Tuesday, April 30, 2013

The Criminal Mind of Adrian Raine

Adrian Raine

Neurocriminology is a fraught subject, as exemplified in this piece by Adrian Raine. On the one hand, proponents contend that criminal culpability is limited by neurological deficits that reduce one's ability to inhibit impulses. On the other hand, they don't want to use those findings to preventatively incarcerate people who exhibit those deficits. They present strong (really, really strong) evidence that criminal behavior is significantly influenced by genetics but they freak out at the suggestion that perhaps society should limit the breeding opportunities of psychopaths. (Actually that's exactly what long-term incarceration does.)

Some excerpts:

The field of neurocriminology—using neuroscience to understand and prevent crime—is revolutionizing our understanding of what drives "bad" behavior. More than 100 studies of twins and adopted children have confirmed that about half of the variance in aggressive and antisocial behavior can be attributed to genetics. Other research has begun to pinpoint which specific genes promote such behavior.


In a landmark 1984 study, my colleague Sarnoff Mednick found that children in Denmark who had been adopted from parents with a criminal record were more likely to become criminals in adulthood than were other adopted kids. The more offenses the biological parents had, the more likely it was that their offspring would be convicted of a crime. For biological parents who had no offenses, 13% of their sons had been convicted; for biological parents with three or more offenses, 25% of their sons had been convicted.

Take the case of Donta Page, who in 1999 robbed a young woman in Denver named Peyton Tuthill, then raped her, slit her throat and killed her by plunging a kitchen knife into her chest. Mr. Page was found guilty of first-degree murder and was a prime candidate for the death penalty.
Working as an expert witness for Mr. Page's defense counsel, I brought him to a lab to assess his brain functioning. Scans revealed a distinct lack of activation in the ventral prefrontal cortex—the brain region that helps to regulate our emotions and control our impulses.
In testifying, I argued for a deep-rooted biosocial explanation for Mr. Page's violence. As his files documented, as a child he suffered from poor nutrition, severe parental neglect, sustained physical and sexual abuse, early head injuries, learning disabilities, poor cognitive functioning and lead exposure. He also had a family history of mental illness. By the age of 18, Mr. Page had been referred for psychological treatment 19 times, but he had never once received treatment. A three-judge panel ultimately decided not to have him executed, accepting our argument that a mix of biological and social factors mitigated Mr. Page's responsibility.
Mr. Page escaped the death penalty partly on the basis of brain pathology—a welcome result for those who believe that risk factors should partially exculpate socially disadvantaged offenders. But the neurocriminologist's sword is double-edged. Neurocriminology also might have told us that Mr. Page should never have been on the street in the first place. At the time he committed the murder, he had been out of prison for only four months. Sentenced to 20 years for robbery, he was released after serving just four years.


Randomized, controlled trials have clearly documented the efficacy of a host of medications—including stimulants, antipsychotics, antidepressants and mood stabilizers—in treating aggression in children and adolescents. Parents are understandably reluctant to have their children medicated for bad behavior, but when all else fails, treating children to stabilize their uncontrollable aggressive acts and to make them more amenable to psychological interventions is an attractive option.

Treatment doesn't have to be invasive. Randomized, controlled trials in England and the Netherlands have shown that a simple fix—omega-3 supplements in the diets of young offenders—reduces serious offending by about 35%. Studies have also found that early environmental enrichment—including better nutrition, physical exercise and cognitive stimulation—enhances later brain functioning in children and reduces adult crime.


There is no question that neurocriminology puts us on difficult terrain, and some wish it didn't exist at all. How do we know that the bad old days of eugenics are truly over? Isn't research on the anatomy of violence a step toward a world where our fundamental human rights are lost?

End excerpts.

The idea that you can "treat" aggression in children and adolescents with pharmaceuticals is not exactly uncontroversial. Some of the most commonly prescribed drugs for aggression in children (e.g., Seroquel) don't seem to be effective. Part of the reason for this is that even the most violent children are violent only rarely, so if you use actual acts of violence as your dependent variable you will run into the same problems as any study of low base rate events. Many of the drugs mentioned by Raine have powerful sedating effects, so that might slow down some violent thugs. So did lobotomies. And in any case, you are not "treating" anything by sedating a violent kid; you are just managing his behaviors.

That omega-3/fish oil study seems pretty intriguing. (More like snake oil, actually -- beware of wondrous findings, especially if they are consistent with your existing beliefs or deepest wishes.) Here's a supplement study that reports a 35% reduction in offending by inmates -- this must be the study to which he is referring in the article.

Finally, it seems pretty clear that "the bad old days of eugenics" are far from over. In the U.S., up to 93% of prenatal diagnoses of Down's Syndrome result in elective termination of the pregnancy (abortion). The American upper middle class can easily employ sex selection (combined with artificial insemination) to get that baby girl they always wanted. As noted above, long-term incarceration of criminals probably has a secondary effect of limiting their potential breeding opportunities. As IVF and preimplantation genetic screening become more commonplace, how do you think potential parents will respond when asked to choose between probable Hi IQ and probable Lo IQ blastocysts (or between those with probable Hi or Lo Callous/Unemotional traits)?

Monday, April 29, 2013

Psychological Consequences of CBRNE Terrorism

A reporter from the Times of Israel interviewed me recently for an article. She had come across a chapter I had written on CBRNE (chemical, biological, radiological, nuclear, high-Explosive) terrorism. The chapter content supplies much of the background for the article. You can read the news article here. An excerpt:

During World War I — the first war in modern history that included the widespread use of chemical weapons — 500 soldiers of the US Army’s 3rd Division exhibited debilitating symptoms of gas exposure: chest pain, difficulty breathing, and blurred vision. It was later discovered that the division had never been exposed to a chemical agent. The press quickly dubbed the phenomenon “gas mania.”

Seventy years later, during the six-week Iran-Iraq War of the Cities of 1988, at least 100,000 (some estimate as many as 1.5 million) residents fled Tehran in response to Saddam Hussein’s threat to load chemical warheads onto the Scud missiles that were hitting the Iranian capital.

In 1991, during the Gulf War, nine people were killed as a result of missile attacks on Israel, seven of whom died by suffocating inside their gas masks when they failed to release the airtight cap. Twenty-seven percent of all injuries during this time were the result of unnecessary atropine injections.

“The punchline in all these events, of course, is that chemical weapons weren’t even used. Just the rumor — the threat — of chemical weapons was enough to cause something of that magnitude,” said Glenn Sullivan, a psychologist who co-authored a book on the psychology of terrorism.

But research also suggests that Israelis are particularly adept at habituating to recurring stressors when compared to people of other nations.

I'm not sure that Israelis are better at habituating to stressors, but that seems to be the point of the article.

Sunday, April 28, 2013

The World Is Too Much With Us

"Getting and spending, we lay waste our powers"


The world is too much with us; late and soon,
Getting and spending, we lay waste our powers;—
Little we see in Nature that is ours;
We have given our hearts away, a sordid boon!
This Sea that bares her bosom to the moon;
The winds that will be howling at all hours,
And are up-gathered now like sleeping flowers;
For this, for everything, we are out of tune;
It moves us not. Great God! I’d rather be
A Pagan suckled in a creed outworn;
So might I, standing on this pleasant lea,
Have glimpses that would make me less forlorn;
Have sight of Proteus rising from the sea;
Or hear old Triton blow his wreathèd horn.
William Wordsworth (1806)
Memorizing poems is well worth the effort and is a habit I have observed in many well educated people. This poem is a great place to start. I suggest that many people do not commit poems to memory because 1) their prior education corrupted them into thinking that a poem was meant to be "analyzed"; 2) memorization requires effort and most people will do anything they can to avoid expending effort; and, 3) they suspect that they will not be the same person they were before if they memorize a poem and they are scared of becoming who they really are -- they have a status quo bias.
I very much enjoy this fellow's readings:

Saturday, April 27, 2013

Cat Stevens -- Where do the children play?

For a Saturday, another fan-created music video. This is a great song about the dehumanizing nature of technological progress ("I know we've come a long way/We're changing day to day"). It also speaks to the pointlessness of limitless consumer choices ("get what you want to if you want, 'cause you can get anything"). It reminds me that Carl Rogers' father was a civil engineer ("Well you roll on roads/over fresh green grass"), as was the father of Albert Bandura. It also makes me think about Ernest Becker's "immortality projects" ("Well you've cracked the sky/scrapers fill the air"). And of course, it raises the issues of preimplantation genetic diagnosis and age-based health care rationing ("Will you tell us when to live, will you tell us when to die?").

That the writer of this song subsequently converted to, and remains a devoted follower of, one of the world's great monotheistic religions is completely unsurprising to me.

Where do the children play?

Well I think it's fine, building jumbo planes.
Or taking a ride on a cosmic train.
Switch on summer from a slot machine.
Yes, get what you want to if you want, 'cause you can get anything.

I know we've come a long way,
We're changing day to day,
so tell me, where do the children play?

Well you roll on roads over fresh green grass.
For your lorry loads pumping petrol gas.
And you make them long, and you make them tough.
But they just go on and on, and it seems that you can't get off.

Oh, I know we've come a long way,
We're changing day to day,
so tell me, where do the children play?

Well you've cracked the sky, scrapers fill the air.
But will you keep on building higher
'til there's no more room up there?
Will you make us laugh, will you make us cry?
Will you tell us when to live, will you tell us when to die?

I know we've come a long way,
We're changing day to day,
But tell me, where do the children play?

Friday, April 26, 2013

Weekend reading -- Spy Novels

Since the point of this blog is to encourage more reading by students of clinical psychology, it seems proper and fitting to include "entertainments" as well as Great Books. Not everything worth reading has to be serious (and not everything serious is worth reading). If people are going to read trashy books for pleasure, they might as well read high-quality trashy books. From here on out, I'll just call it "weekend reading."

Here are three excellent books on espionage that I have enjoyed. Every serious reader has four lists: 1) books they have read; 2) books they intend to read; 3) books they pretend to have read; and, 4) books that they have read twice. All three of these books are in that last, exalted category, which is the finest endorsement of them that I can think of. Of course, your tastes might vary and there is no guarantee that you will enjoy what I do.

1. Vengeance by George Jonas. This is the basis for the movie, Munich (Steven Spielberg, dir.) and is the reason I was so terribly disappointed by that movie, which apparently many people liked. The book was tremendous. There is some controversy about the veracity of the account, as there must be in any memoir of an intelligence operation.

2. Saving the Queen by William F. Buckley. This is the first of the Blackford Oakes series of spy novels, which trace the history of the Cold War. Blacky is arguably far cooler than James Bond (who is rather a psychopath, particularly in the Ian Fleming novels and the movie Casino Royale). This first installment involves the initial recruitment and training of Blackford Oakes into the CIA in the 1950s, which author Buckley presumably knew something about, since he was a CIA officer at that time.

3. The Tears of Autumn by Charles McCarry. This one of several spy novels featuring CIA officer Paul Christopher. McCarry's books are often referred to as "the spy novels that real intelligence officers read." Like Buckley, McCarry also has a history of service in the CIA (although apparently more extensive and covert). This book is not only a high quality novel in its own right but presents one of the most interesting alternative explanations of the Kennedy assassination I have ever encountered. Here is a nice review of the book.

Thursday, April 25, 2013

Dr. Sidney Freedman is dead

It's odd that I mentioned the possible influence of this actor's work on my career choice in a blog post less than 2 weeks ago and now he's dead. Carl Jung might make something of that but I'm not really tempted. If I happen to mention you or someone you love in a blog post, I think you will probably be okay.

From the New York Times obituary:
Allan Franklin Arbus was born in New York City on Feb. 15, 1918. He attended DeWitt Clinton High School and entered City College at 15. He left college a year and a half later for a job at Russek’s Department Store, where he met Diane Nemerov, the daughter of the store’s owners.
They married in 1941 and became passionate about photography. They shot fashion photographs for Russek’s before Mr. Arbus left to serve as a photographer in the Army Signal Corps in Burma during World War II. When he was discharged in 1946 the Arbuses established a studio on West 54th Street for fashion photography and soon won a contract from Condé Nast to supply photos for magazines like Glamour and Vogue. 
In 1956, Ms. Arbus dissolved their business partnership to work full time on her haunting shots of marginalized people. Mr. Arbus continued to work in fashion photography but also took up acting.
The Arbuses separated in 1959 and divorced in 1969, when Mr. Arbus moved to Los Angeles. Ms. Arbus committed suicide in 1971.
I use this photo made by his ex-wife, Diane Arbus, in a presentation I give on Twin Research. I never knew the connection between her and the actor who played Dr. Sidney Freedman. Nor did I know that she died by suicide. I do recommend that you check out her "haunting shots of marginalized people."

Wednesday, April 24, 2013

Unspeakable, Unbearable, Horrible Truth

The following excerpt is from the remarkable book, Facing Human Suffering, by Ronald B. Miller (2004, pp. 184-185). [Emphases added.]

"People who are difficult to get to know often are that way for very good reason. They are concealing aspects of their lives that they believe it would be dangerous to reveal. The information they possess involves aspects of human relationships that are regarded as shameful and immoral, if not illegal (child physical and sexual abuse, illicit sexual affairs, deviant sexual interests, cheating and dishonesty in business, etc.). There is a qualitative difference between the content of the knowledge that is concealed regarding other people and knowledge that nature conceals in the natural sciences via mystery and complexity. Only in a relationship that contains certain moral features -- trust, safety, respect, and confidentiality -- can these critical features of human existence be revealed and discussed. A psychology that wishes to go beyond the surface of social pretense and masks must provide a methodology for exploring the taboo and forbidden aspects of human relationships (Faberow, 1963). Freud (1920/1966), writing in the Introductory Lectures on Psycho-Analysis, made the point that the data of clinical psychoanalysis -- and, by implication, psychology -- are vulnerable to this sort of distortion:

The talk of which psycho-analytic treatment consists brooks no listener, it cannot be demonstrated (to the audience). A neurasthenic or hysterical patient can of course like any other, be introduced to students in a psychiatric lecture. He will give an account of his complaints and symptoms, but of nothing else. The information required by analysis will be given by him only on condition of his having a special emotional attachment to the doctor; he would become silent as soon as he observed a single witness to whom he felt indifferent. For this information concerns what is most intimate in his mental life, everything that, as a socially independent person, he must conceal from other people, and beyond, that as a a homogeneous personality, he will not admit to himself. (pp. 20-21)

Rollo May (1969) concurred in Love and Will and quoted H.S. Sullivan as expressing a similar position:

But neither these psychologists in their laboratories nor those philosophers in their studies can ignore the fact we do get tremendously significant and often unique data from persons in therapy -- data which are revealed only when human beings break down their customary pretenses, hypocrisies and defenses behind which we all hide in "normal" social discourse. There is also the curious situation that unless we are oriented towards helping the person, he will not, indeed in some ways cannot, reveal the significant data. Harry Stack Sullivan's remark on research in therapy is still as cogent as when he first made it: "Unless the interviews are designed to help the person, you'll get artifacts, not real data." (pp. 18-19)

Whether one wishes to join the more psychoanalytic observers in believing that all clinical problems have at their core such unspeakable elements, or whether one takes the more moderate position that many, if not most, do, it is clear that the clinical method of gaining knowledge in psychology is, for all its limitations, the only game in town."

Tuesday, April 23, 2013

George Kelly quote

George Kelly (1905-1967): Personal Construct Theory




"A good deal is said these days about being oneself. It is supposed to be healthy to be oneself. While it is a little hard for me to understand how one could be anything else, I suppose what is meant is that one should not strive to become anything other than what he is. This strikes me as a very dull way of living; in fact, I would be inclined to argue that all of us would be better off if we set out to be something other than what we are. Well, I’m not so sure we would all be better off - perhaps it would be more accurate to say life would be a lot more interesting.”

More on George Kelly, from George Boeree's Personality Theories website.


Monday, April 22, 2013

Robert Nozick's Short List of "Fully Grown Up" Reading

File:Bronze Marcus Aurelius Louvre Br45.jpg
Marcus Aurelius, bronze fragment, after 170 AD (Louvre Museum)

From the philosopher Robert Nozick, author of Anarchy, State, and Utopia and The Examined Life (which I am currently enjoying):

There are very few books that set out what a mature person can believe -- someone fully grown up, I mean. Aristotle's Ethics, Marcus Aurelius's Meditations, Montaigne's Essays, and the essays of Samuel Johnson come to mind. Even with these, we do no simply accept everything that is said. The author's voice is never our own, exactly; the author's life is never our own. It would be disconcerting, anyway, to find that another person holds precisely our views, responds with our particular sensibility, and thinks exactly the same things important. Still, we can gain from these books, weighing and pondering ourselves in their light. These books -- and also some less evidently grown-up ones, Thoreau's Walden and Nietzsche's writings, for example -- invite or urge us to think along with them, branching in our own directions. We are not identical with the books we read, but neither would we be the same without them. (The Examined Life, p. 15)

There you have it: a semester's worth of college-level education for less than one hundred dollars. Read the six books listed above and you will not be the same person you were before. (I would personally put Walden at the bottom of the list.)

(By the way, Nozick's The Examined Life is another book that invites us to think along with the author.)

Another note: If you decide to purchase these books, be aware that I tried to link to good editions. There are now a lot of digital publishers cranking out poor versions of noncopyrighted classic works. I highly recommend sticking closer to The Modern Library (can't go wrong with them, in my experience), Penguin, or Signet Classics. Very often, Amazon reviewers will help steer you to the best edition of a classic work.

Sunday, April 21, 2013

Virginia Woolf's Suicide Note

From the movie, The Hours:



I feel certain I am going mad again. I feel we can't go through another of those terrible times. And I shan't recover this time. I begin to hear voices, and I can't concentrate. So I am doing what seems the best thing to do. You have given me the greatest possible happiness. You have been in every way all that anyone could be. I don't think two people could have been happier till this terrible disease came. I can't fight any longer. I know that I am spoiling your life, that without me you could work. And you will I know. You see I can't even write this properly. I can't read. What I want to say is I owe all the happiness of my life to you. You have been entirely patient with me and incredibly good. I want to say that - everybody knows it. If anybody could have saved me it would have been you. Everything has gone from me but the certainty of your goodness. I can't go on spoiling your life any longer.
I don't think two people could have been happier than we have been.


For more on Virginia Woolf and her death by suicide, see here.

Saturday, April 20, 2013

Rostropovich plays Haydn

 A Saturday observation by the critic, Terry Teachout.
"Few things are rarer than a performer who takes a broader view of the world of art. One such artist was Alec Guinness, who published four books, all of them nominally autobiographical, that offer evidence of his aesthetic cultivation and unusually wide-ranging interests. In "A Positively Final Appearance," a 1999 volume of journal entries written toward the end of his long life, he tossed off this passing remark: "For me there are two salves to apply when I feel spiritually bruised—listening to a Haydn symphony or sonata (his clear common sense always penetrates) and seeking out something in Montaigne's essays. This morning, in spite of the promise of a bright cloudless day, I woke curmudgeonly and disapproving of the world and most of its inhabitants. Montaigne pulled me up sharply." Has it ever occurred to anyone else to yoke those two great spokesmen for the civilized virtues of the Age of Reason? If so, it's news to me."

So for those of you who are feeling spiritually bruised, here's some Haydn. (Search YouTube for  Haydn Cello Concerto Rostropovich 1981 or click link if image below doesn't work.)

 And here's an essay by Montaigne:

The Emperor Vespasian, being sick of the disease whereof he died, did not for all that neglect to inquire after the state of the empire, and even in bed continually despatched very many affairs of great consequence; for which, being reproved by his physician, as a thing prejudicial to his health, "An emperor," said he, "must die standing." A fine saying, in my opinion, and worthy a great prince. The Emperor Adrian since made use of the same words, and kings should be often put in mind of them, to make them know that the great office conferred upon them of the command of so many men, is not an employment of ease; and that there is nothing can so justly disgust a subject, and make him unwilling to expose himself to labour and danger for the service of his prince, than to see him, in the meantime, devoted to his ease and frivolous amusement, and to be solicitous of his preservation who so much neglects that of his people.
Whoever will take upon him to maintain that 'tis better for a prince to carry on his wars by others, than in his own person, fortune will furnish him with examples enough of those whose lieutenants have brought great enterprises to a happy issue, and of those also whose presence has done more hurt than good: but no virtuous and valiant prince can with patience endure so dishonourable councils. Under colour of saving his head, like the statue of a saint, for the happiness of his kingdom, they degrade him from and declare him incapable of his office, which is military throughout: I know one—[Probably Henry IV.]—who had much rather be beaten, than to sleep whilst another fights for him; and who never without jealousy heard of any brave thing done even by his own officers in his absence. And Soliman I. said, with very good reason, in my opinion, that victories obtained without the master were never complete. Much more would he have said that that master ought to blush for shame, to pretend to any share in the honour, having contributed nothing to the work, but his voice and thought; nor even so much as these, considering that in such work as that, the direction and command that deserve honour are only such as are given upon the spot, and in the heat of the business. No pilot performs his office by standing still. The princes of the Ottoman family, the chiefest in the world in military fortune, have warmly embraced this opinion, and Bajazet II., with his son, who swerved from it, spending their time in science and other retired employments, gave great blows to their empire; and Amurath III., now reigning, following their example, begins to find the same. Was it not Edward III., King of England, who said this of our Charles V.: "There never was king who so seldom put on his armour, and yet never king who gave me so much to do." He had reason to think it strange, as an effect of chance more than of reason. And let those seek out some other to join with them than me, who will reckon the Kings of Castile and Portugal amongst the warlike and magnanimous conquerors, because at the distance of twelve hundred leagues from their lazy abode, by the conduct of their captains, they made themselves masters of both Indies; of which it has to be known if they would have had even the courage to go and in person enjoy them.
The Emperor Julian said yet further, that a philosopher and a brave man ought not so much as to breathe; that is to say, not to allow any more to bodily necessities than what we cannot refuse; keeping the soul and body still intent and busy about honourable, great, and virtuous things. He was ashamed if any one in public saw him spit, or sweat (which is said by some, also, of the Lacedaemonian young men, and which Xenophon says of the Persian), forasmuch as he conceived that exercise, continual labour, and sobriety, ought to have dried up all those superfluities. What Seneca says will not be unfit for this place; which is, that the ancient Romans kept their youth always standing, and taught them nothing that they were to learn sitting.
'Tis a generous desire to wish to die usefully and like a man, but the effect lies not so much in our resolution as in our good fortune; a thousand have proposed to themselves in battle, either to overcome or to die, who have failed both in the one and the other, wounds and imprisonment crossing their design and compelling them to live against their will. There are diseases that overthrow even our desires, and our knowledge. Fortune ought not to second the vanity of the Roman legions, who bound themselves by oath, either to overcome or die:
     "Victor, Marce Fabi, revertar ex acie: si fallo, Jovem patrem,
     Gradivumque Martem aliosque iratos invoco deos."

     ["I will return, Marcus Fabius, a conqueror, from the fight:
     and if I fail, I invoke Father Jove, Mars Gradivus, and the
     other angry gods."—Livy, ii. 45.]

The Portuguese say that in a certain place of their conquest of the Indies, they met with soldiers who had condemned themselves, with horrible execrations, to enter into no other composition but either to cause themselves to be slain, or to remain victorious; and had their heads and beards shaved in token of this vow. 'Tis to much purpose for us to hazard ourselves and to be obstinate: it seems as if blows avoided those who present themselves too briskly to them, and do not willingly fall upon those who too willingly seek them, and so defeat them of their design. Such there have been, who, after having tried all ways, not having been able with all their endeavour to obtain the favour of dying by the hand of the enemy, have been constrained, to make good their resolution of bringing home the honour of victory or of losing their lives, to kill themselves even in the heat of battle. Of which there are other examples, but this is one: Philistus, general of the naval army of Dionysius the younger against the Syracusans, presented them battle which was sharply disputed, their forces being equal: in this engagement, he had the better at the first, through his own valour: but the Syracusans drawing about his gally to environ him, after having done great things in his own person to disengage himself and hoping for no relief, with his own hand he took away the life he had so liberally, and in vain, exposed to the enemy.
Mule Moloch, king of Fez, who lately won against Sebastian, king of Portugal, the battle so famous for the death of three kings, and for the transmission of that great kingdom to the crown of Castile, was extremely sick when the Portuguese entered in an hostile manner into his dominions; and from that day forward grew worse and worse, still drawing nearer to and foreseeing his end; yet never did man better employ his own sufficiency more vigorously and bravely than he did upon this occasion. He found himself too weak to undergo the pomp and ceremony of entering. into his camp, which after their manner is very magnificent, and therefore resigned that honour to his brother; but this was all of the office of a general that he resigned; all the rest of greatest utility and necessity he most, exactly and gloriously performed in his own person; his body lying upon a couch, but his judgment and courage upright and firm to his last gasp, and in some sort beyond it. He might have wasted his enemy, indiscreetly advanced into his dominions, without striking a blow; and it was a very unhappy occurrence, that for want of a little life or somebody to substitute in the conduct of this war and the affairs of a troubled state, he was compelled to seek a doubtful and bloody victory, having another by a better and surer way already in his hands. Notwithstanding, he wonderfully managed the continuance of his sickness in consuming the enemy, and in drawing them far from the assistance of the navy and the ports they had on the coast of Africa, even till the last day of his life, which he designedly reserved for this great battle. He arranged his battalions in a circular form, environing the Portuguese army on every side, which round circle coming to close in and to draw up close together, not only hindered them in the conflict (which was very sharp through the valour of the young invading king), considering that they had every way to present a front, but prevented their flight after the defeat, so that finding all passages possessed and shut up by the enemy, they were constrained to close up together again:
          "Coacerventurque non solum caede, sed etiam fuga,"

          ["Piled up not only in slaughter but in flight."]

and there they were slain in heaps upon one another, leaving to the conqueror a very bloody and entire victory. Dying, he caused himself to be carried and hurried from place to place where most need was, and passing along the files, encouraged the captains and soldiers one after another; but a corner of his main battalions being broken, he was not to be held from mounting on horseback with his sword in his hand; he did his utmost to break from those about him, and to rush into the thickest of the battle, they all the while withholding him, some by the bridle, some by his robe, and others by his stirrups. This last effort totally overwhelmed the little life he had left; they again laid him upon his bed; but coming to himself, and starting as it were out of his swoon, all other faculties failing, to give his people notice that they were to conceal his death the most necessary command he had then to give, that his soldiers might not be discouraged (with the news) he expired with his finger upon his mouth, the ordinary sign of keeping silence. Who ever lived so long and so far into death? whoever died so erect, or more like a man?
The most extreme degree of courageously treating death, and the most natural, is to look upon it not only without astonishment but without care, continuing the wonted course of life even into it, as Cato did, who entertained himself in study, and went to sleep, having a violent and bloody death in his heart, and the weapon in his hand with which he was resolved to despatch himself.

Friday, April 19, 2013

"Lone Wolf" suspect in the Boston Marathon bombing?

From CBS Boston:

Nine years ago, Carlos Arredondo gained worldwide attention and sympathy, for being a grieving father who had a heartbreaking reaction to news that his son had been killed in the Iraq war.

Now he lives in Boston, and has found himself in the middle of the marathon bombing story. He is being both praised and questioned at the same time.


He says Boston Police and the FBI came to his Roslindale home and questioned him about the bombing. When they left, they took some items.

They took my clothes, my shoes my pants, my t-shirt, whatever they needed I provided to them,” Arredondo told WBZ-TV.

Arredondo said he went to the marathon to cheer on athletes and National Guard troops who were running in memory of both of his sons. He also said authorities also took some photos that he had taken at the event, and that he was happy investigators appear to be closing in on a suspect.

End Excerpts

Personally, if the Boston Police and the FBI showed up at my door and asked for the clothing I was wearing on the day of a bombing, I would call a lawyer.

The Wikipedia article on Mr. Arredondo is very interesting. First, his is a remarkable case study of ataque de nervios (with self-immolation) after being informed of his son's death in Iraq in 2004. Second, the death of his surviving son by suicide in 2007 draws attention to the secondary effects of war casualties on the home front (the suicide apparently occured in the context of enduring despondency over the death of his brother). This is potentially an enormous public health problem (see here, and here). It has yet to be established that losing a family member in war increases the suicide risk of surviving family members, but it is obviously a question that needs to be investigated.

The United States has a track record of searching for "Lone Wolves" after events like the Boston Marathon bombing. It is probably a good idea to refresh our memories of Richard Jewell, the security guard who spotted the unattended knapsack containing the Centennial Park bomb during the 1996 Summer Olympics in Atlanta. He was the prime suspect in the case for a few months and it nearly ruined his life. It's not difficult to see how Mr. Arredondo could be portrayed by the FBI as having a motive for the Boston attack. The fact that he is an anti-war activist probably heightens the FBI's interest in him. I'm not saying he did it; in fact, I doubt that he did. The attack seems to have been rather complex in its execution, and probably required the participation of several people. Why no group has yet claimed credit for the attack is one of the most puzzling aspects of this case.






Thursday, April 18, 2013

Would you rather work in a Nursing Home or a Slaughterhouse?


According to this excellent article in yesterday's Wall Street Journal, working in a nursing home is as physically taxing as working in a slaughterhouse. They don't mention this, but I would imagine that it is as psychologically taxing as well. Killing animals isn't good for the soul (which is why working in a slaughterhouse is not considered an approriate occupation for someone on the Path to Buddhist Enlightenment; neither is being an arms dealer, by the way). Growing attached to the sick and dying, being exposed daily to human frailty, spending more time caring for them than their own family members, and then suffering serial bereavements can't be good for you, either.

I recently conducted a Social Security Disability Examination of a woman in her 50s who had developed a chronic major depression from working in a nursing home (that wasn't the only factor, but it was front and center). The crazy thing is, if you consider Food Stamps (SNAP) and the money she will get from Social Security Disability, she will only be making a thousand dollars less a year than she did when she was working full time for $12.00/hour at the nursing home (that wage reflects her 30 years of experience as a Certified Nursing Assistant). Not only is the work physically brutal and spiritually draining, but the pay is lousy.

As the Baby Boomers start becoming increasingly demented, we might have to draft warm bodies to provide care to them. One possible approach would be to make two years of service in a nursing home a pre-requisite for receiving Federal student loans for college. (Of the 20 million people who attend college each year in the U.S., 12 million (60%) borrow to cover costs; source). The Journal predicts that we will need 1.5 million more workers in the nursing care industry within the decade, so that ought to do the trick. You could even mandate minimum staffing levels (e.g., one CNA per shift for every six patients) and try to improve care and working conditions at the same time. The downside is that by the time they make it to college, those who worked in nursing homes will be depressed and have bad backs.


Some Excerpts from the article:

A labor shortage is worsening in one of the nation's fastest-growing occupations—taking care of the elderly and disabled—just as baby boomers head into old age.

Nursing homes and operators of agencies providing home-care services already are straining to find enough so-called direct-care workers, who help the elderly or disabled with such things as eating and bathing. They also face looming retirements in the current workforce, in which one-fifth of workers are 55 years old or older.

The reasons for the shortage: pay is low, typically less than $12 an hour, injury rates are high, and the work can be unpleasant and physically draining.


Demand will continue to grow. The number of Americans 65 years and older is projected to reach 73 million in 2030, up from 40 million in 2010. Serving that growing population will require five million direct-care workers in 2020, up 48% from the 2010 level, according to U.S. government projections.


Such demands lead to high labor turnover. Between 43% and 75% of nursing aides turn over each year, various studies have found. That compares with a 28% rate for all health-care and social-assistance jobs in 2012, according to U.S. government data.


Becoming a nursing aide is fairly easy. The federal minimum-training requirement is 75 hours, though some states require 150 to 175 hours. No college degree is needed, and even high-school degrees aren't always required.


Low pay doesn't help. The median hourly wage for nursing aides is $11.74, according to the U.S. Labor Department, compared with $16.71 per hour for all occupations.

"These people are the actual backbone of nursing-home care," says Lew Little, chief executive officer of Harden Healthcare LLC, Austin, Texas. Hourly pay for nursing aides at some of Harden's nursing homes in Texas starts at $8.25, or $1 above the minimum wage.

"We'd love to be in a position" to increase aides' pay, Mr. Little says. But he sees "no clear path" toward higher wages because of cutbacks in Medicaid and Medicare reimbursements, the main source of operators' revenue.


Sonia Dhaliwal, 27, another aide at Cottonwood, is a native of India. While she was helping a resident put on socks one day, the resident punched her in the eye. "You have to be ready physically and mentally," she says. Even so, Ms. Dhaliwal says: "They're our family. We really do love them."


Wednesday, April 17, 2013

The Boulder Model on who should become a clinical psychologist

Portrait of Edmond Maitre (The Reader), Pierre-Auguste Renoir (1871)

In 1948, the Committee on Training in Clinical Psychology released a report that, in part, outlined the personal characteristics and undergraduate preparation ideal for future graduate trainees in clinical psychology. (The overall aim of the report was to outline the "scientist-practitioner" model of training in the field. A lot is said about the "scientist" portion of the report, but the "practitioner" elements don't get as much attention.)

The ability to carry out effectively the combination of functions called for depends upon the clinical psychologist being the right kind of person, a person who has a relevant informal experience background into which has been integrated the proper formal education, both undergraduate and graduate.... Since it is reasonable to expect the clinical psychologist be interested in people and a broad base of human contacts, he should have experiences, particularly in his college years...involving close relations with both ordinary and unusual persons in field, factory, institution, or laboratory. In addition to direct contact with people of various kinds he should have the indirect acquaintance with people that comes from immersion in great literature, because of the emphasis which such portrayals place on the molar aspects of behavior and the insights into human nature they give. (pp. 540-541, emphases added)

So once again, we have as prerequisites for advanced training in the field of clinical psychology: 1) an interest and liking for people; 2) personal experience with people from a wide range of backgrounds (e.g., cloistered in neither affluence nor poverty); and, 3) a habit of reading great literature.

Tuesday, April 16, 2013

Boston Marathon Terror Attack and the Newspaper Fallacy

What is Truth? Nikolai Ge (1890)

As news accounts come out over the next several days, it may be useful to heed this observation by Philip Jenkins, author of the outstanding book, Images of Terror:

In many ways, terrorism poses unusual difficulties for any kind of academic analysis. It differs from other problems in that the official agencies we depend on for information have a powerful vested interest in not revealing the full extent of the information available to them. In saying that, I am not arguing for a conspiratorial view of government behavior, but rather remarking on the nature of the law enforcement response to terrorism. Since so much official action involves clandestine methods or sources, even the most reputable and responsible agencies will on occasion present less than the full truth, or actively give false information in order to protect their methods or sources. Deception is a basic part of the territory, and it is naive to suppose otherwise. (pp. 5-6)

Jenkins also notes that in any terror investigation "several competing versions of reality" are available, and "bureaucratic agencies" must choose "to accept one rather than another" (pp.8-9). The implication is that objective, settled, agreed upon accounts that reveal the Truth about What Really Happened may be impossible to achieve. Further, not only does the general public rarely have access to a full and complete account of what happened and why, but even various insiders disagree about how to interpret agreed upon facts.

Consideration of what I once heard called "the Newspaper Fallacy" may be instructive at this point. If you have ever been a participant in an event covered by the news media, you have most likely have had this experience: You read the story about your Charity 5K run, neighbor's house burning down, Town Council Meeting, etc. and you marvel at just how wrong the reporter got the story. The same thing goes for any topic about which you have some level of expertise, be it treatment of combat-related PTSD or antique car restoration. You read the article again, and you note, with some unease, that you can't point to a single factual error in the story. So what went wrong? The reporter simply did not experience the event from your perspective, did not speak to the same people you did about the event or topic, and even if she did, she decided to emphasize a different segment of that person's observations than the ones you thought were important. You and the reporter both encountered the same reality, and you both walked away with it with very different experiences. Distortion doesn't necessarily involve error, incompetence, or malfeasance. What is shocking is that we generally believe in "objective" accounts when everything in reality is filtered through our individual subjectivity. (By the way, your account isn't "objective" either, in case that wasn't clear.)

But here's the Newspaper Fallacy: Even though we now know not to treat the newspaper account of the event with which we have personal experience as the objective truth of that event, we assume that every other article in that day's newspaper is an objective account of the truth regarding the event with which it is concerned. Stated slightly differently: We know that a news article is not a reliable source of information on topics with which we have some expertise; however, we assume that other news articles are reliable sources of information on topics with which we are relatively unfamiliar. What we should do instead is to treat every media report with the same skepticism that we treat accounts of events about which we have first hand knowledge or experience.

Monday, April 15, 2013

Uh-oh, I'm still annoyed by something I read on the Internet...

As I posted on Friday, I found myself irritated by a brief, and not particularly well stated, essay on The Edge website. The author, a research psychologist, wrote that:

Although many psychologists working as clinicians and therapists do indeed analyze individuals, trying carefully to understand their problems, many work as scientists trying to understand how the mind works just as a chemist tries to understand how chemical bonds work.

[When strangers ask him,] "Are you analyzing me?" [this] implies that I, as a psychologist, could indeed analyze you.

It seems to me that he is saying that clinicians analyze individuals, and psychologists cannot analyze individuals. So any clinician who claims to be able to analyze an individual is somehow deluded or ignorant, as well as not really being a psychologist (and certainly not a "scientist"). Further, Dr. Epley's post, taken in its entirety, seems to suggest that attempting to understand an individual human being is not an appropriate scientific enterprise.
Korchin (1976, pp. 144-156) had something to say about people-reading ("analyzing" people):
Whether as psychologists or laymen each of us each day engages in informal assessments....Our judgments of others even in brief encounters are remarkably full and accurate. Often however, they are incomplete, distorted, and inaccurate....We all know people who seem to have an uncanny understanding of the feelings and motives of others, who are in the German word "Menschenkenner," "people knowers." There are others incapable of understanding people, who are grossly insensitive to our needs and feelings.

Much has been said about the hazards of people practicing psychology who do not have adequate scientific training, who do not consistently demonstrate the habits of mind associated with the scientist. However, not enough is said about the converse hazard: research psychologists who know about scientific methods but who lack understanding about people, who lack what James Bugenthal (1987) called, "the normal sensitivity that all of us have in relating to others, but...carried to a greater than normal acuity" (p. 11).

Sunday, April 14, 2013

Spoon River Anthology -- Edgar Lee Masters

Nellie Clark

And before I grew up and knew what it meant
I had no words for it, except
That I was frightened and told my Mother;
And that my Father got a pistol
And would have killed Charlie, who was a big boy,
Fifteen years old, except for his Mother.
Nevertheless the story clung to me.
But the man who married me, a widower of thirty-five,
Was a newcomer and never heard it
Till two years after we were married.
Then he considered himself cheated,
And the village agreed that I was not really a virgin.
Well, he deserted me, and I died
The following winter.


I suspect that Edgar Lee Masters' Spoon River Anthology doesn't get the respect it deserves today because no English professor is needed to fully appreciate the work. Not all poetry has to be "analyzed."

The concept is terrific: The setting is a hillside graveyard in a small town. The 243 brief (none longer than 45 lines) poems in the work are the voices of the dead buried there. Each poem is titled with the dead person's name. Some poems are poignant, some angry, some inspiring. The scope of human experience depicted is remarkable.

From the forward to the edition I own:

Here we find all manner of humankind, the hopeful and the morose, the enchanted and the disillusioned, the victims and the victimizers. Here we find poets, priests, and prostitutes all lying side by side on the hill....Each of the characters has a message to deliver -- a secret thing to reveal -- but if there is one message that governs all the others it is that death levels all of humanity: the one true democracy is that of the village graveyard.

The purpose of this blog is to direct aspiring clinical psychologists to reading that will further their training and education. Having a broad experience of people from all backgrounds is essential to becoming a good clinical psychologist. Until you gain that experience yourself, literature can be your guide.

If you care to sample the Anthology, some clever fellow has put the entire thing online.

Saturday, April 13, 2013

So why did you become a clinical psychologist?


I wonder for how many of us it is because our favorite character on MASH was Dr. Sidney Freedman? And because when we were about 10 years old the "Billfold Syndrome" episode  completely blew our minds.

From the blog authored by of the original screenwriters:

"Here’s the premise: A young medic arrives at the 4077th with amnesia. Psychiatrist Dr. Sidney Freedman is summoned, who (along with Hawkeye and B.J.’s help) hypnotize the young soldier to bring him back to the exact time and place he lost his memory. They recreate the battle complete with sounds and role playing. It’s maybe the most dramatic scene we’ve even written. I won’t spoil the ending should you not have seen it yet." 

I am glad that he doesn't reveal the ending. Let's just say that the patient has a really good reason for becoming amnestic.

I'm also glad that the guy who wrote the script thinks that it represents some of his best, most dramatic work, and that it was based on actual psychiatrists' experiences during the Korean War. It would be a bit embarrassing if the screenwriter had said, "Oh, that piece of schlock? We threw that together one afternoon because the network said we owed them another episode for the season. Really awful stuff."

Friday, April 12, 2013


I don't think that the response of Nicholas Epley, Professor of Behavioral Science, University of Chicago, Booth School of Business to this Edge Symposium question was intended to irritate me, but it does.

Dr. Epley's response follows (with original typos), with my comments:

I am willing to bet that every psychologist, no matter what aspect of the human mind he or she studies, has experienced something like the following more than once. You meet a stranger, mention that you work as a psychologist, and then the strangers asks, "Are you analyzing me?"
In my experience, the exchange usually goes more like this: You meet a stranger, converse amiably, he or she finds out that you are a psychologist, and then they begin to tell you about their personal problems or about the problems of family members with mental illness. No one has asked me if I was analyzing them -- they simply assume that I am. So usually what I hear instead is, "Don't analyze, or rather over-analyze, what I'm about to say, because I'm aware that it probably sounds half nuts." It's an entreaty, not a question.
I dread this question because it reflects both a superficial misunderstanding of what many psychologists do for a living, but it also highlights a deeper limitation in psychological science. The superficial misunderstanding comes from the long shadow that Sigmund Freud still casts on our field. Although many psychologists working as clinicians and therapists do indeed analyze individuals, trying carefully to understand their problems, many work as scientists trying to understand how the mind works just as a chemist tries to understand how chemical bonds work. I, and every other psychologist you'll see on the Edge site, is of the latter type.
Not sure why he divides "clinicians" and "therapists"; he might be making a distinction between psychologists who treat patients with serious mental illness (e.g., PTSD, Major Depressive Disorder, OCD) and those who treat the "worried well" (i.e., people without a diagnosable mental disorder). Like many academic/research psychologists, he seems to have a partial understanding of Freud's work and influence. Freud did indeed pioneer new methods for treating mental disorders but he also engaged in a the same type of work that Dr. Epley does -- "trying to understand how the mind works". Epley seems to be drawing a (false) distinction between "clinicians" on the one hand, and "scientists" on the other. At the doctoral level of clinical psychology, all clinicians are scientists. However, it is not also true that all scientists are clinicians.
This misconception is easy to fix, and the great popular writing of many authors from this very site is shortening Freud's shadow. But I dread this question more because of the deeper issue it raises. "Are you analyzing me?" implies that I, as a psychologist, could indeed analyze you. The problem is that psychological science has, and always will be, a group-based enterprise. We randomly assign volunteers in our experiments to one condition or another and then analyze the average differences between our conditions relative to the variability within those conditions. We do not analyze individuals in our experiments, nor we do know why some people within a given condition in an experiment behavior differently than others. Our understanding of our own research participants is relatively course. [I believe he meant "coarse."]
Now I am frankly quite lost here. Not all psychological science involves random assignment or even experimentation. To insist that this is the definition of science is to exclude biology and chemistry and geology etc. from "science." It also appears ignorant of the single case series approach to the scientific understanding of human beings. I do agree with Dr. Epley that experimental psychologists usually do not do enough to account for individual differences among research participants, preferring instead to treat trait-based variations as measurement error. The great experimental psychologist Hans Eysenck did more than anymore to attempt to integrate the two great traditions in psychology: the experimental tradition (Wundt, Ebbinghaus) and the individual differences tradition (Galton, Spearman, Cattell).

All sciences work this way. In medicine, for instance, doctors prescribe drugs because the average outcome of those in the treatment group of a drug trial were better than the outcome of those in the placebo group. Not everyone in the treatment group improved and some improved more than others, but enough got better that doctors think it's likely that you'll get better if you take this drug as well. But as a psychologist, I often field questions that call on me to offer more individualized answers than our science can warrant. I'm asked to give precise advice and recommend exact solutions when what we can offer is general advice and broad solutions that may or may not apply exactly to your particular problem. I dread having to explain all of this to people. In fact, I dreaded trying to explain it in this little essay.
I am not sure what Dr. Epley thinks it is that clinicians do. If he thinks that they spend their days giving "precise advice" and recommending "exact solutions," I would recommend that he try a course of psychotherapy to see just how wrong he is. The idea that clinicians "give advice" is a popular misconception in itself, and one that would be corrected with the merest exposure to actual clinical work (or by reading Freud's case studies, by the way -- off the top of my head, I can't recall a single instance of Freud engaging in "advice giving").

So if you should happen to sit next to me on a train or a plane, I'll happily start up a conversation with you and explain that I'm a psychologist. Just rest assured that I am not, in fact, analyzing you.
This little essay disturbs me because it seems to reflect a common attitude among research psychologists: I am interested in neural networks, or cognitions, or memory functions, but I am steadfastly not interested in individual human beings. If by "analyzing" another person, Dr. Epley means "using careful observation to attempt to develop a theory of who this individual is, how is he similiar to and different from other people, and what he might do in the future," it is absurd to suggest that it is impossible to do so. Dr. Epley might not be very good at it, but most of us (I mean human beings, not clinicians) are quite good at making appraisals of other people. We come from a long line of expert people-readers. If you are sitting next to someone on a plane and you are NOT analyzing them, then you are displaying a troubling disinterest in your fellow human beings.

Now, Dr. Epley might avoid analyzing others not out of disinterest, but because he realizes, as I mentioned, that he is not very good at it and therefore the exercise is pointless for him. Clinicians are better than most people at "analyzing" others because 1) we engage in the practice regularly; 2) we have the opportunity to check the accuracy of our initial assessments, which can improve performance; 3) we have much larger personal databases of people from which to compare others to (our interpersonal relations are not limited to fellow academics but include people from incredibly varied backgrounds and circumstances; and, 4) we possess the scientific skills necessary to challenge the cognitive distortions common to such assessments. But even clinicians vary in their ability to arrive at an accurate understanding of another person (i.e., "analyze" them).

To end this post, I've been trying to think about a question about my field that I dread being asked. When I think of one, I will let you know.