Posted in science, Therapy, Voices

Where Research In Re-Framing Our Thoughts Could Take Us

We get consistent word from our therapists that if we re-frame our thoughts, we can change the way we think, the way we perceive things, and that will ultimately help us cope with life. This is often done with Cognitive Behavioral Therapy, which is a very proven (as in scientifically) therapeutic method.

There are people who praise this method for saving their lives and others who don’t, and CBT takes a lot of work–a hell of a lot of work. You won’t see results if you don’t take it seriously, and if you’re anything like me, it’s hard to take it seriously when you’re heavily depressed or so anxious you want to jump from your skin. Let me give some background on why this topic is so interesting today.

Amidst all the anxiety this morning, I spiraled down with thoughts of failure, pain of where I am in my life right now versus where I could be, and felt out of place in the classroom; other students whispered about me, and thought very loudly about me. I lost focus in the lecture and I felt bad about that.

The professor popped a meme up on the screen of some woman with a stack of papers at work scribbling maddeningly and saying “this is a two-cupcake Friday”.

I don’t remember what this portion of lecture was about, or if the meme was even relevant, but through all my cloudy thoughts and thoughts of the students around me, one of my voices said calmly “you’re having a bad day.”

And I was. But the significance of this is far greater than just that realization.

Another thing therapy shoves down our throat is that our problems which feel permanent and hopeless are often temporary and malleable. In the moment, I felt miserable. I thought I was falling into another depression, that I’d spent the last year and a half off meds and this day, today, was going to be the day I decided to go back on them because I just couldn’t take the pain anymore.

It’s been a hard three weeks, and to ignore all of those factors and conclude “it’s just my brain making me mental again” would be foolish. I’ve been stressed, and today has been particularly difficult: I had a bad day. There’s nothing else to look at.

Multiple things came to mind as a result of this voice presenting his softer side. The first was–I tell myself the very same thing all the time. I’ll say to myself, “Ugh, today is a bad day.” And I’ll recognize it, but the reality doesn’t always sink in. And so I thought, as I sat through my second course more invigorated and positive, are we more likely to believe others about our true state of self, of being, than we are to believe ourselves?

Let’s look at this through two lenses:

The Theory Behind It All:

  1. Personality Research Shows that friends/family are more accurate in describing things we may be good at, like school/work. (Look up INFORMANT JUDGEMENTS and studies by Connolly (2010).)
  2. Research in this area also shows friends/family are better than us at predicting our personality traits like contentiousness and openness.
  3. Some personality researchers focus only on showing how much we DON’T know about ourselves (like WHY we think the way we do, or WHY we did something/feel something).
  4. Researcher Carol Dweck studied growth/fixed mindset and the influence on intelligence. In her study, children were influenced with praise on their intelligence versus praise on their effort. The study didn’t have anything to do with the effect of the words, but the outcome. Still, the words had a great effect on the thoughts of the children.

The Questions That Now Arise:

1.We are our largest critics, so they say. Why does it seem we doubt the POSITIVE things we tell ourselves, but are convinced of the NEGATIVE things about ourselves?

2. Can we use this possibility to our advantage?

3. For those of us who hear voices, can we train our voices to re-frame their approach, or do they naturally mature as emotional stability improves and coping mechanisms enhance state of living/being?

4. What makes us more likely to believe NEGATIVE things about ourselves versus POSITIVE things?

5. What makes us put more weight on OTHERS words versus our own?

6. How could research in this area of behavior and cognition help further treatment and therapies for psychosis?

These are passing thoughts I had during my second and last lecture. I wondered about it because I had been soothing myself all morning, giving myself reminders that my anxiety is bad, I’m not having a heart attack, that I’m just having a bad day. The moment my voice reiterated that, relief washed over my body. Suddenly, my heart rate slowed and I could focus in class. My head wasn’t as clouded and I went to my second lecture in a great mood–partly because I was fascinated at the effect he had on me.

And so the wonder continues: there is no argument that when a voice tells you you’re worthless, or stupid, or that you’re going to die, you feel immediate dread, sadness, anger. Therefore, were one to tell you something positive, it seems reasonable the same intensity, but positive (happiness, comfort, contentment) has the potential to flow through you. The problem is there isn’t a lot of research in helping people unite with their voices, nor with themselves, regardless of whether they hear voices or not.

When I attended a Hearing Voices Workshop in San Francisco, the man in the couple leading the discussion heard voices and had just been diagnosed with dementia. They’d been spending time training his voices to remember things for him. According to his self-report, and his wife’s informant judgement, it had been working.

This would be regarded as a case study and we can’t put a lot of weight on those scientifically. But it can be a catalyst for real research and potentially a new therapeutic avenue for soothing psychosis.

It seems that we need affirmation when it comes to positive things about ourselves. It seems we need someone to agree with us, or remind us, that yes, we are safe. Yes, we are okay. Yes, this too shall pass. Yes, you are strong, yes you are this, yes you are that. It’s as if we have the inability to create that foundation for ourselves and truly believe it.

But when it comes to the negative things, our failures or short comings, we take them at face value. We don’t need someone telling us “yeah dude, you failed”, for us to think of ourselves as a failure. In fact, someone affirming our negative beliefs about ourselves seems to make it more likely we’ll believe that in the future, whereas someone affirming our positive traits/beliefs doesn’t.

What could this mean? How could we study it?

Many of us may internalize what trauma we’ve experienced as children or adults and so the automatic sense of “everything is horrible” may influence our natural thought. But even among memories of trauma and experiences of trauma, we had moments of great fun. I grew up with my dad being violent and using drugs, terrorizing my house. But I have equally intense, positive memories of being out in the garden with him, planting tomatoes and helping him work on his cars.

Why is it that the negative becomes the basis of my emotional foundation? And can we use what we know (and can still learn ) about this very automatic bias to creative equally positive, habitual thoughts?

I suppose it’s worth mentioning that since one of my False Angels reminded me I’m “just having a bad day”, I haven’t heard anyone else talking, my anxiety is at a steady, manageable level, and I’m more motivated than ever to finish this degree and research.

And to think: I’ve ignored them for SO long.

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Posted in advocacy, science, Supporting Friends/Family, Voices

Hearing Voices: Internal versus External

Something people who don’t hear voices misunderstand about hearing voices is that it’s not like sitting next to a party of five in a restaurant where you can generally tune out all the giggles and unrelated conversation and focus on the person in front of you. It’s more like that party of five arranged their chairs around you and take turns commenting on your posture, your date’s violent sexual thoughts, your wants you didn’t know you had, while also occasionally blurting a sentence that doesn’t make any sense, like “put that burrito on reservation.”

My point here is that ignoring it isn’t always the easiest or most necessary option. And to understand why this is a fact, we need to understand a little more about this.

Some people are really obvious about their inner experiences. They’ll be talking out loud or gesturing to no one. They might be laughing or crying or whispering. This is what scares people, both people, and what can make getting acquainted with our voices such a daunting experience; we’re aware (some of us) how we appear and that judgement is enough to warrant withdrawal. This tends to make things worse.

But let’s be clear: screaming at yourself at 3am probably isn’t the best way for your roommates to get to know you, nor is it a good way to get to know your voices.

It’s kind of a novel idea, to promote the “getting to know” process of things that don’t exist. But they do exist; they speak, they can have names, we can even have images to describe their non-existent physical features. They may not exist for your little brother or your mom or dad, but they exist for you and that’s still valid.

Psychiatrists and therapists aren’t trained in helping you with this process because school will tell them not to entertain delusions and to teach their clients how to cope with voices by ignoring them. This may be helpful for the clinician so they have a reason not to feel guilty when their client doesn’t remarkably improve, but it’s not always helpful for the client.

Ignoring needs to happen sometimes. But as a primary coping mechanism it sucks.

And so there’s something called “dialoging”, which I didn’t know about until attending a hearing voices workshop put on by the Hearing Voices Network. This is essentially someone on the outside speaking with your voices, getting to know them, their motives, their personality, and validating their existence. It’s for the voice hearer as well, so they can participate in a conversation instead of a shouting match. Because, again, what happens when you shout at someone? They shout back.

It’s also a common misconception, especially in clinical practice, that everyone who hears voices hears them externally.

I read a report of an experiment which examined this. They say that external voices have always been thought to represent more “severe” psychopathology, and to be more common, but that “empirical evidence has been equivocal”, meaning ambivalent. You can read for yourself at this link.

To summarize their study:

  • Some people experience only internal (coming from inside the head) voices
  • Some people experience only external( perceived as outside the head) voices .
  • Some people experience both.
  • In 1996 it was thought external voices were more severe. This project suggests, from observations, that internal ones can be more “disturbing, negative, persistent, involving, and commanding”.
  • Voices commenting and conversing observed (reported as) more internal.
  • “…no differences have been identified between internal vs. external hallucinators in other symptoms or levels of overall psychopathology.”
  • Another study, (cited Stephane et. al 2010) “found that schizophrenia patients with only internal hallucinations performed more poorly than those with only external hallucinations on an internal ‘say/think’ source memory task, suggesting that internal hallucinators may be less able to discriminate between internal versus externalized stimuli…”
  • Those with internal voices were observed to have more insight into the self-generated nature of their voices.

Why is any of this important? Well, it’s important for clinicians to read these kinds of findings and realize that experiences vary, and that one-shot generalized treatment WILL NOT work.

But it’s also important for those of us who do hear internal voices. First of all, it’s validation. Maybe you’ve been disregarded in the mental health system because your experience is perceived as “lesser”. Remember when we talked about the Soggy Boxes and the hierarchy of the mental health system? If you don’t, take a quick read at an older post of mine entitled The Soggy Boxes and The Variation of Us.

I’ve personally been reluctant to ever tell anyone about the internal half of me, because I knew the standard the system held. I also didn’t know they were voices. I did, but I didn’t.

So all this really does is remind us how different and similar we can be with each other. It also proves that the stale mental health system needs to readjust its understanding of life, of humanity, and experience in order to catch up with where we are. They’re behind US. It’s not the other way around.

If you are struggling with this currently, I’d encourage you to reach out to someone you can trust. If you trust no one, find the person you can trust the most. If you know someone who has been through similar things, reaching out to them may be the most helpful. If your options are limited, feel free to email me (info here). People seem to like connecting on Instagram better lately, so you can also reach me via my social media handles (info below).

People are fearful because they don’t understand. The nice thing is that there are many people who will make an effort to understand if you can have the patience to teach.

If you are a voice hearer and are comfortable with sharing your experience, pop it down in the comments below. If it’s a long story and you’d like a guest blog post spot, contact me! I’d love to feature your story on here.

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Posted in advocacy, Peer Support, Supporting Friends/Family

What Makes Us So Divided?

In yesterday’s post, I mentioned that there is a divide in perspectives about mental health in our little neuro-diverse community, and this can effect how we advocate and what we educate ourselves about.

Currently, there are two major extremes, and I think each has existed since the dawn of mental health “treatment”, since we started categorizing behavior and attempting to quantify it. This divide became more noticeable after the cure-all lobotomies were deemed medically unfit, opiates for anxiety and psychosis became too addicting, and the development of Thorazine (I.e the chemical lobotomy) hit the shelves. Patients were more controllable, malleable, and more people were able to leave Asylums and enter society.

The problem with Thorazine and E.C.T, the next best treatment for depression and psychosis, was the damage they caused. No one really knew how medication worked, other than later observing a few chemicals in some people, a few others in other people, and never being able to come to a solid conclusion. We still don’t have one. E.C.T fried some people, disintegrated their personality, shredded their memory, but some were content with this because they weren’t really able to have any other feelings about it.

Drugs made money. Did I forget to mention that? A lot of it.

And eventually groups of people who felt outpatient treatments like medication, and inpatient treatments like E.C.T and solitary confinement, were inhumane, united and developed into the Anti-Psychiatry group.

Now, as time has passed, we have made mental health treatment look very pretty. Hospitals are (mostly) clean, medication is monitored more closely, and drugs like Thorazine are not as widely used in the continental U.S. I can’t speak for Europe or Canada or South America. I know Africa doesn’t have much of a choice but to use the older drugs like Haldol and Thorazine because they don’t ever get monetary assistance with anything. People are still chained to poles in the middle of psychosis in some parts of Africa.

But just because something looks pretty here in the U.S doesn’t mean it’s better. E.C.T is still popular. People say it saves their lives and maybe it does. But to send pulses of electricity through someone’s brain without fully and scientifically understanding the consequences (I.e why does it cause memory loss? Why does it effect some people’s personality?), and without fully and scientifically understanding how the depression is relieved (is it because the brain is being damaged or because their personality is so fried they could care less to be depressed?) is probably one of the least ethical ways to go about treating other humans.

The APA specifies that benefits must outweigh the risks for treatments like this to continue. I’m not convinced they do.

The same goes for medication: it’s researched (barely), results end up skewed (publication bias) and no one actually knows the long term effects for the “updated” ones.

So I understand the mistrust, the disdain, and the need for something better, something that feels compassionate and reasonable and ethical. That’s the driving force of most anti-psychiatry believers. I know because when I read Brain Disabling Treatments in Psychiatry by Peter Breggin M.D at 14, I started reading research (I had friends in college with access to databases) and was appalled. I declared myself anti-psychiatry.

The other extreme side is the medical model. Most people who believe in this model also believe that having the drugs is better than having their lives in shambles because of psychosis or mania or depression or whatever. The risks, for them, DO outweigh the benefits. Many believe that their doctors do the best they can.

They also tend to believe that our experiences are the result of chemical imbalances. They agree that these experiences are brain diseases.

Now, I have no issue with either view. Do I tend to lean toward hypothesizing our experiences are more so a variation of the human mind over hypothesizing chemicals (that have no stable baseline to be compared to) and brain deterioration causes “mental disorders”? Yes, I do. But since neither have been proven absolutely wrong, I can’t say I believe one over the other.

The issue with this division is that it impacts what and how we advocate.

When we should be advocating for whole person care and individualized approaches, we waste time convincing the world that we’re “sick” and therefore need compassion (but not too much because we don’t need pity). We don’t want people seeing our “illness” as us, but flaunt the diagnostic label and call ourselves “just the same as everyone else, but different.” When we should be empowering each other, when we should be guiding each other on how to adapt to our experiences, we waste time hating the medical model and spouting all the reasons it’s wrong.

We’re just going in circles. It’s asinine.

I don’t think we all need to ascribe to each other’s beliefs. That’s one reason why I encourage everyone to read research; when done correctly and ethically, science will tell you facts and you can dispute them, but that doesn’t change them. We can disagree on everything else. But not facts.

Now, it’s another thing when the science is wonky.

But in terms of advocacy, being on the same page is pertinent. Otherwise, we’re only impeding each other’s progress; I’ve been witness to consumers putting other consumers down because they don’t believe in diagnosis, or they do believe in diagnosis. Suddenly wanting off medication and believing that you can live a life off medication is a cardinal mental health sin. Suddenly gaining benefit from medication and feeling more comfortable on it is a cardinal mental health sin.

We need to remember that we’re all on the same side. But we also need to pay attention to facts. When we advocate, it’s not about diagnosis. It’s not about being different. It’s not about how corrupt the pharmaceutical industry is. It’s not about how psychiatrists are over-medicating and over-diagnosing. It’s not about the lack of available facilities, or sub-par care. It’s not even about our own experiences. Let me say why.

A lot of these are issues we want to address are serious issues. But they will be addressed naturally if what we present are coherent arguments and factual knowledge, all with compassionate nudging. If we prove that we are a strong, united forced, if we prove that we have insight to what we need for our mental health improvement, we can work alongside healthcare instead of against it or in spite of it. We can do things besides push medication on each other. We can do things besides convince each other medication is poison.

We can recreate the whole mental health system. And I’m sure we can all agree it needs a serious make-over.

And so I say, when you post on your site, on your social media, or when you’re giving talks, keep this in mind. Keep in mind that it’s not just about your diagnosis or labels in general. It’s about all of us. It’s about integrating into the system and becoming a part of it. If you want things to change, if you want to really be heard, if you want compassionate care for us all, that is the way to do it.

#MentalHealthAwarenessWeek just isn’t going to cut it.

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Posted in Peer Support, psychology, science, Therapy

How To Read A Psychological Research Paper

One thing I notice a lot of advocacy websites falling victim to is citing research without really understanding what that research means. A lot of the time they’re pulling from secondary, third, fourth, or fifth resources because the information they get comes from news reports that are also reporting information from secondary, third, fourth, or fifth resources. A secondary resource, for example, would be a textbook or another article describing the research findings.

The issue with this is very rarely do these articles go into detail about the research procedure, the methods, or any resulting confounding variables. The issue with THAT is the only information YOU receive are the results. And when the results say something like “Eating a Grapefruit Everyday Will Cure Your Anxiety”, you want to believe it. What you’re missing is that the study had 20 subjects, no control variable, and the subjects–by the way–were worms.

I’ll cover some basic ways to judge whether or not a paper you read–and you should be reading the actual paper–is a valid result or something that needs a lot more investigation.

First, if you haven’t yet read any of the series Is Psychology A Science posted here on this website, you can find the first in the 4-article series right here at this link. It will give you background information on why this is important from a scientific perspective.

Contrary to what you may believe, you don’t need to be a seasoned researcher to read these papers. You don’t need to know how to do an ANOVA test or a Chi Squared test. You don’t need to know what p <.05 really means. You don’t even need to know a lot on the subject the paper reports on. All you need is some basic knowledge. Let’s go step by step.

What does a paper consist of?

What’s great about research papers is that you always know what to expect. There will be the first paragraph, which is called an Abstract that tells you what the paper is about and often contains one sentence describing the results.

Often a full-length introduction is followed. This is important when the study is backed by, or has a lot of reference for, other experiments. Here you will find the importance of the subject and what other researchers have found and how this study will differ.

Next commonly comes Methods. This is where all the materials are listed and the procedure (including participants) are described. This is done in great detail so that peer review and (if/when published) practitioners and psychologists and everyone who SHOULD be reading the study, can determine validity. Here, you will learn the ins and outs of the experiment and/or the outside resources used to gather data.

The Results follow. Here you find the final statistics. You will find step-by-step results for how each participant (or group of participants) and sometimes you will see charts, graphs, info-graphics of all types that represent the data.

Discussion comes last. Here you find what those results mean and any recommendations for further research. This is where you will find confounding variables (discussed below) and another place to scrutinize the validity of the study.

Afterward comes acknowledgements, often who financially supported the research. This can be particularly important when reading studies about medication; if the pharmaceutical company that makes Risperdal (Johnson & Johnson) is providing funding for Risperdal research, the paper is subject to publication bias. This can be harder to detect and won’t be discussed here. I will be writing a separate post on this.

Then the reference list, which are other studies cited in the paper.

This layout is important. If the paper you’re reading isn’t like this, it’s not a research paper and what you’re reading is a secondary source, meaning a summation of the original research. This could be so far from the actual research finding, that it’s completely useless.

Is this studying what the researchers meant to study?

When reading a paper, it’s important to sniff out whether what’s been observed is what was actually meant to be observed.

This is known as construct validity. Research in psychology can be tricky because most of the time you’re observing behavior and behavior can be caused by many factors. For example, if we’re trying to study whether or not television violence influences real violence in young children, we need to define what violence is and what constitutes aggressive behavior. If we don’t, trying to find a relationship between behavior and the amount of violent television being watched will be hopeless; you won’t see any relationship, you’ll just see aggressiveness and violent television as separate entities. They may look correlated, but when properly studied you may see different results.

If a paper related to television violence and children do not have operational definitions (the definitions of the behavior we’re looking for), than it’s safe to say that paper isn’t really showing much.

A lot of the time this gets twisted in the media. For example, you’ll read statistics everywhere that those labeled with schizophrenia have a shorter life span of about ten years. A lot of people take that as “schizophrenia kills”. But is that really what reports and studies are saying?

No. There are other factors: taking hardcore, organ-destroying medication for decades is one of them. Less access to proper healthcare–many with the label are homeless and struggling with drugs or just at the mercy of their mind. Disability money doesn’t necessarily fund a heart healthy, body healthy diet either; most organic foods and healthy foods are hard to sustain for those on limited income and no support. Suicide rates are also higher. So this idea that some mythical chemical imbalance causes some mythical disease that slowly kills the brain like some kind of hallucinogenic Alzheimer’s is incorrect. Or rather, it’s never been proven.

This leads us into:

What Are The Confounding Variables?

These are factors which could muck up research findings.

For example, a lot of the papers I referenced in Is Schizophrenia a Brain Disease? had their confounding factors clearly listed. They said blatantly that much of their research has no definitive results. One paper even urged people not to take their results as proof that a chemical imbalance explains what people experience. So where does this idea that this label is a disease come from?

From people taking the one line of results and posting it in the New York Times or a CNN reporter giving a brief run-down of the study on national television. Belief is where this idea comes from. Science says otherwise.

I think one of the most famous incidents of this is the idea of the schizophrenogenic mother.

There was a time doctors and patients believed it was the mother’s bad parenting that created the experiences now labeled as schizophrenia. To test this, one researcher took a group of mothers who had children who matched the diagnosis and studied how they interacted.

She concluded a mother’s behavior can create ‘schizophrenic behavior’. Then she listed that in order to be an official and valid study, she would have to also study mothers who don’t have labeled children and their interactions; her confounding variable was no control group.

So what happened? The results were taken and spread to newspapers, to doctors, to psychologists and psychiatrists and for a while people really believed the mother was to blame for madness.

Because the general public, and even some doctors, didn’t understand how to read research papers. And also because it was an answer and they didn’t have any other answers. Rather than be scientific, they followed their intuition. It’s something that still plagues psychology today.

That’s why

Control Groups

Are super important.

Say you’re reading a paper on the medication Abilify and its relation to a reduction in psychotic symptoms at a dosage of 20mg. You read in the procedure section that thirty five people (an okay sample size) were recruited and given Abilify and you read in the Results section that 89% of the participants reported a reduction in symptoms within the four week time period. You also read in the discussion section that the researchers conclude Abilify has effectiveness at the dosage of 20mg on psychosis.

This sounds legitimate. And any average person who read that paper would probably feel that Abilify really does have an effectiveness on psychosis at 20mg.

What would be some problems with this, though?

One striking thing would be–where is the comparison? In order to see any level of effectiveness, we need to compare it to a group that doesn’t receive the treatment, a group that isn’t manipulated. This is a control group.

We’d also need to know how the participants were randomly chosen. We’d need to know the symptoms which were reduced and whether that was sustained. I’d criticize the four week trial period. Was there also a follow up? If so, what were the results? And, if you are like me and extra-critical, you’d wonder why they didn’t cite all the research in the introduction which says there is no efficacy for an Abilify dose over 10mg.

This can make certain things hard to study ethically and practically. There are many ways around that, but we won’t discuss all that here. If you are reading a paper and have trouble finding what they compared their manipulated variable to, or if their comparison group seems shoddy, search for some more research.

I’d like to point out had that research example I gave above actually been published, hell would have frozen over. There are some shoddy papers out there, but a lot are caught in peer review.

Last but not least:

Results are results. Interpretation is interpretation. Secondary sources are not results.

Media attempts to get things right. But often they don’t.

If you are on an advocacy site for mental health and you read a sentence that says “research shows”, and they don’t list a reference, ask for it. If they do list a reference, click on that reference. If that reference is another secondary source, and that secondary source doesn’t list a primary source, like the actual research paper, than you can’t be sure how accurate that “research shows” statistic is.

I’m not saying we should start mistrusting our fellow advocates. I’m saying as advocates the information we should put out must be backed by facts, not opinion or interpretation. Most of us who advocate are peers, meaning we have lived mental health experience. Great! We already have an advantage by having inside knowledge on experiences that most doctors don’t. Let’s boost that advantage with also having scientific knowledge and thinking critically.

Even I’m guilty of saying “research shows” in previous posts on my old blog and perhaps even this one already. It’s hard work finding these papers and reading them and citing them and analyzing them. But did anything come from soft work? No.

If you want to advocate, help empower us by criticizing research, reading research, and sharing research. Open a discussion about what’s being studied. Push clinical psychologists and psychiatrists to actually read what’s been coming out.

Together, we can change the perspective of mental health in society.

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Posted in psychology, science, Voices

Is Schizophrenia a Brain Disease?

This is hard to write.

I’m sitting here enraged. Confused. Fearful, even, of what I’m about to share.

I told myself I’d only start another blog if I had important things to say, and we’ve covered some very important topics, most recently pertinent information in the series Is Psychology A Science? where we concluded the subject’s only scientific attributes are being ignored and/or underutilized due to political and monetary factors such as an APA president calling randomized clinical trials “fundamentally insane”.

These last few weeks have been incredibly tough for me, hence my lack of posting–because trust me, I have plenty to say–and I’ve spent too much time this week in my head, not exercising, falling into old eating habits and connecting dots that shouldn’t be connected. There are enough thoughts in my mind right now to fill an Olympic pool and they’re not rushing like Olympic swimmers, but they are kind of clustered like when all the palm leaves from the tree near your pool cover the surface until you finally get your lazy ass off the couch to scoop them out.

Jokes aside, there were a few nights I considered voluntarily committing myself. Things have been broadcasted to me, twins are following me, Juice WRLD died not because of Percocet and whatever the fuck “lean” is (I know what it is but because it’s so stupid I just can’t comprehend it’s actual existence), but because of possession, a sign to me–then I remembered I have shitty, low tier health insurance and don’t want medication. So I’m somewhat functioning here in what I’m starting to feel is purgatory. Part of this is stress. My lack of tending to myself. The other part is the effects of Klonopin which does indeed act upon serotonin–I researched it–and had that psychiatrist I ranted about last time listened to my incessant pleas that drugs which so much as touch my serotonin really mess with me–anyway.

In studying for my final, my distracted mind wondered about randomized clinical trials and about psychosis. I wondered if the studies done on those experiencing psychosis for the first time, un-medicated, before the *possible* structural changes due to antipsychotic use, showed structural changes.

This is important. Why?

Well, a disease isn’t a disease unless there is definitive (i.e substantial, valid, reviewed and repeated) proof physical abnormalities are attributed to the alleged progression of the alleged disease.

And so I went onto my favorite place to find psychological research papers. And no, it’s not It’s not some person’s Instagram. It’s not The Mighty or anything related to any kind of advocacy because advocacy is very rarely based in research. It’s NCBI, otherwise known as the National Center for Biotechnology Information. I find myself most often in the PMC section because it’s free and I can use the paper references to find the full length articles in a database. There’s great neuroscience and clinical psychological research articles there, including the PubMed database.

So I’m sure we’ve all heard that “severe mental disorders” like Schizophrenia have notable brain abnormalities such as deformed (enlarged or constricted) ventricles, changes (reduction or increase ) in gray matter, or white matter, or certain neurotransmitters, or this, or that, up, or down, right, or left–and that’s about how accurate all the information you hear is.

Most of it is coming from secondary sources like a textbook or from what I like to call Triple-Source advocacy websites like HealthyPlace that continuously vomit basic and quite honestly uninformed opinions labeled as facts. And I’m not talking about personal stories. I’m talking about those faux information pages that blurt lists of symptoms that pretty much overlap with normal shit and make people worry that hearing their name called in a store means schizophrenia. Here, kind of like this page. Beautiful example of a well-structured, well-written, horribly basic-bitch attempt at explaining something we have no real understanding of.

That’s what I hate the most about advocacy pages I think. I love personal stories and empowerment. I hate the perpetuation of the idea that we really know what’s going on physically in our heads. We don’t. If someone tells you we do, they’re either in the middle of a delusion of grandeur or they’re lying.

And so my first topic to research revolved around first-episode psychosis because that psychosis is *mostly* untouched by heavy psychiatric medications. I researched under the assumption that psychiatric medications influence the structure of our brains and could very well be presenting the “structural abnormalities” which are being used as “evidence” of a “brain disease”. You will find studies that support this. You will find studies that don’t support this. And I found a study tonight, which you can read here, which concluded we don’t really have solid evidence for either hypothesis.

Next post we’ll talk about how to read these papers and determine whether a study has a proper operational definition (is the measurement procedure correct?) and construct validity (is the study measuring what it claims to be?) and how to spot confounding variables (which should be NOTED).

In 2017, a review paper entitled Structural brain changes at different stages of the illness: a selective review of longitudinal magnetic resonance imaging studies concluded there is “adequate evidence that schizophrenia is associated with progressive grey-matter abnormalities particularly during the initial stages of the illness”. These results were concluded after reviewing studies done on patients labeled as “pre-clinical stage” patients, first-episode psychosis patients, and patients labeled with “chronic schizophrenia”.

Even in the abstract, which you can get on the NCBI, they WARN AGAINST using these results as a way to EXPLAIN symptoms of patients. They even mention their confounding variable: antipsychotic medication and long-term treatment.

In 2011, a study entitled Lack of progression of brain abnormalities in first-episode psychosis: a longitudinal magnetic resonance imaging study concluded there were no ventricle abnormalities which could be contributing to symptoms, and that the gray matter abnormalities found have the potential to be easily reversed.

Because they did not list their confounding variables in an easy to find place, and it’s 10:30pm at night as I write this, I searched their references for a study which could either contradict or confirm their findings. I found this study, which you can download as a PDF from Google Scholar. IT concluded gray matter decreases were due to both the natural progression of the illness and use of antipsychotic medication.

They gathered 34 patients labeled with schizophrenia who had been taking medication for 0-16 weeks and compared them, over a year span, to a control group of “healthy” participants. 24 had never taken medication. Those who had taken medication had been taking them for 16 weeks or less. In their conclusion, they admit their findings are in agreement with some studies, but not others, perhaps due to rating differences, group differences, focus differences, and even mental state; some studies, they said, found that the patient’s mental state may have influenced the outcome of the brain volume measurements–those studies I’d like to read too.

I’ve spent the last three hours painstakingly reading variables, reading evidence for grey matter changes, against grey matter changes, for ventricle changes, against ventricle changes, longitudinal studies, short studies, childhood-onset schizophrenia studies, chronic schizophrenia studies, and studies which measured whether or not medication is destroying brain matter.

This was hard to write because I knew there was no definitive answer. And I wanted the answer to be an obvious, valid, no.

But the reality of science is that your wants don’t matter. The reality of science is you read the facts and you either accept them or you start a basic-bitch advocacy site.

What it seems, at this day and age, is that we’ve accepted a bunch of opinion and ignored the facts. My hypothesis? Even as we continue to study this, we will only conclude the same thing as the grief studies in Europe: individual variation is the only certain thing with schizophrenia.

Grief studies showed that some people recovered better by distracting themselves, and others by going into therapy. Both recovered at the same rate when allowed to choose what was best for them.

I purport we’ll find the same for psychosis. Some will do better with medication. Others will do better without medication. We’ll find that medication isn’t the only factor playing the game here, especially if mindset has any influence on brain measurement.

So, is Schizophrenia a disease? As of right now?

There’s no solid evidence pointing in either direction.

What does that mean?

Well, for me it means I need to keep doing what I’m doing, caring for myself in the way that’s been working. Because there’s no study which has proved that won’t help me recover.

For the general public, it probably means ignore all the evidence and keep fighting for mental health to be treated like physical health, as if it isn’t already: in the doctor’s door, out the doctor’s door, five minutes tops.

Posted in science, Therapy

Exposure Therapy May Drown You

My absence is attributed, this time, to preparation for a presentation that I did for my research course. We had great fun: saturated the Google Slides with relevent, cheesy memes, and presented our failed experiment data and had a great laugh about it all. I’m quite satisfied.

Finals week is next week, and all of this stress has had me tossing and turning in my sleep (partly because of my still injured back too) and has had me waking in the morning shaking, sweaty, and on edge. The other night I got minimal sleep because I went to bed angry, woke up a few hours later to a quite the slew of annoying voices, broadcasting really, and I could not sleep without some earbuds playing loud, chaotic rap music. I did not sleep soundly.

But it’s got me thinking about exposure therapy for some reason. I’ve been more talkative than usual, and although shaky the morning of my presentation and not quite as coherent as I wished to be, I was able to start out the presentation, get through my portion of the work, and relate my own experience with psychosis to our study on non-verbal cues and the effects it can have on interaction. The professor was surprised, I could see, and very rarely does anything from his students shock him, so that made me giggle internally.

If you remember me from the Mental Truths blog, you’ll have read tons of rants years old about my past battles with anxiety. So I’m not going to regurgitate everything here. Just know it’s been bad since I was about 5 years old. And every therapist I’ve been to has told me “Face your fears”. That’s the only way to rid the social anxiety–show yourself that you can do it. Prove your brain wrong.

It make sense.

Except that it doesn’t. And let me explain why.

Expose therapy, as a technique, has been proven not so much for specific phobias, but for PTSD. And when I say PTSD, I don’t mean emotional traumas. I mean physical traumas like a car crash you survived or a plane crash. It’s been speculated that it can work in other areas, but there’s no definite research with viable, proper experiments.

Remember, experiments can make claims to findings without being legitimate; it all depends on the method they used. An improper method can invalidate the entire study.

And so I’ve tried exposing myself to social situations in the past. Integrating into groups. Being nice to kids in class. And no matter what I did it seemed I always failed. I’d talk to someone or a group and still end up as the outcast. I concluded exposure therapy is a lie.

This time though, things are different. I’m doing the same things I did back then: taking risks, embracing the risks, following through with them, refusing to let the anxiety dictate whether I do something or not. So what’s the difference this time?


If you struggle with social anxiety and have been to a therapist who constantly tells you that the only way to conquer your anxiety is to face your fears, he/she is not entirely wrong. What he/she is wrong about it is pushing you into it.

If you attempt to face your fears with low self-esteem, showing yourself that you can engage successfully with people will look like a failure regardless. If anything, your therapist should be helping prepare your self-esteem. They should be encouraging you toward readiness, not tossing you in the pool without any floaters.

What helped made me get ready had a small fraction to do with the people around me. Some of it was support from friends. Some of it was a particular conversation with my therapist that, without intending to, made me realize I need to give myself permission to speak. So far, I’d been the only one holding myself back. I’d internalized this idea that I was only allowed to speak when spoken to, and that when I did speak it didn’t matter. People could tell me the opposite all they want; if I don’t believe it, them shoving it down my throat won’t make me believe it.

And so I told myself one day: you are allowed to speak.

And I continued to do so.

Over the course of a few months, reminding myself of this, engaging positively with classmates, roping them into my craziness with humor, leading my team toward good ideas, has shown me that I can communicate effectively. Speaking in front of others reminds me that I struggle with coherency sometimes–

Okay, I’ll finish that sentence in a second. I just saw these twin men who I saw the other day who had made direct eye contact with me and that was the night something was broadcasted to me and the fact that they’re walking into the library I’m in right now tripped me out for a second.


Okay, back to the important stuff.

Speaking in front of others shows me that I still need to work on coherency, and being able to say what I want to say. I always thought Anxiety was the culprit. I always thought it made my mind blank, and it does, but not to the extent I believed it did. Once I stopped believing it was ruining my life, once I worked on my confidence and depression, the effect it’s had has been infinitesimally smaller than it used to be.

In the past, I took my incoherent speaking as a sign I would never improve. Because that was my mindset. Improvement was impossible.

Now that improvement has become possible, the coherency issue hasn’t disappeared but it’s become an obstacle instead of a brick barrier.

What is the point of this post? Well, I want us to do some critical thinking here.

It is true that some people learn to swim by being launched into the deep end of the pool.

It is also true that some people learn by not being launched into the deep end of the pool, but first by gaining confidence to step into the water.

Mindset effects our ability to take advantage of therapeutic techniques which have potential to assist us: that is my hypothesis. As a rough example, were I to test this, I’d do so with those controlled by severe social anxiety as I was. That would be screened with a questionnaire. Those chosen would report their levels of anxiety so we can get a baseline. One group would be given regular, well-defined exposure therapy depending on their greatest social fear. One group would focus on their mindset, specifically their confidence in all aspects of their life with CBT. The third group would be given no technique or put on a waiting list (I know, soooo cruel). This would have to be double blind obviously, considering my intense bias.

At the end of the study, which I would hope I’d have enough resources/money to run this for months, not a puny amount of weeks, I’d ask for a self-report of anxiety but also for them to return to that social situation that makes them the most anxious and rate their anxiety during that time as well.

Would the results be significant? Who knows. I can’t base a generalization to people on how this has helped me. Just as the European study which found people handle grief differently, and that for some “getting back to life” is actually more helpful for them than therapy and being forced into the “five stages of grief”, I would expect to find severe individual variation.

The study I read about non-verbal cues (related to the experiment we did for my course) and their relation to schizophrenia, how patients labeled with such are often influenced by their psychiatrists’ non-verbal cues, is something else I’d like to study. That is, if the psychiatrist is smiling, sitting straight, not monotonous in their tone, their “patients” tend to show a decrease in their symptoms and better satisfaction with their care. I had to find this study from a European research group because there is very little information like this from U.S researchers. That I am capable of finding.

There are so many more things to study in psychology in regards to mental health than pills and there is so much more to mental health awareness than vomiting stale definitions of disorders as “information”.

It’s technique here that makes a difference. That’s another hypothesis I’d like to study. Pit pills and well-researched techniques together and see which comes out on top.

They say that medication and therapy are most successful together. I haven’t read the research on all this yet, but I will. I think there are some things which technique could be better for than medication. This has been shown a few times I believe. But I think it can include certain cases of psychosis.

Post acute episode, of course.

Cognitive Behavior Therapy isn’t going to convince you mid-episode that your neighbor isn’t part of the F.B.I.

Or can it?

Let’s research.

Posted in psychology, science

Is Psychology A Science? Part 2

Welcome back. Yesterday we touched on clinical arrogance a bit, and discovered that the real problem with it isn’t the arrogance of the provider, but the blockade it provides against learning new techniques and staying updated with proper research. I mentioned I had two examples, one was personal, and one was a more wide-scale issue. You can read about clinical arrogance and my psychiatrist visit here.

I want to start this section of the series off with the second example. We are still under my first bullet point from yesterday: practitioners most often rely on intuition rather than verified and reliable research.

One thing psychologists attempt to do is predict a client’s behavior. This already sounds wishy-washy. No one can predict behavior 100% as we are limited in our understanding of ourselves (more on this once we get to my second bullet point), but there are two main methods which are used: The Actuarial Method and The Clinical Method.

The Actuarial Method

With this method, data is gathered within the range of the target population. That data is then plugged into a formula or some charts or graphs, anything that quantifies the data in some way, and what this yields is a general percentage. That general percentage represents how likely someone is to behave a certain way given the observations of their behavior (or scores on an MMPI, or this or that). So, theoretically, and very simply put, if Johnny is experiencing a psychosis we can use this method to get a general idea of how he may behave and what the best treatment may be given the outcome of others who have experienced similar things.

In trying to predict the rate of degeneration in patients who had been diagnosed with neuro-degenerative diseases, this method was correct 83% of the time.

Why is this important? Well, one thing practitioners may need to predict, especially in the current mental health system and current mental health wards is this concept of “dangerousness”. You hear all the time that people particularly labeled with schizophrenia are dangerous, unpredictable, violent. You also have probably heard that the truth is people with mental health adversaries are more likely to be a victim of a crime than to commit one. So let me tell you why this stereotype continues to persist.

In 1999, a researcher, Liener (I tried to find the full paper, I couldn’t; when I do, I’ll link it) asked clinicians to rate clients’ based on their intake interviews. These clients were hallucinating. The providers were supposed to give an answer for which clients were more likely to become violent. He gave the same case studies to untrained, random high school students and requested the same service. Conclusion?

There was no difference in the predictions. That is, the high school students predicted the same level of danger as the clinicians did, and those who were seen as withdrawn were all rated as most likely to be violent. Research shows the opposite. In fact, when mass amounts of individuals locked in criminally insane wards were let out, 97.3% never got into trouble again. 2.7% wound up back in a hospital or prison.

It’s not the public’s lack of awareness, so you can chill on your lovey-dovey, let’s all unite instagram Mental Health Awareness campaigns. We don’t need as much awareness of experiences as you think–we need research. I’ve been saying this before I even started my college journey. Talked about it every May on my previous blog Mental Truths, in fact. Want to bring awareness to something? Bring awareness to the fact that none of the research is being paid attention to. That’s what needs awareness.

The Clinical Method

In this method, we gather data about the individual and use that information to attempt to predict what the individual will do. There is no real, clear-cut formula for this as far as I’m aware, it’s kind of a guess and check system. Kind of like taking psychiatric meds.

In the neuro-degenerative disease study, it was found that this method was correct 58% of the time. Diagnosis was generally accurate, but judgments and human error lead to incorrect predictions. I mean, 58% isn’t bad, that’s ore than half, but it’s no where near 83%.

And so we see the Actuarial method is quite effective when it comes to doing something human brains on their own can’t always do very well: predict things. We see in some Meta Analysis that there was either no difference in correctness between the two study methods or the actuarial worked better. Never once could the clinical method beat it’s cousin.

You can read more about both methods here.

And still, Practitioners insist that their expertise provides a better prediction. Again, this is what I like to call Clinical Arrogance. And maybe it’s not purposeful–as I said yesterday, they worked hard for their degrees and spent long hours accumulating all that knowledge in their head. Let’s not bash these individuals, a lot of them are very bright and are in the field to support people who really need it. They just can’t read. Kind of like the HumanCentIPad from South Park.

“Why won’t it read!” (22 second clip. Totally worth it.)

I think the most hilarious thing out of all of this is that a lot of pracitioners say they never use the actuarial method, and the majority of them say one reason is because they were never trained in it.

Jesus Christ.

Jesus Christ.

And remember now, we’re trying to figure out how much of a science psychology really is. This is a tough question, because so far we see that there are methods which meet the standards for the label of scientific. But they’re not being used, and when they are and the research is done properly, free from bribes by pharmaceutical companies and researchers looking for fame, the results aren’t given any attention. Can something be called a science if it neglects the only aspect of it which is a science?

I want to stop here and let this kind of sink in, because tomorrow we’re going to shoot to the top. We’re going to investigate how this trickles down and make some speculation to why.

It seems like everything is negative, but it’s not. We hear a lot of the positive in most psychology classes, at least the ones I’ve completed, and that’s great. But some of that is misinformation and that’s problematic. This isn’t about focusing on what’s wrong with the industry, this is about awareness. I think it’s great that people feel making a social media page dedicated to a “Safe Space” or whatever can help others–and for people who are super isolated, it probably is nice to see other people experience their pain. But that’s not the kind of awareness that’s going to shift the system. More people knowing the word “Schizophrenia” could indeed perpetuate stigma if you have no research to back it up.

In fact, why not raise awareness about the fact that the dopamine hypothesis is actually kind of a shoddy hypothesis? Why not find some of the studies that point toward the many holes in the chemical imbalance hypothesis? The ones that discount genes as the biggest player in mental health heritability? Where is the awareness of this?

Oh wait. No one reads.

And if someone does read, and they have articles contradicting me, please, please send them. I’m always looking for something challenging! I only ask that the articles either cite actual research so I can find the papers, or are the papers themselves.

Posted in Freedom

To Be A Mental Health Consumer

Yesterday I said today’s post would be about whether or not psychology is a science and how certain types of philosophy play into the ideals psychologists and M.D’s are trained with, but right now I don’t have access to the notes I made in regard to that topic. So today will be kind of an introduction.

We’ll talk about the importance of education and its scary insignificance.

If you’ve ever taken an introductory psychology course, you have most likely heard the story of “Little Albert”. In using classical conditioning, John Watson and Rosalie Rayner conditioned Albert to have a fear of a white rat. They did this, according to my recollection, by making loud, sudden, scary noises when presenting the white rat.

Now, if you’ve taken a recent introductory psychology course which covered this case, and you are not in California, there is a slim chance you were not told what I was told. I’m betting you were, though.

I took General Psychology 5 years ago and was informed that the experimenters discovered this infamous baby known as Little Albert had also been conditioned to fear white things in general. Fluffy, white, harmless things like a puffy rabbit or a dust bunny. My class was then told this fear persisted throughout this child’s life, and that fears could be unconditioned as well. This example is used as evidence to prove that classical conditioning in humans perpetuates specific phobias.

The study was referenced in a few other courses as well, all with similar conclusions. The textbooks were no different.

So, imagine my surprise when my research course revealed Little Albert had been fearful for ten days. After that, his reactions subsided. When they attempted to recondition the fears, his responses were lessened than the first time and the fears did not stick. My research professor said he had never learned this until he actually read the paper Watson and Rayner published.

And so this brings up many serious issues, one of which I’ll talk about tomorrow.

But for today, we can just focus on one main issue: if we can’t trust our education, how can we trust our practical training? Are they following research or intuition? Are they creating programs and trainings that are based in research topics but finalized by idealism?

This doesn’t mean we flush our meds down the toilet and spit at our therapists. Maybe it means that for some people but for me it means self-research is probably one of the most important things I can do for myself as a mental health consumer. I don’t like to say “question everything” because that implies a lack of trust and in order for people to trust you, you also must sacrifice some vulnerability and offer trust. What I say instead is “research everything.”

Get a new diagnosis? Great! It matters to you, it explains what you feel and how you think and you really identify with it. Learn about it, if that’s something that matters to you. And that doesn’t mean googling “schizophrenia” and reading about how your negative symptoms will take over your life after medication quiets the positive symptoms and how medication is the recommended long-term treatment and how some people can still live meaningful lives (after the author spent six pages ripping your self-esteem to shreds).

Learn about negative symptoms if you want. Learn about positive symptoms. Learn about different medications, different therapies (usually CBT) used to help people cope with confused thoughts. Learn about why the dopamine hypothesis is only a hypothesis. Learn about how medications work and how they don’t work. Learn about support groups. Learn about alternative treatments. Learn about how they work and how they don’t work. Learn about hearing voices (if applicable) and learn about the Hearing Voices Network, and affiliated organizations/movements. And most importantly, be objective.

Don’t just swallow the information you’re provided and internalize it. Not even the information in this post: research it for yourself.

This is hard to do when you’re in a crisis. That’s when we’re at our most vulnerable. That’s when we put up defenses and refuse help that may be useful. Or that’s when we’re so outside of ourselves that we have no defenses and so we absorb any help, and sometimes that means forceful and hurtful help.

It took me years of mental growth supported (sometimes unknowingly) by the connections I’ve made at the Peer Respite house I work for, and my own inner revelations, my own retraction from society and sanity, to really learn things which I would have never known had I not had a few questions and some hours of research.

And so the second lesson here is patience. While you go through the horror and the terror and wallow in darkness, look around. Touch the walls you’re trapped in. Smell the air that’s tainted and stale. Feel the ache in your heart. Hear your own screams. Explore the desolation because there is nothing more all-encompassing. And when something is all-encompassing, there is no escaping. So don’t run. Melt into it.

Let me give an example.

I was part of a cultural competency training/story telling event for the company which helps run and fund the respite house. There were other providers from within the company who attended, nurses and clinicians from other mental health and housing programs. (For some background, the company runs 100+ other programs and the Respite is the only fully peer program).

I was one of three who was scheduled to tell my mental health story and how I interacted with providers during the worst of my crisis. This was to provide them a view from the other side.

However, public speaking isn’t usually my thing. I used to faint in elementary school when I had to stand up in front of people, and this fear continued through high school and college until about a year ago. It still makes me intensely nervous, but I’ve gotten just a smidgen better at controlling my body and my thoughts during my presentations.

And so my anxiety sky rocketed the moment I stepped into the building. What this usually means is I go sit somewhere quietly and ignore the room and put some music in my ears and try not to listen to my own self-criticism or voices.

What it meant this time was understanding my limits and using my crutch to further develop my own skills. I took some valium I’d been prescribed for my back. This doesn’t last very long in my body with my metabolism, but it lasted just enough to calm my body. I wear a Google Wear smartwatch that tracks my heart rate religiously and I use it as a biofeedback because biofeedback was what helped me see how my mind exaggerates my feelings.

When the medication kicked in, my heart rate went from 109 to 68. And in this period I felt it. I felt my body and my hands and how cold they were. I felt my eyes moving in their sockets and my tongue brushing across my lips. All the while my mind panicked.

And so I focused my awareness on that disconnect. I spoke with my brain and my body and I told my brain: do you see how the body feels right now? It’s okay. This situation is okay. Feel how grounded we are right now? Feel how I’m leaning on the counter top? See, you made that person laugh. You’re having conversations. Do you feel how loose the body is?

And so I didn’t run. I dove into the discomfort and identified the disconnect that perpetuated my fears. I will and do talk quite a lot of shit about medication. It’s understudied and should not be cleared for long-term use in any one human being or animal. It is studied for short-term usage, all of it (meaning 4 weeks to 3 months) and the only medication I am comfortable with my body enduring is as-needed medication for panic. And the only way I will take one is if I recognize I won’t learn anything from the panic if I can’t get out of my body and into my mind. I have to reconnect the two, and one needs to be isolated (calm) in order for me to show the other one everything is okay.

I quite enjoyed my talk. I’m sure there are many things I could have done better, things I could have said better maybe. But it was the first time I spoke to a room of people without pouring sweat, stumbling over words, or fainting. By the time the talk started, the Valium had left my system.

The key notes to take from this post?

  1. Be Objective.
  2. Have Patience
  3. Don’t Run

Posted in psychology

Objectively being Objective

Do other bloggers/writers enjoy writer’s block as much as I do? I think it’s a time to explore what you want to say versus what you could say. Or maybe I’m one of those horrible people who see light in every darkness, and not in the cliche “there’s a positive in every negative” way.

Of course there’s a positive in every negative. It wouldn’t be negative if there wasn’t. Come on.

I was thinking about my previous post and about craziness in general, and about variation too, about how all of our experiences are different and yet they overlap. I wonder if they overlap because they are caused by similar “defects” (as the medical model persists) or if they overlap because we, again, enjoy organizing things into categories. Because it seems to me, in reading the research, that there are many different pathways that cause many different experiences, and no matter how much the media tells you serotonin is responsible for anxiety and dopamine is responsible for psychosis, no one actually knows.

Here’s a tip: if you hear a psychologist or researcher presenting information to the media, their work probably hasn’t been peer reviewed or replicated yet.

And so that makes me think about the spectrum of psychosis. I mean, there’s a wide range of experiences, and I touched on them last time just; this difference between internal versus external voices and how they were once regarded separate in their effect but now are regarded quite similar, the only difference being those with primarily internal voices have more awareness of their “origin”.

Some people have visual hallucinations, some people don’t. Some people have very few, like me. Some people believe people are coming to kill them. Some people believe spirits are coming to kill them. Some people think they’re God. Some people think you’re Lucifer. Some people sit silent, aloof, and stare at a wall (me). Others run down the street. A tiny fraction of people become violent out of nothing more than fear or confused anger.

So, what is it that varies all these experiences? It can’t all be chemicals. After all, delusions and hallucinations have a lot of fun playing off things/people/events happening around you.

There’s no point in arguing nature versus nurture, we’ll never be conclusive on that. People can have opinions, but the data will never be conclusive. What I think, then, is things like this should be considered with that ambiguity in mind.

It’s another fact that we’re human and humans hold bias. Researchers who want to be that one person to find conclusive evidence that a specific pathway with a specific chemical and electrical impulse in the brain is responsible for the cluster of experiences we call schizophrenia or bipolar or depression or anxiety will find that conclusive evidence. It might not be significant, it might not be real, and it will probably be correlational at best, but they’ll find it because they’re searching for it. They’ll find it because the companies they’re researching for toss out the evidence which doesn’t support the theory–that’s a big source of fraud in medical science these days.

It’s difficult to be objective in regular, everyday life. It’s ten times more difficult in research psychology, especially if you’re after fame or truly believe that your efforts will save millions of lives. Because if you don’t become famous and you don’t save everyone’s lives then you’ve just spend hundreds of thosuands of dollars on a degree in a job that may never pay off in the ways you imagined. And no one wants their fantasy squashed.

So I implore you in your daily lives, and especially those of you studying psychology or any science really, to remember nothing is certain. Remember a theory can never be proven; no matter how much “evidence” you think you find, we can never claim it as an absolute truth. Remember falsifying theories is more important; if we weed out the false ideas we can get closer to the truth, kind of how a limit never approaches zero but does that funny thing where it gets super close. Remember you’re the ass if you bend to the whim of money and fame and bribes.

Who wants to be so certain of everything, anyway? I enjoy waking up in the morning unsure of what the day will bring, and even more so now that I’ve stopped thinking “OH GOD OH GOD WHAT’S GOING TO HAPPEN TODAY” and started embracing “I wonder what could happen today? Well, I guess I’ll just find out.”

Certainty is so boring. That’s probably why the universe doesn’t care for it.