the "right" to feel good most of the time and to manipulate and control other people, a la "My ‘existential integrity’ is superior to yours." In contrast, the "suppression/repression" hypothesis offered as scientific explanation of the increase in anger, seem "reductionist," embarrassingly univariate, and impoverished by failure to account for the remarkable adaptability of human and animal central nervous systems. Ethics Dr. Diamond inadvertently highlights an important ethical issue in his comment: "It is typically in reflecting on such angry outbursts retrospectively (my emphasis) in treatment that inappropriate anger–and often the fear, guilt and shame about it–are recognized." In other words, someone has to get hurt to create a window of opportunity for Dr. Diamond’s insight about "appropriate" vs. inappropriate anger. My experience with many clients whose previous therapists subscribed to the steam engine school of anger suggests that a lot more hurt than Dr. Diamond imagines occurs between his sessions. Although he is right about "acknowledging that anger is present in the consulting room," it is quite another matter to encourage its expression and to validate it. The client will have more compelling motivation in the heat of real-world interactions to use expert validation to justify his anger, than to recall whatever insight about Mom-transference the therapist may have pointed out earlier in the week. I believe it is an ethical imperative when working with angry people to objectively evaluate the effectiveness of your work, not just through the unreliable self-report of the client, but from reports of those who live with him, both during treatment and for a good year after termination. Reducing the Need for Anger In daily living, humans have little need of primary anger – that stimulated by threat of harm to self and loved ones. The vast majority of the anger we experience is in response to rather petty ego offense, hyperbole about existential integrity and "the individual’s most basic right to being an individual" notwithstanding. In the vast majority of anger experience, we feel devalued in some way and blame it on someone else, which creates an illusion of threat, which, in turn, stimulates anger. Here, too, therapeutic focus on the appropriateness of the anger or its presumed roots in childhood tragically misses the point. Anger in response to feeling devalued substitutes a temporary feeling of power for value – you don’t feel more valuable when angry, you simply feel more powerful, as long as the amphetamine effect lasts, after which you crash. Therapy is about teaching clients to raise their self-value when they feel devalued in the real world. (Ultimately, the only way they can sustain true self-value in our highly socialized world is to become more compassionate.) They don’t need to know whether some therapist thinks their substitution of power for value is "appropriate." Rather, their attention must focus on whether their anger is helping them be the kind of person, parent, and intimate partner they most want to be. The focus of therapy is on helping them achieve those ends, not in reinforcing their unfortunate association of perceived vulnerability with anger by pronouncing it "appropriate." Of course no one should feel ashamed for feeling angry, and I doubt that many people do. But we all feel shame for violating our values. Most people violate their values when they perceive others, particularly loved ones, as menacing characters who are nothing other than whatever ego threat they seem to pose at the moment of anger. But the shame is not punishment for the anger; it is motivation to be true to one’s deepest values, i.e., to see others not as a source of emotion but as complex, separate people, independent of emotional reactions to them. When we follow that motivation, there is no need to express or manage anger; it simply becomes unnecessary for protection. I sincerely hope that Dr. Diamond can transcend dogma and present verifiable evidence for his views on anger, which, so far, seem far more literary than scientific. If he does come up with something verifiable, we can have a meaningful debate. © 2009 Psychology Today. This RSS Feed is for personal non-commercial use only. 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Where does competitive sense end and common sense take over? That is a question that coaches must navigate on a regular, even daily, basis when pushing athletes to get the best out of themselves. Some recent incidents illustrate that if coaches and administrators are faulty in their judgment it can have unintended but nevertheless far-reaching and even catastrophic consequences. Defining common sense is a tricky and nebulous task but in almost every physical education or coaching course there is an implicit Hippocratic oath of sorts that requires that the safety of students is always the primary concern of the coach or teacher. This "do no harm" approach is presumed to reach across the physical, psychological and emotional dimensions and to call upon the sensible instincts of those in charge. The recent arraignment of a high school football coach in Kentucky for the reckless homicide death of one of his players is a tragic example of a worst-case scenario coming to pass. The student died of heat exhaustion- related complications following a pre-season practice in the sweltering heat of August. It is claimed that the coach denied the players water and neglected to swiftly attend to the young man after he collapsed. Afforded the benefit of 20-20 hindsight most people would look at the situation and determine a number of common sense mileposts were missed by the coach and his staff that may have resulted in a much less tragic outcome. While there is probably plenty of culpability to be meted out in this case it may be instructive to look at the fragile line that coaches often tiptoe between competitive sense and common sense. Coaches and the innumerable methods they employ to accomplish their aims are a kaleidoscopic mixture of ideas , theories, beliefs, techniques, systems and philosophies. But, at the more serious levels of sports, high school, college and professional for example, there is an almost universal acceptance that an athlete, in order to accomplish their true potential in the physical and psychological realms, must be willing to push themselves through escalating levels of personal discomfort to the place where high achievement and accomplishment are to be found. In athletic terms this is how the proverbial wheat is separated from the chaff and if a coach is committed to excellence and winning it is a big part of his or her job to make that happen. The same way of thinking also applies to athletes and it is not at all unusual to find athletes that are willing to push themselves to incredible lengths in order to prove themselves. That sort of competitive sense is understood, accepted and in many cases required within the insular cultural circle of many athletic teams. The unfortunate situation in Kentucky may have been a case of a coach or even an athlete being consumed by their competitive sense and blindly losing sight of the obvious warnings of common sense related to heat, hydration and fatigue. Sadly a well-liked and respected coach and mentor, who knows that safety comes first and is doubtless well aware of the dangers of heat-related injuries appears, by not being on top of the gravity of a situation in his practice environment, to have perhaps allowed, however unwittingly, competitive sense to trump common sense with disastrous results. Common sense seems to have been a victim in another high school sports debacle that occurred in Texas recently when Covenant School trounced Dallas Academy 100-0 in a girls basketball game. To make matters worse, it was reported in the local papers that some Covenant parents and an assistant coach were gleefully cheering and celebrating three point shots made late in the game when the result was already irreversibly skewed. The outcome of the game and the conduct of some people associated with the school caused Covenant to issue an apology and to request that the game be forfeited citing the whole matter as "shameful" and an "embarrassment." The Covenant coach refused to apologize for running up the score claiming that his players had done nothing wrong and were simply playing the game the way it is supposed to be played. In the arena of competitive sense he is absolutely right because after all, you play to win and if the other team isn’t very good that’s their problem. That way of thinking may be apropos in the NBA but it scarcely seems to make any sense in a tiny parochial league against a team that hadn’t won a game in four years! Competitive sense versus common sense got that coach fired because in the context of a low-level girls basketball league he appeared to lose sight of some of the other reasons that kids play sports in small parochial schools. It is debatable whether a coach should be particularly concerned about the well-being of the other team but given the context of this event it seemed a particularly egregious flouting of the notion that one should respect and honor ones opponents. Interestingly, Dallas Academy, the "victims" in this drama never complained about the score. After the furor in the media their athletic administrators decided to remove the team from the league and put the them into a JV league where the talent level is more comparable. After four years of seeing their team over-matched to the point of losing every single game, common sense would seem to beg the question "what took you so long?" Ultimately these unfortunate cases both illustrate that all competitive coaches, whether they like it or not, still have a responsibility to maintain a level of common sense and perspective in their work. Being competitive does not grant immunity from respecting the accepted norms that operate in the particular culture or environment, especially where the physical, and sometimes, mental health and well-being of athletes is at stake. © 2009 Psychology Today. This RSS Feed is for personal non-commercial use only. If you are not reading this material in your news aggregator, the site you are looking at is guilty of copyright infringement. Please contact blogs@psychologytoday.com so we can take legal action immediately.