Tag: science

Posted in Peer Support, psychology, science, Therapy

How To Read A Psychological Research Paper

Posted on by alidware

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.

Would you like to continue the conversation, see silly (and beautiful) photos, or nonsensical two second videos? Great! Follow me:

Instagram: @written_in_the_photo

*New* Twitter: @philopsychotic

Snapchat: @FabulousIRL

If you liked this article, please share it, hit the like button, and follow ThePhilosophicalPsychotic on WordPress or with email notifications. I appreciate every reader and commentator. You give me more reason to continue this joyous hobby.

Posted in Emotions, Freedom, psychology, Voices

How Philosophy Helped Me Process Psychosis

Posted on by alidware

This will be part of my story but also a tribute to the power and destructive properties of thought.

I started cracking up shortly after I took my first philosophy introductory course 5 years ago. We covered everything from determinism to Cogito Ergo Sum to relativisms and categorical imperatives. I suppose I should specify this was a Western Philosophy introduction class.

Mortality and ethics, both western and eastern thought, were the subjects I focused on after that. Why? Well, debates intrigued me and the confusion on whether we’re born with an innate sense of what’s right and wrong or whether it’s developed based upon laws, society, and culture struck me as a paradox; we can’t know what we knew (or if we knew anything) when or before we were born, and therefore have no variable to isolate—we will never know which influences us more; instinct or culture.

Scientifically, as of today, this is impossible to study. Philosophically, the debate rages. And no, your opinion on whether or not morality is innate is not scientific evidence. You could create a viable hypothesis, just know it’s probably not testable in a way that will provide valid results. But, nurture your beliefs anyway. Beliefs keep us alive.

On the journey into the murky, grey waters of morality, I got a sight of hell. I felt the hot breath of demons. They told me I was a dead man walking every time I stepped. They hunted me. And I couldn’t figure out why.

It started with possession. They invaded my body and others near me. This happened, I reasoned, because it was finally time. They’d been watching me all my life, I’d felt them as a child, and now they were trying to throw me off my divine path. I was here to influence the world, thwart their plans. Dead celebrities wrote through me; they’d also been watching me since I was a child. Still, when I hear of deaths, I feel them joined with me.

I turned to ancient Egyptian beliefs and amulets. I felt Thoth on my side, and spent nights creating rituals to talk with him.

Classmates were possessed, armed against me in this spiritual warfare. I dropped classes.

I didn’t believe in hell though, or God, not in the sense of “white Jesus”. I didn’t believe spiritual masters controlling our fate. And because I didn’t believe in any of this, the creatures possessing me, massacring people, were not demons. I realized I’d labeled them as such because I had no better words to do so. They never called themselves demons. And that lead me to Eastern Philosophy.

Unity is what saved me. The unity of all living things, of all emotions, of all concepts, of my body and my mind. There are forces that unify particles and molecules and atoms. Matter is just condensed energy, in the simplest terms, after all. This realization turned me toward The Tao Te Ching specifically, and Daoism; The Way. True Daoism isn’t interested much in this physical world or the conundrums that man spends so much time trying to reason himself through. As someone who was and always has been very logical and scientific, this thought confused me. What else was there in life besides reasoning?

What’s great is that a lot of mystical ideas within Taoism, ideals which could have been scientific had the philosophers not seen analysis as such a waste of time (in a lot of ways it is, though), have been and continue to be paralleled with modern science, particularly physics. The Tao of Physics by physicist Fritjof Capra is a great book to read more on this subject. I read it a few months ago, and it’s the book pictured at the top of this blog.

The Daoist way acknowledges and observes the natural transformation of things in nature, like the blossoming and decaying of a flower. Yes, this is where the T’ai-Chi T’u diagram comes in: it represents the unification of these polar opposites: one must exist for the other to exist. We’re talking, of course, about Yin and Yang. A consequence of life is death (or cellular regeneration if we’re talking freaky single cell organisms) and you cannot have died without once having been alive. In fact, we would have no concept of being alive or living if death did not rear its gentle head. And if we were always dead, well, we wouldn’t know it and words for it wouldn’t exist.

Both Yin (the darker element of existence representative of the earth) and Yang (the creative, heavenly—meaning not of earth—element of existence) have equal importance and balance everything. The symbol’s flowing movement, according to Capra, represents continuous cycles; in other words, these opposites are constantly within each other, influencing each other, and being each other because if they were alone, neither would exist.

This isn’t a Western way of thought. Here, someone is either guilty or innocent. Something is either right, or wrong. The flower is either alive or dead, and we see these things as separate from each other in the same way we see ourselves separate from each other. You can see this disconnect rooted in things like in segregation, in P.C culture, and in Mental Health. And because we don’t ascribe to the idea of fluid existence, of fluid transformation, because everything for us is so hard lined and linear—which is only logical because we experience existence in a physical sense despite knowing Time isn’t linear—we’ve developed an individualist and autonomous society.

That’s not to say it’s wrong. In fact, I stopped believing in the hard sense of right and wrong a long time ago.

And so how can something so abstract apply to life and how in the world did it help me balance madness?

Chuang Tzu explains this beautifully:

“The sayings ‘shall we not follow and honour the right and have nothing to do with the wrong?‘ and ‘shall we not follow and honour those who secure good government and have nothing to do with those who produce disorder?’ Show a want if acquaintance with the principals of Heaven [not of earth; cosmos, spiritual universe] and Earth and with the different qualities of things. It is like following and honouring Heaven and taking no account of Earth; it is like following and honouring the yin and taking no account of the yang.”

Chuang Tzu. Also quoted in The Tao of Physics.

And suddenly life made a lot of sense.

Suddenly I understood why conclusions of morality always felt so contrived. I understood why “staying positive” never worked, and never would. I understood separation and dissociation and, most of all, I understood the fluid duality of everything, including my demons.

They weren’t demons after all, just as I’d suspected. I call them false angels now, because they are good in their badness and bad in their goodness. They couldn’t be demons because according to this natural, fluid transformation and existence of all things in the universe, everything has a polar opposite. Yes, classical physics tells us this, but not in terms of fluidity.

A demon has no goodness. But because I looked through this lens of consistently being unified with all opposites, these voices and spirits had no choice but to be both good and bad. They struggled with the universal order just like every particle, every force, every human.

This concept I have brought into the novel I’ve been working on, and I’m not mentioning how much I processed these thoughts through a first draft years ago, so whenever it gets published and you read it (and you WILL read it) you will see the similarities and thought process. You will think back to this post and say hey, I remember this! I was there! I. Was. There.

I could empathize with being torn apart by duality. I often found myself between sanity and madness. Between the right decision or the wrong decision. Between living and dying. Between happy and sad. And so I empathized with these damaged, clever, and now exposed beings. I saw the path they carved, the fork in the road that they drove me toward, and saw that this was never a battle between light and dark like I interpreted. They were always both protecting and hurting me; it’s the natural order of things.

That’s the real reason I stopped fighting. Not because I couldn’t anymore, not because I was too tired or because a bunch of therapists told me to, but because I recognized the pain and confusion and duality that radiates through the waves of the entire universe. I saw myself in it, and slowly my fear dissolved.

I get frustrated sometimes still at things they say or things I feel they’re influencing. I get swept away sometimes still, too. I mentioned before I thought of voluntarily committing myself some weeks ago. So this has not eliminated the struggle. What it’s done is give it purpose. It’s given it a place in the universe. It’s given me a reason not to feel sorry for myself or tortured or scream “why me!” Into the sky. It’s helped me learn to share my body and mind and the power of thought with whatever it is in my head, whether that’s a few misguided chemicals or actual spiritual contact. Neither are different from each other: they both follow that natural, fluid rotation. They are bound by the chaotic, ordered, unity of opposites.

This is the reason not referring to myself as “mentally ill” or “sick” has always set me free. This is why listening to my body and choosing to stray from medication was the right decision for me.

Philosophy saves lives.

Would you like to continue the conversation, see silly (and beautiful) photos, or nonsensical two second videos? Great! Follow me:

Instagram: @written_in_the_photo

*New* Twitter: @philopsychotic

Snapchat: @FabulousIRLTho

If you liked this article, please share it, hit the star, and follow ThePhilosophicalPsychotic on WordPress or with email notifications. I appreciate every reader and commentator. You give me more reason to continue this joyous hobby.

Posted in science, Therapy

Exposure Therapy May Drown You

Posted on by alidware

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?

Readiness.

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.

Squirrel!

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, Voices

Is Psychology A Science? Part 4

Posted on by alidware

We’ve arrived to the conclusion of this series, and bullet point number two: psychology is the quantum physics of human study.

There is valid psychological research out there. The world has learned many things thanks to proper psychological researchers following proper scientific methods and procedures. Politics and bureaucracy, warped ethics and poorly developed philosophy has given much of psychology and psychiatry a bad name. The fact of the matter is psychology is the study of the mind, the mind studying itself, and it takes a certain level of scientific measure to do so.

There are many aspects for why there won’t be a yes or no answer to the title. We find ways to quantify behavior of everything we observe in psychology and other sciences; that’s the point, really, to quantify our observations so that we can logically and mathematically find systems and patterns and create better understanding. It’s how the DSM should be developed, but it hasn’t been. In fact, there isn’t much science involved in that infamous book. None of the members of the board are researchers or scientists.

Emil Kraepelinian, a german psychiatrist and researcher who furthered much psychiatric thought in his time pushed for empirical evidence in clinical study when it came to mental conditions. His love of philosophy sputtered a bit, as he focused more on the natural science of the mind; realism became his muse. Psychiatry, he said, and the science of it, should focus on what is presented, what is seen, and what is really “real”, observed and reported objectively.

He pushed for diagnostic causes, the scientific philosophy that is supposed to be backed by the DSM. That is, each diagnostic label is used as explanation for the behavior observed, a cause. He said “cases arising from the same causes would always have to present the same symptoms and the same post-mortem result”.

What I find interesting about almost anyone who supports the medical model, and almost anyone who advocates for anti-psychiatry, is this idea that any of this is based in absolutes. As if something as complicated as the human brain, something which is as unique chemically as a fingerprint, could present the same symptoms and the same post-mortem result. As if chemicals in the brain don’t play any role at all. As if genes don’t. As if environment doesn’t. As if individual variation in perception of life, in thought, in personality, doesn’t. As if we will ever be able to quantify exactly what a combination of all of that means.

So why do I call psychology the quantum physics of human study? Normally it would be a compliment, a toast to the complexity and beauty of psychology, but until the science of it actually starts behaving as such, I refuse to compliment it.

My reasoning can be summed up in one simple, and pretty obvious word: probability.

You can calculate the trajectory of a ball and where it will land based on the height the ball starts and the force which propels it. You’ll look at angles and velocity. It’s pretty straight forward classical physics, just like you can take a look at a particular chemical structure in the brain and label it dopamine, serotonin, or GABA; when you see each structure, you can accurately predict the label, just as you can accurately predict where the ball will land as long as you can do math.

But when you get into particles that seem to appear chaotically, randomly, and pop out of existence just as suddenly as they’ve popped into existence, when you can’t observe the actions with the naked eye, things become less obvious. When you start attempting to measure when serotonin will be released, how, where, and the effects that will cause, with the same types of stipulations, things also become less obvious.

As much as they tell you serotonin causes anxiety, there is no certainty in this. There’s no certainty in the dopamine hypothesis or even the entire “theory” of chemical imbalance. There is some research, often funded by pharmaceutical companies, which claim reliable and valid results with a minimally valid sample size that allows them to generalize, or predict, that for many people, a rise or decrease in serotonin (there’s been research showing both instances) can cause anxiety and/or depression.

Statistics gives an idea of how many of these pop-up particles will/can appear at a given time, in a given space, but it will never be 100% accurate. Statistics gives us an idea of how many people will experience a given “symptom” compared with their genetics, their neurochemistry, and their life experiences. But because we don’t have solid understanding of any of those categories, the predictions and statistical significance must still be taken with a grain of salt.

So what does this mean? If we can only observe a small amount of our physical existence, if that can only be quantified using a symbolic system which is also only based in our observable spectrum of the universe, than does anything matter? If we can never be sure of anything, what’s the point?

Curiosity, I suppose. Curiosity and acceptance.

Part of the philosophy behind the Uncertainty Principal and the paradoxes within, which we discussed here, is that we must, particularly within the study of ourselves, of the universe, find acceptance in our limitations because we are inherently limited by our physicality. We will never see with our own objective, naked eyes whether that photon’s interference pattern is being influenced by the light we use to see said interference pattern, or if the photon indeed behaves as both a wave and a particle depending on observation.

There is indeed always a confounding variable we can never control for: our humanity.

And so I say, my friends, don’t take things so seriously. I lose myself in delusions quite consistently. It’s terrifying. Sometimes it’s beautiful. Sometimes the terror is beautiful and I’m not sure when I was able to see that beauty, but I’m thankful for the psychosis showing me the light side of the dark–and by this, I don’t mean “the bright side” or “the light at the end of the tunnel”. There is a lightness nestled within the darkness, and you have to go very deep to find it. But it’s there. It’s there because the same darkness lies deep within the light.

I laughed at myself the other day because most people I speak with who have experienced psychosis have found some kind of light, spiritual light in all of this, been pained by demons and blessed by God (or Gods) and I’ve been quite the opposite. I’ve embraced the demons and the darkness and recognized their validity. I’ve called them my protectors more than once this last week, terrified that they’ve been steering me purposefully this whole time and I’ve been resisting out of fear and misunderstanding.

They’ve become false angels–angelic in their intent but false in their goodness and I can appreciate a being which can drop its pride and admit the unity of good/bad which churns inside them. If you’re curious of this, and my thoughts on my voices/where my beliefs come from, I’ll write a post explaining it all. It’s quite detailed.

Hell, even if you’re not interested, I’ll probably write on it.

And so psychology is as science as philosophy in the sense that thoughts/ideas can never be proven and neither can the theory of chemical imbalance.

We can provide enough evidence to disprove it.

And I promise, we will.

P.S: It is inherently and philosophically inaccurate to call this theory a chemical “imbalance” as there is no “balance” to compare it to. And so I say we will disprove the imbalance aspect not because I don’t believe chemicals play a role, but because I recognize that there is no standard for comparison. Neurotransmitters and neurons change and grow depending on experience and variation, and therefore we can never have a generalized “true north” version of our chemical make-up.

Posted in Peer Support, psychology, science, Therapy

Is Psychology A Science? Part 3

Posted on by alidware

You’re here–great! This post would have been here yesterday, but I took an extra two shifts at work this week and am worn out for other reasons.

In the last post, we talked about the Clinical Method and the Actuarial method, and declared the Actuarial method more accurate. We are still under bullet point number 1: practitioners and their intuition/expertise, or what I’ve been calling Clinical Arrogance for years.

Now, why is there such a level of clinical arrogance out there? Well, it probably has something to do with the lack of push for randomized clinical trials in psychology and this idea that case studies are the best way to identify/predict other client’s behavior.

For example, Ronald Fox, a previous president of the APA is quoted with:

“Psychologists do not have to apologize for their treatments. Nor is there any actual need to prove their effectiveness.”

Why Many People Perceive the Study of Human Behavior Unscientific

For those unaware, the APA is the American Psychological Association. They argue over the DSM and other irrelevant things.

There was a push for randomized clinical trials to become a staple for the understanding of the mind, for understanding better avenues of treatment for mental health adversities, but this would have sprung detailed instructions for treatments (backed by the research) and standardized treatments. Psychologists had a somewhat valid argument, that there needs to be some flexibility in treatment. Standardized tests are shit, and I believe there’s probably a huge chance standardized treatment could end in the same category. However, I’m not sure if the standardized tests given in school are backed by any research saying they are accurate predictors of a student’s knowledge. These standardized treatments would be developed based solely on the research.

But clinical psychologists disagreed for other really stupid reasons too, rest assured. They believed psychology is an art, not a science. It doesn’t need to measure variables. Intensive case study analysis gives better understanding and insight anyway.

They’re quoted with:

“Alternative ways of knowing [case study, intuition], for which the scientific method is irrelevant, should be valued and supported in the practice of clinical psychology.”

Defining Psychology: is it worth the trouble?

Another APA president was found to say starting up randomized clinical trials would be “fundamentally insane” .

Why is this a thing? Well, I could think of many reasons. Some reasons revolve around the fact that psychologists are educated in psychology minus research. They take a couple courses maybe in their career, but there is no effort put into helping them really understand the value research has in their practice, and so we have many clinical psychologists who firmly believe psychotherapy techniques emerge from experience. Research says differently: there are certain techniques, like CBT, that work better for certain adversities, but because no one reads the research, no one implements the technique when it’s most appropriate.

This provides for a very naive group of professionals. And what does naivete strengthen?

Well, drug companies for one. They could have research that says a medication has zero efficacy and it will still be prescribed by practitioners.

For example, Abilify has no efficacy above 10mg. It’s in the physicians desk reference. I read it. Back when I was on medication, my psychiatrist kept pushing me to 20mg because it would “help my voices”.

She obviously doesn’t read, obviously doesn’t know much about Abilify, and obviously doesn’t understand anything about the spectrum of voices.

It’s a well known fact that insurance companies, drug companies, and the APA are all very connected. That can be another series I’ll push out when I’m less worn out. It’s a very tangled web.

The issue with ignoring research which says certain treatments are more likely to have an effect over others is that psychologists never learn from their mistakes–mostly because they don’t know they’re making any mistakes. If a treatment doesn’t work, it’s because the client isn’t focused. The client isn’t “putting in the work”. While that can be the case, it can also be the case that the psychologist hasn’t kept updated with the information in their field and therefore has some build up clinical arrogance.

There was a push in 1990 for evidence based practices to be the center of psychological practice. The APA’s response? Let’s lower what it means to have “evidence”; more things will be approved and more treatments will be made.

A group of scientists and researchers realized their efforts to drill logic and intelligence into the APA was vain. They then formed the APS, the Association for Psychological Science.

In the same way that Peer Respites and peer alternative programs were started out of the need for compassion in mental health care, the APS was started out of the need for competent practitioners and valid research in psychology. They sponsor science-based clinical psychology and there are many universities in the united states which hold their Psychological Clinical Science Accreditation. More are being accredited each year. UC Berkeley is one. I mention them only because I plan to attend that program for graduate school assuming I continue with psychological research.

So there are many elements of science within psychology. The issue isn’t with whether or not it’s a science. The issue is with whether or not the science is embraced and whether or not we are too limited in our human ability to learn anything worth while. Is human variation too much of an obstacle? Is that what pushes clinical psychologists to believe their intuition can outsmart a math formula? Math formulas, after all, can only describe what we observe and what we observe is inherently limited. We can generalize behavior from a sample size, we can generate neurological predictions when observing the behavior of neurotransmitters but none of it ever seems to be certain; even what we’ve studied, the effects we see, are simply based in probability.

Sound familiar?

Tomorrow we’ll talk about bullet point number 2: how this probability relates to other sciences and why I call psychology the quantum physics of human study.

Posted in psychology, science

Is Psychology A Science? Part 2

Posted on by alidware

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 psychology, science, Therapy, Voices

Is Psychology A Science? Part 1.

Posted on by alidware

That question won’t be answered in this post.

This will be a multi-part series I think. There is a lot to say here, a lot to absorb, and it’s not really a matter of opinion. That tends to turn people away, because they want their opinion heard and other’s heard. Your opinion can be heard, just know its validity lies in facts and not how much you (or anyone else for that matter) believes in it.

We hear a lot today that disorders are on the rise, specifically ADHD, Autism, and Bipolar (in children). We hear that there are all these new holistic approaches. We hear about EMDR, we hear about Mindfulness, we hear that long-term medication is the only reasonable approach for certain experiences. We hear supplements will one day replace these medications. We hear psychiatry kills. We hear psychiatry saves. We hear a mix of the two–not sure how you can both kill and save someone, but psychiatry seems to be pretty good at it.

So, how do we make decisions on what is accurate and what is not? Most of the time it’s a matter of opinion. You read something good on the internet, an article that cites specific sources and looks very professional and so you trust it. You do the same with your doctor. You hear things from friends and somehow generalize their great experience to all the population of mental health consumers and suddenly you’re an advocate for acupuncture exercising demons from the tips of your fingers and you’re not quite sure how you got there, but now you’re there and you really believe it.

The thing we don’t ask for is research. The things doctors don’t read is research.

There are about 40,000 psychological research papers published each year. The majority of clinical psychologists read 1 of those research papers a month. That’s about .03% of all psychological research papers.

So let’s talk about what’s going on. There are two main issues:

  1. Practitioners rely more heavily on their intuition than repeated, peer-reviewed research (which they haven’t read).
  2. The actual science of psychology is basically the quantum physics of social sciences.

We’ll start with number 1.

We talked in the last post about the differences between a Ph.D and Psy.D (both psychologists), MFT’s and LCSW’s. We talked about how the technique the clinician uses dictates the effect on the client more than the supposed higher or lower degree/education level of the clinician. What we didn’t talk much about is why a lot of repeatedly proven therapeutic techniques are being replaced with new fad-like “holistic” and “client-centered” approaches. There are a couple reasons and one of those reasons has to do with practitioner intuition.

They have gone through years of school. Residency for some. Internships. Hours upon hours of supervised practice (3000 for those who want licensing in my home state of California, 1000 most everywhere else). They’ve made sacrifices for this, thrown themselves into debt, worked shitty jobs, lived in cramped situations. They gave up a lot for their passion and now they can be called an expert. That means they’re, well, the expert.

It’s very difficult to read a paper that says your technique has been proven multiple times to present no significant effect on the wellness of most people (we’ll talk about this idea of “most people equating to the general population later, that’s related to my second point) and be forced to change your method of practice that you’ve grown comfortable with. It’s hard when you have to admit you may very well be wrong. It’s much easier to come up with reasons why the research may be wrong–you’ve seen the progress in your clients (confirmation bias; you want to see that, so you will see that), your colleagues are using the same techniques with great success (they may be biased in the same way, and may have not read the research), and you’ve read articles which said this technique is effective; in fact, you went to a specialized school for that technique. And so you ignore the shoddy research–there’s probably no control groups, a poor sample size/selection, not evidence of peer review, and a lot of pseudo-science talk telling you that this new discovery they’re providing you with is being “stifled” and “shunned” by the medical community.

It boils down to practitioners struggling to admit they may be wrong. Ironic considering the work they’re in.

The issue with this isn’t their pride. The issue is that by not considering the possibility that they don’t know everything, they don’t have the chance to learn something that could indeed improve their practice and the well-being of their clients.

Now, the effectiveness of clients (as much as I despise that word, it’s appropriate for what I’m talking about) is measured by behavior noted by neutral observers. To properly do this, behavior is measured before and after “treatment”.

From this scientific approach, we’ve learned that ECT has been “effective” (when effective is defined as a positive change in behavior, and “positive change” is defined as the patient’s depression lessening). But, the effects have been found to be temporary, we don’t know why it temporarily works, and it causes a myriad of health issues, most severely memory loss.

We’ve learned that CBT treats panic disorder better than no treatment, better than a placebo, and better than Alprazolam (A version of Xanax). 87% of participants reported they were free of symptoms 15 weeks into CBT. 50% reported freedom after 15 weeks of Xanax. 36% with the placebo, and 33% with no treatment–they were told they were put on a waiting list (Klosko, 1990). Now what this shows us is a couple things.

  1. CBT works pretty damn well for those struggling with panic disorder.
  2. With the simple passing of time, people get better. That’s very important to consider in this field with certain experiences.

The scary thing is a lot of people who struggle with panic don’t get CBT treatment. I didn’t, not for many years.

Now, I have two examples of practitioners believing more in their expertise than research. One is a wide-spread example, and the other is a personal experience from 10:30am this morning.

I’ll start tomorrow’s post with the wide-spread example, because there is a little background needed.

This personal experience of mine sent me in a tail spin. My thoughts today have been taken over with good and evil (not the separation of them, but the unification of it) and the spirits, the voices, have essentially been trying to thwart my success and I’m struggling with whether they’re doing it to save me or to torment me for both. They played a particular song to mock me in the store today, and there was a woman following me around, going where I went, picking products next to me just to let me know that they’re here with me again, the spirits. And so this is an example of why clinicians need to pay attention to how they speak with people.

I literally just did a panel presentation on this shit to some local mental health workers yesterday, and then this asshole comes along.

He wasn’t trying to be an asshole, I know this. He is a young psychiatrist, very kind, and struggled to find the right words to dominate me with. I made an appointment with him because the person who’d been recommended to me had appointments months out and I couldn’t wait; I’m looking for a PRN for my panic as my current techniques (CBT, and processing my emotions) haven’t been working as well lately. I want it for short-term use so I can get back on track. I am on no other medications right now.

Problem is, I was prescribed Percocet and Valium for my back two weeks ago. And he saw this.

He didn’t ask me much about myself. Which was strange; usually psychiatrists go very in-depth at the first appointment. He asked what my diagnoses had been. I told him one psychiatrist couldn’t decide between Psychosis NOS or Schizoaffective. I told him my current therapist believes Bipolar 1 with Psychotic Features (mainly because she believes schizoaffective means your psychosis is only in your depressive episodes; we’re discussing this).

In ten minutes, he says he thinks I’m Bipolar 2.

This is after I tell him about my voices. This is after I tell him I was hospitalized after the Vegas shooting as it perpetuated a delusion of mine. He didn’t ask me about the voices really, or the delusion.

The problem with his diagnosis is that psychosis doesn’t happen in Bipolar 2. That would automatically make it bipolar 1. I also haven’t been depressed in over a year, and Bipolar 2 is mainly depression and hypomania. He believes my manic episode in the beginning of college was not mania because I’d get at least two hours of sleep every day. I understand that reasoning. But it’s not a reason to conclude bipolar 2 in ten minutes.

So he didn’t believe the voices. Why? I’m not sure. He didn’t ask if they were external or internal. He asked me what they said and I gave him a couple examples. He asked me if I’d heard them within the last week. I said yes, and within the last month. I told him it’s not a constant roll of voices all the time, every day. When i’m doing well, it’s less frequent. When i’m not doing well, it’s constant.

He didn’t want to prescribe a PRN because of the Oxycodone prescribed to me. I told him I’m not using the Percocet for back pain; I have 16 out of the 20 pills left. I don’t need them. He seemed intent of giving me more Valium. I said I didn’t want Valium; it has a half life of three days and I don’t want a slight risk of physical dependence.

He suggested Gabapentin (the nerve pain and anti-convulsant that keeps being prescribed in psychiatry even though it shouldn’t be, like many other drugs)or Busbar. Both are taken daily. I said no. I told him three times SSRI medication did not work well for me, and he respected that. But he still tried to squeeze it in there, advertising it as a safer drug than Valium.

What this ended with is me with a 30 day supply of Klonopin (which I’ll use maybe once every two months??? I don’t need it all the damn time) and a lot of anger. A lot. I felt invalidated. Ignored. He was young, confused maybe, thinking I was lying, manipulative, and the voices told me that’s what he thought and I believe them. He thinks I was there for drugs and he didn’t believe my psychosis.

Who lies about psychosis?

This sprung a lot of thoughts. The store I stopped to shop in was malevolent. Class was difficult. My thoughts are not nice, they’re disorganized right now, and I’m disheveled.

But it’s an amazing example for today’s post: if you’re a clinician or a psychiatrist and you rely heavily on your intuition, you’re invalidating the tiny scientific standing psychiatry has in the medical community.

Take a day off and read some research.

To Be Continued . . .

Posted in Freedom

To Be A Mental Health Consumer

Posted on by alidware

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 Peer Support, psychology

Own Your Care

Posted on by alidware

Today’s post is a little late because I’ve just come back from Urgent Care to get my back checked out. I overextended in the gym and have torn some lower back muscles. The pain is pretty severe, the doctor is thinking it’s very deep tissue, and let me know what I need to do to continue recovery.

But the events leading up to Urgent Care inspired this post on how important it is to own your care, both physical and mental.

The thing is, you’re going into the office of a person who (usually) doesn’t know you very well other then the check ups or issues you come in for on a haphazard basis, and even if they do know you well they don’t know you so well that they are aware of your body more than you are. The same goes for psychiatrists.

An important thing I’ve learned to remember in both my physical and mental health care is that no one, regardless of Ivy League education or multiple specialties/degrees, knows my body better than me. No one.

For example, I’m considering getting a PRN (as needed) medication for my anxiety, as my panic has been off the Richter scale lately. It would be something I took maybe once a month, or even less, as I tend to work very hard on balancing my panic when it comes on. (I’m careful not to say I “control” my panic, because I’m not going to run around in circles and play Panic’s power-struggle game).

Since I’ve got to find a new psychiatrist for this, I filled out an intake form which asked me what my primary concerns were and if I had any other information about medication or suicidal tendencies. I wrote something along the lines of: “SSRI’s and SNRI’s do not work for anxiety for me; I do not want them. I don’t need anymore antipsychotics, they make me dead. I am coming in for a PRN for anxiety, and nothing more. I have been happily off medication for a year and three months.”

I stated that twice.

The reason being when the psychiatrist sees my history of psychosis and mood swings and depression and says “weeeeeeeell, how would you feel if we also try a little–”

I can then say “Weeeeeeeeell, why don’t we try reading my intake form where I state exactly what I’m here for?”

Because the fact of the matter is that yes, I still struggle, often daily. But I know myself. I know my limits. And I know that getting back on meds would wreck more havoc on my body. No psychiatrist can know that. All they know is what they read in a textbook.

Conversely, if you are content with taking poorly-researched medications, and you feel they improve your well-being, it doesn’t cause any side effects and hasn’t yet ruined your physical health and a doctor tries to tell you “this med isn’t very good, I’d like to try another,” your response should be something along the lines of “well this doctor isn’t very good, I’d like to try another.”

Not to be a smart ass. Not to insert your dominance. But to make sure you’re being heard and that you’re in control of your health. A lot of people like to say “doctor’s work for you”, but I don’t use that phrase because that initiates yet another power-dynamic with you on top. That’s not the goal here. The goal is fair collaboration.

Having an advocate accompany you to your psychiatrist appointments can be helpful as well, preferably someone who is very clear on what your concerns and wants are, and someone who has been through similar situations. Not only will you walk in the office with confidence, but if you’re someone like me who wasn’t always present or aware of what was going on and so assertiveness took a backseat, you have someone to fall back on who you know will do you justice. Doctor’s can be intimidating with their degrees and “factual” knowledge and they’ll blurt things at you that make you feel lesser, not always out of intention but just because that’s how they show you they “know what they’re talking about”.

This doesn’t mean be afraid of new things or ideas. If something isn’t working for you, speak about what’s not working specifically. Don’t say “I just don’t like it,” because that gives them more of a reason to convince you you’re just not giving it enough chance. If you feel coming off medication is something you’d like to try, find the doctor that will support your decisions. Don’t let anyone tell you that you can’t, because you’ll start believing it. Yes, you can come off medication, even with severe psychosis. If you’ve been on them for years, 10+ as many are, you’ll be needing to come down 50x slower. Even as small as .025mg at a time. Doctor’s words, not mine. Also, researcher’s words, not mine.

In the world of psychiatry, we must be wary of manipulative words. Whether they mean to be manipulative or not. When our brains are fragile we are at our most vulnerable.

And so take this post with you to your next psychiatrist appointment if you’d like, if you feel you haven’t been heard or respected and you’d like some strong words from an internet stranger to back you up. Hell, have your advocate read it and them snap their fingers in the “Z” formation afterward. Your doctor’s response will tell you all you need to know about that doctor.

Posted in psychology

Objectively being Objective

Posted on by alidware

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.