It was a room of a hundred thousand windows each one looking out onto a different world

I could quite easily rob a library. It's one of the only places I would happily rob. Whenever I go the urge to sweep every book in the YA section into the hood of my hoodie or under my hoodie preggo style is unbearable. I CONFESS. I am a book lover, a bookworm if you will. I can read a whole book in a day and forget to breathe. Skip meals and construct a soundproof bubble around me so when my mum tells me to tidy my room for the hundredth time, her voice simply bounces off me. Useful. 


"You can start reading pink books now." BAM. I made it. Straight to the top. The top row of books in the school library were mine all mine. You see the pink books were the clever books, the books with the dramatic plots, small words, no pictures, LOTS of pages. Clearly these books were only readable by those who were strong mentally and could take the tragedies and heart racing dramas. I was prepared. I was excited. JACQUELINE WILSON WAS MINE. Corgi Yearling? KMT. Drop that Yearling and place a Corgi single in my hands. Eat your heart out Biff Chip and Kipper. The Very Hungry Caterpillar? Eat cake. Louise is ready for the big ones.


The school library was good, for school. But it didn't beat our Shenfield Library, and was a speck of dust on the shoulder of Brentwood Library, and we knew it. When the librarian from Shenfield came to our school to tell us about the new books we knew our library was NOTHING compared to this. The Summer Reading Challenge was EVERYTHING. The ultimate competition (excluding the easter egg challenge obv) at school. Who would read the 6 books and get the medal? 1 book a week? Bring it. Commence the staring down at classmates you see at the library, getting their record stamped. 


Mum took us to the library about once a month when we were little. We'd be allowed 6 books out every time but when she caught me amongst the beanbags with a pile of 9 and already half way through one while flicking through the bottom shelf between pages, she gave in and helped me carry them to the desk. Occasionally I'd drop hints and borrow 7 books about cats. Never worked. Book Week at school was the best because we got a book voucher. I could BUY a book. The only other times I could actually own a book was my birthday and Christmas, or when we went on holiday. Mum would pack my bag and hide books and magazines for the plane. Amazing. The trouble with buying books was that I could never choose just one, and I couldn't buy more than one because it was too expensive and my book voucher couldn't take it. Back to the library.


Around 400 libraries are due to be closed by the government. That's MILLIONS of books gone. What are they going to do with them? Burn them? Turn them back into trees? When reading through tweets about the #savelibraries campaign this morning I stumbled across author Joanne Harris who was doing storytime and has let me use her tweets in this post. She told the story perfectly... 


Once upon a time, in a village like yours, there lived an old librarian. (A librarian is a person who studies hard to do a professional job and is paid relatively little. Bit like an independent bookshop owner.) Lots of people loved the library. (A library is a place full of books that anyone can borrow, for FREE. You just read them, and then bring them back. And every time you borrow a book, the author gets paid a tiny bit of money. This helps authors keep writing). 


Anyway, kids loved the library because the old librarian (who liked stories) used to have storytime every day. Students loved the library because they could do their homework there - and meet girls, or boys, who liked to read (totally the best kind). Old people loved the library, because they could meet their friends there, borrow books that had gone out of print, and have a cup of tea. Some old people lked to borrow books that their children deemed UNSUITABLE for them, like LOLITA. It was allowed. No-one stopped them. Readers' groups loved the library, because authors used to do readings there and answer questions about their books. And the librarian loved the library, because it was his life's work. It looked like a room full of old books, but actually it was a room of a hundred thousand windows, each one looking out onto a different world. 


But there was one person who didn't like the library. This was the Mayor of the village. It wasn't that the Mayor didn't like books. I fact, he owned several. He also had a library of his own - well, not quite a library. These were all the Mayor's own books, bought in bulk by his interior designer. None of them were ever lent out, and of course, there was no librarian. And the Mayor said: "The library is old. The roof leaks. It's outdated. There are books in there that haven't been taken out for years." And he said: "We have to make CUTS. We have no choice. It's either the library or the school, or the old peoples' home. Or the poor." And because the Mayor was Mayor (as well as being very rich), the villagers believed him, and really thought they had no choice. Some people suggested that the cuts might not be necessary as the Mayor seemed to think. Some even suggested taking the BANKS instead of the poor, but they were quickly dismissed as radicals. Some well-meaning people said that cutting POVERTY was surely the priority...but poverty has more than one face, thought the old librarian. Some things can't be bought with money. And so he protested - timidly. He was a very polite old librarian. But what can one old librarian do? "We can't fight PROGRESS," said the Mayor. "We have to TIGHTEN OUR BELTS." (In fact the Mayor's belt was already tight, but this was simply because he was very, very fat.) Things looked hopeless for the old librarian, and for all those in the village who couldn't afford a private library like the Mayor's. And that's enough storytime for now. Will the old librarian win? Or will it be the fat Mayor? Cont'd after lunch. Bring cake. x


Today is Save Libraries day. Libraries up and down the country are holding protests, having author talks and mass readings. The acts themselves may not save the libraries but the unison of people showing how much libraries are loved will definitely prove that they are SO needed. Now hush up, Scarlett is lost in America and I need to put myself in her shoes for the next few hours, amongst the beanbags... #savelibraries

Ve Have Vays of Making You Talk Part IV Fatalism

In Part I of this post, I discussed why family members hate to discuss their chronic repetitive ongoing interpersonal difficulties with each other (metacommunication), and the problems that usually ensue whenever they try.
I discussed the most common avoidance strategy - merely changing the subject (#1) - and suggested effective countermoves to keep a constructive conversation on track. In Part II, I discussed strategies #2 and #3, nitpicking and accusations of overgeneralizing respectively. In Part III, I discussed strategy #4, blame shifting.  Now I move on to strategy #5.

To review once again, the goal of metacommunication is effective and empathic problem solving. In this post, I will discuss an avoidance strategy called fatalism, and describe appropriate counter-strategies to get past it.

As with all counter-strategies, maintaining empathy for the Other and persistence are key.

Strategy #5: Fatalism

Fatalism is a doctrine that advances the idea that almost all events are fixed in advance so that human beings are powerless to change them. It is commonly used to refer to an attitude of helplessness and resignation in the face of some ongoing events which are thought to be unalterable, or in the face of some future event or events which are thought to be inevitable.

In metacommunication, fatalism is most commonly invoked in order to resist and discourage further attempts at solving family problems whenever somebody tries. When one family member wants to bring up a highly emotionally salient past event that has led to unresolved feelings, for example, a second family member protests, "Why are you bringing this up again? You cannot change the past."

Well of course you cannot change the past.  At least not as far as we know, anyway.  The past seems to be rather fixed, does it not? No one denies that. Perhaps there is an alternate universe out there somewhere, but if so, we have no access to it. 

The fallacy here, however, is the implication that the past is no longer having any effect on the present, nor will it have any continuing effect on the future. It implies that people are not affected by memories in the here and now, and that they do not use past events in order to predict future ones.   It almost seems to be arguing that every moment in the present is entirely independent and disconnected from every previous moment.

Fatalism is unfortunately a significant component of the be­lief systems of many cultural groups that have emigrated to the United States. Many times, patients who attempt to metacommunicate about family problems so that they can be solved are accused of being troublemakers.

Another accusation based on a belief in fatalism is the charge that patients who are known to be in therapy are inappropriately trying to be psychiatrists themselves. "Quit trying to analyze everything!" is a frequent family rallying cry.

Fatalism-implying accusations can, however, be used to pave the way for individual family members to question, rather than perpetuate, established fatalistic family belief sys­tems. Individuals can empathize with fatalistic family members by admitting that they themselves used to think just as the family does.  However, they then go on to add that they now have developed real doubts about those ideas.

Why shouldn't they try to analyze a situation? Understanding a problem is benefi­cial for figuring out a way to solve it.  People in the family may disagree, but only because they feel helpless about changing their future. These feelings of helplessness often stem from past experiences or catastrophes that befell their forefathers.  That anxiety has been passed down from one generation to the next, often with the source of the original anxiety becoming lost. Times have changed for the better, but the family continues to act as if these somewhat ancient horrors are still in operation.

In response to the accusation that they are dwelling on the past, individuals can point out how those past situations are continuing to affect the family's present situation. They can say that they are bringing them up because they want to have better relationships with the family. The old problems are creating distance, and they want to be closer.

In response to the charge that they are being troublemakers and creating dissonance in the family, individuals can reply that the dissonance already exists, and they are trying to reduce it by discussing its causes. They can add that if the bad feelings can be reduced, then the whole family will wind up feeling happier and warmer with one another.

Welcome to the wonderful world of panic attacks

Anxiety: Welcome to the Wonderful World of Panic Attacks is a comic by Rachel Poulson.

Cool Depression anxiety and panic attacks are not a sign of weakness. they are signs

Using this document everybody will probably enable you to obtain a helpful research based on assessment regarding existing posts Depression anxiety and panic attacks are not a sign of weakness. they are signs prospects for discourse mainly because many end users exactly who are searhing for the item. for benchmark Recovering everyone benefit from an array of the search engines listed here are photos that happen to be strongly related to Depression anxiety and panic attacks are not a sign of weakness. they are signs .

Pictured previously you can download and save it all within the personal pc disc drive to ensure whenever you demand it will be straightaway connected readily. Depression anxiety and panic attacks are not a sign of weakness. they are signs stands out as the main on your behalf which wants to connected subject areas. So you went on that labor to get the details intended for major benefit of your readers. Store much of our websites which will allows you to seek out extra reports associated with the actual key phrases

Depression anxiety and panic attacks are not a sign of weakness. they are signs - to aid produce the interest individuals website visitors also are incredibly to help make this site. improving the quality of the article will we try on a later date so that you could certainly fully understand once discovering this place. Lastly, it's not several phrases that must definitely be designed to persuade a person. still because the rules about foreign language, you can easlily sole latest all the Depression anxiety and panic attacks are not a sign of weakness. they are signs argument all the way up in this case

The Architecture of Fear

If you’re anything like me, your panic- or anxiety-fraught periods produce a sense of place that’s particularly attuned to anything even potentially fearsome. For example, usually I love crowded events, feeding off the energy of the audience, the thrill of watching something happen in person – ballgames, concerts, theater. But when I’m feeling anxious, even the sight of a sports stadium or concert hall gives me the willies. (As do highways, bridges, subways, shopping malls, airports, office buildings, supermarket freezer aisles, crowded sidewalks, parking structures, the gym…. Raise a glass to agoraphobia!)

What if it’s not just your panic or anxiety speaking, though? What if there are ways that “be afraid!” messages are embedded in many aspects of society, whether intentionally or not? This is the kind of question posed by the art in “The Architecture of Fear,” a show at the Belgian gallery Z33.

From the show’s catalog:

The society of fear is more than just a feeling…Think of the many government warnings, the health messages and increased safety measures. Risk elimination is the word…The question of course is how and to what extent this affects an individual. Do these countless warnings not only inspire more fear? Does that camera above the station tunnel not suggest that something is wrong? 

…The fact that fear is used as a life style choice, as a sales pitch or as political bait makes it no less real. The question is how we deal with fear, what kind of world we want to create for ourselves.

Some cool stuff here, in a variety of media. (My inner conspiracy theorist is particularly drawn to Trevor Paglen's "limit telephotography" of secret military bases.) Wish I could afford a quick trip to Belgium!

The Waters of the Afterlife Are Filled with Man Killing Fish

I recently had a conversation with Littlest Son, now age 6. Somehow we got on to speaking of the meaning of life, and where he might have been before he graced us with his presence on the planet.

Mom: Where were you before you got here?

Son: In the Before Place. It's just grass. Grass and lots of darkness, and people talking in the darkness.

Mom: Babies about to be born—they're the ones who are talking?

Son: No, there are no ages in the Before Place. Well, actually, everyone is five years old.

Mom: What about life after you die—do you think there is an afterlife? What's it like there?

Son: How would I know?! I am not dead yet!

Mom: But what do you think it might be like there?

Son: Oh, it is all trees and grass and flowers! Everything is very beautiful. And peaceful. Half of the world is grass and trees, and the other half of the world is water. The water is blue. It's all beautiful!

Mom: And?

Son: And the part of the world that is water is totally filled with sharks.

Mom: Sharks?

Son: Oh yeah, sharks.

Mom: So, in the afterlife, you can't even swim because the water is completely shark-infested?

Son: Yes, but this is only including those sharks who have died. Not all sharks.

Mom: So, a reduced number of sharks?

Son: Yes.

Mom: What about the bunnies? Aren't there any bunnies in the afterlife? Butterflies? Nice things like that?

Son: Nope, only sharks!

In the category of "Where on Earth did we come from?" you might also like The Oeuf Room.

Curse of knowledge and other cognitive biases that lead to wrong decision making

A person may be consciously biased towards or against an ideology, a political party, a religion, a creed, a caste, a country, an ethnic group etc. But a cognitive bias is different from such conscious partisanship. Cognitive bias is an unconscious psychological process which guides the individual in decision making without the individual’s conscious awareness. It is the result of perceptual distortion, inaccurate judgment, or illogical interpretation of facts. A conglomeration of these is called irrationality.

Cognitive biases are the result of distortions in the human mind that always lead to the same pattern of poor judgment, often triggered by a particular situation. But how can one person decide the judgment of another person poor? In order to decide the judgment to be poor there should a standard of “good judgment”.  In scientific investigations of cognitive bias, the source of “good judgment” is that of people outside the situation which is presumed to cause the poor judgment or a set of independently verifiable facts.

Positive side of cognitive biases

According to the evolutionary psychology some cognitive biases are adaptive and beneficial because they lead to more effective actions in given contexts or enable faster decisions when faster decisions are of greater value for survival or reproduction.  

Some common cognitive biases

Anchoring

This common cognitive bias is also called focalism. It refers to a common human tendency to rely too heavily, or “anchor” on one piece of information when making decisions. During normal decision making anchoring occurs when individuals overly rely on a specific piece of information to govern their thought-process. Once the anchor is set, there is a bias toward adjusting or interpreting other information to reflect the “anchored” information. Through this cognitive bias, the first information about a subject can affect future decision making and analysis of new information. For example when a person looks to buy a used car he/she may focus attention excessively on the distance travelled by it as indicated by the odometer rather than considering how well the engine or the transmission is maintained.

Focusing effect

Daniel Kahneman 

It is also called focusing illusion. This cognitive bias occurs when people place too much importance to an event, causing an error in accurately predicting the utility of future outcome.  In economics utility means a measure of satisfaction. People focus on notable differences, excluding those that are less conspicuous, when making predictions about happiness or convenience. For example, a rise in income has only a small and transient effect on happiness and well-being, but people consistently overestimate this effect. Nobel laureate Israeli-American psychologist Daniel Kahneman and associates proposed that this is as a result of a focusing illusion, with which people focusing on conventional measured of achievement rather than on everyday routine. Kahneman writes: “Surveys in many countries conducted over decades indicate that, on average, reported global judgments of life satisfaction or happiness have not changed much over the last four decades, in spite of large increase in real income per capita. While reported life satisfaction and household income are positively correlated in a cross-section of people at a given time, increase in income has found to have mainly transitory effect on individuals’ reported life satisfaction.” (Would You Be Happier If You Were Richer? By Daniel Kahneman et. al. CEPS Working Paper No. 125 May 2006)

Confirmation Bias

The confirmation bias refers to the tendency to selectively search for and consider information that confirms one's beliefs.

Examples: A student who is going to write a research paper may primarily search for information that would confirm his or her beliefs.  The student may fail to search for or fully consider information that is inconsistent with his or her beliefs.

A reporter who is writing an article on an important issue may only interview experts that support her or his views on the issue.

An employer who believes that a job applicant is highly intelligent may pay attention to only information that is consistent with the belief that the job applicant is highly intelligent.

Curse of knowledge

Robin Hogarth 

The curse of knowledge is a cognitive bias according to which better-informed individuals may have the disadvantage that they lose some ability to understand properly the lesser-informed individuals. As such added information may convey some disutility. The term “curse of knowledge” was coined by the film and TV music composer Robin Hogarth. In one experiment, one group of participants "tapped" a well-known song on a table while another group listened and tried to identify the song. Some "tappers" described a rich sensory experience in their heads as they tapped out the melody. Tappers on average estimated that 50% of listeners would identify the specific tune; in reality only 2.5% were able to. This means that the better informed individuals failed to understand properly the lesser informed individuals.  It has been argued that the curse of knowledge could contribute to the difficulty of teaching.

Conservatism

It is a cognitive bias. In 1973 British psychologist Glenn Wilson published an influential book providing evidence that a general factor underlying conservative beliefs is “fear of uncertainty.” An analysis of research papers in 2003 established that not only fear of uncertainty but many other psychological factors like intolerance of ambiguity and need for “cognitive closure” contribute to the degree of one’s political conservatism. The term cognitive closure has been defined as “a desire for definite knowledge on some issue and eschewal of confusion and ambiguity.” (European Review of Social Psychology No. 18 pps. 133-173)

Availability bias

Availability bias is a cognitive bias that causes many to overestimate probabilities of events associated with memorable or dramatic occurrences. More than a bias, it is a “cognitive illusion.” Since, memorable events are further magnified by coverage in the media; the bias is compounded on the society level. Two well-known examples would be estimations of the probability of plane accidents and the kidnap of children. Both events are quite rare, but the huge majority of the population outrageously overestimates their probability, and behaves accordingly. In reality, one is more likely to die from an automobile accident than from a plane accident, and a child has a higher risk of dying in an accident than the risk of getting kidnapped. Availability bias is at the root of many other human biases.

Part 5 of Dr Allens Discussion About Borderline Personality Disorder The Earth Needs Rebels Show on Orion Talk Radio

Part 5 of my discussion of borderline personality disorder on Free Thinking Voice - The Earth Needs Rebels internet radio show was on live Tuesday, November 12, from 12-2 PM U.S. Central Time, and is now found on their website.    

Here is the link to the downloaded broadcast: http://oriontalkradio.com/archives.htm.  Click on "down" and not on "listen."  The date and times posted for the broadcast: Tuesday, November 12, at 1:05 and 2:05 PM.

ARC of Ally Condies CROSSED Plus 5 More to Give Away!

I have fresh ARCs! I have acquired them through stealth and at great peril to life and limb. Despite the fact that I carried them over snowy mountain passes, past slavering wolfhounds, etc., I am giving them all away. Why? Because I did a bad, bad thing in a former life (when I was but a lowly beetle) and I am still trying to fix my karma. Your reading pleasure may prevent me from returning to my next life once again in the form of a beetle. My name is still bandied about in the beetle kingdom with much bad talk, and I am not keen to return.

Post a comment here if you want these titles (and feel free to mention a title that you particularly want). Make sure to include your Twitter handle or another way to contact you. I will randomly select one or two winners, and will send the books out. It's that easy!

You've got to be a follower of The Party Pony blog to qualify. Those who Tweet and share the word will get Super Bonus Points, and their names will be put in the random drawing more than once; other bribes are not accepted (even dirty martinis sent by parcel post). Make sure to alert me @feralpony so you can claim your bonus points, you greedy, greedy thing.

If you amuse me in the comments, your name may be placed in the Random Name Kitty 3x, or even 4x! Your odds will be better to win this book derby than that horsie with the wings!

Winners will be selected sometime on Wednesday morning (6/22) after the sun rises. Good luck! Fare thee well, my friends!

(P.S. If you win, it's nice to blog about the books you read and share the love!)

Crossed
By Ally Condie (Nov 2011)

Audition
By Stasia Ward Kehoe (Oct 2011)

Fox & Phoenix
By Beth Bernobich (Oct 2011)

The Space Between
By Brenna Yovanoff (Nov 2011)

The Future of Us
By Jay Asher & Carolyn Mackler (Nov 2011)

Legend
By Marie Lu (Nov 2011)

Is Your Psychiatrist Committing Malpractice Even if Doing What a Lot of Other Psychiatrists Are Doing

My malpractice carrier, which is physician owned and operated, recommends taking one of their seminars or online courses on different aspects of medical malpractice every year, and gives those policy owners who do a 10% discount on their yearly premium. 

The course I took this year was on misdiagnosis.

The course was not really geared to psychiatrists at all, but it seemed to me that the general advice still applies to them. However,  in my experience the advice is not clearly being followed by a lot of my colleagues these days. If these recommendations are indeed valid, and I certainly agree that they are, a lot of psychiatrists are getting away with gross negligence. 

Statistics show, by the way, that doctors are actually far more likely to get sued for something they did not do wrong than they are to get sued for actual malpractice. Isn’t that bizarre?

Some of the advice in the malpractice course concerns two major criticisms of my colleagues that I have written about extensively on this blog and in my last book: relying on symptom checklists, and relying on a diagnoses made by a prior clinician. Truly frightening.

So, as a public service, here’s some information from the course that psychiatric patients might find useful if they are considering suing a psychiatrist for malpractice. From MedRisk (Medical Risk Management, Inc.).

Misdiagnoses were more likely to be considered negligent in malpractice suits. Misdiagnoses were more than three times more likely to result in serious patient injury than medication errors.

2.      Multiple case law decisions have consistently held that the patient has no duty to volunteer information the physician does not ask about, and the patient’s only duty is to answer the physician’s questions honestly. (A smoker actually has no duty to tell his cardiologist about the smoking if the cardiologist does not ask!)

3.      Review any written history questionnaires with the patient to make sure the information is accurate. Patients who are sick or in pain can’t be relied on to even read the questions carefully, let alone provide thoughtful answers. Many patients will simply respond with a “No” to all prior diseases without reading the list and some patients, as discussed below, may not even be able to read or understand the questions. For example, the patient with a known history of high blood pressure may answer “No” when asked if he has ever been diagnosed with hypertension simply because he doesn’t know that they are the same thing. So make sure that your questionnaires are worded as simply as possible. Even then, review the responses verbally with the patient and make sure that you really do have a useful medical history. 

      

      Most healthcare instructional materials provided to patients are written on a 10th grade reading level or higher. Yet the reading level of the average patient is 4.6 grade levels below the last year of school completed, which means that a typical high school graduate reads at around an 8th-grade level. Further, the average Medicaid recipient reads at less than a 6th grade level, with more than one-third reading below the 4th grade level.

4.      Hear the patient outwhile taking the history and do not interrupt. Physicians are often overworked, overbooked, and scrambling to stay on schedule. This can leave them anxious to get to the point of a patient visit. One study found that physicians on average interrupted patients only 18 seconds into the explanation of the reason for the visit. This is significant because patients typically have a list of several complaints or observations they would like to discuss, yet rarely get beyond the first or second before being interrupted. Cutting the patient off before you’ve heard him out is called “premature closure,” and the main problem with this approach is that it assumes that the presenting complaint carries the most medical significance.

This is often not the case because the patient experiencing multiple symptoms may not know which are the most important, nor which may be related to the same underlying cause. For example, the patient who reports transient blurriness in her right eye may not realize that the simultaneous tingling sensation she feels in her right arm and leg are related. Premature closure typically involves a patient with a serious but uncommon diagnosis who presents with symptoms suggestive of a less serious and more common diagnosis.  

Contributing to premature closure is a general human tendency to hear what we expect to hear, and mentally filter out as extraneous any details that we don’t expect. Fortunately, the main assumption underlying premature closure—that patients will talk endlessly if allowed—appears to be incorrect. Several studies have found that patients who are allowed to list all their concerns without interruption rarely speak for more than two minutes. Allowing the patient those two minutes not only prevents premature closure, but can actually save you time by allowing you to focus on the most important symptoms first. It also avoids those “Oh, by the way…” conversations in which the patient brings up a new problem just as you’re headed for the door.

And finally:

5.      Every doctor owes a duty of making an independent assessment of the patient, utilizing the full range of his or her clinical skills, regardless of whether you’re a primary care provider or a sub-specialty consultant. If you’re an FP [family practitioner] and receive a specialty ob-gyn report informing you that a 60-year-old woman who had a hysterectomy 15 years ago is pregnant, you’d obviously recognize that you’d received the wrong patient’s report or that some other mix-up had occurred. Yet far less blatant errors occur all the time in the exchange of patient information, and you should always be mindful of that possibility any time the specialist’s opinion doesn’t fit your clinical finding or the patient fails to respond to treatment as expected.

Clearly, the same can be said for not entirely relying on the diagnosis of some other practitioner even  in the same specialty, who may or may not have done a good diagnostic workup, but instead doing one’s own independent assessment. If a  psychiatrist prescribes something to you after initally talking to you for just fifteen or twenty minutes, find another doctor.

The whos who of Panic

• Panic Attack - Panic attacks are periods of intense fear or apprehension that are of sudden onset and of relatively brief duration. Panic attacks usually begin abruptly, reach a peak within 10 minutes, and subside over the next several hours. Often, those afflicted will experience significant anticipatory anxiety and limited symptom attacks in between attacks, in situations where attacks have previously occurred.

• Panic Disorder - Panic disorder is a type of anxiety disorder in which you have repeated attacks of intense fear that something bad will occur when not expected.

Wherein I dissect a scandal Sort of Maybe

During my little hiatus, a few dramas unfolded in the YA blogosphere, and the two I directly observed had one thing in common: someone well-known did something disappointing.

Now, if you've read this blog for a while, you know I'm not going to hop up on a soapbox and add my opinion about the scandals to the pile. I do that rarely here, simply because there are enough opinions out there, so why would anyone want to hear mine?

What I will do: dissect it a bit, from a psychological perspective. That's why you come here, right? Oh, that or you're a kind, patient person with a high tolerance for eccentricity, and maybe we're friends, or possibly you're my dad (hi, Dad. I love you).

Okay! Someone well-known does something disappointing. And gets caught--and called out publicly. (No, I'm not going to link, sorry.) When these events went down, I read post after post with interest, and noticed that the (hundreds of) reactions coalesced into a few different types:

1. People who had neutral or negative opinions of WELL-KNOWN PERSON (WKP), and openly and loudly (you know, with all-caps and hashtags, etc.) condemned WKP for committing the TRANSGRESSION.

2. People who had positive opinions of WKP, who might have otherwise been extremely offended by the TRANSGRESSION, but who were much more willing to forgive and forget the transgression because of who committed it.

If you're wondering, yes, there were plenty of in-between kinds of opinions, but much of what I saw landed in one of these two camps, and that's what I'm going to focus on today (or else this would be a *really* long post).

Anyway, what's going on here? Both camps were presented with the evidence. Not just he said-she said--there was data! Screen captures! Time stamps! And it was evidence of something that is accepted by everyone in this community as BAD. How could people differ so widely in their reactions to something objectively labeled as unethical?


Well. This happens all the time, doesn't it?

A few psychological concepts are in play here, and I'm only going to mention two of them:

Cognitive dissonance--the discomfort we feel when we hold two conflicting beliefs in our heads at once. Example: TRANSGRESSION is bad. WKP is good. But WKP committed TRANSGRESSION. That's a recipe for a lot of distress ... unless you kind of ... let one of those beliefs become slightly less important. In this case, people who held the above beliefs could either reject WKP or downplay the TRANSGRESSION (i.e., "it wasn't that bad.").

See how that might have been at work here? *Some* of the reactions to what happened could have been due to people trying to resolve cognitive dissonance by de-emphasizing a previously strongly held belief because it was just too uncomfortable to hold onto both beliefs at once. (I find cognitive dissonance so fascinating that I'll be posting more on it next week.)

Person vs. Situation explanations--when we're trying to understand behavior, we make guesses about WHY someone does something. Even when we're not consciously aware of doing so. Sometimes, we attribute behavior to the person: He is lazy. He is dishonest. She is insincere. She only looks out for herself. Sometimes, we attribute behavior to the situation: It was a momentary lapse in judgment. It was an isolated incident. She was under a lot of pressure. He was exhausted from trying to do too many things at once.

Again--you can see how this might have come into play. People who did not know WKP very well--or who didn't like WKP very much--probably erred on the side of person-oriented explanations, attributing the transgression to something inherent, permanent, and likely to generalize across situations--and that would leave them wary of WKP and unlikely to forgive easily, because the transgression was the result of  a character flaw. People who know WKP, or who have had positive experiences with WKP, or who have benefited from association with WKP, probably erred on the side of situation-oriented explanations, attributing the transgression to something external to the person, temporary, and unlikely to generalize to other situations--which makes it easier to forgive and forget, because anyone could find themselves in that situation, right?


There you have it--this is how people react so differently to the same TRANSGRESSION. And it happens to all of us, every single day. None of us is immune to the effects of cognitive dissonance or person vs. situation explanations. None of us is as objective and logical as we'd like to believe. So now it's your turn, assuming I haven't utterly bored or confused you: can you think of a situation where a WKP has committed a TRANSGRESSION, and people had vastly different responses to it? What was your response, and why?

Traumatizing Your Characters Part 3 Factors That Determine Severity of the Trauma

Welcome back! If you're just coming upon this post, the first two parts of this series are:

Part 1: general information about trauma
Part 2: types of trauma and examples of each

Today I'd like to discuss factors that make trauma worse or ... better (er ... relatively speaking).

But first, I want to stop here and acknowledge that some of you have been through traumatic events in your lives. Some of you are dealing with the aftereffects every day and every moment. Although these posts are in no way meant to be taken as medical or psychological advice, I just want to put it out there that some things I post might be triggering, and if that happens to you, please talk to someone about it. We'll go over factors that make characters (and people) more vulnerable in the next post, but social supports are KEY in recovering from and coping with trauma, so please seek that support if you need it. If you don't already have someone in your life who gives you that, there are several national hotlines of various types. It doesn't mean you have to talk about things before you're ready. It just means you might need someone to understand that things are hard sometimes, and no one should be alone.

Okay.

Lots of factors determine how likely it is that a person will experience lingering negative effects.* 

• Proximity. There's a continuum. The closer you are, the harder it is. 

Personal victimàloved one/friendàWitnessàSaw on televisionàHeard about it

Here's an example: We ALL went through the recent bombings at the Boston Marathon (which is actually why I'm not going to post a picture to remind you of it). Most of us were nowhere near the actual event, but we saw it on TV and on Twitter and pretty much anywhere we looked--it was nearly inescapable. Horrific images, emotional narratives ... but the people who were THERE smelled it, and felt it against their skin, and heard it ringing in their ears. Some of them witnessed it. Some of them saw their friends or family members hurt. Some of them were hurt.

People, and especially children, can develop PTSD symptoms after repeated viewing of traumatic images. That was proven after 9/11, when some children in Europe developed symptoms after watching all the television coverage (KEEP THE CHILDREN AWAY FROM THE TV DURING THESE EVENTS PLEASE I BEG YOU THE MEDIA SHOWS ZERO RESTRAINT THESE DAYS). However, the "distance" from the event means less risk overall.

Other factors that determine severity:

• Interpersonal trauma--like a physical or sexual assault--is more effecting (in general) than trauma caused by something like a natural disaster or a car accident. 
• Trauma at the hands of an intimate partner or family member increases risk for PTSD.
• As mentioned in the last post, chronic trauma is far more complicated to treat than single event trauma, and generally takes longer to recover from because of the pervasive nature of chronic trauma. Again, we'll devote an entire post to chronic trauma, particularly when it occurs in childhood. 
• How invasive the trauma is also affects risk for PTSD. You can experience sexual trauma if someone flashes you, but it's (obviously, I think) harder to recover from a more invasive sexual trauma, such as one that involved penetration.
• If the trauma resulted in lasting injuries, it might increase risk for developing symptoms of PTSD. Lasting injuries can act as reminders, and sometimes triggers, of what the individual has gone through.

If you're writing about a character who's experienced a traumatic event, think about these factors. Identify how close they were, who was responsible (if anyone), how intimately linked the perpetrator was to your character, how long the trauma lasted, how invasive it was, and whether it left lingering physical scars.

Then spend some time thinking about what the character experienced during the event. Here's where you put on your WRITERPANTS. What did your character see, feel, smell, and hear? Be specific. Be detailed. This is what will make your story more authentic and your character's reaction more interesting. It will also help you when we reach the post where we discuss TRIGGERS. 

*When I say something's "better" or "worse" or use qualitative words like that, I'm speaking very narrowly. What I mean is that something is more or less likely to result in long-term PTSD symptoms. I am not in any way dismissing any person's experience of a specific event or series of events.

Robbing Those Disturbing Symptoms of Power

It was in 1996, at the age of thirty, when I began to suffer weird turns. Frequency varied from once in six weeks to almost daily when I was extremely fatigued or under a lot of stress.

These turns, which I labelled ‘spike attacks,’ were unlike anything I had experienced before. Here is an example of one.

I walked into the copy-room at work to file some bank statements. As I entered the room, a tremendous sense of deju vu overcame me – convincing me that this exact event had happened before in exactly the same way. Somehow, it was happening all over again. As my confused mind tried to understand how such a thing could be possible, a vision of crystal-clarity popped into my mind. I saw a scene from my past, a pair of tennis shoes beside a door. (A mundane vision accompanied each spike attack - once it was a garage door, another time a staircase in the Melbourne tennis centre.)

As the vision faded every single nerve ending in my body spiked with adrenalin – which felt like receiving a billion tiny electric shocks simultaneously. This was following by the sensation that I was falling helplessly down a very deep elevator shaft with my stomach leading the way. When the falling sensation ceased a moment later, my stomach snapped back up into place with an explosion of utter agony that felt like a thousand knives being plunged home. Then it was over, leaving me dazed and confused. I would turn to the Lord and cry out to Him in my mind, “Oh Jesus, that hurt so bad!” Several minutes of frantic reflection was required to convince myself the sense of déjà vu was wrong - I had not experienced this exact event before. These episodes only took several seconds but felt much longer.

I had no idea what these spike attacks were or where they were coming from. There were disturbing, disorientating, confusing, and painful, and I could have lived in fear of them and dreaded their return. They could have turned my life into a nightmare – but they did not.

I did not fear the spike attacks, nor worry about them happening again.

Psalm 46:1-3
God is our refuge and strength,
an ever-present help in trouble.
Therefore we will not fear, though the earth give way
and the mountains fall into the heart of the sea,
though its waters roar and foam
and the mountains quake with their surging.
Selah

I was able to trust in God and have no fear of these attacks by putting into practice a technique that I had learnt from reading “Self Help for Your Nerves” by Dr Claire Weekes. In her book, Dr Weekes explained a very effective system of helping us not to fear depression’s distressing physical symptoms. By not fearing those symptoms, we rob them of their power. Depression typically inflicts its sufferers with a plethora of disturbing physical symptoms such as very bad shoulder or neck pain, aching jaw, tightness in the chest or stomach, heartburn, insomnia, missed or racing heartbeats, a prickling sensation in the limbs, and so on. (Note, the spike attacks were not caused by depression - more on that later…)

So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand. Isaiah 41:10

When I had a spike attack, instead of fearing it, I studied it analytically from the perspective of a curious observer, carefully studying each of its phases. I contemplated the visions to see if they had any significance, (they never did) and applied myself to the task of convincing myself that this experience had not happened before. Instead of fearing the return of these turns, when they occurred it was simply another chance to study them.

So the turns were terrible, painful and exhausting, but overall, a curiosity. I did not fear them at all. I accepted that they were part of life and kept on living as usual. My wife was the only person who could tell I was having an attack.

This same technique, when applied the depression’s distressing physical symptoms, also robs them of power by teaching us not to fear them. If you get a chance to read “Self Help for Your Nerves,” she explains this technique in detail in Chapter Six, Cure of the More Constant Symptoms. And for physical symptoms caused by depression, it can cure them, as my life can testify. Once we no longer fear those symptoms and are willing to live with them as background music to our day, the fear related adrenalin flow begins to reduce, causing the symptoms to grow weaker until they disappear completely.

So let us place our trust in the Lord and take refuge in Him, and fear not depression’s distressing symptoms. God will help us overcome such enemies that seek to destroy us through fear.

Psalm 27:1-3
The LORD is my light and my salvation -
whom shall I fear?
The LORD is the stronghold of my life -
of whom shall I be afraid?
When evil men advance against me
to devour my flesh,
when my enemies and my foes attack me,
they will stumble and fall.
Though an army besiege me,
my heart will not fear;
though war break out against me,
even then will I be confident.

Back to the spike attacks – it was in 2002 that I discovered what they were – complex partial epileptic seizures (also known as temporal lobe epileptic seizures), confirmed by MRI and EEG scans. Anti-seizure meds have now stopped those seizures. But I praise God for showing me a practical way of learning not to fear the things that can go wrong in my mind and body. Although I suffered hundreds of seizures, I trusted in God instead of fearing them.

Isaiah 41:13 For I am the LORD, your God, who takes hold of your right hand and says to you, Do not fear; I will help you.

(All verses from the NIV)

image from freeimages.co.uk

Download a pdf booklet of this blog's articles

Yet Another Drug Company Fined for Off Label Marketing of Psych Medication

Since I started this blog way back in March of 2010, I have posted several times about big Pharma companies being fined for the off-label marketing of various psychiatric medications. Well, the hits just keep on coming.

The Consumerist was one of several news sources to recently report that: 

"New York Attorney General Eric Schneiderman announced the settlement Thursday resolving allegations that Bristol-Myers Squibb improperly marketed and promoted the drug Abilify.

Abilify — the brand name for the prescription drug aripiprazole – is a second-generation antipsychotic prescription drug, commonly, commonly referred to as “atypical antipsychotics,” that were originally used to treat schizophrenia.

According to the states’ complaint, which was also filed today, BMS engaged in off-label marketing, which is the promotion of drugs for uses that are not FDA-approved.

For example, the complaint claims that BMS improperly promoted Ability for pediatric use and for use in elderly patients with symptoms consistent with dementia and Alzheimer’s disease.

This, despite the fact that in 2006, Abilify received a “black box” warning stating that elderly patients with dementia-related psychosis who are treated with antipsychotic drugs have an increased risk of death.

Additionally, the complaint alleges that BMS violated state consumer protection laws by misrepresenting and minimizing the risks of the drug including metabolic and weight gain side effects and by misrepresenting the findings of scientific studies.

Under the proposed agreement, BMS is prohibited from promoting Ability from off-label uses; making false or misleading claims about the drug; compensating health care providers for attended promotional activities; using grant funds to promote Ability; and providing samples of the medication to health care providers who do not intend to use it for labeled purposes."

Bristol-Myers Squibb settled the claims with 43 states for a total of 19.5 million dollars. That sounds like a lot of money, but for big drug companies, it is actually a paltry sum. Fines like that are considered a cost of doing business

As readers know, I am rabidly against the use of antipsychotic medications in non-psychotic children, which is unfortunately becoming more and more common. However, I must admit I have negative feelings about that black box warning regarding the use of any (not just Abilify) antipsychotic medication in patients in nursing homes with advanced dementia due to Alzheimer's disease or other severe brain conditions. 

Things have gotten to the point where docs are afraid to prescribe these medications even in such patients who are actively psychotic with hallucinations and/or paranoid delusions, for which there are no other effective treatments.

Even in non-psychotic demented patients, antipsychotic meds are often the best agents for controlling assaultive behavior in this population. Unlike other sedatives, they do so while only minimally exacerbating memory and cognitive deficits in these people. Our society seems to want to pay nursing assistants only the minimum wage to take care of our impaired family members as they age. Long-term facilities are very expensive as it is. Not only that, but we under-staff them as well. While there may be psychosocial interventions which would reduce assaultive patients with dementia, we do not want to pay people to provide them.

Given those conditions, what is left? Medications, that's what. Do we really want to expose underpaid and overworked caretakers to dangerous aggressive behavior from patients who basically have no life anyway - just to prevent a tiny percentage of them from dying a little sooner due to the medications' cardiovascular side effects? Time to either pay up or shut up.

The Impact of Intervention in Addiction Through an Amy Winehouse Scope

Today's post in a guest post courtesy of Allison Gamble, a writer for psychologydegree.net. 

“They tried to make me go to rehab, I said, "No, no, no"

Yes, I've been black but when I come back you'll know, know, know

I ain't got the time and if my daddy thinks I'm fine

He's tried to make me go to rehab, I won't go, go, go”

           ~ "Rehab" Amy Winehouse

The late singer Amy Winehouse released “Rehab” in 2007, a now haunting song that revealed her struggles with drug and alcohol abuse, her reluctance to seek help, and the role her family and friends played in her life. Some attempted to push her towards treatment, while others seemed to enable Winehouse's destructive behavior and ignored warning signs that may have caused her sudden death. While Winehouse’s plight has gained media attention, her celebrity is one of the only factors that separated her situation from the problems that many individuals who abuse drugs and alcohol deal with every day.

Like many other families who have loved ones with a substance abuse problem, Amy’s family is placing fault on others for her sad demise. It doesn’t take a degree in psychology to smell the denial in the air. Interviews with her parents show they lay blame for her death on detox methods instead of also looking at both their behavior and having not intervened in time to possibly help Amy.  Of course, losing a child is awful enough, but they are likely also feeling tremendous guilt that they had not taken more steps to try to protect her from a fate no one wanted to believe would come to fruition.

In American and the UK alike, due to the absence or failure of family members and friends intervening, many addicts like Amy are left to cycle through pricey rehab clinics and wind up taking endless supplies of anti-psychotics, anti-depressants, anti-anxiety meds and more. Gaining the approval of doctors, rehab clinics and pharmaceutical companies, families are held harmless as they look at addiction as a disease. With this medical model, the one loser winds up being the addict.

While little has been revealed about Winehouse’s upbringing, it is known that her parents separated when she was 9 years old. Father, Mitch Winehouse, claimed in a 2008 interview, titled “How my affair made Amy suffer,” with British newspaper The Daily Mail, that a longstanding affair with a colleague was an open secret in their home. Winehouse’s paramour was even known by Amy and her siblings as “Daddy’s work wife.” Mitch Wineshouse claims he never realized that their family’s dysfunction had impacted Amy so negatively until years later when he heard her song “What it is About Men” that the line “all the shit my mother went through” referred to his deception.

Amy’s mother Janis claims her Amy had always been a rebel but that her defiant streak intensified when Amy became a teenager. In an unusual move by Janis, Amy was allowed to leave home to live with a friend at the age of 15. "It would have been fine but she moved out for her own convenience. She wanted to live with a friend. Perhaps she wanted her mum to fight to make her stay. But I felt she had grown up by then,” her mother said in a January 2008 interview, eerily titled “Amy Winehouse’s mum says she’ll be dead in a year,” with the Sunday Mirror. This is not to say that Janis is solely responsible - there are surely hundreds of children who move out early without overdosing at 27. But could a firmer hand have helped steady the wheel? We’ll never know.

Janis went on to say that she while she doesn’t feel responsible for Amy’s decline into drugs, she reveals being lackadaisical when Amy started running into trouble. "Amy was never an easy child and she was always open to any new bad influence. Her life became a bit muddled when she left home. She started smoking marijuana and got her first tattoo - a Betty Boop on her back. I just said, 'Oh well.’”

Amy’s family always seemed to have a disturbing dynamic. Janis was unhappy; Amy was rebellious, but always trying to please her out-of-the-picture father Mitch. "I don't do happy. [Amy] doesn't, it seems, do emotion either. But it's just her way of coping,” Janis explained.

As a Amy became an adult, her family unit added another dysfunctional member: ex-husband Blake Fielder-Civil. A self-admitted addict, Blake claims to have introduced Amy to narcotics usage. “I’m not trying to defend his behavior and I know him for what he is: he’s an addict and he has done some terrible things. He feels enormous grief and responsibility for some of the things that have happened, as well he should,” Fielder-Civil’s mother, Georgette, told the Daily Mail in “Don’t blame my son for Amy’s death: Blake Fielder-Civil's mother's plea as she insists the couple were still in love.”

Although some families shift the blame for a substance abuse problem on medical issues, they are often the ones who have, perhaps unwittingly, facilitated the problem to a significant degree. In 1991, The Journal of the Academy of Child and Adolescent Psychiatry reported that researcher James R. McKay and colleagues had studied adolescent substance abusers and confirmed what we know anecdotally: that greater perceived degrees of dysfunction were linked to increased levels of substance abuse prior to hospitalization.

With modern medicine focusing on the disease model of addiction, pharmaceutical companies have been instrumental in keeping substance abusers like Amy addicted by flooding the market with painkillers and psychoactive meds, while also profiting from drugs to counter addiction.

In July 2011, financial website This is Money reported that one such company, Reckitt Benckiser Pharmaceuticals, was delighted to announce that its newest delivery system for the heroin addiction drug, Suboxone, would now be a big moneymaker. “As is well known, our Suboxone tablets can become subject to generic competition in the U.S. at any time, and moving more of our business into the film remains a key priority. At the end of June 2011, the Suboxone film had captured a 41 per cent volume share of the U.S. market,” he said.

Talk show host and former journalist Piers Morgan knew Winehouse and told Entertainment Tonight in “Piers Morgan hits out at Amy Winehouse’s record company after singer’s death,” that while the troubled singer ultimately succumbed due to her own addictive behavior, others in her life failed to take responsibility. Echoing a common question, Morgan wanted to know where everyone was when she needed help. He stated, “I do blame people. Where were all the people making money out of her when it mattered? Really, where were they? You know, it's just not good enough that they're all going to make millions out of it now she’s dead.”

Blake Fielder-Civil’s mother seems to agree. “We all played our part in what happened to her. I have had to look deep into my heart and wonder if I could have helped, done things differently,” she said.

While we may never know what caused Amy's death, ultimately she was responsible for her actions. However, family members, “friends,” doctors, rehab centers and pharmaceutical companies must also accept responsibility for the role they played in her destruction. We need to move towards a more cohesive model that merges psychology and psychiatry to prevent more parents from losing their daughters.