“Song Portraits”

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“Seems so Long” by Stevie Wonder

Synasthesia is “a neurological phenomenon in which stimulation of one sensory or cognitive pathway leads to automatic, involuntary experiences in a second sensory or cognitive pathway.” Synasthesia’s effects can take many forms. For example, some people with the condition – called synesthetes – may experience letters and numbers or music as having unique colors (grapheme-color synesthesia, chromesthesia, respectively). Less common forms include “tasting” words (lexical-gustatory synesthesia) and “feeling” sounds (auditory-tacticle synesthesia).

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“At Last” by Etta James.

It’s probably no surprise that synesthesia is understood to aid the creative process in those who experience it. Missouri artist Melissa McCracken is a perfect example: she “hears” color, and renders her experience into paintings in which she “translates sound into color.” McCracken paints a wide range of songs, from classic rock to jazz to modern electronica. The results are abstract and quite beautiful. I’ve included a few examples here, but you can read about the artist and see more paintings here.

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“Karma Police” by Radiohead.

Related links:

– Melissa McCracken’s website.
– Melissa McCracken’s Etsy shop, where she sells prints of her paintings.
– Oliver Sacks’ book Musicophilia.
– NPR story about pianist Laura Rosser, who is a synesthete.

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Cognitive Behavioral Therapy via Your Password

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Photo credit: Mauricio Estrella

Here’s an interesting idea, courtesy of Mauricio Estrella. In a blog post titled How a Password Changed My Life, Mauricio shares how he came up with the idea of using the monthly event of changing his log in to set a daily reminder or goal or imperative. It started with a nudge to forgive his ex (“Forgive@h3r”), and evolved into lifestyle goals such as quitting smoking (“Quit@smoking4ever”), losing weight (“Eat2times@day”), and saving for a trip to Thailand (“Save4trip@thailand”).

Although Mauricio never says it, these daily reminders, or one-word “scripts,” strike me as a simple way to build Cognitive Behavioral Therapy (CBT) into something so mundane as updating a password. I think it’s a great idea: turning cyber security into real-world gains. What do you think? Would it work for you?

Our Neglected Mental Health System

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Manteno State Hospital, Illinois. Opened in 1930, Manteno State Hospital was once the largest psychiatric hospital in the United States, with a peak population of 8,195. The hospital closed for good in 1985.

In the first class of my first day of graduate school when I was studying clinical psychology, the professor stood in front of us and asked, “When we think about the mentally ill, what do they have in common the world over? In every country on earth, this one fact is true of all mentally ill people. What is it?” The answer? They are ignored.

A recent piece by Liz Szabo of USA Today titled The Cost of Not Caring: Nowhere to Go offers an in-depth exploration of the current state of mental health care in the United States. Echoing what my professor said years ago, the situation can be summed up in one word: neglect.

Nearly 40% of adults with “severe” mental illness — such as schizophrenia or bipolar disorder — received no treatment in the previous year, according to the 2012 National Survey on Drug Use and Health. Among adults with any mental illness, 60% were untreated.

Szabo’s story is broken down into four relatively short chapters, each of which focuses on one topic and one individual: 1) Our neglected mental health care system, 2) Jails and homeless shelters have become the “new asylums,” 3) Emergency rooms overwhelmed by patients with mental health needs, and 4) Disappearing mental health services as programs are cut nationwide.

If you have the time, I recommend Szabo’s piece as a good overview of some of the aspects of the problem. It is a complicated issue, with many causes, and no single story can capture all of it. But I am glad to see the topic is getting more attention. If you are truly interested, you may want to visit the mental health advocacy website mentalillnesspolicy.org. There you’ll find dozens of links to articles, essays, surveys, policy papers, legal rulings, and summaries on every mental health policy topic imaginable.

Further exploration:

Mental Association for Greater Chicago’s Mental Health Services Directory for the greater Chicago area.

Mental Illness in America radio episode from BackStory.

States are cutting back on psychiatric hospital beds, despite increasing demand.

New York mayor Bill de Blasio is looking into ways to reduce the city’s population of mentally ill jail inmates.

The United Kingdom is grappling with its own mental health crisis in London.

Doctors in Ireland are warning of a “suicide crisis.”

More than half of agencies serving children and adolescents in England cut funding over the last five years.

The Problem with Selective Selection

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Back in January, Peta Pixel shared a series of photos from Infinity Imagined that compared images of cities at night as seen from the International Space Station with neurons imaged with fluorescence microscopy. The similarities are striking and upon first blush, quite compelling.

But if you think about it, these are an excellent example of confirmation bias: finding correlation where you look for it. For every “match” between a city and a neuron, there must be many non-matches that were deliberately set aside; pictures of cities that didn’t fit the hypothesis. This kind of selective thinking occurs in many areas of life – astrologers and numerologists, for example, count on their audience remembering the “predictions” that came true while conveniently forgetting the vast majority that did not.

Lately there has been an uptick in negative press surrounding researchers in the fields of neuroscience, psychology and sociology. They are accused of regularly engaging in a form of selective thinking by bending data to reach desired conclusions. Some are even calling it a “mini crisis.” The accusations range from double-dipping data, to using too-small sample sizes, to outright fraud.

Here is a sampling of the recent bad press:

  • According to an analysis of 49 meta-analyses, the field of neuroscience produces a lot of small, low-powered studies, which leads to a lot of false and/or misleading conclusions (a.k.a. “discoveries”).
  • A scathing take-down of a study linking fist-clenching with memory. In the comments section, no less! (Another take-down was just posted on The Neurocritic).
  • A 2009 study about the practice of double-dipping (using overlapping data) in the field of neuroscience was recently making the rounds.
  • A lengthy profile in the Sunday New York Times Magazine of the eminently unlikeable Diederik Stapel, the infamous Dutch social sociologist who perpetrated perhaps the biggest academic fraud in the field of sociology (retractions to date: 53 articles and counting). (Film studies side note: Stapel’s account of going back to the sites of some his faked experiments and trying to make the actual setting fit his fabricated descriptions is strikingly similar to the sequence in Shattered Glass when Chuck Lane goes back to the locations Stephen Glass describes in his fabricated stories and tries to reconstruct the truth).

But there may be some good news. A recent editorial in The New Yorker by Gary Marcus says that this is all a tempest in a teapot. Marcus doesn’t claim that the accusations are wrong per se, but rather that the field of psychology is well prepared to address the problems. He also assures us we’ll be better off for the effort, even if we have to suffer through a “lost decade” of dubious research.

Finally, if you want to keep track of scientists keeping track of themselves, I recommend the blog Retraction Watch. It reads like a gossip column about all manner of scientific bad behavior. It’s the TMZ of science!

Illustrated Timeline of the History of Schizophrenia Through the Ages

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Scientific American just published an interactive timeline of the history of schizophrenia, from Ancient Egypt to the present. It’s very interesting, and comes on the heels of important discussions taking place surrounding the release of the DSM-5. From the article:

“Less than two hundred years ago, schizophrenia emerged from a tangle of mental disorders known simply as madness. Yet its diagnosis remains shrouded in ambiguity. Only now is the Diagnostics and Statistical Manual of Mental Disorders, psychiatrists’ primary guidebook, shedding the outdated, nineteenth-century descriptions that have characterized schizophrenia to this day.
“There is substantial dissatisfaction with schizophrenia treated as a disease entity, its symptoms are like a fever—something is wrong but we don’t know what,” says William Carpenter, a psychiatrist at the University of Maryland and chair of the manual’s Psychotic Disorder Workgroup. Psychiatrists may discover that this disorder is not a single syndrome after all but a bundle of overlapping conditions.”

Further Reading:
Vaughan Bell’s latest article, about new research on schizophrenia.

The Trouble With Pre-Crime Assessment

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Still from “Minority Report” (2002).

In the wake of the tragedy at Sandy Hook, there has been increased interest in looking at ways to prevent such devastating crimes. Variations on the theme of gun control is obviously at the forefront of that discussion, judging by the national debate at the moment. But others are talking about psychological screening tools to asses future risk of violence in criminals.

With echoes of the fantastical PreCrime Unit in the sci-fi thriller Minority Report, the desire for a pre-screener for violence is nothing new. But a recent article published in the journal Behavioral Sciences & The Law details what the authors – preeminent forensic psychologists – conclude is a fatal flaw in actuarial risk assessment instruments used to predict recidivism rates. From the abstract:

“Consistent with past research, ARAI scores were moderately and significantly predictive of failure in the aggregate, but group probability estimates had substantial margins of error and individual probability estimates had very large margins of error.”

Described another way,

“[T]he researchers established through a traditional statistical procedure, logistic regression, that the margins of error around individual scores were so large as to make risk distinctions between individuals “virtually impossible.” In only one out of 90 cases was it possible to say that a subject’s predicted risk of failure was significantly higher than the overall baseline of 18 percent.”

At issue is whether or not such actuarial surveys can be admissible in court. Researchers Stephen Hart and David Cooke say ‘no,’ and declare they have definitively proven that any accuracy in predictive ability is a statistical artifact resulting in “fundamental uncertainty,” whereas the massive margin of error is “reality.”

For a very readable summary and analysis of the research, I suggest this blog post by forensic psychologist Karen Franklin, Ph.D. Some highlights:

  • The APA ethics code requires psychologists to inform clients of “the strengths and limitations of test results and interpretation” and to “indicate any significant limitations of their interpretations.”
  • The fundamental uncertainty of actuarial risk assessment “cannot be overcome,” therefore Hart and Cooke recommend use of such statistical algorithms be stopped.
  • The “image of certitude” projected by actuarial risk assessments is misleading and can result in cognitive biases, therefore their admissibility in court should be seriously questioned.
  • Courts should not rely on any one assessment of an individual’s supposed traits or characteristics, but instead must look at all information in context.

As I see it, the implications for school psychologists are twofold. First, school psychologists should be wary of any assessment instrument purporting to determine a student’s risk of future violence. Just the legal implications alone should give pause to anyone considering administering – and interpreting – such an assessment in the context of a school setting.

Second, Hart and Cooke’s final recommendation that legal professionals and the courts “recognize that their decisions ultimately require consideration of the totality of circumstances – not just the items of a particular test” is exactly in line with best practices for school psychologists. We are never supposed to make an academic or clinical decision based on the results of only one test.

The pressure is on right now, and in such a climate schools may be tempted to change or adopt practices quickly in order to ease political tension. Research like this reminds us of the importance of ethics codes and best practices guides: they provide a steady rudder to guide us through periodic storms.

Further reading:

Link to original journal article.
Link to Karen Franklin’s blog post about the article.
The Minority Report and Other Classic Stories by Philip K. Dick

The Scared is scared (of things you like)


Here’s a wonderful little movie created by a 6-year-old boy named Asa (with a little help from a grown up, but still).

The movie, called the Scared is scared, tells the tale of a bear, a mouse, swimming pools, sleepovers, friendship, pizza and life. It’s excitement, fear, joy and bewilderment wrapped up into a story full of heart and humor that only a six-year-old’s imagination could provide.

It also is a great lesson in handling adversity. When you find yourself facing a challenge – a major life transition, a metaphorical door closing, anxiety, a monster under your bed – Asa has this advice:

“You should just say ‘OK! I’m fine!’ I usually let it go. I just think of something that I really like to do…just think of something else until the nervous has gone out of you…”

In other words, by thinking of something you like, you can help relieve sadness, anxiety, tension, etc. Asa: “The Scared is scared of things you like.” 

Asa doesn’t know it, but his approach is a lot like cognitive behavioral therapy: by challenging your negative thoughts, you can have a positive impact on your mood and behavior. Way to go, Asa. Thanks for the important reminder!

Oh, The Humanities!

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New research shows that reading difficult prose and poetry “lights up” the brain more than reading dumbed-down versions of the same text. Specifically, researchers gave subjects passages by Shakespeare, Wordsworth, and T. S. Eliot (among others). The readers’ brains were then monitored as they read, and the results seem to be two-fold.

First, there was more electrical activity in the brain while subjects read the difficult (original) passages. Second, when subjects read poetry, regions in the brain associated with memory and self-reflection became active.

“The [original] version caused a greater degree of brain activity, lighting up not only the left part of the brain concerned with language, but also the right hemisphere that relates to autobiographical memory and emotion.”

The study’s authors suggest that this pattern of brain activity indicates a deeper engagement with the text that leads to meaningful self reflection. Philip Davis, an English professor who was part of the research team, said this:

“Poetry is not just a matter of style. It is a matter of deep versions of experience that add the emotional and biographical to the cognitive[…]This is the argument for serious language in serious literature for serious human situations, instead of self-help books or the easy reads that merely reinforce predictable opinions and conventional self-images.”

As a longtime Shakespeare disciple, I’m excited to see scientific confirmation of what his fans have known for centuries: Shakespeare really does put the ‘human’ in ‘humanities.’

Interestingly, this comes at a time when recent Common Core guidelines are being interpreted as calling for fiction and poetry to be gradually tapered from classroom instruction in order to make room for “harder” reading, such as technical manuals and non-fiction writing. Others say teachers are misinterpreting the guidelines and that Shakespeare still should be taught.

States are just beginning the long journey to the Common Core, so time will tell what it will ultimately look like. Let’s just hope that by the time it’s all sorted out, when we ask a student what he’s reading, rather than answering “Words, words, words,” he’ll say “How many goodly creatures are there here! How beauteous mankind is! O brave new world, That has such people in’t!”

Link to another news story about the study, with a slightly different angle.
Link to Science Daily report on the study.
Link to LA Times editorial about the implications of Common Core.

A Tale of Two News Stories

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If you were in a hurry and only had time to read the first half of the #5 most e-mailed article on the New York Times website today, titled “Study Questions Effectiveness of Therapy for Suicidal Teenagers,” you probably would have come away pondering the following important points:

  1. “55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.”
  2. “…[T]he new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.”
  3. “The study suggests that effective treatment for severely suicidal teenagers must address not just mood disorders, but also behavior problems that can lead to impulsive acts, experts said.”

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But, if you read the first half of a Reuters article posted on the NBC News website titled, “1 in 25 U.S. teens attempts suicide, national study finds,” you probably would have come away pondering these important points:

  1. “About one in 25 U.S. teens has attempted suicide, according to a new national study, and one in eight has thought about it.”
  2. “Just over 12 percent of the youth had thought about suicide, and four percent each had made a suicide plan or attempted suicide.”
  3. “…[A]lmost all teens who thought about or attempted suicide had a mental disorder, including depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD) or problems with drug or alcohol abuse.”

The difference? The first story initially focuses on the fact that more than half of teens who attempt suicide had already received mental health treatment; the second story places its initial focus on facts and figures and diagnoses. Interestingly, if you continued to read both articles they wind up mirroring one another: The NY Times article ends with a discussion of the facts and figures and diagnoses, while the NBC News article ends with a discussion of the previous treatment issue.

In a continuation of the overall mirroring between articles, both include daunting quotes from mental health professionals:

NY Times: “I think one of the take-aways here is that treatment for depression may be necessary but not sufficient to prevent kids from attempting suicide,” said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, who was not involved in the study. “We simply do not have empirically validated treatments for recurrent suicidal behavior.”

NBC News: “We know that a lot of the kids who are at risk and thinking about suicide are getting (treatment),” [researcher Matthew Nock] told Reuters Health. However, “We don’t know how to stop them – we don’t have any evidence-based treatments for suicidal behavior.”

So what is the take away from this little exercise? Both articles were written about the same research study. Yet a causal reader would have come away with different impressions depending on which article they read. An important reminder to cast a net far and wide when analyzing data, and always consult the original source when possible.

Speaking of the original source, there was an interesting finding not mentioned in either article. The study found that more than 80% of suicidal adolescents “receive some form of mental health treatment.” The 55% figure quoted in both news stories above applies only to therapy that had begun before the “onset of suicidal behaviors,” yet failed to prevent them.

Link to original JAMA article.

It Takes an Idealist to be a Realist

“If we take man as he is, we make him worse. But if we take man as he should be, we make him capable of becoming what he can be.”  -Viktor Frankl

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It’s a new year, which means for the next few weeks we can expect to be bombarded with articles and blog posts and facebook links about starting over, renewal, changing habits, becoming a better person, etc., etc. etc. (quick tip: research shows that if you plan to change a habit – e.g. achieve automaticity vs. relying on willpower alone when engaging your new behavior – you must stick to the new behavior for at least 66 days. Just something to keep in mind).

The common thread among all of these bits of inspiration is, of course, the natural desire to be better than we are. In 1972 the psychiatrist Viktor Frankl gave a talk in which he addressed the dichotomy between who we are and who we hope to become. His lesson (via Goethe) was that you have to be an idealist in order to be a realist. If we simply take a man as he is, in reality he will fall short of that. But if we view a man as the best possible version of himself, then he just might possibly become the version of himself of which he is capable. If that’s not a good metaphor for the essence of a New Year’s resolution, I don’t know what is.

Happy New Year, everybody!